Labor & Delivery.NCLEX Clinical Cheat Sheet

Mom's Vital Signs

MAP ≈ weeks gestation or higher.

Newborn Vital Signs

HR up to 180 crying / 100 sleeping. Abdominal, irregular breathers.

Stages of Labor

L&D Medications

Oxytocin	stimulates contractions
Misoprostol	cervical ripening
Terbutaline/Nifedipine	HALT contractions (tocolytic)
Mag sulfate	stops seizures (antidote Ca gluconate)
Betamethasone	fetal lung maturity

Obstetrical Emergencies

Emergency	Description	Treatment
Preeclampsia / Eclampsia	New HTN + proteinuria >20 wk; eclampsia = seizures	BP control, MgSO₄, deliver
Postpartum Hemorrhage	>500 mL vaginal / >1000 mL cesarean (atony = #1)	Fundal massage → oxytocin, hemabate, misoprostol
Placenta Previa	Placenta over os — PAINLESS bright red bleed	NO vaginal exam; C-section
Abruptio Placentae	Premature separation — PAINFUL dark bleed, rigid uterus	Emergency delivery; watch DIC
Uterine Rupture	Uterine wall tears (pressure / prior C-section)	STAT delivery, transfusion

APGAR Scoring (at 1 & 5 min)

Sign	0	1	2
Activity (tone)	Limp	Some flexion	Active
Pulse	Absent	<100	> 100
Grimace (reflex)	None	Grimace	Cry / cough
Appearance (color)	Blue / pale	Acrocyanosis (blue hands/feet)	Pink all over
Respiration	Absent	Slow, irregular	Vigorous cry

7–10 routine care • 4–6 stimulate, suction, O₂ • 0–3 full resuscitation.

Fetal Monitoring — VEAL CHOP

Variable	Cord compression
Early	Head compression
Acceleration	OK (reassuring)
Late	Placental insufficiency — BAD

Late/variable → reposition left, O₂, stop oxytocin, notify.

Newborn Resp. Distress

Signs	retractions, nasal flaring, grunting
Tip	count RR a FULL minute; hand on abdomen

Keep a finger on the pulse while counting respirations.

Original NCLEX Deck reference of standard clinical facts. Educational only; verify against facility protocol & the current NCSBN test plan.