Labor pain first, then the birth plan, then bleeding risk in the fourth stage: NU143 Unit 4's care plan re-ranks three diagnoses as a composite labor advances. Searches like "nu 143 unit 4 assignment example", "nu143 unit 4 sample" and "nu143 unit 4 example" land here.
What a finished NU143 Unit 4 care plan looks like
The plan is a table in the format most sections supply, with columns for the nursing diagnosis, the goal, each intervention and its rationale, and evaluation, split into bands by stage. The first band lists labor pain related to contractions and cervical change, with a goal stated as she describes it: coping she rates acceptable between contractions. Interventions include position changes, a warm shower, counterpressure on the lower back from her partner, and voiding every two hours, since a full bladder can slow descent. Fetal heart rate is checked by intermittent auscultation at the intervals the course text sets for a low-risk labor. At 8 centimeters she asks for an epidural, and the evaluation column records the plan changing with her. The fourth-stage band covers fundal checks, bleeding and skin-to-skin contact.
How a NU143 Unit 4 example is structured
Stages organize the plan rather than body systems, which is the choice this unit usually rewards. Each band opens with a one-line stage summary: cervical change, expected duration for a first labor, and what the nurse watches most closely there. Diagnoses are ranked within each band and the ranking shifts as labor advances; bleeding risk sits low early and becomes the priority after the placenta delivers. Every intervention carries a rationale cited to the course text. Goals are measurable and timed, such as a firm, midline fundus at or near the umbilicus on each check through the first hour. The second patient appears in every band, from auscultation during the first stage to the newborn on her chest in the fourth. Under the table, a short narrative explains how her birth preferences were honored and where they changed.
Bands by stage, not by system
Pain in the first stage, pushing in the second, separation signs in the third and fundal tone in the fourth each get their own band, so the plan reads in the order the labor happened.
A goal she sets herself
Coping is measured by her own rating between contractions, not by a pain number alone. That choice fits an unmedicated plan, where some pain is expected and the question is whether she can work with it.
When the preference changes
At 8 centimeters she asks for an epidural. The evaluation records the request, the conversation about timing, and the plan revised to her new choice, without framing the change as a failure of the original plan.
Signs the placenta has separated
The third-stage band lists a gush of blood, lengthening of the cord and a uterus that rises and turns globular, and times delivery against the thirty minutes the course text treats as usual.
The fourth stage as its own priority
Checks every fifteen minutes for the first hour track fundal firmness, position, bleeding and vital signs, while the newborn stays skin to skin. The ranking puts bleeding risk first for that hour.
Where marks go in NU143 Unit 4
Treating labor as one static state is the costliest error: a single band with the same three diagnoses from admission to recovery shows the stages were never applied. Goals such as 'patient will have less pain' give no measure or time and cost the goals criterion. Rationales copied without citation, or offered for only some interventions, draw deductions. Leaving the fetus out of the first and second stages, or the newborn out of the fourth, misses this course's two-patient emphasis. Handling the epidural request as a deviation from the plan, rather than as her decision, often draws comment on client-centered care. Fourth-stage bands that omit fundal checks or give no frequency lose safety marks. Placing the separation signs in the wrong stage costs accuracy points.
Get a NU143 Unit 4 example written to your instructions
Some sections want this plan built by body system or in a concept-map layout instead of by stage; others supply their own diagnosis list. Whichever it is, include the form, the labor scenario and the rubric, and the care plan follows them. The first sample written to your instructions is free, with delivery in 24-48h.
NU143 Unit 4 questions, answered
Which nursing diagnosis comes first in a labor care plan?
It depends on the stage, which is the point of building the plan in bands. Labor pain usually leads in the first stage for a low-risk woman, fetal status gains weight in the second, and bleeding risk moves to the top once the placenta is out. A plan that fixes one ranking for the whole labor tends to lose prioritization marks.
How should the plan handle a birth preference that changes?
In the sample it goes into the evaluation column as a change in her goals, with the conversation that led to it, and the interventions are revised from that point. The earlier preference stays visible, because it shows the plan respected it for as long as she held it. Graders often look for language treating the new choice as hers rather than as a plan that failed.
Does the fourth stage belong in a labor care plan?
In most NU143 sections, yes. The first hours after the placenta delivers are when postpartum hemorrhage is most likely, and they are also when the newborn's first feed and skin-to-skin contact happen. A plan that ends at birth leaves out the stage with the highest bleeding risk, and some prompts name the fourth stage specifically for that reason.