ATI MENTAL NEWBORN 2021  

ATI MENTAL NEWBORN 2021   Main topics covered on proctored & need to know information* PLUS PROCTORED EXAM 2020 QUESTIONS Contraception:  Diaphragms o Must be refit every 2 years, if client has gained more than 15 lbs, and if becomes pregnant o You must use spermicide with every act of coitus interruptus; every time you withdrawal, more spermicide should be instilled o Do not remove diaphragm for 6 hours following sexual intercourse  Oral contraceptives o Side effects: chest pain, SOB, leg pain, increased risk for DVT, headache, vision problems, stroke, hypertension o Contraindicated in women with histories of blood clots, stroke, cardiac conditions, smoking, breast or estrogen related cancers  Depo-Provera AKA Medroxyprogesterone o Injectable progestin; key piece of information to know – can cause decreased bone mineral density and/or loss of calcium ****** Presumptive signs of pregnancy: other conditions may cause these signs to occur  Amenorrhea  Fatigue  Nausea, vomiting  Urinary frequency  Quickening (“stomach flutter”) Probable signs of pregnancy:  Hegar’s sign  Chadwick’s sign  Ballottement  Braxton hicks contractions  Positive pregnancy test Positive signs of pregnancy:  Fetal heart sounds heard  Baby seen via ultrasound  Fetal movement felt GTPAL: G = gravidity: number of times a woman has been pregnant, including current pregnancy* (don’t forget) T = Term births: numbers of babies delivered at 37 weeks+ P = Preterm births: number of babies born before 37 weeks A = Abortion: spontaneous or miscarriages L = Living children Routine lab tests:  Blood type, Rh factor,  CBC with differential, hgb, and hbt - anemia  Rubella titer  Hep B screening  Group B strep – 35-37 weeks gestation  Urinalysis – identifies pregnancy, DM, gestational HTN, renal disease, infection  1 hr glucose tolerance test! o 24-28 weeks o 140 mg/dl = follow up with 3 hr glucose tolerance test  3 hr glucose tolerance test o Screening tool for DM; diagnosis is based on two elevated glucose readings  MSAFP – between 15 and 22 weeks o Used to rule out down syndrome (low levels) and neural tube defects (high) Biophysical Profile (BPP):  (5) variables o Reactive FHR o Fetal breathing movements o Gross body movements o Fetal tone o Qualitative amniotic fluid volume (2 = adequate, 0 = not)  Score of 8-10 = normal; low risk for chronic fetal asphyxia Amniocentesis:  Aspiration of amniotic fluid w/ needle into client’s uterus & amniotic sac with use of an ultrasound  May be performed after 14 weeks gestation**  Alfa-fetoprotein (AFP): 16-18 weeks gestation – neural tube defects or chromosomal disorders o High levels = neural o Low levels = down syndrome  Fetal lung maturity: 37 weeks gestation; obtains lecithin/sphingomyelin (L/S) Ratio (normal = 2:1) Chorionic villus sampling:  Assessing portion of developing placenta; 1st trimester, 10-12 weeks  Determines genetic chromosome abnormalities