ATI RN Maternity Study Guide (Latest Solution) ABCDE PRINCIPLE
Airway/Cervical Spine : This is the most important step in performing the primary survey.
If a patent airway is not established, subsequent steps of the primary survey are futile.
Protect the cervical spine if head or neck trauma is suspected.
Breathing: After achieving a patent airway, assess for the presence and effectiveness of
breathing.
Circulation: After ensuring adequate ventilation, assess the circulation.
Disability: Perform a quick assessment to determine the client’s level of consciousness.
Exposure: Perform a quick physical assessment to determine the client’s exposure to adverse elements such as heat or cold.
MASLOW’S HIERARCHY OF NEEDS
Physiological; oxygenation, circulation, nutrition, elimination, fluid balance, activity and
exercise, rest and sleep
Safety and security; living in a safe environment, adequate income, shelter from
environmental elements
Love and belonging; love, affection, relationships
Self esteem; self respect, personal worth, social recognition Self Actualization; personal growth, fulfilling own potential
NY Heart Association Classifications
Class I: means no symptoms and no limitations in ordinary physical activity
Class II: mild symptoms and slight limitation during ordinary activity
Class III: marked limitation in activity due to symptoms, even during less than ordinary
activity.
Class IV: severe limitations, with symptoms experienced at rest
RANDOM NOTES FROM ATI Q’s
●The Kleihauer-Betke test is used to determine the amount of fetal blood in the
maternal circulation when there is a risk of Rh-isoimmunization ●A pregnant client should take 600 mcg of folic acid daily to prevent neural tube
defects.
●A pregnant client should drink 3 L water a day
●A pregnant client should increase protein intake to 71g during second and third
trimester
●A pregnant client should increase caloric intake by 340 cal during the second
trimester and 452 cal during the third trimester.
●If a pregnant patient is having a seizure, place oxygen on the patient to ensure
adequate oxygenation to the fetus.
●If a pt is using patterned breathing during labor and has tingling and numbness,
this is because the pt is hyperventilating. Placing an oxygen mask over the nose
and mouth will help bring up CO2 levels and reduce the intake of oxygen.
●Rhogam; given within 72 hours post delivery for Rh negative to prevent antibody
formation for future pregnancy
●Hx of cholecystitis, htn, and migraine headaches is a contraindication for oral
contraceptives
●Folate occurs naturally in foods like liver, dark-green leafy veggies, orange juice,
legumes
●Meconium should be passed within 24 to 48 hours after delivery
●Erythromycin ointment in eye prevent infection such as gonorrhea
●Vitamin K given to prevent hemorrhage to infant at birth
●First immunization is Hep B at birth, then 1 or 2 months and then 6 months
●Ectopic pregnancy
○When the ovum becomes implanted outside of the uterus, often the
fallopian tubes
○Comes with unilateral stabbing pain , and tenderness in the lower abd
quadrant.
○The fallopian tube bursting can be very dangerous for mom
○Severe shoulder pain is a finding with ruptured ectopic pregnancy
○Abdominal cramping can indicate ectopic pregnancy or manifestations of
spontaneous abortion
●Molar pregnancy (Hydatidiform mole) ○Proliferation and degeneration of trophoblastic villi in the placenta
○Sx of bleeding that resembles prune juice/dark brown
●Placenta previa
○When the placenta abnormally implants in the lower segment of the
uterus, over/near the cervical os
○Painless bright red vaginal bleeding during 2nd or 3rd trimester
○Can be complete, incomplete or partial
○If completely covering the cervical os, cesarean section is DEFINITELY
needed
●Abruptio placentae
○Premature separation of placenta from uterus
○High rate of fetal and maternal morbidity/mortality
○Sudden onset of excruciating and localized pain, bright red bleeding
●Incompetent cervix
○Recurrent premature dilation of the cervix, or cervical insufficiency ○Cervix does not stay clused during pregnancy, and can result in uterine
contents from leaking/falling out
○Woman gets a cerclage to keep cervix from dilating. Removed at 37
weeks or when spontaneous labor occurs
○Can resulting in a miscarriage
●Gestational Diabetes Mellitus (GDM)
○Most oral antidiabetic meds are contraindicated with pregnancy. Insulin is
used most commonly to control glucose
○Test occurs between 24-28 weeks, starts off with 1 hour test
○No fasting required,
○50 g oral glucose is given to woman, and test an hour later
○If it over 130-140 mg/dL, next test is done, which is the OGTT (Oral
Glucose Tolerance Test),
○OGGT requires fasting, avoid caffeine/smoking/chewing gum/tea
■Fasting glucose level will be taken, the Woman will be given 100mg of glucose, then test blood at 1 hour, 2 hours and 3 hours.
○If GDM is developed, it places women at higher risk for developing
diabetes after pregnancy
○Increase change of fetal macrosomia
Basal Body temperature
●Can drop slightly at time of ovulation
●Inexpensive and convenient
●Reliability can be influenced by variables causing inaccurate interpretations- temp
changes, stress, fatigue, illness, alcohol, warmth of sleeping environment
Diaphragm
●Replace every two years or with 20% weight change
●Leave in place 6 hours post intercourse
●Needs to be fitted properly
●Insert vaginally over cervix with spermicidal jelly or cream applied to cervical side of dome and around rim
●Re-apply spermicide with each act of coitus
Airway/Cervical Spine : This is the most important step in performing the primary survey.
If a patent airway is not established, subsequent steps of the primary survey are futile.
Protect the cervical spine if head or neck trauma is suspected.
Breathing: After achieving a patent airway, assess for the presence and effectiveness of
breathing.
Circulation: After ensuring adequate ventilation, assess the circulation.
Disability: Perform a quick assessment to determine the client’s level of consciousness.
Exposure: Perform a quick physical assessment to determine the client’s exposure to adverse elements such as heat or cold.
MASLOW’S HIERARCHY OF NEEDS
Physiological; oxygenation, circulation, nutrition, elimination, fluid balance, activity and
exercise, rest and sleep
Safety and security; living in a safe environment, adequate income, shelter from
environmental elements
Love and belonging; love, affection, relationships
Self esteem; self respect, personal worth, social recognition Self Actualization; personal growth, fulfilling own potential
NY Heart Association Classifications
Class I: means no symptoms and no limitations in ordinary physical activity
Class II: mild symptoms and slight limitation during ordinary activity
Class III: marked limitation in activity due to symptoms, even during less than ordinary
activity.
Class IV: severe limitations, with symptoms experienced at rest
RANDOM NOTES FROM ATI Q’s
●The Kleihauer-Betke test is used to determine the amount of fetal blood in the
maternal circulation when there is a risk of Rh-isoimmunization ●A pregnant client should take 600 mcg of folic acid daily to prevent neural tube
defects.
●A pregnant client should drink 3 L water a day
●A pregnant client should increase protein intake to 71g during second and third
trimester
●A pregnant client should increase caloric intake by 340 cal during the second
trimester and 452 cal during the third trimester.
●If a pregnant patient is having a seizure, place oxygen on the patient to ensure
adequate oxygenation to the fetus.
●If a pt is using patterned breathing during labor and has tingling and numbness,
this is because the pt is hyperventilating. Placing an oxygen mask over the nose
and mouth will help bring up CO2 levels and reduce the intake of oxygen.
●Rhogam; given within 72 hours post delivery for Rh negative to prevent antibody
formation for future pregnancy
●Hx of cholecystitis, htn, and migraine headaches is a contraindication for oral
contraceptives
●Folate occurs naturally in foods like liver, dark-green leafy veggies, orange juice,
legumes
●Meconium should be passed within 24 to 48 hours after delivery
●Erythromycin ointment in eye prevent infection such as gonorrhea
●Vitamin K given to prevent hemorrhage to infant at birth
●First immunization is Hep B at birth, then 1 or 2 months and then 6 months
●Ectopic pregnancy
○When the ovum becomes implanted outside of the uterus, often the
fallopian tubes
○Comes with unilateral stabbing pain , and tenderness in the lower abd
quadrant.
○The fallopian tube bursting can be very dangerous for mom
○Severe shoulder pain is a finding with ruptured ectopic pregnancy
○Abdominal cramping can indicate ectopic pregnancy or manifestations of
spontaneous abortion
●Molar pregnancy (Hydatidiform mole) ○Proliferation and degeneration of trophoblastic villi in the placenta
○Sx of bleeding that resembles prune juice/dark brown
●Placenta previa
○When the placenta abnormally implants in the lower segment of the
uterus, over/near the cervical os
○Painless bright red vaginal bleeding during 2nd or 3rd trimester
○Can be complete, incomplete or partial
○If completely covering the cervical os, cesarean section is DEFINITELY
needed
●Abruptio placentae
○Premature separation of placenta from uterus
○High rate of fetal and maternal morbidity/mortality
○Sudden onset of excruciating and localized pain, bright red bleeding
●Incompetent cervix
○Recurrent premature dilation of the cervix, or cervical insufficiency ○Cervix does not stay clused during pregnancy, and can result in uterine
contents from leaking/falling out
○Woman gets a cerclage to keep cervix from dilating. Removed at 37
weeks or when spontaneous labor occurs
○Can resulting in a miscarriage
●Gestational Diabetes Mellitus (GDM)
○Most oral antidiabetic meds are contraindicated with pregnancy. Insulin is
used most commonly to control glucose
○Test occurs between 24-28 weeks, starts off with 1 hour test
○No fasting required,
○50 g oral glucose is given to woman, and test an hour later
○If it over 130-140 mg/dL, next test is done, which is the OGTT (Oral
Glucose Tolerance Test),
○OGGT requires fasting, avoid caffeine/smoking/chewing gum/tea
■Fasting glucose level will be taken, the Woman will be given 100mg of glucose, then test blood at 1 hour, 2 hours and 3 hours.
○If GDM is developed, it places women at higher risk for developing
diabetes after pregnancy
○Increase change of fetal macrosomia
Basal Body temperature
●Can drop slightly at time of ovulation
●Inexpensive and convenient
●Reliability can be influenced by variables causing inaccurate interpretations- temp
changes, stress, fatigue, illness, alcohol, warmth of sleeping environment
Diaphragm
●Replace every two years or with 20% weight change
●Leave in place 6 hours post intercourse
●Needs to be fitted properly
●Insert vaginally over cervix with spermicidal jelly or cream applied to cervical side of dome and around rim
●Re-apply spermicide with each act of coitus
