This post is part of a series to help prepare the nursing student for specific areas of study. You can find how to prepare for nursing school Pediatric version (here) and the Medical Surgical version (here). Nursing school will provide you with the basic knowledge you need to pursue a career in Maternity. This post is here to provide you with some basic information to start creating that foundation or even refresh your memory.
Some books that I used throughout my Maternal Newborn class that helped me are listed below. You can click on the names to find out how much they cost on Amazon.
- Lippincott Q&A Review for NCLEX-RN
- Saunders Comprehensive Review for the NCLEX-RN Examination
- Maternal & Newborn Success: A Q&A Review Applying Critical Thinking to Test Taking
So let’s jump right in. Below you will find basic information you will need to know while in nursing school. You will need to be able to apply this information to answer test questions and care of your patients while in clinical. I will be honest and say that Maternity was not my cup of tea or in my case cup of coffee but it is necessary and important to know this information. Also, please remember that every program is different in terms of what they teach. This information is fundamental and you will need to know the information listed below.
During labor the nurse will set up the pregnant patient up to an electronic fetal monitor that will check the fetal heart rate and monitor how the baby is handling the mothers contractions. As a nurse you will need to be able to interpret the monitor to determine if the baby is safe or in distress. You will also need to know what types of interventions to take when needed. The strip below shows an example of how the tracing may appear. Remember accelerations equal an increase in fetal heart rate and decelerations are a decrease in heart rate.
- Variable Decelerations
This type of tracing is not good. This can occur at any time or when the mother is having a contraction and the fetal heart rate drops drastically. The normal fetal heart rate should be around 160 bpm. The cause of this deceleration is umbilical cord compression. The correct answer on a test is always to change the position of the patient to her left side and administer oxygen.
- Early Decelerations
This is when the fetal heart rate decreases slightly due to head compression. They occur in sync with the mothers contractions. They should return to normal when the contraction has passed. The nurse should continue to monitor the patient.
This occurs when the fetal heart rate increases and it can occur with the maternal contraction of at any point. They are reassuring and show fetal movement and stimulation.
- Late Decelerations
This type of tracing is not good either. This occurs when the mother has a contraction but the fetal heart drops after the contraction has started and returns to baseline after the contraction has already ended. The cause of this is uteroplacental insufficiency and can cause fetal hypoxia. The nurse should turn the patient to her left side and administer oxygen.
Of course there is a trick to memorize the information listed above! It also will be helpful for you to do a google search and view the different types of tracings. Okay…the easy way to remember the types of tracings and their causes because you need to know what is causes the problem to fix it.
You will need to know how to calculate the due date for a pregnant women. In nursing school you will need to memorize this rule. It is based of the women’s last menstrual cycle.
- Determine the last menstrual date.
- Subtract 3 months.
- Add 7 days.
- Add 1 year.
Example: If a women’s last menstrual cycle was September 20, 2016 her due date would be June 27, 2017.
Stages of Labor
As a nursing student, you will be required to know the stages of labor and specific interventions based on each stage. You should familiarize yourself with the chart below to understand what each stage consists of.
Labor and Birth of the Fetus
This topic covers a ton of information and lots of terms that you will hear and need to understand. I am including a link to a website that focuses on the information (here) just because the information is extensive. This site has some great information and pictures that help explain. Some terms you should familiarize yourself with are: Fetal Attitude, Fetal Presentation, Fetal Lie, Station and Engagement. You should also learn and be able to locate the sutures and bones of the fetal skull. You will need to use this information to answer test questions and also to be able to perform a newborn assessment.
Speaking of the newborn assessment nursing school requires you to know the reflexes that the newborn possess. These include moro or startle reflex, step reflex, crawl reflex, palmer grasp reflex and the root and suck reflex. You will also need to be able to perform an APGAR score on the newborn. This is done at 1 minute and 5 minutes after the birth of the newborn. This score determines how the newborn is doing at birth and handling external life. You will need to know what score requires intervention and what is a good score.
Misc. Maternity Topics of Importance
Below are some topics you should become familiar with during your rotation through maternity.