Maternal and Child Nursing
Core concepts
Maternal and child questions integrate normal physiology, risk recognition, and family-centered care. In antepartum care, know gravida and para, GTPAL, estimated date of delivery, danger signs, and screening for preeclampsia. In intrapartum care, understand the stages of labor, fetal monitoring, comfort measures, and signs of complications such as cord prolapse or uterine rupture. Postpartum priorities include uterine tone, bleeding, vital signs, pain, breastfeeding support, and emotional assessment. Newborn care emphasizes airway, warmth, glucose, feeding, elimination, jaundice, and infection prevention.
Traps to watch
Do not assume that a visibly calm mother is safe: postpartum hemorrhage often begins with uterine atony and may be hidden until shock appears. In preeclampsia with magnesium sulfate, monitor respirations, deep tendon reflexes, urine output, and level of consciousness; calcium gluconate is the antidote for magnesium toxicity. In newborn items, thermoregulation and respiratory effort outrank feeding or bonding in an unstable infant. Avoid giving oral feedings to a newborn with respiratory distress. Also distinguish normal lochia changes from heavy bleeding with clots.
Worked example: Naegele’s rule
If the first day of the last menstrual period is March 10, add 7 days and subtract 3 months: March 17 minus 3 months gives December 17 of the same year. Adjust for cycle length only when the item provides it.
Exam approach
Ask whether the client is antepartum, intrapartum, postpartum, or newborn. Then identify the greatest threat: breathing, circulation, bleeding, infection, or safety. Choose monitoring and immediate nursing action before lengthy teaching.