ATI MATERNAL NEWBORN OB EXAM (4 VERSIONS)

ATI MATERNAL NEWBORN OB EXAM (4 VERSIONS)




































Car seat safety - CORRECT ANSWER-Use rear-facing car seat in back seat, preferably the middle until age 2 or until the child reaches max height and weight

position the seat so that the newborn is at a 45° angle.

If car has no backseat, carseat must be placed in front seat w/ air bag disabled.

Use the vehicle's seat belts to secure the newborn's seat and provide adequate protection in a motor-vehicle crash.

position retainer clip at the level of newborn axillae

place shoulder harness straps in slots at or below level of newborn shoulders

Neonatal Respiratory Distress - CORRECT ANSWER-Report to the provider:
-tachypnea
(RR > 60/min)
-nasal flaring
-retractions
-expiratory grunting

Acrocyanosis - finding during the first 24 hr after birth. CORRECT ANSWER-a bluish discoloration of the hands and feet of the newborn and is an expected

Hydrotherapy - CORRECT ANSWER-therapy using water

initiated once in Active labor

use of hydrotherapy during latent stage may decrease contraction strength & frequency

nurse will perform intermittent monitoring of FHR w/ doppler stethoscope

Risk for Electric Shock
internal fetal heart monitor contraindicated

water temp. between
36-37ºC
(96.8-98.6ºF)

no limitation as long as FHR remains in expected range
using for 30-60min w/ breaks can alleviate pain more effectively.

Moro reflex - CORRECT ANSWER-Infant reflex where a baby will startle in response to a loud sound or sudden movement.

tonic neck reflex - CORRECT ANSWER-head is quickly turned to one side, the arm and leg on the same side extend, while the arm and leg on the opposite side flex.

Magnet reflex - CORRECT ANSWER-newborn will push against the examiner's hands when pressure is applied to the soles of the newborn's feet.

crawling reflex - CORRECT ANSWER-newborn is placed on the abdomen, he will appear to make crawling movements with the arms and legs.

Maternal Lab Values - CORRECT ANSWER-Hgb: 12-18

BUN: 10-20

Creatinine: 0.5-1.0

Platelet: 150,000-400,000

Hct: > 33%

Serum Protein:

WBC:


Glucose after tolerance test: < 140

Neonatal lab values - CORRECT ANSWER-Glucose: 30-60

Platelet: 150,000-300,00

EBC: 9,000-30,000

Hgb: 14-24

to treat engorgement - CORRECT ANSWER-Nursing Mother:
use breast pump to:
-soften breast prior to breastfeeding
-after feeding to empty breast completely

drink enough fluid to satisfy thirst
decreasing fluids will decrease milk production

breastfeed every 2hr
frequent feedings soften breast and decrease pain

apply cold compresses after feedings

take warm shower immediately before feeding to soften breast



Non-nursing Mother:
-apply cold cabbage leaves to breast
-do not use pump because it can cause in increase in milk production
-do not massage breast
stimulation will promote milk production
-do not wear underwire bra as this can cause ducts to get plugged resulting in mastitis

Methylergonovine (Methergine) - CORRECT ANSWER-Oxytocic that acts directly on the uterine muscle to stimulate forceful contractions.

Used for postpartum hemorrhage.

Side effects:
potential vasoconstriction
hypertension/ hypotension
headache
nausea
vomiting
cramping
dizziness

Interventions: continuously monitor BP, assess uterine bleeding and uterine tone.

during pregancy - CORRECT ANSWER-Expected findings:
-leukorrhea (greyish, mucus-like discharge)
-spider nevi, vascular spiders
-fundal height
(ex. 30 wks = 30cm)
-10 fetal movements in 2h period @ 36wk
-nonpitting edema @ 36wk
-leg cramps @ 36wk
-BP below 140/90
-1.3kg (2.9 lbs) in 4 weeks
-tingling in fingers
-insomnia

Fetus:
-HR of 110-160 bpm
-

Report to provider: