OB Maternal Newborn ATI Exam Study Guide

Video #1: Contraception & Infertility

 Diaphragms: client must be refitted for a diaphragm for the following 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