ExamFinch.com My Study

Study guide

4.3 Maternal and Newborn Care (Antepartum)

Practice this exam

NCLEX-RN Registered Nurse

Track your progress as you read

Finished sections get a check mark.

1 Introduction

About the NCLEX-RN Exam Next Generation NCLEX (NGN) Clinical Judgment Measurement Model (NCJMM) How to Use This Course

2 Chapter 2: Management of Care

2.1 Legal Rights and Responsibilities 2.2 Advance Directives and Self-Determination 2.3 Informed Consent Protocols 2.4 Client Advocacy and Rights (HIPAA) 2.5 Assignment, Delegation, and Supervision 2.6 Five Rights of Delegation 2.7 Scope of Practice (RN vs LPN vs UAP) 2.8 Ethical Practice Principles

3 Chapter 3: Safety and Infection Prevention and Control

3.1 Standard Precautions and Hand Hygiene 3.2 Transmission-Based Precautions (Contact, Droplet, Airborne) 3.3 PPE Donning and Doffing Sequences 3.4 Fall Prevention and Restraints 3.5 Fire Safety (RACE/PASS) 3.6 Disaster Triage and Emergency Response

4 Chapter 4: Health Promotion and Maintenance

4.1 Growth and Development (Erikson/Piaget) 4.2 Developmental Stages: Infancy through Older Adult 4.3 Maternal and Newborn Care (Antepartum) 4.4 Intrapartum Care and Fetal Monitoring 4.5 Postpartum Care (BUBBLE-HE) 4.6 Health Screening Guidelines 4.7 Immunization Schedules

5 Chapter 5: Psychosocial Integrity

5.1 Therapeutic Communication Techniques 5.2 Non-Therapeutic Communication (What to Avoid) 5.3 Anxiety Disorders and Mental Health Concepts 5.4 Schizophrenia: Hallucinations and Delusions 5.5 Depression and Suicide Assessment 5.6 Substance Misuse and Withdrawal 5.7 Grief and End-of-Life Care

6 Chapter 6: Basic Care and Comfort

6.1 Mobility and Hazards of Immobility 6.2 Assistive Devices (Crutches, Canes, Walkers) 6.3 Nutrition and Diet Therapy 6.4 Enteral Nutrition (Tube Feeding) 6.5 Bowel Elimination and Ostomy Care 6.6 Urinary Elimination and Catheter Care

7 Chapter 7: Pharmacological and Parenteral Therapies

7.1 Medication Administration Rights 7.2 Medication Calculations 7.3 High-Alert Medications: Insulins 7.4 High-Alert Medications: Anticoagulants 7.5 High-Alert Medications: Opioids 7.6 High-Alert Medications: Digoxin and Electrolytes 7.7 IV Therapy and Complications 7.8 Blood Product Administration 7.9 Total Parenteral Nutrition (TPN)

8 Chapter 8: Reduction of Risk Potential

8.1 Laboratory Values: Hematology (CBC) 8.2 Laboratory Values: Metabolic Panel (BMP) 8.3 Laboratory Values: Coagulation Studies 8.4 Vital Signs and Trend Recognition 8.5 Perioperative Care (Pre-Op and Post-Op) 8.6 Nasogastric Tubes and Therapeutic Procedures

9 Chapter 9: Physiological Adaptation

9.1 Fluid Imbalances (Hypovolemia and Hypervolemia) 9.2 Arterial Blood Gases (ABGs) and Acid-Base Balance 9.3 Medical Emergencies: Stroke (CVA) 9.4 Medical Emergencies: Myocardial Infarction (MONA) 9.5 Diabetic Emergencies (Hypoglycemia and DKA) 9.6 Respiratory Conditions (COPD, Pneumonia) 9.7 Cardiac Conditions (Heart Failure) 9.8 Neurological Conditions (Seizures)

4.3 Maternal and Newborn Care (Antepartum)

Key Takeaways Explain This Topic AI

Naegele's Rule calculates EDD: First day of LMP minus 3 months plus 7 days (assumes 28-day cycle with ovulation on day 14)

GTPAL documents obstetric history: Gravida (total pregnancies), Term births, Preterm births, Abortions/miscarriages, Living children

Folic acid 400 mcg daily before conception and during first trimester prevents neural tube defects (spina bifida, anencephaly)

Warning signs requiring immediate evaluation include vaginal bleeding, severe headache, visual changes, epigastric pain, and decreased fetal movement

First trimester discomforts (nausea, fatigue, breast tenderness) differ from second trimester (heartburn, constipation, hemorrhoids) and third trimester (dyspnea, edema, back pain)

Last updated: January 2026

Antepartum Care Overview

Antepartum care encompasses all nursing care during pregnancy, from conception to the onset of labor. The goals are to monitor maternal and fetal well-being, provide anticipatory guidance, and identify complications early.

  • Dating the Pregnancy
  • Naegele's Rule

Naegele's Rule calculates the Estimated Date of Delivery (EDD):

  • First day of Last Menstrual Period (LMP) - 3 months + 7 days = EDD
  • Example
  • LMP: March 15, 2026
  • March 15 minus 3 months = December 15
  • December 15 plus 7 days = December 22, 2026
  • Important Assumptions
  • Regular 28-day menstrual cycle
  • Ovulation on day 14
  • Accurate LMP date

If LMP is uncertain, ultrasound dating (most accurate in first trimester) is used.

  • Pregnancy Duration
  • 40 weeks (280 days) from LMP
  • 38 weeks from conception
  • Term : 37-42 weeks
  • Preterm : Before 37 weeks
  • Post-term : After 42 weeks
  • GTPAL: Obstetric History

GTPAL documents a woman's complete pregnancy history:

  • Letter Meaning Description
  • G Gravida Total number of pregnancies (including current)
  • T Term Births at 37+ weeks
  • P Preterm Births at 20-36 weeks
  • A Abortions Losses before 20 weeks (spontaneous or elective)
  • L Living Number of living children
  • Example

A woman pregnant for the fourth time with two living children born at term, one preterm birth (deceased), and one miscarriage at 10 weeks:

  • G4 T2 P1 A1 L2
  • Exam Tip

Current pregnancy counts in the Gravida (G) but NOT in T, P, or A until delivery occurs.

  • Prenatal Nutrition
  • Key Nutritional Requirements
  • Nutrient Recommendation Purpose
  • Folic Acid 400-800 mcg daily Prevents neural tube defects
  • Iron 27 mg daily Supports increased blood volume
  • Calcium 1,000 mg daily Fetal bone development
  • Protein 60-75 g daily Tissue growth
  • Calories +300 kcal/day (2nd-3rd trimester) Energy needs
  • Folic Acid
  • Begin BEFORE conception (ideally 1-3 months prior)
  • Continue through first trimester minimum
  • Prevents neural tube defects (spina bifida, anencephaly)
  • Found in fortified cereals, leafy greens, legumes
  • Foods to Avoid
  • Food Reason
  • Raw/undercooked meat, fish Bacterial/parasitic infection
  • High-mercury fish (shark, swordfish, king mackerel) Fetal neurotoxicity
  • Unpasteurized dairy/juice Listeria risk
  • Deli meats (unless heated) Listeria risk
  • Raw eggs Salmonella risk
  • Alcohol Fetal alcohol spectrum disorders
  • Prenatal Discomforts by Trimester
  • First Trimester
  • Discomfort Management
  • Nausea/Vomiting Small, frequent meals; avoid empty stomach; ginger; vitamin B6
  • Fatigue Rest when possible; adequate sleep; iron levels checked
  • Breast tenderness Supportive bra
  • Urinary frequency Normal; rule out UTI if painful
  • Second Trimester
  • Discomfort Management
  • Heartburn Small meals; avoid lying down after eating; antacids as approved
  • Constipation Increase fluids, fiber, activity
  • Hemorrhoids Fiber, fluids, sitz baths, witch hazel
  • Leg cramps Stretch; calcium/magnesium balance
  • Third Trimester
  • Discomfort Management
  • Dyspnea Upright positioning; small meals
  • Edema Elevate legs; avoid prolonged standing; assess for preeclampsia
  • Back pain Good posture; supportive footwear; pelvic tilt exercises
  • Braxton Hicks Hydration; rest; distinguish from true labor
  • Warning Signs in Pregnancy

Teach patients to report immediately:

  • DANGER Signs Mnemonic
  • D - Dysuria with fever
  • A - Abdominal pain (severe)
  • N - Nausea/vomiting (severe, persistent)
  • G - Gush of fluid (ruptured membranes)
  • E - Edema (face/hands - preeclampsia)
  • R - Reduced fetal movement
  • Additional Warning Signs
  • Sign Possible Condition
  • Vaginal bleeding Placenta previa, abruption, miscarriage
  • Severe headache Preeclampsia
  • Visual changes (blurring, spots) Preeclampsia
  • Epigastric pain Preeclampsia (HELLP syndrome)
  • Temperature >100.4°F (38°C) Infection
  • Decreased fetal movement Fetal distress
  • Fetal Assessment
  • Fetal Heart Rate (FHR)
  • Normal range : 110-160 bpm
  • First heard with Doppler at 10-12 weeks
  • Fetoscope audible at 18-20 weeks
  • Quickening
  • First fetal movement felt by mother
  • Primigravida: 18-20 weeks
  • Multigravida: 16-18 weeks
  • Kick Counts
  • Begin at 28 weeks
  • Goal: 10 movements in 2 hours (varies by method)
  • Decreased movement = needs evaluation
  • Prenatal Visits
  • Schedule
  • Gestational Age Visit Frequency
  • 0-28 weeks Every 4 weeks
  • 28-36 weeks Every 2 weeks
  • 36-40 weeks Weekly
  • Standard Assessments Each Visit
  • Weight
  • Blood pressure
  • Urine (protein, glucose)
  • Fundal height
  • Fetal heart rate
  • Fetal movement inquiry