Labor, Delivery & Complications: Four Ps, Fetal Monitoring, and Obstetric Emergencies | Chapter 24 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)

Labor, Delivery & Complications: Four Ps, Fetal Monitoring, and Obstetric Emergencies | Chapter 24 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)

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Welcome to Chapter 24 of the Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri. This chapter delivers a full breakdown of labor and delivery, equipping nurses with the knowledge needed for safe, evidence-based care during childbirth. Covering the physiologic process, fetal monitoring, labor stages, obstetric procedures, and life-threatening complications, this review is a must for NCLEX-PN and real-world maternity practice.

Watch the complete video summary below, and subscribe to Last Minute Lecture for every NCLEX-PN labor and birth walkthrough and emergency scenario review:

The Four Ps of Labor and Mechanisms of Birth

  • Powers: Uterine contractions and maternal pushing.
  • Passageway: Birth canal anatomy—pelvis and soft tissue.
  • Passenger: Fetus—lie, presentation, position, station, engagement, and attitude.
  • Psyche: Maternal emotional state, anxiety, and support.
  • True vs. false labor, pre-labor indicators like lightening and nesting.

Stages of Labor and Nursing Interventions

  • First Stage: Latent, active, and transition phases—cervical dilation and contractions.
  • Second Stage: Delivery of the baby; supporting maternal pushing and monitoring fetal descent.
  • Third Stage: Delivery of the placenta and monitoring for hemorrhage.
  • Fourth Stage: Immediate postpartum care and maternal stabilization.
  • Leopold’s maneuvers for assessing fetal position.

Fetal Monitoring and Pain Management

  • External and internal fetal monitoring: interpretation of baseline, variability, accelerations, and decelerations.
  • Recognizing nonreassuring FHR patterns—early, late, and variable decelerations, and appropriate interventions.
  • Pain management: breathing techniques, epidural and spinal anesthesia, and nursing responsibilities during anesthesia administration.

Obstetric Procedures and Birth Complications

  • Cesarean delivery, forceps, vacuum extraction, amniotomy, Bishop score, and episiotomy—indications and nursing roles.
  • Major complications: placenta previa, abruptio placentae, uterine rupture, prolapsed cord, preterm labor, dystocia, amniotic fluid embolism, precipitous labor, and fetal distress.
  • Emergency interventions: positioning, oxygen, rapid response, and preparation for surgery if needed.

Postpartum Care and Monitoring

  • Fundal checks, vital signs, bleeding assessment, pain control, and newborn bonding in the fourth stage of labor.
  • Nursing priorities in immediate recovery to ensure maternal and newborn safety.

For in-depth labor scenarios and NCLEX-style practice questions, watch the video above and subscribe to Last Minute Lecture for maternity care strategies and emergency guides!

Conclusion: Preparedness for Labor, Delivery, and Obstetric Emergencies

Chapter 24 of Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) ensures that you are ready to interpret labor progression, monitor fetal well-being, support safe delivery, and rapidly respond to emergencies. Mastering these skills will help you excel on the NCLEX-PN and provide outstanding maternity care.

If you found this breakdown helpful, subscribe to Last Minute Lecture for more NCLEX-PN labor, delivery, and birth complication reviews and expert clinical tips.

If you found this breakdown helpful, be sure to subscribe to Last Minute Lecture for more chapter-by-chapter textbook summaries and academic study guides.

Explore the full YouTube playlist for Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) here: Complete Playlist

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