ATI OB Maternal Newborn Exam Study Guide Video #1: Contraception & Infertility
Diaphragms: client must be refitted for a diaphragm for the following
... [Show More] conditions:
1. It’s been 2 years since she has been fitted
2. Gained more than 15 pounds (7kg)
3. Had a full-term pregnancy
4. Had a second term abortion
o When you use a diaphragm, you need to use spermicide with every act of coitus (withdrawal of penis from vagina prior to ejaculation). Every time you withdrawal, instill more spermicide.
o Diaphragm must stay inserted for 6hrs after act of coitus.
Hormonal Contraceptives (Oral)
o Side effects: Chest pain, SOB, Leg pain (from a possible clot), headache or eye problems (from a stroke or hypertension)
o Contraindications: Women with a history of blood clots, stroke, cardiac problems, smoker, breast or estrogen related cancers (pill contains estrogen)
Depo-Provera/Medroxyprogesterone
o Injectable progestin
o Can cause decreased bone mineral density or loss of calcium
Nursing action: Ensure patient has adequate intake of calcium and vitamin D
IUD
o Increase risk for PID
o Can cause uterine perforation or ectopic pregnancy (increases risk for ectopic pregnancy)
o Look out for/Notify PCP:
Change in string length IUD is moving and not in the right place
Foul smelling vaginal discharge
Pain with intercourse
Fever/Chills (infection)
Infertility is defined as an inability to conceive desire engaging in unprotected sexual intercourse for a prolonged period of time or at least 12 months.
Common factors associated with infertility include:
o Decreased sperm production (Sperm analysis)
o Endometriosis
o Ovulation disorders
o Tubal occlusions If you test and use DYE (used in the fallopian tubes), make sure the woman is not allergic to iodine or shellfish/seafood
Video #2: Signs of Pregnancy
Presumptive: Can be defined by things/reasons other than pregnancy
Amenorrhea Can be anorexic or exercising too much
Fatigue Didn’t sleep well
Nausea/Vomiting Sick
Urinary Frequency UTI
Quickening/Fluttering in stomach Gas
Probable: Changes that make the examiner suspect a woman is pregnant (primarily related to physical changes of the uterus).
Abdominal enlargement: Related to changes in uterine size, shape, and position
Hegar’s Sign: Softening and compressibility of the lower uterus Chadwick’s Sign: Deepend violet bluish color of cervix and vaginal mucosa Goodell’s Sign: Softening of cervical tip
Ballottement: Rebound of unengaged uterus
Braxton Hicks Contractions: False contractions that are painless, irregular, and usually relieved by walking
Positive Pregnancy Test: Woman’s hormonal level may not be normal
Fetal Outline: Positive: Very distinct things.
Fetal Heart Sounds
Fetal Heartbeat can be heard
Can see the baby with ultrasound
Can feel movement in the uterus
Naegele’s Rule: Last menstrual period minus (– ) 3 months + 7 days + 1-year ;Cathy’s Rule: + 9 months + 1 week
Gravidity and Parity:
Gravida: a woman who is pregnant
Gravidity: number of pregnancies
o Nulligravida: a woman who has never been pregnant
o Primigravida: a woman who is pregnant for the [Show Less]