Ati maternal 2 PDF

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ATI maternal remediation ...

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ATI remediation-Maternal Newborn PN

1. Complications of the Newborn: Use of phototherapy Lights Pg. 244  Place an eye mask over the newborns eyes after they are gently closed to protect the corneas and retinas.  Avoid applying lotions or ointments to newborns because they absorb heat and can cause burns.  Turn off the phototherapy lights before drawing blood for testing.  Remove newborns every 2 hours to expose all of the body surfaces to the phototherapy lights and prevent pressure sores. 2. Nursing care of the Newborn: Newborn Safety Pg. 224  Keep small objects out of reach of newborns.  Provide a firm mattress for newborns to sleep on. Never put pillows, large floppy toys, or loose plastic sheeting in crib.  The space between the mattress and sides of the crib should be less than two fingerbreasths.  The slats on the crib should be no more than 2.5 inches apart. 3. Assessment of Fetal well-being: nonstress test Pg. 42  Seat the client in a reclining chair or place in a semi-flowers or left lateral position.  Perform Leopold’s maneuvers to locate the fetal back.  Apply conduction gel to the ultrasound transducer.  Secure a Doppler transducer to the client’s abdomen over the fetal back to record the FHR pattern. 4. Care of the postpartum client: epistomy care Pg. 154  Apply ice packs to the client’s perineum for the first 24 to 48 hours to reduce edema and provide anesthetic effect.  Encourage sitz baths at a temperature of 38-40 degrees at least twice a day.  Administer analgesia as prescribed for pain and discomfort.  Apply topical anesthetics to the client’s perineal area as needed or witch hazel compress to the rectal area. 5. Nursing care of the newborn: cord care Pg. 221  Keep the cord dry and keep the top of the diaper folded underneath it.  Avoid submerging newborns in water until the cord falls off around 10 to 14 days after birth. Give sponge baths until the cord falls off.  Report any foul smelling, purulent drainage, or redness at the cord site to the provider. 6. Nursing care of the newborn: Reinforcing teaching about elimination Pg. 221

Inform patents that newborns should have 6 to 8 wet diapers a day with adequate feedings and may have 3 to 4 stools per day.  Instruct parents to keep the newborns diaper area clean and dry. Recommend changing the newborns diaper frequently and cleaning the perineal are with warm water or wipes and drying thoroughly to prevent skin breakdown. Apply barrier cream if skin becomes irritated. 7. Prenatal care: Monitoring fetal heart tones Pg. 44  Obtain a baseline FHR, fetal movement, and contractions for 10 to 20 min and document. 8. Newborn Assessment: Postmaturity Pg. 196  Head to toe examination of newborn within 24 hours.  An APGAR score obtained.  Obtain vital signs in following sequence: respirations, heart rate, blood pressure, and temperature.  Obtain measurements. (length and weight) 9. Nursing care of the client during the postpardum period: Education regarding rubella vaccination Pg. 159  A client who has a titer of less that 1:8 is administered a subcutaneous injection of rubella vaccine or an meals, mumps, and rubella vaccine during the postpartum period to protect a subsequent fetus from malformations. Clients should not get pregnant for 4 weeks following the vaccination. 10. Nutrition during pregnancy: vitamin and mineral intake Pg. 57  Iron should be increased from 18 to 27mg for pregnant women.  Folate should be increased from 400 to 600mcg for pregnant women.  Vitamin B12 should be increased from 2.4 to 2.6mcg for pregnant women. 11. Contraception: use of oral contraceptives during lactation Pg. 8  Progestin-only oral contraceptives are safe to take while breastfeeding  Have fewer side effects when compared to a combination of oral birth control pills. 12. Newborn Assessment: priority findings Pg. 197  Obtain measurements. (length and weight)  Obtain vital signs in the following sequence: respirations, heart rate, blood pressure, and temperature.  Obtain an APGAR score.  Head to toe 13. Early Onset of Labor: pharmacological therapy Pg. 104  Brethine- beta-adrenegic agonist that relaxes uterine smooth muscle by stimulating beta2 receptors in the smooth muscle fibers to inhibit uterine activity.  Magnesium Sulfate- relaxes the smooth muscle of the uterus and thus inhibits uterine activity by suppressing contractions. 

Indocin- is a nonsteroidal anti-inflammatory drug that suppresses preterm labor by blocking the production of prostaglandins. This inhibition of prostaglandins suppresses uterine contractions. 14. Prenatal Care: RhoGAM Injection Pg. 23  Administer RhoGAM injection around 28 weeks of gestation for clients who are Rh-negative. 15. Clinical Disorders: Reporting Critical finding during gestation Pg. 85  Reports of nausea and vomiting past 12 weeks of gestation-hyperemesis gravidarum  Fatigue, irritability, cravings to ingest materials that are not food- Anemia  Hypertension, nausea, vomiting- preeclampsia 16. Complications of the Newborn: Hypoglycemia Pg. 245  Hypoglycemia is a serum glucose level of less than 40 mg/dL for term newborns occurring in the first 3 days of life and less than 25 mg/dL for preterm newborns.  Untreated hypoglycemia can result in seizures, brain damage, and/or death. 

17. Prenatal Care: Reinforcing client teaching about laboratory testing Pg. 23  Instruct clients to avoid all over the counter medications, supplements, and prescription medications unless prescribed by the provider.  Instruct clients to watch for signs of potential complications and to repost occurrence to provider.  Explain importance of regular follow up to include monthly prenatal visits for the first seven months, then every two weeks during the eighth month, and every week during the last month. 18. Clinical Disorders: Abnormal findings Pg. 83  Unexpected medical conditions include incompetent cervix, hyperemesis gravidarum, anemia, gestational diabetes, gestational hypertension, preeclampsia, and heart disease. 19. Complications of Pregnancy: Nursing Interventions Pg. 103  Instruct clients to remain on bed rest with bathroom privileges.  Encourage clients to rest in the left lateral position to increase blood flow to the uterus and decrease uterine activity.  Tell clients to avoid sexual intercourse.  Ensure hydration.  Monitor FHR and contraction pattern. 20. Fetal assessment during labor: priority intervention for spontaneous rupture of membrane Pg. 107  Check vital signs every 4 hours.  Obtain vaginal, urine, and blood cultures prior to administration of antibiotics.  Monitor FHR and uterine contractions.  Monitor for signs and symptoms of infection.

21. Prenatal care: reinforcing teaching regarding heartburn Pg. 25  Eat small frequent meals  Sit up for 30 mins after meals.  Check with the provider prior to using any over the counter antacids.

22. Bleeding during pregnancy: Abruptio Placentae Pg. 65  Uterine pain with vaginal bleeding  Fetal distress  Vaginal bleeding  Board like tender abdomen...