ATI VATI maternal newborn remediation Completed for 2022/2023

ATI VATI maternal newborn remediation 1. Complete an ATI Focused Review® and send me a detailed summary (2-3 sentences each) of 4 concepts that you learned from the focused review. Interventions for prolapsed umbilica ...

ATI VATI maternal newborn remediation 1. Complete an ATI Focused Review® and send me a detailed summary (2-3 sentences each) of 4 concepts that you learned from the focused review. Interventions for prolapsed umbilical cord  Call for assistance immediately, notifying the provider  Reposition the client in a knee-chest , Trendelenburg or, side-lying position with a rolled towel under the client’s right or left hip to relieve pressure on the cord  Apply a warm, sterile, saline-soaked towel to the visible cord to prevent drying and maintain blood flow Priority interventions to prevent meconium aspiration  Assess neonate’s respiratory efforts, muscle tone, and heart rate  Suction mouth and nose using a bulb syringe if respiratory efforts are strong, muscle tone , and heart rate greater than 100/min  Suction below vocal cords using an endotracheal tube before spontaneous breath occurs if respirations are depressed, muscle tone decreased, and heart rate less than 100/min Findings of contraction stress test  Negative CST ( normal findings): Indicated if within a 10min period, with three uterine contractions, there are no late decelerations of the FHR  Positive CST ( abnormal finding): indicated with persistent and consistent late decelerations with 50% or more of the contractions; suggestive of uteroplacental insufficiency Fundal height  Immediately after delivery, the fundus should be firm, midline with the umbilicus, and approximately at the level of the umbilicus  At 12 hours postpartum, the fundus May be palpated at 1 cm above the umbilicus  Every 24 hrs , the fundus should descent approximately 1 to 2 cm Answer the following questions and review the suggested learning activities. Send me your answers here. 1. How can the nurse prevent infant abduction? Identification is applied to the newborn by the nurse immediately after birth. The nurse should ensure the information on the infant’s and parent’s bracelets matches exactly. It is an important safety measure to prevent the newborn from being given to the wrong parents, switched, or abducted. The newborn, client, and client’s partner are identified by plastic identification wristbands with permanent locks that must be cut to be removed. Identification bands should include the newborn’s name, sex, date, and time of birth, and client’s medical record number. The newborn should have one band placed on the ankle and one on the wrist. In addition, the newborn’s footprints and client’s finger print are taken. The above information is also included with the footprint sheet 2. A nurse is caring for a client during a nonstress test. What is the nurse's responsibility during the test and what teaching should be reinforced?  Obtaining information regarding the patient most current health status to identify any contraindications for implementing the stress testing.  Obtain informed consent as indicated as indicated.  Obtain an EKG. Operating appropriate exercise equipment as indicated.  Monitoring vital signs. What teaching should be reinforce  ECG stress testing is painless, has little risk, and does not use radiation.  During the procedure you will lie on a reclining chair. You will have your blood pressure taken at regular interval during test  Instruct the client to press the button on the handheld event marker each time she feels the fetus move. 3. What education should the nurse reinforce to the postpartum client regarding mastitis?  Improper latch is most common cause of nipple soreness and mastitis  Use ice packs or warm packs on her affected breasts for discomfort.  Begin breastfeeding from the unaffected breast first to initiate the letdown reflex in the affected breast that is distended or tender.  Continue breastfeeding frequently (at least every 2 to 4 hr), especially on the affected side. Instruct clients to manually express breast milk or use a breast pump if breastfeeding is too painful. If an abscess forms, it can cause contamination of breast milk. If this occurs, breastfeeding should be stopped and the breasts pumped until resolved. 4. How is Nagele's rule used to calculate the estimated date of birth? Naegele’s rule: Take the first day of the woman’s last menstrual cycle, subtract 3 months, and then add 7 days and 1 year, adjusting for the year as necessary. 5. What are abnormal findings during pregnancy that the client should be instructed to notify their provider about if they occur?  Vaginal bleeding  Convulsions/fits  Severe headaches with blurred vision  Fever and too weak to get out of bed  Swelling of fingers, face and legs  Fast or difficult breathing  Severe abdominal pain 6. A nurse is reinforcing teaching with a pregnant client who is diagnosed with iron deficiency anemia and has been prescribed iron supplements. Which of the following statements made by the client indicates an understanding of the teaching? A. "I will take the iron with ice water." B. "I will drink low-fat or whole milk with my iron." C. "I should drink tea or coffee with my medication." D. "I should take the medication with orange juice." 7. A pregnant client is prescribed iron supplements. Identify two (2) teaching points regarding iron absorption the nurse can reinforce in teaching to facilitate increase in red blood cell production during pregnancy. 1) Instruct the client to take the supplement on an empty stomach. 2) Encourage a diet rich in vitamin C-containing foods to increase absorption. 3) Suggest that the client increase roughage and fluid intake in the diet to assist with discomforts of constipation.8. The nurse is collecting data on a 10-week gestation client experiencing vomiting. What data would the nurse collect that are risks for developing hyperemesis gravidarum? Objective Data  Physical Findings  Excessive vomiting for prolonged periods and diarrhea  Dehydration with possible electrolyte imbalance  Weight loss  Increased pulse rate  Decreased blood pressure  Poor skin turgor and dry mucous membranes Laboratory Tests  Urinalysis for ketones and acetones (breakdown of protein and fat) is the most important initial laboratory test.  Elevated urine specific gravity.  Chemistry profile revealing electrolyte imbalances, such as: o Sodium, potassium, and chloride reduced from low intake o Acidosis resulting from excessive vomiting o Elevated liver enzymes  Thyroid test indicating hyperthyroidism.  Hct concentration is elevated because inability to retain fluid results in hemoconcentration. 9. The nurse is collecting data from a first trimester client with hyperemesis gravidarum. What symptoms would indicate dehydration?  Urine output less than 1 L/kg/hr  Urine-specific gravity more than 1.015  Weight loss  Dry mucous membranes  Poor skin turgor 10. What are three (3) nursing care interventions for the client who is using hydrotherapy during labor? 1) Taking warm or hot showers during labor can be incredibly relaxing to a laboring woman 2) Water has been known to reduce the intensity of pain and make the woman’s body more buoyant, lessening the pressure on the woman’s body and allowing her to progress in labor more comfortably. 3) Some facilities may allow giving birth in a bathtub. 11. A nurse is reviewing lab results for a newborn infant born at 38 weeks gestation, born 24 hours ago to an Rh negative mother. Which of the following results should be reported to the care provider? a. Blood glucose level of 45 mg/dL b. Total serum Bilirubin 12 mg/DL c. Blood type B positive d. Coombs Negative12. A postpartum client asks the nurse why her baby needs a newborn screen. What teaching should the nurse reinforce regarding why this test is necessary? - Newborn is tested for a group of health disorders that aren’t otherwise found at birth. With a simple blood test, doctors can check for rare genetic, hormone- related and metabolic conditions that can cause serious health problems. - Newborn screening helps us find babies who have certain serious medical conditions so that they can begin treatment right away. In most cases, these babies look normal and healthy at birth. They usually do not begin showing symptoms until a few weeks or months later. Newborn screening helps to diagnose these babies before they start showing symptoms. By starting treatment early, serious problems like illness, intellectual disabilities, or death can often be prevented. 13. The nurse is caring for a client who had a cesarean section two days ago and is now complaining of gas pain. What are three (3) teaching points the nurse should reinforce to the client to assist in alleviating the discomfort? Suggested Maternal Newborn Learning activity: Normal Postpartum care  Encourage coughing and deep breathing  Sacral counter pressure  Provide appropriate pain relief  Frequent maternal position changes 14. A nurse is reinforcing teaching to a pregnant client regarding fetal kick counts. What are two (2) teaching points the nurse should reinforce about completing kick counts?  Fetal movement/kick counts to ascertain fetal well-being  Diagnostic testing for fetal well- being (no stress test, biophysical profile, ultrasound, contraction stress test)  Observe for placental insufficiency Suggestion Maternal Newborn Learning Activity: Teaching Reinforcement for the Antenatal Client 15. A pregnant client is newly diagnoses with gestational diabetes. What are four (4) teaching points the nurse should reinforce to the client regarding hypoglycemia?  Blood glucose levels less than 45mg/dL should be followed up with serum glucose level  Check blood glucose before feeding  Feed early  Provide supplementation ( Oral, nasogastric gavage, intravenous)  An asymptomatic at risk newborn who has a blood glucose level 25mg/dL in the first 4hrs, or less than 35 mg/dL from 4 hours to 24 hrs of age should be offered oral feedings to increase levels to greater than 45 mg/dL  Initiate IV dextrose for a symptomatic newborn. Suggested Maternal Newborn Learning Activity: Gestational Diabetes