Maternal and Newborn (Obstetric) Nursing
What you must understand
Know the stages of labour, normal fetal heart rate (110–160 bpm), the signs of true versus false labour, postpartum haemorrhage definitions, and the physiology of breastfeeding and involution. Understand pre-eclampsia (hypertension after 20 weeks with proteinuria or end-organ signs) and its complication, eclampsia.
Traps in questions
- Magnesium sulphate is given for seizure prophylaxis in pre-eclampsia. Monitor respirations, deep tendon reflexes, and urine output; the antidote is calcium gluconate.
- Postpartum haemorrhage - the most common cause is uterine atony; the first action is fundal massage and uterotonic medication, not waiting for lab results.
- Fetal decelerations - early decelerations are benign head compression; variable decelerations suggest cord compression (reposition); late decelerations suggest uteroplacental insufficiency (reposition, oxygen, notify).
- Lochia progresses rubra to serosa to alba; foul odour suggests infection.
Worked rule of thumb
For any deceleration, the first nursing action is reposition the mother to the left side and give oxygen, then reassess and notify. Late and variable decelerations are the ones that demand urgent action; early decelerations are usually reassuring.
Postpartum safety
Assess the fundus (firm, midline, at the umbilicus initially), lochia, and vital signs. A boggy fundus with heavy bleeding is an emergency requiring immediate massage and escalation.