🤰 Maternal-Newborn & OB Mastery: 2026
NGN Edition
Comprehensive Cheat Sheets + 30 High-Yield MCQs + Detailed Rationales
Shop: Premium Nursing Resources
© 2026 All Rights Reserved
📑 Section 1: The Foundations
GTPAL Scoring System
G (Gravida): Total number of pregnancies (current included).
T (Term): Delivered at 37 weeks 0 days+.
P (Preterm): Delivered between 20w 0d and 36w 6d.
A (Abortion): Ended before 20 weeks (spontaneous or induced).
L (Living): Number of currently living children.
Naegele’s Rule (Due Date Calculation)
Formula: Last Menstrual Period + 7 Days - 3 Months + 1 Year
Example: LMP June 10, 2025 → EDD: March 17, 2026.
📑 Section 2: Fetal Monitoring & Labor
The VEAL CHOP Mnemonic
Variable Decels → Cord Compression (Intervention: Move client).
Early Decels → Head Compression (Intervention: Normal/Monitor).
Accelerations → Okay! (Intervention: None).
Late Decels → Placental Insufficiency (Intervention: LION).
LION Protocol for Late Decels:
L: Left Side Position.
, I: IV Fluid Bolus.
O: Oxygen (8-10L via Face Mask).
N: Notify Provider & Discontinue Oxytocin.
📑 Section 3: OB Pharmacology Table
Medication Indication Nursing Considerations & Side Effects
Preeclampsia / Antidote: Calcium Gluconate. Monitor for absent DTRs
Magnesium Sulfate
Seizures and RR <12.
Labor Induction / Stop if contractions >90 sec or <2 min apart. Monitor
Oxytocin (Pitocin)
PPH FHR closely.
Preterm Labor Hold for Maternal HR >120. Causes tremors and
Terbutaline
(Tocolytic) tachycardia.
Steroid given IM to mom; stimulates surfactant
Betamethasone Fetal Lung Maturity
production.
Rho(D) Immune Given at 28 weeks and within 72 hours of birth to Rh-
Rh Incompatibility
Globulin moms.
Postpartum
Methylergonovine Contraindicated in Hypertension/Preeclampsia.
Hemorrhage
Misoprostol Cervical Ripening /
Monitor for uterine tachysystole.
(Cytotec) PPH
📑 Section 4: 30 High-Yield Practice Questions
Q1. A client at 34 weeks gestation reports sudden, painless, bright red vaginal bleeding. Which action
is strictly contraindicated?
A. Placing the client on bed rest.
B. Performing a manual vaginal examination.
C. Initiating a non-stress test (NST).
D. Obtaining a CBC and Type & Screen.
Q2. (SATA) A nurse is monitoring a client on Magnesium Sulfate for Preeclampsia. Which findings
indicate Magnesium toxicity? Select all that apply.
A. Respiratory rate of 10 breaths/min.
B. Deep tendon reflexes (DTRs) of 0 or 1+.
C. Urine output of 50 mL/hr.
D. Altered mental status/Slurred speech.
E. Serum Magnesium level of 6 mEq/L.
NGN Edition
Comprehensive Cheat Sheets + 30 High-Yield MCQs + Detailed Rationales
Shop: Premium Nursing Resources
© 2026 All Rights Reserved
📑 Section 1: The Foundations
GTPAL Scoring System
G (Gravida): Total number of pregnancies (current included).
T (Term): Delivered at 37 weeks 0 days+.
P (Preterm): Delivered between 20w 0d and 36w 6d.
A (Abortion): Ended before 20 weeks (spontaneous or induced).
L (Living): Number of currently living children.
Naegele’s Rule (Due Date Calculation)
Formula: Last Menstrual Period + 7 Days - 3 Months + 1 Year
Example: LMP June 10, 2025 → EDD: March 17, 2026.
📑 Section 2: Fetal Monitoring & Labor
The VEAL CHOP Mnemonic
Variable Decels → Cord Compression (Intervention: Move client).
Early Decels → Head Compression (Intervention: Normal/Monitor).
Accelerations → Okay! (Intervention: None).
Late Decels → Placental Insufficiency (Intervention: LION).
LION Protocol for Late Decels:
L: Left Side Position.
, I: IV Fluid Bolus.
O: Oxygen (8-10L via Face Mask).
N: Notify Provider & Discontinue Oxytocin.
📑 Section 3: OB Pharmacology Table
Medication Indication Nursing Considerations & Side Effects
Preeclampsia / Antidote: Calcium Gluconate. Monitor for absent DTRs
Magnesium Sulfate
Seizures and RR <12.
Labor Induction / Stop if contractions >90 sec or <2 min apart. Monitor
Oxytocin (Pitocin)
PPH FHR closely.
Preterm Labor Hold for Maternal HR >120. Causes tremors and
Terbutaline
(Tocolytic) tachycardia.
Steroid given IM to mom; stimulates surfactant
Betamethasone Fetal Lung Maturity
production.
Rho(D) Immune Given at 28 weeks and within 72 hours of birth to Rh-
Rh Incompatibility
Globulin moms.
Postpartum
Methylergonovine Contraindicated in Hypertension/Preeclampsia.
Hemorrhage
Misoprostol Cervical Ripening /
Monitor for uterine tachysystole.
(Cytotec) PPH
📑 Section 4: 30 High-Yield Practice Questions
Q1. A client at 34 weeks gestation reports sudden, painless, bright red vaginal bleeding. Which action
is strictly contraindicated?
A. Placing the client on bed rest.
B. Performing a manual vaginal examination.
C. Initiating a non-stress test (NST).
D. Obtaining a CBC and Type & Screen.
Q2. (SATA) A nurse is monitoring a client on Magnesium Sulfate for Preeclampsia. Which findings
indicate Magnesium toxicity? Select all that apply.
A. Respiratory rate of 10 breaths/min.
B. Deep tendon reflexes (DTRs) of 0 or 1+.
C. Urine output of 50 mL/hr.
D. Altered mental status/Slurred speech.
E. Serum Magnesium level of 6 mEq/L.
