妇产科护理学

The core task of this step is to select a representative maternal case and design a perinatal nursing framework covering pregnancy, labor, and postpartum periods. Cases can be normal pregnancy or high-risk (gestational hypertension, GDM, placenta previa, preterm labor).

• Select typical case: choose from normal pregnancy, gestational hypertension, gestational diabetes mellitus, placenta previa, premature rupture of membranes, preterm labor; obtain complete prenatal care records, laboratory tests, and ultrasound results
• Design perinatal nursing framework: design nursing content for pregnancy, intrapartum, and postpartum periods; each phase includes health assessment, nursing diagnoses, goals, interventions, evaluation; address both maternal care and fetal/neonatal monitoring
• Determine assessment tools: select pregnancy-specific tools: pregnancy risk assessment, external pelvimetry, fetal movement counting, contraction monitoring, Apgar score, postpartum hemorrhage risk assessment, Edinburgh Postnatal Depression Scale (EPDS)

The core task of this step is to conduct systematic nursing assessment of the pregnant woman and provide individualized prenatal health guidance. Pregnancy assessment includes maternal health status and fetal intrauterine status evaluation.

• Prenatal health assessment: conduct comprehensive prenatal evaluation including general status (vital signs, weight, BMI), obstetric examination (fundal height, abdominal girth, fetal position, FHR, presentation, pelvimetry), laboratory tests (CBC, urinalysis, LFT/RFT, glucose, blood type, coagulation, Down syndrome screen, OGTT), ultrasound (NT, anomaly scan, growth measurements); use pregnancy risk screening tool
• Fetal well-being assessment: teach pregnant woman fetal movement counting (1 hour each morning/noon/evening, ≥3 movements/hour normal); explain electronic fetal monitoring (NST) meaning and interpretation (reactive/non-reactive); analyze BPP (Manning score) parameters
• Prenatal health guidance: develop individualized prenatal care plan including nutrition guidance (dietary reference intakes, weight gain goals), exercise guidance (pregnancy-safe exercises, intensity monitoring), daily life guidance (sleep position, work, travel, sex), common discomfort management (nausea/vomiting, constipation, backache, leg edema), prenatal education and birth preparation

The core task of this step is to closely monitor and care during the labor process, ensuring maternal and fetal safety. The intrapartum period is the most critical phase of perinatal care, requiring continuous monitoring of labor progress, fetal heart rate, and maternal condition.

• Labor observation and assessment: systematic observation by labor stages (first stage latent/active, second stage, third stage); use partogram to record cervical dilation, fetal descent, contraction intensity/frequency; measure vital signs every 4 hours; perform vaginal exams every 1-2 hours to assess progress
• Fetal monitoring: auscultate FHR every 15-30 minutes in first stage, every 15 minutes in active phase, every 5-10 minutes in second stage, or use continuous electronic fetal monitoring; promptly identify abnormal FHR patterns (early deceleration, variable deceleration, late deceleration) and take measures (left lateral position, oxygen, discontinue oxytocin)
• Intrapartum care and support: provide labor analgesia (non-pharmacological: breathing techniques, massage, hydrotherapy; pharmacological: epidural anesthesia); teach pushing techniques; provide daily care (diet, voiding, positioning); provide psychological support and doula care; prepare for delivery and neonatal resuscitation

The core task of this step is to provide comprehensive care for postpartum women and newborns, promoting maternal recovery and neonatal health. The postpartum period is critical for maternal organ recovery, requiring close monitoring of uterine involution, lochia, wound healing, and lactation.

• Postpartum maternal assessment and care: daily assessment of vital signs, uterine involution (fundal height, firmness), lochia (amount, color, odor), perineal or abdominal wound (redness, swelling, heat, pain, healing), breasts (milk supply, nipple condition), elimination; monitor postpartum hemorrhage risk (focus on first 2 hours); prevent puerperal infection
• Newborn care: conduct newborn physical examination and health assessment including Apgar score, vital signs, weight change, jaundice monitoring (transcutaneous bilirubin), umbilical cord care, skin care, immunizations (HepB, BCG), newborn screening (PKU, congenital hypothyroidism, hearing screen)
• Breastfeeding and postpartum rehabilitation guidance: teach correct breastfeeding positions and latch; evaluate breastfeeding effectiveness (feeding frequency, urine output, weight gain); guide breast care and management of special situations (sore nipples, engorgement, insufficient milk); provide postpartum rehabilitation guidance (pelvic floor exercises, postpartum exercise, nutrition, contraception); conduct postpartum mental health assessment (EPDS)

The core task of this step is to organize perinatal nursing data, write a complete perinatal nursing case report, and summarize nursing experience and reflections. Perinatal care requires a holistic approach, connecting pregnancy, labor, and postpartum care organically.

• Organize perinatal nursing records: chronologically organize all nursing data from pregnancy, labor, and postpartum periods, including assessment records, nursing diagnoses, care plans, interventions, outcome evaluations; form complete perinatal nursing record
• Write case report: follow case report format including case introduction, nursing assessment, nursing diagnoses, care plan and implementation, nursing outcomes, discussion and reflections; focus on high-risk factor identification and management, nursing difficulties, lessons learned; demonstrate evidence-based nursing
• Create health education materials: develop a health education manual or PPT for this case, covering prenatal care, birth preparation, postpartum recovery, newborn care, breastfeeding; illustrated and easy to understand, suitable for pregnant women and families