N211 MATERNAL NEWBORN-FALL - RUSH CLINICAL ROTATION ATI STUDY GUIDE LATEST UPDATE 2022

N211 MATERNAL NEWBORN-FALL -
RUSH CLINICAL ROTATION ATI
STUDY GUIDE LATEST UPDATE 2022


AMNIOCENTESIS) page 33-34
Obtain FHR PRIOR to procedure.
● Amniocentesis is a prenatal test. Is the sampling of
amniotic fluid using a hollow needle inserted into the
uterus, to screen for developmental abnormalities in a
fetus.
● Prescribed for a pt. who is at increased risk of having a baby
with a birth defect or genetic condition.
● An ultrasound transducer is used to show a baby's position in
the uterus on a monitor prior to procedure.
● It may be performed after 14
weeks of gestation. Patient Education
● Instruct client to empty her bladder prior to procedure
● During procedure slight pressure will be felt, keep breathing.
○ The diaphragm is lowered when pt holds the breath.
Nursing Interventions
● With Rh negative will be given Rho(D) immune globulin, to
protect against Rh isoimmunization.
● Monitor FHR after the procedure for 30mins
● Notify provider for leakage, bleeding on site, pressure,
contraction


N211 MATERNAL NEWBORN-FALL -
RUSH CLINICAL ROTATION ATI
STUDY GUIDE LATEST UPDATE 2022
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,N211 MATERNAL NEWBORN-FALL -
RUSH CLINICAL ROTATION ATI
STUDY GUIDE LATEST UPDATE 2022
ULTRASOUND EDUCATION: () page 29
● instruct patient to have full bladder. “Drink 1 quart of water
prior to the procedure”er
● put the Wedge UNDER the right buttuck to prevent supine
hypotension.


NONSTRESS TEST: NURSING INTERVENTIONS: page 31
● “What are you looking at while you monitor my baby?”
○ “This test monitors the response of your baby’s FHR to
fetal movement.”
● Which trimester can this noninvasive test be performed? 3rd,
32 weeks
● Let's look at 2 strips to determine reactive vs. non reactive.
○ Let’s go over the reactive definition AGAIN!
○ Nonreactive, baby is sleeping, Opioid and
nicotine(smoking) can cause baby to relax which can
cause a false nonreactive NST
● Why do we ALSO need to connect the client to the Toco
transducer during this test?
○ If an acceleration occurs at the same time as a contraction it
does not count
● Best Maternal Position during this exam?


N211 MATERNAL NEWBORN-FALL -
RUSH CLINICAL ROTATION ATI
STUDY GUIDE LATEST UPDATE 2022
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,N211 MATERNAL NEWBORN-FALL -
RUSH CLINICAL ROTATION ATI
STUDY GUIDE LATEST UPDATE 2022
○ High fowler’s or left side
○ Supine with wedge under hip
● What is the ‘normal’ range for the FHR? (page 86)
○ 110 -160 bpm
○ After birth: 100 - 160 bpm




N211 MATERNAL NEWBORN-FALL -
RUSH CLINICAL ROTATION ATI
STUDY GUIDE LATEST UPDATE 2022
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, N211 MATERNAL NEWBORN-FALL -
RUSH CLINICAL ROTATION ATI
STUDY GUIDE LATEST UPDATE 2022
NONSTRESS TEST: RESULTS:)-third trimester
Done twice a week at 28-32 weeks gestation, IF HIGH RISK
PREGNANCY (PAGE 31, BOTTOM LEFT under Client Presentation.)
● Reactive (good): FHR normal baseline with moderate
variability. Accelerates at least 15 beats for 15 sec and it
occurs twice during 20 mins
● Remember, it’s not counted as an acceleration IF it occurs
DURING a contraction!!!
● Non-reactive: no demonstration of 2 qualifying accelerations in
20 mins
● Some medications, like Opioids & Nicotine can cause non-
reactive results.
○ Stimulate baby for 3 sec, give food or drink OJ
○ Reffered to get BPP or CST
● False non-reactive NST when baby is asleep (sleep periods 20-
30 mins), if Pt is on opioids (dilaudid) or is a smoker (page 31)
● Moderate variability with a minimum of 2 accelerations
● What is the definition of a acceleration?
○ 915 bpm above the fetal baseline and lasts for 15
seconds during a 20 minute period. (I say, “it’s a 15
by 15”)
○ Less than 32 weeks = 10 bpm, lasts 10 seconds


Identification of Prolonged Decelerations:

N211 MATERNAL NEWBORN-FALL -
RUSH CLINICAL ROTATION ATI
STUDY GUIDE LATEST UPDATE 2022
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