lOMoARcPSD|3920845
Maternity ATI Review
Chapter 1: Contraception
Chapter 2: Infertility
• Female: >35 yrs, more than 1 yr w/o contra, >35 only 6 mos, endocrine dx,
pelvic/abdominal procedures, ob: spontaneous abortions, hormone levels, uterine
contours, scar tissue, intercourse hx, STIs, environmental hazards, alcohol,
tobacco, heroin, methadone,, dx: pelvic exam, hormone analysis, postcoital test,
US, hysteroscopy, laprascopy, hysterosapingography
• Male: mumps, same as above, semen analysis, US
• Stress that it is nobodies fault
• Methods of conception: IVF, intrauterine insemination, gamete intrafallopian
transfer, donor oocyte, donor embryo, gestational carrier, surrogate mother,
donor sperm
• Genetic counseling: recommended
Chapter 3: Expected Physiological Changes During Pregnancy
• Signs of pregnancy: presumptive: amenorrhea, fatigue, N/V, urinary frequency,
breast: dark areola, quickening (16-20 wks,) uterine enlargement, probable:
abdominal enlargement, Chadwick: blue vagina, Goodell: soft cervix,
Ballottement: rebound of fetus upon palpation, Braxton-Hicks, positive
pregnancy test, positive: FHR, ultrasound, movement felt by provider; Serum
tests: hCG (7- 8 days)
• EDD: Naegle’s Rule: LMP minus 3 months plus one week plus one year, 18-32
weeks approximately matches fundal height, grava: number of pregnancy,
parity:
, lOMoARcPSD|3920845
Maternity ATI Review
number of pregnancies that fetus aged to 20 wks, GTPAL: G: grava, T: term
birth (38 wks) P: preterm (37 wk or less) Abortion (prior to 22 wk) L: living
children
• Physio Changes: repro: uterus grows, CV: CO inc 50%, BV inc, HR inc, resp:
lungs smaller, RR increase, MS: relaxin, GI: N/V/C, renal: frequency, endocrine:
placenta makes hCG, progesterone, estrogen
• Ax: BP: slight increase, pulse: slight increase, RR: slight increase, may hear S3,
36 weeks fundus reaches xiphoid, SOB
Chapter 4: Prenatal Care
• Ax: hx, birth plan, medical hx, psych, care begins @ 12 wks, monthly appt from
16-28 wks, q2 wks 29-36, qwk 36 wks until birth
• Lab tests: blood type, Rh, irreg antibodies, Rh neg Coombs’ test @ 24/38 wks,
Rhogam after amnio… CBC, Hgb, Hct, Rubella, GBS (35-37 wks,) Hep B,
urinalysis, GTT (>140 requires follow up,) PPD, CXR, HIV, MSADP (down
syndrome, TORCH
• Education: avoid OTC meds, supplements, prescription meds unless talking to
provider, tobacco (low birth weight,) alcohol (birth defect,) exercise q30/day,
no hot tubs or saunas, 8-10 glasses of water/day, emotional liability,
ambivalence is normal, conflicting feelings
o First tri: physical and psych changes, discomforts, complications, growth,
exercise, lab testing
o Second tri: benefits of BF, discomforts, sex, posture, clothing, seat
belt, complications (GDM, PROM, HTN,) birth plan, child birth
classes
, lOMoARcPSD|3920845
Maternity ATI Review
o Third tri: childbirth prep/classes, relaxation techniques, TENS,
music, infant/PP care, kick counts two-three times/day, 2 hr post
meal or bed time, less than 3/hr or none for 12h is danger
• Discomforts: N/V: crackers before rising, no spicy foods, avoid empty
tummy, breasts: tight, supportive bra, urinary freq: Kegel’s, UTI: cotton
undies, water,
retaining urine is no good, heartburn: sit up after meals, small feels, not too full or
too hungry, leg cramps: extend the leg, keep knee straight, dorsiflexion of foot,
sleep in LL position, nasal stuffiness normal d/t estrogen
• Danger Signs: burning on urination, hyperemesis, diarrhea, fever (tachy in baby,)
ab cramp, vaginal bleeding, gush of fluid from vagina, changes in fetal
activity, headaches, dysuria, blurred vision, edema of face and hands, epi pain,
fruity breath
Chapter 5: Nutrition During Pregnancy
• Gain 25-30 lb during preg, 1-2 kg (2.2-4.4 lb) first tri, 0.4 kg (1 lb) per week
after that. Underweight women 28-40 lb, overweight: 15-25 lb.
• Increase calories 340/day second tri, 462/day third tri, 450-500 for BF moms, 400
mcg folic acid non preg, 600 mcg/day preg woman, iron (vit C aides in
absorption,) calcium: 1,000 mg/day >19 yrs old, 1,300/day <19 yrs old, no more
than 200 mg of caffeine/day
• Risk factors: pica: eating non nutritive foods, vegeterains need protein, calcium,
iron, zinc, B12; ED, do not take nausea meds (call provider,) ginger may
help, frequently eat q2-3h, PKU is dangerous to fetus, low in phenylalanine,
high in protein foods avoided, aspartame avoided, monitor carbs and limits
sweets
Maternity ATI Review
Chapter 1: Contraception
Chapter 2: Infertility
• Female: >35 yrs, more than 1 yr w/o contra, >35 only 6 mos, endocrine dx,
pelvic/abdominal procedures, ob: spontaneous abortions, hormone levels, uterine
contours, scar tissue, intercourse hx, STIs, environmental hazards, alcohol,
tobacco, heroin, methadone,, dx: pelvic exam, hormone analysis, postcoital test,
US, hysteroscopy, laprascopy, hysterosapingography
• Male: mumps, same as above, semen analysis, US
• Stress that it is nobodies fault
• Methods of conception: IVF, intrauterine insemination, gamete intrafallopian
transfer, donor oocyte, donor embryo, gestational carrier, surrogate mother,
donor sperm
• Genetic counseling: recommended
Chapter 3: Expected Physiological Changes During Pregnancy
• Signs of pregnancy: presumptive: amenorrhea, fatigue, N/V, urinary frequency,
breast: dark areola, quickening (16-20 wks,) uterine enlargement, probable:
abdominal enlargement, Chadwick: blue vagina, Goodell: soft cervix,
Ballottement: rebound of fetus upon palpation, Braxton-Hicks, positive
pregnancy test, positive: FHR, ultrasound, movement felt by provider; Serum
tests: hCG (7- 8 days)
• EDD: Naegle’s Rule: LMP minus 3 months plus one week plus one year, 18-32
weeks approximately matches fundal height, grava: number of pregnancy,
parity:
, lOMoARcPSD|3920845
Maternity ATI Review
number of pregnancies that fetus aged to 20 wks, GTPAL: G: grava, T: term
birth (38 wks) P: preterm (37 wk or less) Abortion (prior to 22 wk) L: living
children
• Physio Changes: repro: uterus grows, CV: CO inc 50%, BV inc, HR inc, resp:
lungs smaller, RR increase, MS: relaxin, GI: N/V/C, renal: frequency, endocrine:
placenta makes hCG, progesterone, estrogen
• Ax: BP: slight increase, pulse: slight increase, RR: slight increase, may hear S3,
36 weeks fundus reaches xiphoid, SOB
Chapter 4: Prenatal Care
• Ax: hx, birth plan, medical hx, psych, care begins @ 12 wks, monthly appt from
16-28 wks, q2 wks 29-36, qwk 36 wks until birth
• Lab tests: blood type, Rh, irreg antibodies, Rh neg Coombs’ test @ 24/38 wks,
Rhogam after amnio… CBC, Hgb, Hct, Rubella, GBS (35-37 wks,) Hep B,
urinalysis, GTT (>140 requires follow up,) PPD, CXR, HIV, MSADP (down
syndrome, TORCH
• Education: avoid OTC meds, supplements, prescription meds unless talking to
provider, tobacco (low birth weight,) alcohol (birth defect,) exercise q30/day,
no hot tubs or saunas, 8-10 glasses of water/day, emotional liability,
ambivalence is normal, conflicting feelings
o First tri: physical and psych changes, discomforts, complications, growth,
exercise, lab testing
o Second tri: benefits of BF, discomforts, sex, posture, clothing, seat
belt, complications (GDM, PROM, HTN,) birth plan, child birth
classes
, lOMoARcPSD|3920845
Maternity ATI Review
o Third tri: childbirth prep/classes, relaxation techniques, TENS,
music, infant/PP care, kick counts two-three times/day, 2 hr post
meal or bed time, less than 3/hr or none for 12h is danger
• Discomforts: N/V: crackers before rising, no spicy foods, avoid empty
tummy, breasts: tight, supportive bra, urinary freq: Kegel’s, UTI: cotton
undies, water,
retaining urine is no good, heartburn: sit up after meals, small feels, not too full or
too hungry, leg cramps: extend the leg, keep knee straight, dorsiflexion of foot,
sleep in LL position, nasal stuffiness normal d/t estrogen
• Danger Signs: burning on urination, hyperemesis, diarrhea, fever (tachy in baby,)
ab cramp, vaginal bleeding, gush of fluid from vagina, changes in fetal
activity, headaches, dysuria, blurred vision, edema of face and hands, epi pain,
fruity breath
Chapter 5: Nutrition During Pregnancy
• Gain 25-30 lb during preg, 1-2 kg (2.2-4.4 lb) first tri, 0.4 kg (1 lb) per week
after that. Underweight women 28-40 lb, overweight: 15-25 lb.
• Increase calories 340/day second tri, 462/day third tri, 450-500 for BF moms, 400
mcg folic acid non preg, 600 mcg/day preg woman, iron (vit C aides in
absorption,) calcium: 1,000 mg/day >19 yrs old, 1,300/day <19 yrs old, no more
than 200 mg of caffeine/day
• Risk factors: pica: eating non nutritive foods, vegeterains need protein, calcium,
iron, zinc, B12; ED, do not take nausea meds (call provider,) ginger may
help, frequently eat q2-3h, PKU is dangerous to fetus, low in phenylalanine,
high in protein foods avoided, aspartame avoided, monitor carbs and limits
sweets
