ATI Maternal-Newborn Study Guide
2021/2022
Basic Care and Comfort
Client education: lactation suppression, engorgement
● Advantages
o Anyone can feed
o Less painful
o Can feed at any time
o Know how much infant is getting
● Disadvantages
o Economical-Expensive
o Can mix wrong
o Less immunity
o Need to prepare it: Mix and warm it
▪ Considerations for Mom
● Supportive bras/bind breasts
● Avoid nipple stimulation
● Apply ice packs or frozen cabbage leaves for engorgement
● Suppression of lactation is necessary for clients who are not
breastfeeding. Avoid breast stimulation and running warm water over
the breasts for prolonged periods until no longer lactating.
Hyperemesis gravidarum
▪ Excessive vomiting
▪ May be hospitalized for this
▪ Unknown etiology
▪ Usually 0-12 weeks
▪ Treat with: IV fluids, Phenergan, Prilosec, Reglan, Zofran, TPN
if severe
▪ Small frequent bland meals
Nutrition during pregnancy
▪ Need extra 340 calories a day
▪ Double for twins
o Increase caloric intake by 340 calories per day, should get a
minimum of 2200 calories per day
,o Increase water intake 8-10 cups a day
o Avoid sodium rich foods
o Avoid raw fish
o Soft cheese unless it is pasteurized
o Normal BMI gain between 25-35 lbs
▪ Most weight gain is in the last trimester
,Pain management during labor: pharmacological and nonpharmacological
● Pharmacological
o Includes systemic analgesia and local/regional analgesics.
o Opioids/Epidural; To avoid slowing the progress of labor, prior to
administering analgesic medications, the nurse should verify that labor
is well established by performing a vaginal exam and evaluating
uterine contraction pattern. Alleviates pain sensations or raises the
threshold for pain perception.
● Nonpharmacological
o Continuous labor support
Ambulation and position
changes Acupuncture and
acupressure Attention
focusing and imagery
Therapeutic touch and massage; effleurage
Breathing techniques (e.g., patterned-paced
breathing) Hydrotherapy
Postpartum assessment findings
● PP Assessment
o Vitals are important; including pain
● Fundal Assessment
o Want a firm centrally located fundus
▪ If not midline typically shifted to right due to bladder; caused
uterus to become boggy
▪ Every 24hrs drop 1 fingerbreath below umbilicus
▪ First action for a boggy uterus is massage
● Lochia
o Bleeding post-delivery
o First 24 hours it should be dark red, scant to moderate amount
o Should not saturate 1 peripad in 15 min.
o Amount should decrease over time
o Still see blood even after a c-sx
▪ Counter pressure on incision line is important when performing
an assessment
o Assess
▪ Amount, color, and odor
▪ Goes from Rubra, Serosa and Alba
● Perineum
o Assess for trauma and healing process
, o Degree of episiotomy/laceration
▪ 1st degree-skin
▪ 2nd degree-perineal muscle
▪ 3rd degree-anal sphincter
▪ 4th into rectal wall
▪ REEDA
2021/2022
Basic Care and Comfort
Client education: lactation suppression, engorgement
● Advantages
o Anyone can feed
o Less painful
o Can feed at any time
o Know how much infant is getting
● Disadvantages
o Economical-Expensive
o Can mix wrong
o Less immunity
o Need to prepare it: Mix and warm it
▪ Considerations for Mom
● Supportive bras/bind breasts
● Avoid nipple stimulation
● Apply ice packs or frozen cabbage leaves for engorgement
● Suppression of lactation is necessary for clients who are not
breastfeeding. Avoid breast stimulation and running warm water over
the breasts for prolonged periods until no longer lactating.
Hyperemesis gravidarum
▪ Excessive vomiting
▪ May be hospitalized for this
▪ Unknown etiology
▪ Usually 0-12 weeks
▪ Treat with: IV fluids, Phenergan, Prilosec, Reglan, Zofran, TPN
if severe
▪ Small frequent bland meals
Nutrition during pregnancy
▪ Need extra 340 calories a day
▪ Double for twins
o Increase caloric intake by 340 calories per day, should get a
minimum of 2200 calories per day
,o Increase water intake 8-10 cups a day
o Avoid sodium rich foods
o Avoid raw fish
o Soft cheese unless it is pasteurized
o Normal BMI gain between 25-35 lbs
▪ Most weight gain is in the last trimester
,Pain management during labor: pharmacological and nonpharmacological
● Pharmacological
o Includes systemic analgesia and local/regional analgesics.
o Opioids/Epidural; To avoid slowing the progress of labor, prior to
administering analgesic medications, the nurse should verify that labor
is well established by performing a vaginal exam and evaluating
uterine contraction pattern. Alleviates pain sensations or raises the
threshold for pain perception.
● Nonpharmacological
o Continuous labor support
Ambulation and position
changes Acupuncture and
acupressure Attention
focusing and imagery
Therapeutic touch and massage; effleurage
Breathing techniques (e.g., patterned-paced
breathing) Hydrotherapy
Postpartum assessment findings
● PP Assessment
o Vitals are important; including pain
● Fundal Assessment
o Want a firm centrally located fundus
▪ If not midline typically shifted to right due to bladder; caused
uterus to become boggy
▪ Every 24hrs drop 1 fingerbreath below umbilicus
▪ First action for a boggy uterus is massage
● Lochia
o Bleeding post-delivery
o First 24 hours it should be dark red, scant to moderate amount
o Should not saturate 1 peripad in 15 min.
o Amount should decrease over time
o Still see blood even after a c-sx
▪ Counter pressure on incision line is important when performing
an assessment
o Assess
▪ Amount, color, and odor
▪ Goes from Rubra, Serosa and Alba
● Perineum
o Assess for trauma and healing process
, o Degree of episiotomy/laceration
▪ 1st degree-skin
▪ 2nd degree-perineal muscle
▪ 3rd degree-anal sphincter
▪ 4th into rectal wall
▪ REEDA
