Understanding maternal and newborn concepts is essential for NCLEX success. These topics are packed with safety-critical assessments, priority nursing interventions, and predictable test patterns. This guide breaks everything down into quick-learning, clinically accurate sections to help you apply—not memorize—what matters most.

Why This Maternal & Newborn NCLEX Guide Matters

Maternal and newborn nursing is loaded with high-yield safety checkpoints that appear frequently on NCLEX. To pass, you must apply core concepts—pregnancy physiology, labor priorities, postpartum risks, and newborn stabilization—using clinical judgment.
Use this structured breakdown to anchor your study and reinforce decision-making under pressure.

Antepartum Care (Before Birth)

Normal Physiologic Changes

Cardiovascular

• ↑ Blood volume 30–50%

• ↑ HR 10–15 bpm

• ↓ BP during 2nd trimester

• ↑ Cardiac output 30–50%

• Watch for supine hypotension → position left side-lying

Respiratory

• ↑ Tidal volume + O₂ needs

• Mild dyspnea expected

Renal

• ↑ GFR 40–50%

• Urinary frequency and ↑ UTI risk

GI

• Delayed gastric emptying → N/V, reflux, constipation

Musculoskeletal

• Relaxin → ligament laxity

• Low-back strain, posture changes

Common Pregnancy Discomforts & Quick Nursing Fixes

• N/V (1st trimester) → Small frequent meals, ginger, avoid triggers

• Heartburn → Small meals, stay upright

• Constipation → Fiber, fluids, activity

• Back pain/SOB (3rd tri) → Posture support, elevate head while sleeping

• Edema → Leg elevation; report sudden swelling

Prenatal Nutrition: Must-Know Values for NCLEX

• Folic acid: 400–800 mcg/day (neural tube defect prevention)

• Iron: 27 mg/day

• Calcium: 1,000 mg/day

• Protein: 70–100 g/day

Avoid: Raw/undercooked foods, high-mercury fish, unpasteurized dairy, alcohol
Limit caffeine: ~200 mg/day

Intrapartum Care (Labor & Delivery)

Stages of Labor — Fast Recall

Stage 1: Dilation

• Early: 0–3 cm

• Active: 4–7 cm

• Transition: 8–10 cm

Stage 2: Birth

Stage 3: Placenta (5–30 min)

Stage 4: Recovery (first 1–4 hours) → highest PPH risk window

True vs. False Labor

Fetal Heart Rate (FHR) Essentials

• Baseline: 110–160 bpm

• Moderate variability: 6–25 bpm (very reassuring)

• Accelerations: good oxygenation

Late Decelerations → Uteroplacental Insufficiency

Interventions:

1. Left side-lying

2. O₂ 8–10 L via non-rebreather

3. IV bolus

4. Stop oxytocin

5. Notify provider

6. Prepare for delivery if persistent

Variable Decelerations → Cord Compression

• Reposition

• Consider amnioinfusion per orders

Postpartum Care (BUBBLE-HE Assessment)

B — Breasts

Engorgement, nipple integrity, mastitis signs

U — Uterus

Firm, midline; descends ~1 cm/day
Massage if boggy

B — Bladder

Empty q2–3h; overdistention ↑ bleeding

B — Bowel

Fluids, fiber, stool softeners

L — Lochia

• Rubra: 1–3 days

• Serosa: 4–10 days

• Alba: 10–14+ days

E — Episiotomy/Laceration

Check REEDA; ice/sitz baths

H — Homan’s/Extremities

DVT risk; encourage ambulation

E — Emotion

Bonding, blues vs. depression

Postpartum Hemorrhage (PPH) — NCLEX Red Flags

Indicators:

• Boggy fundus

• Heavy bleeding/clots

• Tachycardia, hypotension

First Steps:

1. Fundal massage

2. Empty bladder

3. IV fluids

4. Oxytocin

5. Add uterotonics/escalate if needed

High-Yield Pregnancy Complications

Hypertensive Disorders

Gestational Hypertension

• ≥140/90

• After 20 weeks

• No proteinuria

Preeclampsia

• HTN + proteinuria or end-organ signs

• Headache, vision changes, RUQ pain

Eclampsia

• Seizures
  Magnesium sulfate:

• Monitor RR, DTRs, urine output

• Keep calcium gluconate ready

Third-Trimester Bleeding

Placenta Previa

• Painless bright-red bleeding

• No vaginal exams

• Often requires C-section

Placental Abruption

• Painful bleeding

• Rigid/tender uterus

• Emergency stabilization + delivery

Maternal & Newborn Care: First Minutes After Birth

APGAR (1 and 5 minutes)

• Appearance

• Pulse

• Grimace

• Activity

• Respiration

7–10: Normal
4–6: Moderate support
0–3: Resuscitation

Immediate Newborn Priorities

• Dry, warm, hat, skin-to-skin

• Clear airway as needed

• Vitamin K

• Erythromycin ointment

• ID bands

• First glucose check for at-risk infants

Fundamentals: Infection Control, Safety & Documentation

Precautions

Use PPE appropriate to:

• Contact

• Droplet

• Airborne pathogens

Fall Risk

Low bed, non-skid socks, clear pathways

Restraints

Last resort; require order; frequent reassessment

Documentation — The 5 C’s

Clear, concise, complete, correct, current

Delegation Rules (Know for NCLEX)

Registered Nurse (RN)

• Initial assessments

• Teaching

• Evaluations

• Unstable patients

LPN/LVN

• Stable patients

• Routine meds

• Wound care

• Focused assessments

UAP

• ADLs

• Hygiene

• Stable vitals

• Ambulation & positioning

Study Smarter (Not Harder)

• Drill: FHR patterns, PPH steps, magnesium toxicity, preeclampsia triage

• Do NGN-style case studies daily

• Use spaced repetition for values and protocols

• Practice with safety-focused scenarios

Helpful Next Reads (Internal Links)

Use anchor text naturally as requested:

• Fetal Heart Rate Patterns: Recognize & Respond

• Postpartum Hemorrhage: First 5 Minutes

• Preeclampsia & Magnesium Sulfate Safety

• Newborn First Hour: Warmth, Airway, Glucose

External Reference

• NCSBN NCLEX Test Plan