ATI MATERNITY STUDY GUIDE
ATI MATERNITY
STUDY GUIDE
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.
,ATI MATERNITY STUDY GUIDE
● 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 month 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, cecarean 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
● Incompetent cervix
○ Recurrent premature dilation of the cervix, or cervical
insufficiency
○ Cervix does not stay clused during pregnancy, and can result in
urterine contents from leaking/falling out
, ATI MATERNITY STUDY GUIDE
○ 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
○ 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, next test is done, which is the OGTT,
○ OGGT requires fasting, avoid caffeine/smoking
■ 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
● Wash with mild soap and warm water after each use
● RISK: hx of TSS, frequent UTI, increased risk of TSS- high fever, faint
feeling, drop in BP, watery diarrhea, HA, muscle aches
Presumptive Signs of Pregnancy
● Things that can be explained by a reason other than pregnancy
● Amenorrhea, Fatigue
● Nausea and vomiting
● Urinary frequency
● Breast changes (darkened areola)
● Quickening (fluttering movements 16-20 weeks)
● Uterine enlargement
Probable signs of pregnancy
● Abdominal enlargement
● Hegar’s sign: softening and compressibility of uterus
● Chadwick’s sign: deepened violet bluish color of cervix and vaginal
mucosa
ATI MATERNITY
STUDY GUIDE
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.
,ATI MATERNITY STUDY GUIDE
● 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 month 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, cecarean 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
● Incompetent cervix
○ Recurrent premature dilation of the cervix, or cervical
insufficiency
○ Cervix does not stay clused during pregnancy, and can result in
urterine contents from leaking/falling out
, ATI MATERNITY STUDY GUIDE
○ 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
○ 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, next test is done, which is the OGTT,
○ OGGT requires fasting, avoid caffeine/smoking
■ 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
● Wash with mild soap and warm water after each use
● RISK: hx of TSS, frequent UTI, increased risk of TSS- high fever, faint
feeling, drop in BP, watery diarrhea, HA, muscle aches
Presumptive Signs of Pregnancy
● Things that can be explained by a reason other than pregnancy
● Amenorrhea, Fatigue
● Nausea and vomiting
● Urinary frequency
● Breast changes (darkened areola)
● Quickening (fluttering movements 16-20 weeks)
● Uterine enlargement
Probable signs of pregnancy
● Abdominal enlargement
● Hegar’s sign: softening and compressibility of uterus
● Chadwick’s sign: deepened violet bluish color of cervix and vaginal
mucosa
