Maternal, Newborn and Women's Health Nursing
What candidates must know
Antepartum: GTPAL, estimated date of delivery, routine antenatal labs, and danger signs. Intrapartum: stages of labour, cervical change, and fetal heart monitoring interpretation. Postpartum: the BUBBLE-HE assessment (breasts, uterus, bladder, bowel, lochia, episiotomy, Homan sign, emotions). Newborn: transition to extrauterine life, APGAR at 1 and 5 minutes, thermoregulation, feeding cues, and jaundice.
Fetal monitoring
Early decelerations mirror contractions (head compression, benign). Variable decelerations are abrupt V shapes from cord compression - reposition, often knee-chest or side-lying, and check for prolapse. Late decelerations begin after the contraction peak and reflect uteroplacental insufficiency - turn to left lateral, give oxygen, stop oxytocin, notify. Category III tracings need the provider now.
Emergencies
Postpartum haemorrhage: fundal massage first, then uterotonics; a boggy uterus is the usual cause. Preeclampsia: magnesium sulfate with monitoring of deep tendon reflexes, respiratory rate, and urine output; loss of reflexes or a respiratory rate under 12 means stop the infusion and give calcium gluconate. Prolapsed cord: knee-chest, elevate the presenting part, never attempt to replace the cord.
Traps
Items blur 'expected' with 'abnormal' - a 1-minute APGAR of 7 with a lusty cry is expected. Distinguish lochia rubra, serosa, and alba by timing, and remember breastfeeding is compatible with most situations.
Worked rule
Name the deceleration, then match the action: early = no action; variable = reposition; late = reposition, oxygen, stop oxytocin, notify.