RN ATI Capstone Maternal Newborn and Womens Health 2026

1. Cancer Disorders: Risk Factors for Ovarian Cancer (Active Learning Template - System Disorder, RM AMS

RN 10.0 Chp 92)

a. Age greater than 40 years

b. Nulliparity or first pregnancy after 30 years of age

c. Family history of ovarian, breast, or genetic mutation for hereditary nonpolyposis colon cancer

(HNPCC)

d. BRCA1 or BRCA2 gene mutations

e. Diabetes mellitus

f. Early menarche/late menopause

g. History of dysmenorrhea or heavy bleeding

h. Endometriosis

i. High-fat diet (possible risk)

j. Hormone replacement therapy

k. Use of infertility medications

l. Older adult clients following surgery for cancer

2. Contraception: Contraindication to Intrauterine Device (Active Learning Template - Basic Concept, RM

MN RN 10.0 Chp 1)

RISKS/CONTRAINDICATIONS

• Best used by women in a monogamous relationship due to the risks of STIs
• Can cause irregular menstrual bleeding
• Risk of bacterial vaginosis, uterine perforation, or uterine expulsion
• Must be removed in the event of pregnancy

Contraindications: Active pelvic infection, abnormal uterine bleeding, severe uterine distortion; for

copper IUD also Wilson’s diseases and copper allergy

3. Contraception: Evaluating Client Understanding of an Intrauterine Device (Active Learning Template -

Medication, RM MN RN 10.0 Chp 1) A nurse is caring for a client who is considering use of a hormonal

intrauterine system. What information regarding the advantages of an Intrauterine Device (IUD) should the

nurse provide?

• Can maintain effectiveness for 1 to 10 years
• Can be inserted immediately after abortion, miscarriage, childbirth, and while breastfeeding
• Contraception can be reversed with immediate return to fertility
• Does not interfere with spontaneity
• Safe for mothers who are breastfeeding
• It is 99% effective in preventing pregnancy
• Hormonal IUDs: decrease menstrual pain and heavy bleeding
• Copper IUD: no hormones so it’s safe for women cautioned against hormonal birth methods

 Chemically active T-shaped device inserted through the cervix and placed in the uterus by the provider.

 Releases a chemical substance that damages sperm in transit to the uterine tubes and prevents

fertilization. The most effective contraceptive methods at preventing pregnancy are the long acting reversible contraceptive (LARC) methods: implant and IUDs.

 IUDs can be used by nulliparous and multiparous women.

 CLIENT EDUCATION: The device must be monitored monthly by clients after menstruation to ensure

the presence of the small string that hangs from the device into the upper part of the vagina to rule

out migration or expulsion of the device

4. Expected Physiological Changes During Pregnancy: Identifying a Client's Obstetrical History (Active

Learning Template - Basic Concept, RM MN RN 10.0 Chp 3)

Reproductive

Uterus increases in size and changes shape and position.

Ovulation and menses cease during pregnancy.

Cardiovascular

Cardiac output increases (30% to 50%) and blood volume increases (30% to 45% at term) to meet the greater

metabolic needs. Heart rate increases during pregnancy beginning around week 5 and reaches a peak

(10to15/min above pre-pregnancy rate) around 32weeks of pregnancy.

Respiratory

Maternal oxygen needs increase. During the last trimester, the size of the chest might enlarge, allowing for

lung expansion, as the uterus pushes upward. Respiratory rate increases and total lung capacity decreases.

Musculoskeletal

Body alterations and weight increase necessitate an adjustment in posture. Pelvic joints relax.

Gastrointestinal

Nausea and vomiting might occur due to hormonal changes and/or an increase of pressure within the

abdominal cavity as the pregnant client’s stomach and intestines are displaced within the abdomen.

Constipation might occur due to increased transit time of food through the gastrointestinal tract and, thus,

increased water absorption.

Renal

Filtration rate increases secondary to the influence of pregnancy hormones and an increase in blood volume

and metabolic demands. The amount of urine produced remains the same. Urinary frequency is common

during pregnancy.

Endocrine

The placenta becomes an endocrine organ that produces large amounts of hCG, progesterone, estrogen,

human placental lactogen, and prostaglandins. Hormones are very active during pregnancy and function to

maintain pregnancy and prepare the body for delivery

5. Infections: Caring for a Client in Labor Who Had a Positive Group B Streptococcus Screen (Active Learning

Template - System Disorder, RM MN RN 10.0 Chp 8) A nurse is caring for a client who was diagnosed with

group B streptococcus during her initial screening. What effects can this infection have on her pregnancy?

• Premature rupture of membranes

• Preterm labor and delivery

• Chrioamnionitis

• Infection of the urinary tract

• Maternal sepsis

Administer intrapartum antibiotic prophylaxis to the following clients:

 Client who has GBS bacteriuria during current pregnancy

 Client who has a GBS-positive screening during current pregnancy

 Client who has unknown GBS status who is delivering at less than 37 weeks of gestation

 Client who has maternal fever of 38° C (100.4° F)

 Client who has rupture of membranes for 18 hr or longer

6. Infertility: Risk Factors Affecting Fertility (Active Learning Template - Basic Concept, RM MN RN Chp 2)

 ASSESSMENT Female

 AGE: Age greater than 35 years can affect fertility.

 DURATION OF INFERTILITY: More than 1 year of coitus without contraceptives. For women over the

age 35 or who have a known risk factor, the recommendation is for 6months.

 MEDICAL HISTORY: Atypical secondary sexual characteristic, such as abnormal body fat distribution or

hair growth, is indicative of an endocrine disorder. Assessment should include hormonal and adrenal

gland disorders, as these can contribute to infertility.