OB

Maternity Study Guide for Nursing Exam

Stages of Labor

  1. First Stage (Dilation)

    • Latent Phase: 0-3 cm dilation; contractions are mild and irregular.

    • Active Phase: 4-7 cm dilation; contractions are more intense and closer together.

    • Transition Phase: 8-10 cm dilation; strong contractions, with the urge to push.

  2. Second Stage (Expulsion)

    • Begins at complete dilation and ends with the birth of the baby.

    • Focus on pushing techniques and maternal positioning.

  3. Third Stage (Placental Delivery)

    • Delivery of placenta occurs after the birth.

  4. Fourth Stage (Recovery)

    • Postpartum recovery, monitoring for complications such as hemorrhage.

Contraction Assessment

  • Frequency: How often contractions occur (in minutes).

  • Duration: How long each contraction lasts (in seconds).

  • Intensity: Strength of contractions (can be assessed with palpation: mild, moderate, strong).

  • Resting tone: The state of uterine muscle between contractions; should be relaxed.

Safety Protocols

  • Always adhere to infection control practices: hand hygiene, use of personal protective equipment (PPE).

  • Continuous monitoring of maternal and fetal vitals.

  • Early identification of risks and complications (e.g., uterine rupture, fetal distress).

Postpartum Priorities

  • Assessment: Vital signs, uterine tone, lochia, and perineal care.

  • Emotional support: Monitor for signs of postpartum depression.

  • Education: Provide information on infant care and maternal recovery.

Newborn Care

  • Initial Assessment: APGAR scoring to evaluate newborn's health at 1 and 5 minutes after birth.

  • Warmth: Ensure the newborn is kept warm to prevent hypothermia.

  • Feeding: Encourage early breastfeeding or bottle feeding if breastfeeding is not possible.

Preeclampsia

  • Definition: A pregnancy complication characterized by high blood pressure and protein in urine.

  • Symptoms: Headaches, vision changes, swelling, and abdominal pain.

  • Management: Close monitoring, antihypertensives, and magnesium sulfate for seizure prophylaxis if severe.

HELLP Syndrome

  • Definition: A severe form of preeclampsia.

  • Signs: Hemolysis, elevated liver enzymes, low platelet count.

  • Management: Delivery of the baby is the definitive treatment; monitor for liver rupture and other complications.