NSG210 Exam 2 Readings Outline

Exam 2: Monday, October 12, 2026, 1400-1520. Content cutoff is Week 07 / October 7 (see exam_conflicts; the calendars originally marked September 30). Exam 2 therefore includes OB Lecture 3A and 3B (labor and birth, fetal heart rate assessment, complications of labor, cesarean birth), Durham Ch. 8-11.

This is a detailed, chapter-by-chapter outline of the assigned textbook readings for Exam 2, built from the chapter PDFs in textbooks/exam02/ (symlink to ~/Documents/texts/nursing/NSG210/exam02/). That folder now holds Durham Ch. 4, 6, 7, 8, 9, 10, 11 and Hinkle Ch. 22, 24; Durham Ch. 8-11 and Hinkle Ch. 22 were moved there from exam03/. It follows the order of each chapter and keeps the textbook’s numbers, criteria, and nursing actions. Check the original chapter when a detail matters.

Readings

Note on Hinkle: the weekly outline assigns Ch. 25 for Week 04 valvular heart disease, but in the 15th edition valvular disorders are in Ch. 24. The exam02 readings folder holds Ch. 24, so that is what is outlined here. Likewise the reading list assigns Ch. 23 for arrhythmias, but Ch. 22 is the arrhythmia chapter in the 15th edition.

Week 07 labor content and dysrhythmias (Ch. 22) are both heavily weighted on Exam 2. Do not skip either.

What Each Chapter Covers

• Hinkle Ch. 24 - valve disorders (mitral valve prolapse, mitral regurgitation and stenosis, aortic regurgitation and stenosis), murmurs, valvuloplasty and valve replacement (mechanical vs tissue valves, anticoagulation), cardiomyopathies (dilated, hypertrophic, restrictive, arrhythmogenic RV), heart transplant and VADs, rheumatic and infective endocarditis, myocarditis, pericarditis and cardiac tamponade.
• Durham Ch. 4 - normal physiological changes of pregnancy by body system, preconception care, signs of pregnancy, Naegele’s rule and term definitions, GTPAL, prenatal visit schedule and labs by trimester, RhoGAM, nutrition and weight gain, kick counts, GBS screening, warning signs by trimester, common discomforts and relief measures.
• Durham Ch. 6 - the nurse’s role and informed consent, screening vs diagnostic tests, genetic testing, ultrasound, Doppler, MRI, CVS, amniocentesis, PUBS, cell-free DNA, AFP, quad screen, kick counts, NST, VAS, CST, AFI, BPP, modified BPP.
• Hinkle Ch. 22 - see nsg210-hinkle-ch22-arrhythmias-outline: conduction system, ECG components and strip analysis, sinus, atrial, junctional and ventricular rhythms, AV blocks, cardioversion and defibrillation, pacemakers, ICDs. Related: nsg210-acls-algorithms.
• Durham Ch. 8 - signs of impending labor, true vs false labor, the 5 Ps (passenger, passageway, powers, position, psyche), pelvis types, station, Leopold’s maneuvers, cardinal movements, stages and phases of labor, maternal positions, fourth stage, newborn care and Apgar.
• Durham Ch. 9 - external vs internal FHR monitoring, baseline, variability, accelerations, early/variable/late decelerations, category I-III tracings, intrauterine resuscitation.
• Durham Ch. 10 - dystocia, induction and augmentation (Bishop score, oxytocin), tachysystole, preterm and post-term labor, shoulder dystocia, umbilical cord problems, maternal trigger parameters (MEOWS).
• Durham Ch. 11 - indications and risks of cesarean birth, perioperative and intraoperative care, postoperative and postpartum care, discharge preparation.
• Durham Ch. 7 - preterm labor (tocolytics, steroids, magnesium), PROM and PPROM, cervical insufficiency and cerclage, multiple gestation, hyperemesis, cholestasis, pregestational and gestational diabetes, hypertensive disorders (gestational hypertension, preeclampsia, eclampsia, HELLP, magnesium sulfate), previa, abruption, accreta, pregnancy loss (abortion, miscarriage, ectopic, molar), infections (HIV, STIs, TORCH, UTI, GBS, Zika, COVID-19, sepsis), trauma, cardiac and pulmonary disease, seizures, VTE, obesity, thyroid disease, lupus, substance use.

High-Yield Numbers Across the Readings

OB:

• Preterm: 20 0/7 to 36 6/7 weeks; early term 37-38 6/7; full term 39-40 6/7; late term 41-41 6/7; post term 42+
• Abortion: loss before 20 weeks
• Prenatal visits: monthly to 28 weeks, every 2 weeks to 36, then weekly
• Fundal height at the umbilicus about 20 weeks; cm roughly equals weeks after 20
• FHR 110-160; Doppler heart tones at 10-12 weeks; quickening 18-20 weeks (primigravida), 14-16 (multigravida)
• Blood volume up 30-50%; plasma 40-60%; RBC about 30%; cardiac output 30-50%; HR up 10-20
• Anemia in pregnancy: Hgb under 11, Hct under 33%; WBC up to 16,000 normal
• RhoGAM 300 mcg IM at 28 weeks and within 72 hours of delivery of an Rh-positive baby
• GDM screen 24-28 weeks; 1-hour 50 g positive at 130-140; 3-hour 100 g - two abnormal values (95/180/155/140)
• Glucose targets: fasting under 95, 1-hour under 140, 2-hour under 120
• GBS swab 35-37 weeks (Ch. 7 says 36-37)
• Kick counts: 10 in 2 hours, or 4 in 1 hour
• NST reactive: 15 bpm x 15 seconds x 2 in 20 minutes (10 x 10 under 32 weeks)
• BPP: 8-10 reassuring, 6 equivocal, 4 or less abnormal
• AFI: normal 8-24 cm; under 5 oligohydramnios; over 24 polyhydramnios
• CVS 10-13 weeks; amniocentesis 15-20 weeks; AFP and quad screen 15-20 (22) weeks; cell-free DNA from 9-10 weeks; NT in first trimester (3.0 mm or more abnormal)
• Hypertension 140/90; severe range 160/110 (treat within 30-60 minutes; goal 140-150/90-100)
• Preeclampsia proteinuria: 300 mg/24 hr or protein/creatinine 0.3
• Severe features: platelets under 100,000; creatinine over 1.1; liver enzymes twice normal
• Magnesium sulfate: load 4-6 g, maintain 1-2 g/hr; therapeutic 4.8-9.6 mg/dL (4-8 mEq/L); DTRs lost about 9 mg/dL (7 mEq/L); respiratory depression 12 mg/dL; cardiac arrest 30 mg/dL; hold for RR under 12, urine under 30 mL/hr, absent DTRs; antidote calcium gluconate 1 g of 10% IV
• Betamethasone 12 mg IM every 24 hours x 2 (24-34 weeks); magnesium for neuroprotection under 32 weeks
• Cerclage 12-16 weeks, removed 36-37 weeks
• Twin delivery timing: di/di 38 weeks; mono/di 34-37 6/7; mono/mono 32-34
• Previa delivery 36-37 6/7 weeks; accreta 34-37 weeks
• Up to 20% of cardiac output (up to 1,000 mL/min) through the placental bed at term; exsanguination in 8-10 minutes
• Obese pregnancy weight gain 11-20 lb; normal BMI 25-35 lb

Med-surg:

• Mitral regurgitation - systolic, blowing, apex to axilla
• Mitral stenosis - diastolic, rumbling, apex
• Aortic regurgitation - diastolic, blowing, left sternal border; water hammer pulse; wide pulse pressure
• Aortic stenosis - systolic, harsh crescendo-decrescendo, right 2nd ICS to carotids; angina, syncope, DOE; narrow pulse pressure
• Warfarin INR after valve replacement: mitral 2-3.5, aortic 1.8-2.2; tissue valve or ring - 3 months
• Bioprosthesis lasts 7-15 years; homograft 10-15; autograft over 20
• Transplanted heart resting rate 90-110; no response to atropine
• Cardiomyopathy teaching: sodium 2 g/day; report 2-3 lb in a day or 5 lb in a week
• Pulsus paradoxus: systolic drop of 10 mmHg or more on inspiration; Beck triad - hypotension, muffled heart sounds, JVD

Connections to Lecture Notes

• nsg210-week-05-complications-in-pregnancy - wiki summary of the September 23 OB lecture notes
• raw/nsg210lecture_2026October07.md - Week 07 class notes for OB Lecture 3A and 3B (Durham Ch. 8-11)
• raw/nsg210_wk07_OBLecture3A.md and raw/nsg210_wk07_OBLecture3B.md - Week 07 slide text (Ch. 8; Ch. 9, 10, 11)
• nsg210-2026-09-30-arrhythmias - September 30 arrhythmia lecture (Hinkle Ch. 22)
• raw/nsg210_wk05_ComplicationsInPregnancy.md - week 5 lecture notes on the same material as Durham Ch. 7 (preterm labor, cervical insufficiency, ROM, twins, hyperemesis, diabetes, hypertensive disorders, HELLP, DIC, IUGR, placental abnormalities)
• raw/nsg210_wk04_VavularDisorders.md and the week 4 valvular case studies - lecture material for Hinkle Ch. 24
• nsg210-ob-terminology - OB terms
• nsg210-textbook-chapter-crosswalk - chapter mapping