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ATI Maternal-Newborn Study Guide

ATI Maternal-Newborn Study Guide

Basic Care and Comfort

Client education: lactation suppression, engorgement
oAnyone can feed
oLess painful
oCan feed at any time
oKnow how much infant is getting
oCan mix wrong
oLess immunity
oNeed to prepare it: Mix and warm it
▪Considerations for Mom
●Supportive bras/bind breasts
●Avoid nipple stimulation
●Apply ice packs or frozen cabbage leaves for engorgement
●Suppression of lactation is necessary for clients who are not breastfeeding. Avoid breast stimulation and running warm water over the breasts for prolonged periods until no longer lactating.
Hyperemesis gravidarum
▪Excessive vomiting
▪May be hospitalized for this
▪Unknown etiology
▪Usually 0-12 weeks
▪Treat with: IV fluids, Phenergan, Prilosec, Reglan, Zofran, TPN if severe
▪Small frequent bland meals
Nutrition during pregnancy
▪Need extra 340 calories a day
▪Double for twins
oIncrease caloric intake by 340 calories per day, should get a minimum of 2200 calories per day
oIncrease water intake 8-10 cups a day
oAvoid sodium rich foods
oAvoid raw fish
oSoft cheese unless it is pasteurized
oNormal BMI gain between 25-35 lbs
▪Most weight gain is in the last trimester

Pain management during labor: pharmacological and nonpharmacological
oIncludes systemic analgesia and local/regional analgesics.
oOpioids/Epidural; To avoid slowing the progress of labor, prior to administering analgesic medications, the nurse should verify that labor is well established by performing a vaginal exam and evaluating uterine contraction pattern. Alleviates pain sensations or raises the threshold for pain perception.
oContinuous labor support Ambulation and position changes Acupuncture and acupressure Attention focusing and imagery
Therapeutic touch and massage; effleurage
Breathing techniques (e.g., patterned-paced breathing) Hydrotherapy
Postpartum assessment findings
●PP Assessment
oVitals are important; including pain
●Fundal Assessment
oWant a firm centrally located fundus
▪If not midline typically shifted to right due to bladder; caused uterus to become boggy
▪Every 24hrs drop 1 fingerbreath below umbilicus
▪First action for a boggy uterus is massage
oBleeding post-delivery
oFirst 24 hours it should be dark red, scant to moderate amount
oShould not saturate 1 peripad in 15 min.
oAmount should decrease over time
oStill see blood even after a c-sx
▪Counter pressure on incision line is important when performing an assessment
▪Amount, color, and odor
▪Goes from Rubra, Serosa and Alba

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