As you know, nurses are responsible for caring for patients from the beginning of life to the end. When preparing for the NCLEX-RN, it can be helpful to break down the content into smaller topics. Today’s blog is going to focus on the obstetrical (OB) area of nursing. This patient care specialty involves caring for women from pre-conception through pregnancy, during and after birth, and also caring for infants in the first few days of life. While it is a specialty area of nursing, the National Council of State Boards of Nursing (NCSBN) has determined from their practice analysis that new nurses in entry level practice must possess the skills and knowledge to care for this population. So, when it comes to OB on the NCLEX-RN, what do you need to know?
Health Promotion and Maintenance
According to the NCSBN test plan, caring for patients under the OB umbrella is part of the test content category of Health Promotion and Maintenance. To sum it up, this content category is designed to assess the nurse’s level of knowledge related to care of clients across the lifespan. Things like being able to distinguish normal and abnormal physical assessment findings in patients at all ages and stages of life and providing safe and effective care at multiple developmental stages would be included. Care of OB patients fits in this category because nurses must be able to identify unique needs in this stage of life and have the knowledge and skills to provide care appropriate to these patients.
OB on the NCLEX-RN: What Do You Need to Know
Using the test plan as a guide, test candidates will need to know about caring for clients in the Ante/Intra/Postpartum periods as well as newborn care. The test plan further describes that nurses will need to be able to provide education both prenatal and postpartum. Nurses must understand the process of labor and birth to provide care to the laboring patient. This will include needing to distinguish normal from abnormal physical assessments for both mother and baby. Understanding the progression of pregnancy and its associated physical changes for mother and infant makes skills such as determining estimated date of delivery, normal fetal heart rate, and what to expect over the various stages of pregnancy, labor, and birth vital knowledge for practicing nurses. In addition to the physical assessments, nurses must also be able to assess the psychosocial aspects of pregnancy such as family support and learning needs.
Plan of Action
If, after reading all that, you are left shaking your head wondering how you’ll be able to prepare for all of this, fear not! A basic plan of action for a test candidate when it comes to studying OB questions contains just a few steps.
- Begin by understanding the basics. Brush up on the facts of prenatal care, care of the normal laboring patient, and normal newborn care. This is where you focus solely on how things progress normally without complication. This is the “textbook” version of pregnancy and birth. How are due dates calculated? What are considered optimal assessment findings both physical and psychosocial?
- Once you feel comfortable that you understand the way things are supposed to go, focus a bit more on how they typically go. Read up on when women normally seek prenatal care and what needs are associated with that stage of pregnancy. Devote some time to identifying typical psychosocial and cultural influences on birth outcomes. Think about what situations nurses may encounter when caring for and educating this population. What are typical physical assessment findings and what interventions are required for these findings? Don’t forget that baby will be a patient too. Spend some time learning about the transition period for babies from birth through the first few days of extra-uterine life. What is considered a normal newborn assessment and what education will be needed to support the mother, baby, and family as they prepare to leave the nurse’s care?
- Last, but not least get comfortable with complications. What are considered major warning signs in the pregnancy and birth period that would need priority intervention? What are things that nurses must be vigilant for identifying early in order to prevent complications and promote the best possible outcomes? How does the plan of care change if any of these complications are present and what must the nurse do in these situations?
By focusing on normal first and then progressing to abnormal or less than optimal conditions, it is easier to understand the key aspects of nursing care in this patient population. Pregnancy is a process and by recognizing patterns in normal pregnancy, it can make it less complicated to focus on and remember what nursing care will look like for these patients throughout the various stages. Don’t forget, like all areas of nursing care, you will need to pay special attention to priorities and the management of care with these patients.
The care of OB patients is considered part of Health Promotion and Maintenance because it focuses on patient care through various stages of development. It can seem overwhelming but like all test preparation, all it takes is a little planning to tackle the studying in a way that puts you on the path to success! Set your timeline to prepare, look for good test preparation resources, and practice with NCLEX-style questions so you know what to expect from the exam. Happy Studying!