ATI IMATERNITY ISTUDY IGUIDE
ABCDE IPRINCIPLE
Airway/Cervical I Spine: IThis I is Ithe Imost Iimportant I step I in Iperforming
I the Iprimary Isurvey. I If Ia Ipatent Iairway Iis Inot Iestablished, Isubsequent
Isteps Iof I the Iprimary Isurvey Iare Ifutile. IProtect Ithe Icervical Ispine Iif
Ihead Ior Ineck Itrauma Iis Isuspected.
Breathing: IAfter Iachieving Ia Ipatent Iairway, Iassess Ifor Ithe Ipresence Iand
Ieffectiveness Iof Ibreathing.
Circulation: IAfter Iensuring Iadequate Iventilation, Iassess Ithe
Icirculation. IDisability: IPerform Ia Iquick Iassessment Ito Idetermine
Ithe Iclient’s Ilevel Iof Iconsciousness.
Exposure: IPerform Ia Iquick Iphysical Iassessment Ito Idetermine Ithe
Iclient’s Iexposure Ito Iadverse Ielements Isuch Ias Iheat Ior Icold.
MASLOW’S IHIERARCHY IOF INEEDS
Physiological; Ioxygenation, Icirculation, Inutrition, Ielimination, Ifluid
Ibalance, Iactivity Iand Iexercise, Irest Iand Isleep
Safety Iand Isecurity; Iliving Iin Ia Isafe Ienvironment, Iadequate Iincome,
Ishelter Ifrom Ienvironmental Ielements
Love Iand Ibelonging; Ilove, Iaffection, Irelationships
Self Iesteem; Iself Irespect, Ipersonal Iworth, Isocial
Irecognition ISelf IActualization; Ipersonal Igrowth, Ifulfilling
Iown Ipotential
NY I Heart I Association I Classifications
Class II: Imeans Ino Isymptoms Iand Ino Ilimitations Iin Iordinary Iphysical
Iactivity IClass III: Imild Isymptoms Iand Islight Ilimitation Iduring Iordinary
Iactivity
Class IIII: Imarked Ilimitation Iin Iactivity Idue Ito Isymptoms, Ieven Iduring Iless
Ithan Iordinary Iactivity.
Class IIV: Isevere Ilimitations, Iwith Isymptoms Iexperienced Iat Irest
RANDOM INOTES IFROM IATI IQ’s
● The Ikleihauer-Betke Itest Iis Iused Ito Idetermine Ithe Iamount Iof Ifetal
Iblood Iin Ithe Imaternal I circulation Iwhen Ithere Iis Ia Irisk Iof IRh-
isoimmunization
● A Ipregnant Iclient Ishould Itake I600 Imcg Iof Ifolic Iacid Idaily Ito
Iprevent
neural Itube Idefects.
● A Ipregnant Iclient Ishould Idrink I3 IL Iwater Ia Iday
● A Ipregnant Iclient Ishould Iincrease Iprotein Iintake Ito I71g Iduring
Isecond Iand Ithird Itrimester
● A Ipregnant Iclient Ishould Iincrease Icaloric Iintake Iby I340 Ical Iduring
Ithe
second Itrimester Iand I452 Ical Iduring Ithe Ithird Itrimester.
● If Ia Ipregnant Ipatient Iis Ihaving Ia Iseizure, Iplace Ioxygen Ion Ithe
Ipatient Ito Iensure Iadequate Ioxygenation Ito Ithe Ifetus.
,● If Ia Ipt Iis Iusing Ipatterned Ibreathing Iduring Ilabor Iand Ihas Itingling
Iand Inumbness, I this I is Ibecause Ithe Ipt Iis I hyperventilating. IPlacing
Ian Ioxygen Imask Iover Ithe Inose Iand Imouth Iwill Ihelp Ibring Iup ICO2
Ilevels Iand Ireduce Ithe Iintake Iof Ioxygen.
● Rhogam; I given I within I 72 I hours I post I delivery I for I Rh I negative I to
prevent Iantibody Iformation Ifor Ifuture Ipregnancy
● Hx Iof Icholecystitis, Ihtn, Iand Imigraine Iheadaches Iis Ia
I contraindication
for Ioral Icontraceptives
● Folate Ioccurs Inaturally Iin Ifoods Ilike Iliver, Idark-green Ileafy
Iveggies, Iorange Ijuice, Ilegumes
● Meconium Ishould Ibe Ipassed Iwithin I24 Ito I48 Ihours Iafter Idelivery
● Erythromycin Iointment Iin Ieye Iprevent Iinfection Isuch Ias Igonorrhea
● Vitamin IK Igiven Ito Iprevent Ihemorrhage Ito Iinfant Iat Ibirth
● First Iimmunization Iis IHep IB Iat Ibirth, Ithen I1 Imonth Iand Ithen I6
Imonths
●
● Ectopic Ipregnancy
○ When Ithe Iovum Ibecomes Iimplanted Ioutside Iof Ithe Iuterus,
Ioften Ithe Ifallopian Itubes
○ comes Iwith Iunilateral Istabbing Ipain, Iand Itenderness Iin Ithe
lower Iabd Iquadrant.
○ The Ifallopian Itube Ibursting Ican Ibe Ivery Idangerous Ifor Imom
○ Severe Ishoulder Ipain Iis Ia Ifinding Iwith Iruptured
Iectopic Ipregnancy
○ Abdominal Icramping Ican Iindicate Iectopic Ipregnancy Ior
manifestations Iof Ispontaneous Iabortion
● Molar I pregnancy I (Hydatidiform I mole)
○ Proliferation Iand Idegeneration Iof Itrophoblastic Ivilli
Iin Ithe Iplacenta
○ Sx Iof Ibleeding Ithat Iresembles Iprune Ijuice/dark Ibrown
● Placenta Iprevia;
○ When Ithe Iplacenta Iabnormally Iimplants Iin Ithe Ilower
Isegment Iof Ithe Iuterus, Iover/near Ithe Icervical Ios
○ Painless Ibright Ired Ivaginal Ibleeding Iduring I2nd Ior I3rd
Itrimester
○ Can Ibe Icomplete, Iincomplete Ior Ipartial
○ If Icompletely Icovering Ithe Icervical Ios, Icecarean
Isection Iis IDEFINITELY I needed
● Abruptio Iplacentae
○ Premature Iseparation Iof Iplacenta Ifrom Iuterus
○ High Irate Iof Ifetal Iand Imaternal Imorbidity/ Imortality
○ Sudden Ionset Iof Iexcruciating Iand Ilocalized Ipain, Ibright Ired
● Incompetent Icervix
○ Recurrent Ipremature Idilation Iof Ithe Icervix, Ior
Icervical Iinsufficiency
○ Cervix Idoes Inot Istay Iclused Iduring Ipregnancy, Iand Ican
Iresult Iin
urterine Icontents Ifrom Ileaking/falling Iout
, ○ Woman Igets Ia Icerclage Ito Ikeep Icervix Ifrom Idilating.
IRemoved Iat I37 Iweeks Ior Iwhen Ispontaneous Ilabor Ioccurs
○ Can Iresulting Iin Ia Imiscarriage
● Gestational IDiabetes
○ Most Ioral Iantidiabetic Imeds Iare Icontraindicated Iwith
Ipregnancy. IInsulin Iis Iused Imost Icommonly Ito Icontrol
Iglucose
○ Test Ioccurs Ibetween I24-28 Iweeks, Istarts Ioff Iwith I1 Ihour Itest
○ No Ifasting Irequired,
○ 50 Ig Ioral Iglucose Iis Igiven Ito Iwoman, Iand Itest Ian Ihour Ilater
○ If Iit Iover I130-140, Inext Itest Iis Idone, Iwhich Iis Ithe IOGTT,
○ OGGT I requires I fasting, I avoid I caffeine/smoking
■ Fasting Iglucose Ilevel Iwill Ibe Itaken, Ithe IWoman
Iwill Ibe Igiven I100mg Iof I glucose, Ithen Itest I blood
I at I1 Ihour, I2 Ihours Iand I3 Ihours.
○ If IGDM Iis Ideveloped, Iit Iplaces Iwomen Iat Ihigher Irisk Ifor
developing Idiabetes Iafter Ipregnancy
○ Increase Ichange Iof Ifetal
Imacrosomia
Basal I Body I temperature
● Can Idrop Islightly Iat Itime Iof Iovulation
● Inexpensive Iand Iconvenient
● Reliability Ican Ibe Iinfluenced Iby Ivariables Icausing Iinaccurate
Iinterpretations- Itemp Ichanges, Istress, Ifatigue, Iillness, Ialcohol,
Iwarmth Iof Isleeping Ienvironment
Diaphragm
● Replace Ievery Itwo Iyears Ior Iwith I20% Iweight Ichange
● Leave Iin Iplace I6 Ihours Ipost Iintercourse
● Needs Ito Ibe Ifitted Iproperly
● Insert Ivaginally Iover Icervix Iwith Ispermicidal Ijelly Ior Icream
Iapplied Ito Icervical Iside Iof Idome Iand Iaround Irim
● Re-apply Ispermicide Iwith Ieach Iact Iof Icoitus
● Wash Iwith Imild Isoap Iand Iwarm Iwater Iafter Ieach Iuse
● RISK: Ihx Iof ITSS, Ifrequent IUTI, Iincreased Irisk Iof ITSS- Ihigh Ifever,
Ifaint Ifeeling, Idrop Iin IBP, I watery Idiarrhea, IHA, Imuscle Iaches
Presumptive ISigns Iof IPregnancy
● Things Ithat Ican Ibe Iexplained Iby Ia Ireason Iother Ithan Ipregnancy
● Amenorrhea, IFatigue
● Nausea Iand Ivomiting
● Urinary Ifrequency
● Breast Ichanges I(darkened Iareola)
● Quickening I(fluttering Imovements I16-20 Iweeks)
● Uterine Ienlargement
Probable Isigns Iof Ipregnancy
● Abdominal Ienlargement
● Hegar’s Isign: Isoftening Iand Icompressibility Iof Iuterus
● Chadwick’s Isign: Ideepened Iviolet Ibluish Icolor Iof Icervix Iand
Ivaginal Imucosa
ABCDE IPRINCIPLE
Airway/Cervical I Spine: IThis I is Ithe Imost Iimportant I step I in Iperforming
I the Iprimary Isurvey. I If Ia Ipatent Iairway Iis Inot Iestablished, Isubsequent
Isteps Iof I the Iprimary Isurvey Iare Ifutile. IProtect Ithe Icervical Ispine Iif
Ihead Ior Ineck Itrauma Iis Isuspected.
Breathing: IAfter Iachieving Ia Ipatent Iairway, Iassess Ifor Ithe Ipresence Iand
Ieffectiveness Iof Ibreathing.
Circulation: IAfter Iensuring Iadequate Iventilation, Iassess Ithe
Icirculation. IDisability: IPerform Ia Iquick Iassessment Ito Idetermine
Ithe Iclient’s Ilevel Iof Iconsciousness.
Exposure: IPerform Ia Iquick Iphysical Iassessment Ito Idetermine Ithe
Iclient’s Iexposure Ito Iadverse Ielements Isuch Ias Iheat Ior Icold.
MASLOW’S IHIERARCHY IOF INEEDS
Physiological; Ioxygenation, Icirculation, Inutrition, Ielimination, Ifluid
Ibalance, Iactivity Iand Iexercise, Irest Iand Isleep
Safety Iand Isecurity; Iliving Iin Ia Isafe Ienvironment, Iadequate Iincome,
Ishelter Ifrom Ienvironmental Ielements
Love Iand Ibelonging; Ilove, Iaffection, Irelationships
Self Iesteem; Iself Irespect, Ipersonal Iworth, Isocial
Irecognition ISelf IActualization; Ipersonal Igrowth, Ifulfilling
Iown Ipotential
NY I Heart I Association I Classifications
Class II: Imeans Ino Isymptoms Iand Ino Ilimitations Iin Iordinary Iphysical
Iactivity IClass III: Imild Isymptoms Iand Islight Ilimitation Iduring Iordinary
Iactivity
Class IIII: Imarked Ilimitation Iin Iactivity Idue Ito Isymptoms, Ieven Iduring Iless
Ithan Iordinary Iactivity.
Class IIV: Isevere Ilimitations, Iwith Isymptoms Iexperienced Iat Irest
RANDOM INOTES IFROM IATI IQ’s
● The Ikleihauer-Betke Itest Iis Iused Ito Idetermine Ithe Iamount Iof Ifetal
Iblood Iin Ithe Imaternal I circulation Iwhen Ithere Iis Ia Irisk Iof IRh-
isoimmunization
● A Ipregnant Iclient Ishould Itake I600 Imcg Iof Ifolic Iacid Idaily Ito
Iprevent
neural Itube Idefects.
● A Ipregnant Iclient Ishould Idrink I3 IL Iwater Ia Iday
● A Ipregnant Iclient Ishould Iincrease Iprotein Iintake Ito I71g Iduring
Isecond Iand Ithird Itrimester
● A Ipregnant Iclient Ishould Iincrease Icaloric Iintake Iby I340 Ical Iduring
Ithe
second Itrimester Iand I452 Ical Iduring Ithe Ithird Itrimester.
● If Ia Ipregnant Ipatient Iis Ihaving Ia Iseizure, Iplace Ioxygen Ion Ithe
Ipatient Ito Iensure Iadequate Ioxygenation Ito Ithe Ifetus.
,● If Ia Ipt Iis Iusing Ipatterned Ibreathing Iduring Ilabor Iand Ihas Itingling
Iand Inumbness, I this I is Ibecause Ithe Ipt Iis I hyperventilating. IPlacing
Ian Ioxygen Imask Iover Ithe Inose Iand Imouth Iwill Ihelp Ibring Iup ICO2
Ilevels Iand Ireduce Ithe Iintake Iof Ioxygen.
● Rhogam; I given I within I 72 I hours I post I delivery I for I Rh I negative I to
prevent Iantibody Iformation Ifor Ifuture Ipregnancy
● Hx Iof Icholecystitis, Ihtn, Iand Imigraine Iheadaches Iis Ia
I contraindication
for Ioral Icontraceptives
● Folate Ioccurs Inaturally Iin Ifoods Ilike Iliver, Idark-green Ileafy
Iveggies, Iorange Ijuice, Ilegumes
● Meconium Ishould Ibe Ipassed Iwithin I24 Ito I48 Ihours Iafter Idelivery
● Erythromycin Iointment Iin Ieye Iprevent Iinfection Isuch Ias Igonorrhea
● Vitamin IK Igiven Ito Iprevent Ihemorrhage Ito Iinfant Iat Ibirth
● First Iimmunization Iis IHep IB Iat Ibirth, Ithen I1 Imonth Iand Ithen I6
Imonths
●
● Ectopic Ipregnancy
○ When Ithe Iovum Ibecomes Iimplanted Ioutside Iof Ithe Iuterus,
Ioften Ithe Ifallopian Itubes
○ comes Iwith Iunilateral Istabbing Ipain, Iand Itenderness Iin Ithe
lower Iabd Iquadrant.
○ The Ifallopian Itube Ibursting Ican Ibe Ivery Idangerous Ifor Imom
○ Severe Ishoulder Ipain Iis Ia Ifinding Iwith Iruptured
Iectopic Ipregnancy
○ Abdominal Icramping Ican Iindicate Iectopic Ipregnancy Ior
manifestations Iof Ispontaneous Iabortion
● Molar I pregnancy I (Hydatidiform I mole)
○ Proliferation Iand Idegeneration Iof Itrophoblastic Ivilli
Iin Ithe Iplacenta
○ Sx Iof Ibleeding Ithat Iresembles Iprune Ijuice/dark Ibrown
● Placenta Iprevia;
○ When Ithe Iplacenta Iabnormally Iimplants Iin Ithe Ilower
Isegment Iof Ithe Iuterus, Iover/near Ithe Icervical Ios
○ Painless Ibright Ired Ivaginal Ibleeding Iduring I2nd Ior I3rd
Itrimester
○ Can Ibe Icomplete, Iincomplete Ior Ipartial
○ If Icompletely Icovering Ithe Icervical Ios, Icecarean
Isection Iis IDEFINITELY I needed
● Abruptio Iplacentae
○ Premature Iseparation Iof Iplacenta Ifrom Iuterus
○ High Irate Iof Ifetal Iand Imaternal Imorbidity/ Imortality
○ Sudden Ionset Iof Iexcruciating Iand Ilocalized Ipain, Ibright Ired
● Incompetent Icervix
○ Recurrent Ipremature Idilation Iof Ithe Icervix, Ior
Icervical Iinsufficiency
○ Cervix Idoes Inot Istay Iclused Iduring Ipregnancy, Iand Ican
Iresult Iin
urterine Icontents Ifrom Ileaking/falling Iout
, ○ Woman Igets Ia Icerclage Ito Ikeep Icervix Ifrom Idilating.
IRemoved Iat I37 Iweeks Ior Iwhen Ispontaneous Ilabor Ioccurs
○ Can Iresulting Iin Ia Imiscarriage
● Gestational IDiabetes
○ Most Ioral Iantidiabetic Imeds Iare Icontraindicated Iwith
Ipregnancy. IInsulin Iis Iused Imost Icommonly Ito Icontrol
Iglucose
○ Test Ioccurs Ibetween I24-28 Iweeks, Istarts Ioff Iwith I1 Ihour Itest
○ No Ifasting Irequired,
○ 50 Ig Ioral Iglucose Iis Igiven Ito Iwoman, Iand Itest Ian Ihour Ilater
○ If Iit Iover I130-140, Inext Itest Iis Idone, Iwhich Iis Ithe IOGTT,
○ OGGT I requires I fasting, I avoid I caffeine/smoking
■ Fasting Iglucose Ilevel Iwill Ibe Itaken, Ithe IWoman
Iwill Ibe Igiven I100mg Iof I glucose, Ithen Itest I blood
I at I1 Ihour, I2 Ihours Iand I3 Ihours.
○ If IGDM Iis Ideveloped, Iit Iplaces Iwomen Iat Ihigher Irisk Ifor
developing Idiabetes Iafter Ipregnancy
○ Increase Ichange Iof Ifetal
Imacrosomia
Basal I Body I temperature
● Can Idrop Islightly Iat Itime Iof Iovulation
● Inexpensive Iand Iconvenient
● Reliability Ican Ibe Iinfluenced Iby Ivariables Icausing Iinaccurate
Iinterpretations- Itemp Ichanges, Istress, Ifatigue, Iillness, Ialcohol,
Iwarmth Iof Isleeping Ienvironment
Diaphragm
● Replace Ievery Itwo Iyears Ior Iwith I20% Iweight Ichange
● Leave Iin Iplace I6 Ihours Ipost Iintercourse
● Needs Ito Ibe Ifitted Iproperly
● Insert Ivaginally Iover Icervix Iwith Ispermicidal Ijelly Ior Icream
Iapplied Ito Icervical Iside Iof Idome Iand Iaround Irim
● Re-apply Ispermicide Iwith Ieach Iact Iof Icoitus
● Wash Iwith Imild Isoap Iand Iwarm Iwater Iafter Ieach Iuse
● RISK: Ihx Iof ITSS, Ifrequent IUTI, Iincreased Irisk Iof ITSS- Ihigh Ifever,
Ifaint Ifeeling, Idrop Iin IBP, I watery Idiarrhea, IHA, Imuscle Iaches
Presumptive ISigns Iof IPregnancy
● Things Ithat Ican Ibe Iexplained Iby Ia Ireason Iother Ithan Ipregnancy
● Amenorrhea, IFatigue
● Nausea Iand Ivomiting
● Urinary Ifrequency
● Breast Ichanges I(darkened Iareola)
● Quickening I(fluttering Imovements I16-20 Iweeks)
● Uterine Ienlargement
Probable Isigns Iof Ipregnancy
● Abdominal Ienlargement
● Hegar’s Isign: Isoftening Iand Icompressibility Iof Iuterus
● Chadwick’s Isign: Ideepened Iviolet Ibluish Icolor Iof Icervix Iand
Ivaginal Imucosa
