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ATI Maternal-Newborn Study Guide

ATI Maternal-Newborn Study Guide


Basic Care and Comfort

Client education: lactation suppression, engorgement
●Advantages
oAnyone can feed
oLess painful
oCan feed at any time
oKnow how much infant is getting
●Disadvantages
oEconomical-Expensive
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
●Pharmacological
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.
●Nonpharmacological
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
●Lochia
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
oAssess
▪Amount, color, and odor
▪Goes from Rubra, Serosa and Alba

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