NUR 254 Units 1-3 Objectives: Pregnancy, Labor & Delivery Study Guide | Galen College of Nursing Maternal Newborn Review

Master the first half of your Maternal Newborn course with this comprehensive Units 1-3 study guide covering everything from conception through labor and delivery! This is the ultimate foundation for NUR 254. I've organized all the critical information from early pregnancy signs to labor stages into a clear, easy-to-memorize format with nursing interventions, priority actions, and must-know complications. What's Inside: Pregnancy Basics: Nägele's Rule: First day of LMP - 3 months + 7 days Presumptive vs. Probable vs. Positive Signs of Pregnancy—know the difference! Quickening: First fetal movements (16-20 weeks) Physiological Changes by System: Cardiovascular (↑HR, ↑blood volume), Renal (↑UTI risk), GI (N/V, constipation), Respiratory (SOB), Musculoskeletal (backache) Vena Cava Syndrome: Compression of vena cava—GET MOM ON HER SIDE! Prenatal Care & Testing: Rh Status: RhoGAM at 28 weeks if mom Rh(-), again within 72hrs postpartum if baby Rh(+) Rubella/Varicella: Titers checked in pregnancy, vaccine given postpartum Glucose Tolerance Test: Fast 12hrs, drink glucose, blood drawn at 1hr—goal 140 Nutrition: Folic Acid 400mcg/day (neural tube closes by 4-6 weeks!), Caffeine 200mg/day Weight Gain Guidelines: Underweight (28-40lbs), Normal (25-35lbs), Overweight (15-25lbs), Obese (11-20lbs) Iron Deficiency Anemia: Increase iron (meat, greens, nuts)—AVOID coffee/tea/milk with iron! Sickle Cell Crisis Prevention: IV fluids, pain control, minimize ischemia Pregnancy Complications (HIGH-YIELD): Preeclampsia: BP ≥140/90 after 20 weeks, proteinuria, headache, vision changes HELLP Syndrome: Hemolysis, Elevated Liver enzymes, Low Platelets—can lead to DIC! Magnesium Sulfate: Seizure prevention—Antidote = Calcium Gluconate! Therapeutic level: 4-7 mEq/L Toxicity S/S: Decreased RR, decreased DTRs, decreased LOC, cardiac arrest Common SE: Flushed, warm feeling, burning at IV site Seizure precautions: O2 and suction at bedside Preterm Labor (PTL): Risk factors (hx of PTL, multifetal, AMA, obesity, UTI), S/S (regular contractions, pelvic pressure, ROM), Treatment (hydration, tocolytics—magnesium, nifedipine, terbutaline) Placenta Previa vs. Abruptio Placentae: Previa: Painless BRIGHT RED bleeding—NO vaginal exams! Ultrasound diagnoses Abruption: Severe pain, DARK RED bleeding, rigid board-like abdomen—EMERGENCY! Cerclage: Stitches in cervix to prevent preterm birth—bed rest, monitor for infection Diabetes in Pregnancy: Insulin needs—1st trimester ↓, 2nd trimester ↑, 3rd trimester 2-4x more! Gestational Diabetes: Risk factors (obesity, AMA, hx of GD, large babies), management Labor & Delivery (The 5 P's): Passenger: Presentation, Position, Station, Lie, Attitude Passageway: Pelvis size & shape Powers: Contractions (effacement, dilation), Bearing-down reflex Position: Mom's position—left side improves circulation! Psychological: Anxiety, support, preparation Stages of Labor: 1st Stage (Onset of contractions → full dilation): Early (0-5cm), Active (6-10cm) 2nd Stage (Full dilation → delivery of baby): Latent (descent), Active (pushing) 3rd Stage (Delivery of baby → delivery of placenta) 4th Stage (Delivery of placenta → stable mom/baby) Nursing assessments and care for each stage! Fetal Monitoring (VEAL CHOP - MUST KNOW!): Variable decelerations = Cord compression Early decelerations = Head compression Accelerations = OK (healthy!) Late decelerations = Placental insufficiency How to document contractions: Frequency, Duration, Intensity Prolonged deceleration causes Labor Interventions: Rupture of Membranes (ROM): PRIORITY = check FHR first! Then assess color (clear), odor (odorless), amount (700-1000mL). Check temp Q2H. NST (Non-Stress Test): Looking for FHR accelerations (15 beats x 15 seconds with fetal movement) Induction of Labor: Reasons (HTN, fetal demise, chorioamnionitis, diabetes, post-term), methods (Pitocin, AROM) Oxytocin (Pitocin) Contraindications VBAC: Contraindicated with vertical incision or 3 previous c-sections Quick Facts: Group B Strep (+): ABX during delivery Fundal Height: At umbilicus by 20 weeks, at xiphoid by 36 weeks Umbilical Cord: 2 arteries, 1 vein DO NOT change litter box (toxoplasmosis risk!) False Labor: Irregular, improves with walking, pain in abdomen/groin True Labor: Regular, strengthens with walking, pain in back, cervical change Ultrasound Prep: Vaginal = empty bladder, Abdominal = full bladder Galen-Specific Content: Designed to align perfectly with NUR 254 Units 1-3 objectives. Topics Covered: Signs of Pregnancy (Presumptive, Probable, Positive) Physiological Changes in Pregnancy Prenatal Nutrition & Weight Gain RhoGAM & Rh Incompatibility Glucose Tolerance Testing Preeclampsia, Eclampsia, HELLP Magnesium Sulfate Administration & Toxicity Preterm Labor (PTL) Placenta Previa vs. Abruptio Placentae Gestational Diabetes Stages of Labor (1st, 2nd, 3rd, 4th) Fetal Monitoring & VEAL CHOP NST & Induction of Labor Rupture of Membranes (ROM) Assessment Cultural Considerations in Pregnancy Don't walk into your exam confused. Get the complete, organized review that covers everything from early pregnancy to delivery!