| Course | NSG 222 Family Nursing |
|---|---|
| Unit | Unit 2 |
| Paper type | Labor progress record |
| Length | About 630 words, 5 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 222 Unit 2
A Trial of Labor After Cesarean, Hour by Hour: One Chart for Mother and Fetus, Stage Boundaries Marked, and a Reading by Direction
Student Name
Department of Nursing, Herzing University
NSG 222: Family Nursing
Instructor Name
January 21, 2026
A Trial of Labor After Cesarean, Hour by Hour: One Chart for Mother and Fetus, Stage Boundaries Marked, and a Reading by Direction
Context
The composite patient from Unit 1, now at 39 weeks 3 days. Her operative report confirmed a low transverse uterine incision, and after counseling she chose a trial of labor after cesarean, which guidance supports for most women with one prior low transverse cesarean in a hospital able to perform an emergency cesarean (American College of Obstetricians and Gynecologists [ACOG], 2019). She arrived at 0600 with regular contractions since 0200. Continuous electronic fetal monitoring was used, as recommended for labor after cesarean. Fetal heart rate patterns are described with the standard definitions and categories (Macones et al., 2008).
The Chart
Maternal and fetal columns are kept together so both series can be read across the same times.
| Time | Cervix / station | Contractions | Maternal vitals and coping | Fetal heart rate | Other |
|---|---|---|---|---|---|
| 0615 | 4 cm, 70% effaced, -2 | Every 5 min, 45 s, moderate | BP 118/72, HR 82, T 36.8; talking through contractions | Baseline 135, moderate variability, accelerations present; Category I | Membranes intact |
| 0815 | 5 cm, 80%, -2 | Every 4 min, 50 s | BP 122/74, HR 86; breathing through them, walking | Baseline 135, moderate variability, accelerations; Category I | |
| 1015 | 6 cm, 90%, -1 | Every 3 min, 60 s, strong | BP 124/76, HR 90; asks for an epidural | Baseline 140, moderate variability, early decelerations; Category I | Epidural placed 1040 |
| 1215 | 8 cm, 100%, 0 | Every 2-3 min, 60 s | BP 116/70, HR 88, T 37.1; resting, pain 2/10 | Baseline 140, moderate variability, early decelerations; Category I | Membranes ruptured 1150, clear fluid |
| 1345 | 10 cm, +1 | Every 2 min, 60-70 s | BP 120/74, HR 94; feels pressure | Baseline 145, moderate variability, early decelerations; Category I | Pushing begins 1400 |
| 1440 | Crowning | Every 2 min | HR 104; pushing effectively | Baseline 150, moderate variability, variable decelerations recovering quickly; Category II | |
| 1452 | Birth | Girl, Apgar 8 and 9 | |||
| 1500 | BP 118/70, HR 96; uterus firm | Placenta delivered complete 1500 |
Stage Boundaries and What Placed Them
Latent phase of the first stage: before 1015. The entries at 0615 and 0815 show a cervix changing slowly, from 4 to 5 cm in two hours, which is expected before active labor.
Active phase: from about 1015, placed by the 6 cm finding. Current guidance places the start of active labor at 6 cm rather than the older 4 cm threshold, based on contemporary labor patterns (Caughey et al., 2014; Zhang et al., 2010).
Second stage: from 1345, placed by the finding of full dilation.
Third stage: from the birth at 1452 to delivery of the placenta at 1500.
Reading by Direction
Climbing: cervical dilation, by 1 cm an hour after 1015, which is within expected rates for active labor. Contraction frequency and strength, as expected. Maternal heart rate, from 82 to 104 by the end of pushing, consistent with effort. Fetal baseline, from 135 to 150 in the second stage, still within the normal range.
Falling: pain score after the epidural, from strong enough to request it to 2 of 10.
Flattening: blood pressure, stable between 116 and 124 systolic throughout, including after the epidural, when a fall is a known risk.
Not shifting: fetal variability, moderate at every check. Moderate variability is the single most reassuring feature of the tracing, because it indicates a well-oxygenated fetus at that moment (Macones et al., 2008).
The one change in category, to Category II during pushing with variable decelerations that recovered quickly, is common in the second stage from compression of the umbilical cord and did not persist.
Nursing Actions Recorded Alongside the Chart
The chart holds findings; the nursing actions that went with them were recorded in the same time frame. Before the epidural at 1040, a fluid bolus was started as ordered and her blood pressure was checked every five minutes for the first twenty minutes afterward. After the epidural she was repositioned side to side each hour and her bladder was checked, since she could no longer feel it filling. When membranes ruptured at 1150, the fluid color and the fetal heart rate in the next minutes were recorded. During pushing, the nurse coached her with open-glottis pushing and read the tracing between each push.
What Was Watched Because This Was Labor After Cesarean
The most common sign of uterine rupture is an abnormal fetal heart rate pattern, with sudden prolonged decelerations or bradycardia; other signs include new, constant abdominal pain between contractions, bleeding, a change in the shape of the abdomen, and loss of the fetal station (ACOG, 2019). None appeared: the tracing stayed Category I until the brief Category II in the second stage, station advanced steadily, and pain between contractions did not return after the epidural. These were checked at every entry, not only noted as a risk at admission. The labor record follows the course text's structure (Lowdermilk et al., 2020). The patient is a composite.
References
American College of Obstetricians and Gynecologists. (2019). ACOG Practice Bulletin No. 205: Vaginal birth after cesarean delivery. Obstetrics & Gynecology, 133(2), e110-e127. https://doi.org/10.1097/AOG.0000000000003078
Caughey, A. B., Cahill, A. G., Guise, J.-M., & Rouse, D. J. (2014). Safe prevention of the primary cesarean delivery. American Journal of Obstetrics and Gynecology, 210(3), 179-193. https://doi.org/10.1016/j.ajog.2014.01.026
Lowdermilk, D. L., Perry, S. E., Cashion, K., Alden, K. R., & Olshansky, E. F. (2020). Maternity & women's health care (12th ed.). Elsevier.
Macones, G. A., Hankins, G. D. V., Spong, C. Y., Hauth, J., & Moore, T. (2008). The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: Update on definitions, interpretation, and research guidelines. Obstetrics & Gynecology, 112(3), 661-666. https://doi.org/10.1097/AOG.0b013e3181841395
Zhang, J., Landy, H. J., Branch, D. W., Burkman, R., Haberman, S., Gregory, K. D., Hatjis, C. G., Ramirez, M. M., Bailit, J. L., Gonzalez-Quintero, V. H., Hibbard, J. U., Hoffman, M. K., Kominiarek, M., Learman, L. A., Van Veldhuisen, P., Troendle, J., & Reddy, U. M. (2010). Contemporary patterns of spontaneous labor with normal neonatal outcomes. Obstetrics & Gynecology, 116(6), 1281-1287. https://doi.org/10.1097/AOG.0b013e3181fdef6e
Reading the NSG 222 Unit 2 instructions
Unit 2 asks you to record labor progress across stages for mother and fetus. Expect to give context, chart findings at intervals, mark stage boundaries with the findings that placed them, read trends and record nursing actions. Many versions ask how often to chart and how to define the start of active labor. Check whether your section uses current labor curves. Keep maternal and fetal data on the same timeline. Active labor is now often placed at 6 cm based on Zhang's work. Trial of labor after cesarean needs closer watching for uterine rupture. Record nursing actions, such as position changes, beside the findings they answered.
How this NSG 222 Unit 2 example is built
The record opens with context, including incision type and gestational age. The chart lists times with maternal vital signs, contractions, cervical change and fetal heart rate. The boundaries section explains each stage change with the finding behind it. The direction section reads trends, such as steady dilation and stable fetal heart rate variability. Nursing actions are recorded in a separate column so findings and responses line up. The final section names signs of uterine rupture and how they were watched. The chart is easy to read across a row, and each boundary is justified, which shows the student understands why the stages change rather than just labeling them.
NSG 222 Unit 2 rubric: what full points look like
Herzing's rubric for a labor record typically covers context, the combined chart, stage boundaries, trend reading, nursing actions and safety monitoring. Stage boundaries and their justification draw the closest reading, since graders want each boundary placed by a finding rather than by the clock. Chart points reward maternal and fetal data on the same times. Trend criteria look for direction and rate. Action points go to nursing responses linked to findings. Safety earns credit for rupture signs in labor after cesarean. Current labor definitions are expected. ACOG's TOLAC bulletin and Zhang's contemporary labor curves support the chart. Membrane status, fluid color and pain management recorded beside the findings are often credited.
NSG 222 Unit 2 help before you submit
A Unit 2 labor record often falls short when mother and fetus are charted separately, which hides how they relate. Another frequent problem is placing active labor at 4 cm using outdated curves. Students often skip nursing actions or list them apart from the findings they answered. Stage boundaries are given without findings. Rupture signs are not mentioned for a trial of labor after cesarean. Fetal heart rate is recorded as a number without baseline, variability or decelerations. Times are irregular, so rates of change cannot be judged. Pain management and the mother's coping are left out. Membrane status and fluid color are forgotten. Finally, justify each boundary with a finding, because graders reward a record that explains why labor moved from one stage to the next.
Get a NSG 222 Unit 2 example written to your instructions
Send the Unit 2 instructions and the rubric from your NSG 222 classroom, with the case or the recorded values the assignment provides. We write a custom example that charts both patients in one table, commits each stage boundary to a time, organizes the reading by direction and cites the stage criteria used. First custom sample free, back in 24 to 48 hours.
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NSG 222 Unit 2 questions, answered
How many timed entries does the record need?
The case usually settles that, and where you build the series yourself, put in enough that a direction shows rather than being asserted. One detailed snapshot cannot demonstrate movement however thorough it is, while a modest run of timed entries can. Any count your assignment specifies overrides whatever the case would otherwise suggest.
Where do the stage definitions come from?
Your course materials, named in the record. Descriptions of the stages and of what marks the end of each differ between texts, professional bodies and clinical settings, so a record identifying a boundary against an unnamed definition cannot be marked fairly. Where your reading and your clinical site describe the same transition differently, write both and say which one governed the chart.
Can I write this from a birth I observed in clinical?
Some sections encourage exactly that and others supply the case, so check what yours asks. Where you write from an observation, nothing that could identify the patient, the family or the site belongs in the document, and times are best shifted. What you witnessed and what you were signed off for stay yours; a sample shows the shape of the record around them.
Where can I find a free NSG 222 Unit 2 sample paper?
Read the complete NSG 222 Unit 2 labor record here at no charge, mother and fetus on one chart with stage boundaries explained. A record for a different labor can be prepared on request.
What are the warning signs of uterine rupture during labor after cesarean?
The most common sign is an abnormal fetal heart rate pattern, such as prolonged decelerations. Others include new abdominal pain, vaginal bleeding and loss of the baby's station. This sample explains how each was watched.