Maternal and Pediatric ATI
Proctor LATEST 2024
Natural family planning - ANS-abstinence
coitus interrupts (withdrawal)
calendar method
basal body temperature
Barrier methods - ANS-male condom- protects against STIs and involves the male in
the birth control method
diaphragm and spermicide- be properly fitted with a diaphragm by a provider; replace
every 2 years and refit for a 20% weight fluctuation; can be inserted up to 6 hrs. before
intercourse and must stay in place 6 hrs. after intercourse but for no more than 24 hrs.;
reapply spermicide with each act of coitus
Combined oral contraceptives adverse effects - ANS-chest pain, SOB, leg pain for
possible clot, headache, eye problems from a stroke, and HTN, breakthrough bleeding,
fluid retention and breast tenderness
Combined oral contraceptives complications - ANS-women who have a history of
thromboembolic disorders, stroke, heart attack, CAD, uncontrolled HTN, smoking
Injectable progestins - ANS-is an intramuscular or subcutaneous injection given to a
female client every 11-13 weeks
Maintain an adequate intake of calcium and vitamin D
Adverse effects- decrease in bone mineral density
intrauterine device (IUD) - ANS-report to provider abdominal pain or pain with
intercourse, abdominal or foul-smelling vaginal discharge, a change in string length
Can increase risk of PID, uterine perforation, or ectopic pregnancy
,Transcervical sterilization - ANS-insertion of small flexible agents through the vagina
and the cervix into the Fallopian tubes. This results in the development of scar tissue in
the tubes
Transcervical sterilization advantages/disadvantages/risks - ANS-quick procedure
requires no general anesthesia
not intended for use in the client who is postpartum, delay in effectiveness for 3 months.
The client should use an alternative means of birth control until confirmation of blocked
Fallopian tube occurs
perforation can occur; increased risk of ectopic pregnancy if pregnancy occurs
Female sterilization - ANS-procedure of severance or burning or blocking the Fallopian
tubes to prevent fertilization
Carries a risk of complications, infection, hemorrhage, or trauma
Male sterilization (vasectomy) - ANS-cutting of the vas deferens in the male as a form of
permanent sterilization
Use alternate forms of birth control for approximately 20 ejaculations or 1 week to
several months to allow all of the sperm to clear the vas deferens. Follow up is
important for sperm count
Presumptive signs of pregnancy - ANS-amenorrhea, N/V, urinary frequency, breast
changes, quickening, abdominal enlargement
Probable signs of pregnancy - ANS-Hegar's sign- softening and compressibility of lower
uterus
Goodell's sign- softening of cervical tip
Chadwick's sign- deepened violet-bluish color of cervix and vaginal mucosa
Ballottement- rebound of unengaged fetus
Braxton-Hicks contractions- false contractions that are painless, irregular, and relieved
with walking
Positive pregnancy test
Positive signs of pregnancy - ANS-fetal heart sounds, visualization of the fetus, fetal
movement palpated by an experienced examiner.
Nagele's Rule - ANS-Take the first day of the client's last menstrual cycle, subtract 3
months, and then add 7 days and 1 year
Measurement of fundal height - ANS-in centimeters from the symphysis pubis to the top
of the uterine fundus (between 18 and 32 weeks of gestation) approximates the
gestational age
GTPAL system - ANS-G = gravidity (# of times pregnant)
T = term (38-42 weeks)
P = preterm birth (20-37 weeks)
, A = abortion (< 20 weeks)
L = living children
Supine hypotensive syndrome - ANS-dizziness, lightheadness, and pale, clammy skin.
Encourage client to lie on the left side, in a semi-Fowler's position, or, if supine, with a
wedge placed under one hip to alleviate pressure to the vena cava
pregnancy skin changes - ANS-linea nigra- dark line of pigmentation from the umbilicus
extending to the pubic area
Striae gravidarum- stretch marks most notably found on the abdomen and thighs
Prenatal laboratory tests - ANS-Blood type, Rh factor (Indirect Coombs test), CBC with
diff, Hgb, Hct, Hgb electrophoresis, Rubella titer, hepatitis B screen, GBS, urinalysis
with microscopic, 1 hour glucose tolerance, Pap test, vaginal/cervical culture, PPD,
syphilis screening, HIV, TORCH screening, maternal serum alpha-fetoprotein (MSAFP)
Common discomforts of pregnancy - ANS-N/V, urinary frequency, UTIs, heartburn,
constipation, hemorrhoids, SOB, varicose veins and lower extremity edema, gingivitis,
nasal stuffiness, and epistaxis (nosebleed)
Weight gain during pregnancy - ANS-25-35 lbs. Client should gain 1-2 kg during the first
trimester and approximately 0.4 kg per week for the last two trimesters. Underweight
clients are advised to gain 29-40 lbs. Overweight clients, 15-25 lbs
Increase calories - ANS-340 calories/day is recommended during the second trimester.
452 calories/day is recommended during the third trimester
Breast feeding clients should add 450-500 calories/day
protein intake - ANS-increasing is essential to basic growth
Folic Acid - ANS-is crucial for neurological development and the prevention of fetal
neural tube defects. Take 600 mcg of folic acid
Iron supplements - ANS-is best absorbed between meals and when given with a source
of vitamin C
Calcium - ANS-is important to a developing fetus, is involved in bone and teeth
formation. Recommendation is 1,000 mg for pregnant and nonpregnant 19-50 years of
age
fluid - ANS-8-10 (2.3 L) glasses of fluid is recommended
limit caffeine - ANS-a daily intake of no more than 200 mg caffeine
PKU diet - ANS-low protein diet
Proctor LATEST 2024
Natural family planning - ANS-abstinence
coitus interrupts (withdrawal)
calendar method
basal body temperature
Barrier methods - ANS-male condom- protects against STIs and involves the male in
the birth control method
diaphragm and spermicide- be properly fitted with a diaphragm by a provider; replace
every 2 years and refit for a 20% weight fluctuation; can be inserted up to 6 hrs. before
intercourse and must stay in place 6 hrs. after intercourse but for no more than 24 hrs.;
reapply spermicide with each act of coitus
Combined oral contraceptives adverse effects - ANS-chest pain, SOB, leg pain for
possible clot, headache, eye problems from a stroke, and HTN, breakthrough bleeding,
fluid retention and breast tenderness
Combined oral contraceptives complications - ANS-women who have a history of
thromboembolic disorders, stroke, heart attack, CAD, uncontrolled HTN, smoking
Injectable progestins - ANS-is an intramuscular or subcutaneous injection given to a
female client every 11-13 weeks
Maintain an adequate intake of calcium and vitamin D
Adverse effects- decrease in bone mineral density
intrauterine device (IUD) - ANS-report to provider abdominal pain or pain with
intercourse, abdominal or foul-smelling vaginal discharge, a change in string length
Can increase risk of PID, uterine perforation, or ectopic pregnancy
,Transcervical sterilization - ANS-insertion of small flexible agents through the vagina
and the cervix into the Fallopian tubes. This results in the development of scar tissue in
the tubes
Transcervical sterilization advantages/disadvantages/risks - ANS-quick procedure
requires no general anesthesia
not intended for use in the client who is postpartum, delay in effectiveness for 3 months.
The client should use an alternative means of birth control until confirmation of blocked
Fallopian tube occurs
perforation can occur; increased risk of ectopic pregnancy if pregnancy occurs
Female sterilization - ANS-procedure of severance or burning or blocking the Fallopian
tubes to prevent fertilization
Carries a risk of complications, infection, hemorrhage, or trauma
Male sterilization (vasectomy) - ANS-cutting of the vas deferens in the male as a form of
permanent sterilization
Use alternate forms of birth control for approximately 20 ejaculations or 1 week to
several months to allow all of the sperm to clear the vas deferens. Follow up is
important for sperm count
Presumptive signs of pregnancy - ANS-amenorrhea, N/V, urinary frequency, breast
changes, quickening, abdominal enlargement
Probable signs of pregnancy - ANS-Hegar's sign- softening and compressibility of lower
uterus
Goodell's sign- softening of cervical tip
Chadwick's sign- deepened violet-bluish color of cervix and vaginal mucosa
Ballottement- rebound of unengaged fetus
Braxton-Hicks contractions- false contractions that are painless, irregular, and relieved
with walking
Positive pregnancy test
Positive signs of pregnancy - ANS-fetal heart sounds, visualization of the fetus, fetal
movement palpated by an experienced examiner.
Nagele's Rule - ANS-Take the first day of the client's last menstrual cycle, subtract 3
months, and then add 7 days and 1 year
Measurement of fundal height - ANS-in centimeters from the symphysis pubis to the top
of the uterine fundus (between 18 and 32 weeks of gestation) approximates the
gestational age
GTPAL system - ANS-G = gravidity (# of times pregnant)
T = term (38-42 weeks)
P = preterm birth (20-37 weeks)
, A = abortion (< 20 weeks)
L = living children
Supine hypotensive syndrome - ANS-dizziness, lightheadness, and pale, clammy skin.
Encourage client to lie on the left side, in a semi-Fowler's position, or, if supine, with a
wedge placed under one hip to alleviate pressure to the vena cava
pregnancy skin changes - ANS-linea nigra- dark line of pigmentation from the umbilicus
extending to the pubic area
Striae gravidarum- stretch marks most notably found on the abdomen and thighs
Prenatal laboratory tests - ANS-Blood type, Rh factor (Indirect Coombs test), CBC with
diff, Hgb, Hct, Hgb electrophoresis, Rubella titer, hepatitis B screen, GBS, urinalysis
with microscopic, 1 hour glucose tolerance, Pap test, vaginal/cervical culture, PPD,
syphilis screening, HIV, TORCH screening, maternal serum alpha-fetoprotein (MSAFP)
Common discomforts of pregnancy - ANS-N/V, urinary frequency, UTIs, heartburn,
constipation, hemorrhoids, SOB, varicose veins and lower extremity edema, gingivitis,
nasal stuffiness, and epistaxis (nosebleed)
Weight gain during pregnancy - ANS-25-35 lbs. Client should gain 1-2 kg during the first
trimester and approximately 0.4 kg per week for the last two trimesters. Underweight
clients are advised to gain 29-40 lbs. Overweight clients, 15-25 lbs
Increase calories - ANS-340 calories/day is recommended during the second trimester.
452 calories/day is recommended during the third trimester
Breast feeding clients should add 450-500 calories/day
protein intake - ANS-increasing is essential to basic growth
Folic Acid - ANS-is crucial for neurological development and the prevention of fetal
neural tube defects. Take 600 mcg of folic acid
Iron supplements - ANS-is best absorbed between meals and when given with a source
of vitamin C
Calcium - ANS-is important to a developing fetus, is involved in bone and teeth
formation. Recommendation is 1,000 mg for pregnant and nonpregnant 19-50 years of
age
fluid - ANS-8-10 (2.3 L) glasses of fluid is recommended
limit caffeine - ANS-a daily intake of no more than 200 mg caffeine
PKU diet - ANS-low protein diet
