NUR202 — Pregnancy, Labor & Birth
NUR 202
Pregnancy, Labor & Birth
Study Guide & Cheat Sheet
Covers: Labor & Birth Part 1 • Birth Part 2 • Pain Management & Complications
Built from live lecture recording (Olivia, RN)
Use alongside Canvas modules, the posted PowerPoints, and the instructor's updated study guide.
PART 1 — STUDY GUIDE | PART 2 — QUICK-REFERENCE CHEAT SHEET
Page 1
, NUR202 — Pregnancy, Labor & Birth
PART 1 — STUDY GUIDE
This section walks through each high-yield topic the instructor emphasized, with the reasoning behind the correct
answers — not just the facts, but the "why," since exam questions are scenario-based.
1. Factors Affecting Uncomplicated Labor — The 5 Ps
• Power — uterine contractions: frequency, duration, intensity; also maternal pushing effort
• Passenger — the fetus: presentation, position, lie, and attitude are the highest-yield sub-topics
• Passage — the maternal pelvis (true pelvis: inlet, mid-pelvis, outlet)
• Psyche — maternal mental state, fatigue, and support system
• Position — of the laboring client (repositioning is a first-line nursing action for many complications)
During any contraction, always monitor two things together: fetal heart rate (FHR) and maternal vital signs. Both an
increase or a decrease from baseline can be concerning — always compare to the scenario given, not an absolute
number.
2. Maternal & Fetal Adaptations to Labor
Know what is physiologically normal for both mother and baby during labor — this is tested as straightforward recall.
• When membranes rupture (mother's "water breaks"), immediately assess FHR — the fetus has lost its cushioning
fluid, raising the risk of umbilical cord compression or cord prolapse.
• Cord compression → classic sign is a variable deceleration on the fetal monitor.
3. Priority Scenario — Oxytocin + Sudden FHR Drop
Classic NCLEX-style trap: Mother is on IV oxytocin; FHR suddenly drops.
Correct first action: Reposition the mother (e.g., side-lying) to relieve cord compression.
You will also stop the oxytocin and apply oxygen — but repositioning is the immediate first step because the
underlying problem is cord compression, not the medication itself. Read the whole scenario before choosing — don't
jump to "stop the drug" as the automatic first answer.
4. Stages of Labor
• Stage 1 — onset of true labor → full dilation (10 cm). Includes latent, active (6–10 cm), and transition phases.
• Stage 2 — full dilation → birth of the baby.
• Stage 3 — birth of baby → delivery of the placenta.
• Stage 4 — recovery period (first 1–4 hours postpartum); fundal checks and hemorrhage risk are priorities here.
Know the numeric definitions of each stage cold — these are tested directly (e.g., "a patient is 7 cm dilated and
contracting q3min — what stage/phase is she in?").
5. Normal Labor Contraction Pattern (Key Numbers)
• Duration of a contraction: about 60 seconds
• Frequency: about every 2–5 minutes, start to start
• Resting period between contractions: about 2–4 minutes — this is the recovery time that protects fetal oxygenation,
so watch for contractions that don't relax (tachysystole).
6. The True Pelvis
The true pelvis has three parts the baby travels through:
• Pelvic inlet — entrance
• Mid-pelvis (pelvic cavity) — where the ischial spines are located; this is the landmark for "0 station"
Page 2
NUR 202
Pregnancy, Labor & Birth
Study Guide & Cheat Sheet
Covers: Labor & Birth Part 1 • Birth Part 2 • Pain Management & Complications
Built from live lecture recording (Olivia, RN)
Use alongside Canvas modules, the posted PowerPoints, and the instructor's updated study guide.
PART 1 — STUDY GUIDE | PART 2 — QUICK-REFERENCE CHEAT SHEET
Page 1
, NUR202 — Pregnancy, Labor & Birth
PART 1 — STUDY GUIDE
This section walks through each high-yield topic the instructor emphasized, with the reasoning behind the correct
answers — not just the facts, but the "why," since exam questions are scenario-based.
1. Factors Affecting Uncomplicated Labor — The 5 Ps
• Power — uterine contractions: frequency, duration, intensity; also maternal pushing effort
• Passenger — the fetus: presentation, position, lie, and attitude are the highest-yield sub-topics
• Passage — the maternal pelvis (true pelvis: inlet, mid-pelvis, outlet)
• Psyche — maternal mental state, fatigue, and support system
• Position — of the laboring client (repositioning is a first-line nursing action for many complications)
During any contraction, always monitor two things together: fetal heart rate (FHR) and maternal vital signs. Both an
increase or a decrease from baseline can be concerning — always compare to the scenario given, not an absolute
number.
2. Maternal & Fetal Adaptations to Labor
Know what is physiologically normal for both mother and baby during labor — this is tested as straightforward recall.
• When membranes rupture (mother's "water breaks"), immediately assess FHR — the fetus has lost its cushioning
fluid, raising the risk of umbilical cord compression or cord prolapse.
• Cord compression → classic sign is a variable deceleration on the fetal monitor.
3. Priority Scenario — Oxytocin + Sudden FHR Drop
Classic NCLEX-style trap: Mother is on IV oxytocin; FHR suddenly drops.
Correct first action: Reposition the mother (e.g., side-lying) to relieve cord compression.
You will also stop the oxytocin and apply oxygen — but repositioning is the immediate first step because the
underlying problem is cord compression, not the medication itself. Read the whole scenario before choosing — don't
jump to "stop the drug" as the automatic first answer.
4. Stages of Labor
• Stage 1 — onset of true labor → full dilation (10 cm). Includes latent, active (6–10 cm), and transition phases.
• Stage 2 — full dilation → birth of the baby.
• Stage 3 — birth of baby → delivery of the placenta.
• Stage 4 — recovery period (first 1–4 hours postpartum); fundal checks and hemorrhage risk are priorities here.
Know the numeric definitions of each stage cold — these are tested directly (e.g., "a patient is 7 cm dilated and
contracting q3min — what stage/phase is she in?").
5. Normal Labor Contraction Pattern (Key Numbers)
• Duration of a contraction: about 60 seconds
• Frequency: about every 2–5 minutes, start to start
• Resting period between contractions: about 2–4 minutes — this is the recovery time that protects fetal oxygenation,
so watch for contractions that don't relax (tachysystole).
6. The True Pelvis
The true pelvis has three parts the baby travels through:
• Pelvic inlet — entrance
• Mid-pelvis (pelvic cavity) — where the ischial spines are located; this is the landmark for "0 station"
Page 2
