ATI Rationales Keypoints PDF

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Oxytocin- contraindications late decelerations. Oxytocin enhances uterine contractility, decreasing vaginal bleeding Gonorrhea- mom is putting baby at risk for premature rupture of membranes, chorioamnionitis, preterm birth, neonatal sepsis, and intrauterine growth restriction. S/E; ulcers on mouth, pharyngitis if on rectum- painful defac ,bleeding diarrhea Treatment: zithro and rocephin/ceftriaxone HIV- should be reported to Health dept, and to be started on load dose of antiviral HAARt during pregnancy and after to prevent the baby getting HIV Oligohydramnios -decreased amniotic fluid, associated with congenital anomalies such as renal agenesis and intrauterine growth restriction PreclampsiaSwelling of the face, protein urea, sacral area, and hands can indicate gestational hypertension or preeclampsia. Hyperglycemia- Increased urinary output, nausea and vomiting, reports of thirst, abdominal pain, constipation, drowsiness, and headaches Hypoglycemia- diqphoretic blurred or double vision, shallow respirations Umbilical cord protruding out-insert two fingers into the vagina toward the cervix, exerting upward pressure onto the presenting part to relieve umbilical cord compression and increase oxygenation to the fetus. Keep moist never dry apply, 8-10L of O2, knee to chest position or trendelensburg to avoid pressure Diagnostics-Ch.6 Non stress test- takes 20-30 min, reclined in a chair or semi fowlers, drink OJ to stimulate fetal movements, press button if you feel baby move Doppler -The nurse should assess FHTs using the Doppler stethoscope just above the umbilicus if the fetus is in a transverse or breech amniocentesis is used to determine lung maturity, detect congenital anomalies, and diagnose fetal hemolytic disease absence of PG=resp distress in fetus- also watch for leakage of fluid Lecithin/sphingomyelin (L/S) ratio is done as a part of an amniocentesis to evaluate fetal lung maturity 2:1 Cordocentesis- identifies fetal blood type and RBC when there is a risk of isoimmune hemolytic anemia. Maternal Alpha-fetoprotein (AFP) is a laboratory test used to assess for neural tube defects or chromosome disorders- if abnormal recommend genetic ,amniocentesis and Ultrasound

Kleihauer-Betke- is used to determine the amount of fetal blood in the maternal circulation when there is a risk of Rh-isoimmunization. Nitrazine test to determine the pH of the fluid. An alkaline pH can indicate rupture of membranes A positive contraction stress test indicates that further evaluation of the fetus is necessary. A biophysical profile will provide further evaluation with a real-time ultrasound. Newborn ormal signs of newborn assesment- acrocyanosis(blusih purple24hrs, babinski(footreflex), 2 umbilicus artery Apgar score 1-5min after birth Dry baby immediately after delivery, Lay baby supine to prevent sids Acroyanosi/ bluishpurples is a normal finding in babies up to 24 Baby head 33cm,Overlapping sutures are normal Erythema toxicum- is a rash seen in newborns after they are born Pink tinged urine in the 1st week is normal, urine is concentrated New born should pass stool in 24- 48 hrs, an axil temp greater than 99.5 should be reported to doctor newborn's pain include facial expressions (for example, chin quivering, grimacing, and furrowing of the brow increased HR dilated pupils, rapid shallow breathing Phototherapy- have baby wear only diaper so the light breaks down bilirubin, avoid any lotions to baby skin Neverfeed newborn water or glucose, Weight-2.5kg-4kg Length-17.7-21.7 Resp-30-60min FHR-110-160 Temp-97.7-99.5

MOM At the end of the first trimester of pregnancy, the client's uterus is approximately the size of a grapefruit and is positioned low in the pelvis slightly above the symphysis pubis. Therefore, the nurse should begin assessing for FHTs just above the symphysis pubis. Insomnia, braxton hicks are normal around 38 weeks 15 weeks numbness and tingling is normal Epistaxis happens at beginning, Mom should increase her calories to 340 -452 by trimester and protein to 71 g 600 mcg of folic acid 3L of water a day

Baby that has hypoglycemia is a risk for resaratory distress, hypothermia, hypotonia Abdominal cramping - ectopic pregnancy, spontaneous birth always asses first Mag sulfate-...