ATI Maternal Newborn 2019 B Remediation PDF

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maternity study guide; ATI Maternal Newborn 2019 B Remediation...

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ATI Maternal Newborn 2019B Remediation

Safety/ Risk reduction -

Look first for safety risk. For example, is there a finding that suggests a risk for airway obstruction, hypoxia, bleeding, infection, or injury? Next Ask, “what’s the risk to the client?” and “How significant is the risk compared to other posed risks?” Give priority to responding to whatever findings poses the greatest (or most imminent) risk to the client’s physical well-being.

Identification Identification (using two identifiers) is applied to the newborn immediately after birth by the nurse. It is an important safety measure to prevent the newborn from being given to the wrong parents, switched, or abducted. -

The newborn, client, and client’s partner are identified by plastic identification wristbands with permanent lock that must be cut to the removed. Identification bands should include the newborn’s name, sex, date and time of birth, and client’s health record number. The newborn should have one band placed on the ankle and one on the wrist. In addition, the newborn’s footprints and clients’ thumb prints are taken. The above information is also included with the footprint sheet.

Assessment - Provides physical care for the infant (feeding, diapering) - Responds to the infant’s cries - Smiles at, talks to, and signs to the infant - Touches the infant and maintains close physical proximity and contact Risks/Possible complications/contraindications -

Clients who have a history of thromboembolic disorders stroke, heart attack, coronary artery disease, gallbladder disease, cirrhosis or liver tumor, headache with focal neurologic findings, uncontrolled hypertension, diabetes mellitus with vascular involvement, breast, or estrogen- related cancers, pregnancy, lactating less than 6 weeks postpartum, or smoking (if over 35 years of age) are advised not to take oral contraceptive medications.

Epidural Block -

Consists of a local anesthetic, bupivacaine, along with an analgesic, morphine, or fentanyl, injected into the epidural space at the level of the fourth or fifth vertebrae.

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This eliminates pain from the level of the umbilicus to the thighs, relieving the discomfort of uterine contractions, fetal descent, and stretching of the perineum.

Nursing actions for Epidural block -

Monitor maternal blood pressure and pulse, and observe for hypotension, respiratory depression, and decrease oxygen saturation Assess FHR patterns continuously Maintain the IV line, and have oxygen and suction available Assess for orthostatic hypotension

Nursing Administration for insulin -

Adjust the insulin dosage to meet insulin needs. The dosage can need to be increased in response to increase in caloric intake, infection, stress growth spurts, and in the second and third trimesters of pregnancy. The dosage can need to be decreased in response to level of exercise or first trimester of pregnancy

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Ensure adequate glucose is available at the time of onset of insulin and during all peak

Teaching about a nonstress test -

Seat the client in a reclining chair, or place in a semi fowler’s or left-lateral position Apply conduction gel to the clients’ abdomen Apply two belts to the clients’ abdomen and attach the FHR and the urine contraction monitors

Leopold maneuvers -

Vertex position: Fetal heart tones should be assessed below the clients’ umbilicus in either the right or left lower quadrant Breech presentation: FHT should be assessed above the clients’ umbilicus in either the right or left upper quadrant of the abdomen

Postpartum hemorrhage -

Firmly massage the uterine fundus Monitor vital signs Assess for source of bleeding Assess bladder for distention. Insert an indwelling urinary catheter to assess kidney function...