RECENT 2024 ATI CAPSTONE MATERNAL NEWBORN ASSESSMENT

RECENT 2024 ATI CAPSTONE MATERNAL NEWBORN ASSESSMENT

What hormone is the basis for pregnancy testing? - ANSWER ==Human chorionic gonadotropin



Excreted by the placenta and promotes the excretion of progesterone and estrogen.



Uterine fibroid - ANSWER ==Can increase the risk for postpartum hemorrhage due to the increase in blood supply to the uterus, which supports the fibroid.



Will undergo serial US examinations during pregnancy to monitor because they are likely to grow during pregnancy in response to the increased circulating estrogen.



Can have a vaginal delivery if it is small and not near the cervical os.



Hydatidiform mole - ANSWER         ==AKA a molar pregnancy.



A benign proliferative growth of the chorionic villi, which gives rise to multiple cysts.



The products of conception transform into a large number of edematous, fluid-filled vesicles.



As cells slough off the uterine wall, vaginal discharge is usually dark brown and can contain grape-like clusters.



Alleviating lower back pain during the latent phase of labor - ANSWER             ==Counter- pressure applied to the client's sacral area during contractions.



This lifts the fetal head away from the sacral nerves, which decreases pain.



Preterm labor - which medication should the nurse plan to administer? - ANSWER

==Betamethasone IM



A glucocorticoid that stimulates fetal lung maturity and thereby prevents respiratory depression.



Methylergonovine - ANSWER         ==An ergot alkaloid.



For patients experiencing postpartum hemorrhage.



Stimulates uterine contractions.



Poractant alfa - ANSWER ==A synthetic lung surfactant.



Administer to a preterm newborn who is experiencing respiratory distress.



Misoprostol - ANSWER       ==Stimulates uterine contractions for a client who is undergoing labor induction.



Oligohydramnios - ANSWER ==A volume of amniotic fluid less than 300 mL during the third trimester.



Occurs when there is a renal system dysfunction or obstructive uropathy.



Absence of fetal kidneys will cause this.



What causes late decelerations? - ANSWER ==Fetal hypoxemia due to insufficient placental perfusion.



Treatment of late decelerations - ANSWER ==Reposition the client, initiate oxygen, and increase the infusion rate of IVF to enhance placental perfusion.



What causes early decelerations? - ANSWER            ==Fetal head compression.



What causes variable decelerations? - ANSWER ==Compression of the umbilical cord.



Often occurs after ROM.



Nagele's rule - ANSWER         ==Count back 3 months from the first day of the LMP, then add 7 days.



Most accurate means of obtaining client's F&E status? - ANSWER   ==Daily weights!



Placenta previa - ANSWER ==The placenta implants in the lower part of uterus and obstructs the cervical os.



Avoid vaginal examinations, which can cause tearing of the placenta and increased bleeding.



What should you do if a client that is in labor has moderate bright red vaginal bleeding?

- ANSWER ==Obtain blood samples for baseline laboratory values (Hgb and Hct).

 





The patient should be on strict pelvic rest (no vaginal exams or ultrasounds).



Early manifestation of gestation HTN or pre-eclampsia - ANSWER ==Blurred or double vision



Swollen face



Decreased urinary output



Proteinuria



Decreased fetal activity



Should a pregnant patient be concerned about increased white vaginal discharge? - ANSWER ==No.



An increase in vaginal discharge can occur due to the cervix becoming hyper-stimulated from an increase in hormones.



Probable signs of pregnancy - ANSWER         ==- Chadwick's sign

- Positive pregnancy test



Presumptive signs of pregnancy - ANSWER   ==Amenorrhea



Can also occur due to stress, endocrine disorders, and significant weight loss



Quickening (client's report of fetal movement)



Chadwick's sign - ANSWER ==A bluish discoloration in the cervix, vagina, and vulva that occurs at 6-8 weeks.



Probable sign of pregnancy.



After first pregnancy, the discoloration can remain, making it of little value as an indicator in subsequent pregnancies.



Positive signs of pregnancy - ANSWER   ==- Palpable fetal movements



Other causes of positive pregnancy test - ANSWER   ==- Menopause

-  Choriocarcinoma

-  Hydatidiform mole



HIV positive mother - ANSWER ==Continue to take zidovudine throughout pregnancy to decrease the risk of transmission to the newborn.

 





Use a condom during sexual intercourse.



NO BREASTFEEDING!



Bladder during abdominal US? - ANSWER ==Needs to be full to help lift the gravid uterus out of the pelvis during the exam.



Determining the length of the cervix? - ANSWER ==Transvaginal US.



Second and third trimesters to assess for preterm labor.