Semester 4
Two patients, one bed, no time to hesitate.
OB moves faster than any other clinical rotation, and it's the one where the 'stable' patient becomes an emergency in ninety seconds. Fetal strips, postpartum hemorrhage, and preeclampsia are the three things that will show up on your exam, your clinical, and your worst shift.
The single most-tested OB concept in nursing school.
Memory trick
VEAL CHOP: Variable = Cord compression, Early = Head compression (benign), Accelerations = Okay, Late = Placental insufficiency (bad). Variable and Late both need action; Early does not.
Early is fine, Variable means squeeze, Late means the placenta is failing. Move.
You need the cause to pick the intervention.
Memory trick
Tone (uterine atony — most common), Trauma (laceration), Tissue (retained placenta), Thrombin (coagulopathy). Atony: massage, empty bladder, oxytocin, then methylergonovine (NOT in hypertension) or carboprost (NOT in asthma), tranexamic acid.
Methergine and high BP don't mix. Hemabate and asthma don't mix. Know your patient before you push.
Two topics that are always fused together on exams.
Memory trick
Severe features: SBP ≥160 or DBP ≥110, headache, visual changes, RUQ pain, platelets <100k, elevated LFTs, proteinuria. Mag prevents seizures, it doesn't lower BP. Monitor: reflexes (first to go), respirations ≥12, urine output ≥30 mL/hr, LOC. Antidote: calcium gluconate at the bedside.
Reflexes gone = mag is too high. Stop it before the respirations follow.
Interventions are stage-specific.
Memory trick
Stage 1: onset to 10 cm (latent 0–5, active 6–10). Stage 2: complete to birth (pushing). Stage 3: birth to placenta (5–30 min). Stage 4: first 1–4 hours postpartum — the hemorrhage window, vitals q15 min.
BUBBLE-HE is used in clinical and on your final.
Memory trick
Breasts, Uterus (firm, midline, position relative to umbilicus), Bladder (a full bladder displaces the fundus and causes bleeding), Bowel, Lochia (rubra 1–3 days → serosa → alba), Episiotomy/perineum, Homan's/DVT signs, Emotions.
Fundus off to the right? That's a full bladder. Make them pee before you panic.
First-minute decisions and a scoring system you'll use for real.
Memory trick
APGAR at 1 and 5 minutes: Appearance, Pulse, Grimace, Activity, Respirations — 0–2 each. 7–10 normal, 4–6 needs support, 0–3 resuscitate. Normal newborn: HR 110–160, RR 30–60, glucose >40. Cold stress burns glucose fast — dry and warm immediately.
Patient teaching questions are built from this list.
Memory trick
Report immediately: vaginal bleeding, gush of fluid, severe headache, visual changes, epigastric or RUQ pain, decreased fetal movement, persistent vomiting, painful urination, contractions before 37 weeks.
One you never examine, one you never miss.
Memory trick
Previa = PAINLESS bright red bleeding, soft uterus, NO vaginal exam ever. Abruption = PAINFUL dark bleeding, rigid board-like uterus, fetal distress, possible concealed bleeding.
Painless = previa. Painful and hard as a rock = abruption. Two words separate them.
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Nursing Fundamentals
Semester 1
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Pharmacology
Semester 2
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Med-Surg I
Semester 2
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Med-Surg II
Semester 3
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Pediatrics
Semester 3
