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Ante-/Intra-/Postpartum and Newborn CareAce Your NCLEX-RN® Test Plan: Client Needs Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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NCLEX-RN® Test Plan: Client Needs | Registered Nurse (RN) School Study Aid
Contraception
- Indications
- Preventing Unplanned Pregnancy
- Barrier Methods
- Spermicides
- Diaphragm
- Cervical Cap
- Contraceptive Sponge
- Male Condom
- Hormonal Method
- Oral Contraceptive
- Intrauterine Device (IUD)
- Injectable Progestins
2 mins
Prenatal Care
- Prenatal Visits
- Vital Signs, FHR
- Fundal Height
- Urine Dipstick
- Weight
- Prenatal Screening
- Laboratory Testing
2 mins
Prenatal Nutrition
- Prenatal Vitamins
- Iron Supplement 30 mg Daily
- Folate/Folic Acid 400 mcg Daily
- Appropriate Weight Gain Recommendations
- 340 Calorie Increase
- 25 gram Protein Increase
- Foods and Substances to Avoid
- Coffee, Alcohol, Tobacco
- Fish Containing High Mercury Levels
3 mins
Infertility
- No Conception After 1 Year
- Interventions
- Artificial Insemination
- In Vitro Fertilization (IVF)
- Drug Therapy
- Clomiphene Citrate (Clomid)
- Menotropins
- GnRH Agonists
- Considerations
- Treat Underlying Disorders
- Emotional Support
- Multiple Gestations
3 mins
Presumptive Signs of Pregnancy
- Amenorrhea
- Fatigue
- Urinary Frequency
- Nausea and Vomiting
- Breast Changes
- Quickening
1 min
Positive Signs of Pregnancy
- Fetus on Ultrasound
- Fetal Heart Rate by Doppler or Fetoscope
- Fetal X-ray
- Fetal Movements
1 min
Probable Signs of Pregnancy
- Goodell Sign
- Chadwick Sign
- Hegar Sign
- Positive Serum and Urine Sample
- Braxton Hicks Contractions
- Ballottement
2 mins
Lab and Diagnostic Tests During Pregnancy
- Complete Blood Cell Count
- Blood Typing
- Rubella Titer
- Hepatitis B
- HIV Testing
- Urinalysis
- Diabetes
- Pap Smears
2 mins
Lab and Diagnostic Tests During Pregnancy (Other Visits)
- Diagnosis
- 10-13 Weeks
- Offer Chorionic Villus Sampling (CVS)
- 15-18 Weeks
- Quad Screen
- 18-20 Weeks
- Ultrasound
- Anatomic Screening
- 24-28 Weeks
- One-Hour Glucose Challenge Test
- 35-37 Weeks
- Streptococcus Agalactiae
3 mins
Lab and Diagnostic Tests During Pregnancy (1st Visit)
- Diagnosis
- Complete Blood Count (CBC)
- Blood Typing and Rh
- Rubella
- HIV
- Hepatitis B
- Tuberculosis Skin Mantoux Test (PPD)
- Sexually Transmitted Infections
- Chlamydia
- Neisseria gonorrhoeae
- Syphilis
- Pap Smears
- Urinalysis
- Sickle Cell Screening (If Indicated)
2 mins
Amniocentesis
- Mechanism
- Transabdominal Puncture
- > 14 weeks gestation
- Indications
- Genetic and Congenital Anomalies
- Fetal Hemolytic Disease
- Fetal Lung Maturity
- Complications
- Miscarriage
- Hemorrhage
- Infection
- Considerations
- RhoGAM (Rh Immune Globulin)
2 mins
Quad Screen Results Interpretation
- Markers
- AFP
- Estriol
- hCG
- Inhibin A
- Associations
- Increased hCG + Inhibin A (HIgh)
- Down Syndrome
- Decreased hCG + Estriol + AFP (Low HEAp)
- Edward Syndrome
- Increased AFP
- Neural Tube Defects
- Abdominal Wall Defects
2 mins
Discomforts of Pregnancy - First Trimester
- Breast Tenderness
- Supportive Bra
- Nausea and Vomiting
- Frequent Small Meals
- Urinary Frequency and Urgency
- Frequently Empty Bladder
- Leukorrhea
- Perineal Pad
- Ptyalism
2 mins
Discomforts of Pregnancy - Second Trimester
- Supine Hypotension
- Side-lying Position
- Food Cravings
- Heartburn (Pyrosis)
- Constipation
- Moderate Exercise
- Varicose Veins
- Elevate Legs
- Backache
- Pelvic Tilt Exercise
- Considerations
- Nutrition
2 mins
Discomforts of Pregnancy - Third Trimester
- Shortness of Breath (SOB)
- Rest Periods
- Return of Urinary Frequency and Urgency
- Empty Bladder Regularly
- Leg Cramps
- Stretching Exercises
- Ankle Edema
- Elevate Legs
2 mins
Hyperemesis Gravidarum
- Signs and Symptoms
- Excessive Vomiting
- Significant Weight Loss
- Dehydration
- Hypotension
- Electrolyte Imbalance
- Interventions
- Antiemetics
- Frequent Small Meals
- IV Therapy
2 mins
Preeclampsia Assessment
- After 20 Weeks of Pregnancy
- Mild
- Hypertension > 140/90
- Proteinuria or End-Organ Dysfunction
- Severe
- Hypertension > 160/110
- Progressive Renal Insufficiency
- Vision Changes
- HELLP Syndrome
- Pulmonary Edema
2 mins
Preeclampsia Interventions
- Side Lying Position and Bedrest
- Antihypertensives
- Magnesium Sulfate
- Labor Induction
1 min
Pregnant Cardiac Patient Assessment
- Mechanism
- Cardiac Decompensation
- Signs and Symptoms
- Frequent Cough
- Dyspnea
- Palpitations
- Excessive Fatigue
- Pulse > 100 bpm
- Crackles
2 mins
Eclampsia
- Mechanism of Action
- Increased Central Nervous System Irritability
- Signs and Symptoms
- Hyperreflexia
- Positive Ankle Clonus
- Headaches
- Visual Disturbances
- Epigastric or RUQ Pain
- Seizures
- Coma
- Considerations
- Don't Leave Bedside
- Magnesium Sulfate
2 mins
Fetal Circulation
- Placenta
- Umbilical Vein
- Ductus Venosus
- Right Atrium
- Foramen Ovale
- Left Atrium
- Aorta
- Right Ventricle
- Ductus Arteriosus
- Umbilical Arteries
2 mins
Decelerations (and Accelerations) Overview
- VEAL CHOP
- Variable Deceleration
- Cord Compression
- Early Deceleration
- Head Compression
- Acceleration
- Okay
- Late Deceleration
- Placental Insufficiency
2 mins
Patent Ductus Arteriosus
- Continuous
- Machine like murmur
- Often Due to Congenital Rubella
- Prematurity
1 min
Pregnant Diabetic Patient Interventions
- First Trimester
- Increase Insulin then Decrease
- Metformin
- Nutrition
- Exercise
- Second Trimester
- Increase Insulin
- More Likely to Develop Hypoglycemia than Hyperglycemia
- Third Trimester
- Double or Quadruple Insulin
- Early Delivery
- Postpartum
- Drastically Decrease Insulin
- Monitor Neonate for Hypoglycemia
3 mins
Late Decelerations
- Cause
- Uteroplacental Insufficiency
- Occurs During
- Disruption of Oxygen Transfer to Fetus
- Considerations
- Abnormal Pattern
- Interventions
- Discontinue Oxytocin
- Oxygen with Non-Rebreather (8-10 L/min)
- Side-lying Position
- Elevate Legs
- Increase Rate of IV Solution
2 mins
Early Decelerations
- Cause
- Fetal Head Compression
- Occurs During
- Uterine Contractions
- Placement of Internal Mode of Monitoring
- Vaginal Examination
- Fundal Pressure
- Considerations
- Normal Pattern
1 min
Variable Decelerations
- Mechanism
- Umbilical Cord Compression
- Occurs During
- Abnormal Cord Position
- Considerations
- Transition Phase
- Interventions
- Oxygen with Non-Rebreather (8-10 L/min)
- Change Maternal Position
- Discontinue Oxytocin
2 mins
Mechanism of Labor
- Engagement
- Descent
- Flexion
- Internal Rotation
- Extension
- External Rotation (Restitution)
- Expulsion of Infant
2 mins
Induction of Labor
- Indications
- Premature Rupture of Membranes
- Danger to Fetus or Mother
- Prolonged Gestation
- Contraindications
- Placenta Abnormalities
- Transverse Fetal Position
- Prolapsed Umbilical Cord
- Active Genital Herpes Infection
- Transfundal Uterine Incision
- Hemorrhage
3 mins
True vs. False Labor
- Bloody Show
- True Labor
- Regular, Strong Contractions
- Progressive Effacement and Dilation
- Engagement of Presenting Part
- False Labor
- Irregular Contractions
- Cervix Soft
- No Engagement of Presenting Part
2 mins
Terbutaline (Brethine)
- Mechanism of Action
- Beta-2 Agonists
- Indications
- Asthma
- Tocolytic
- Side Effects
- Hypotension
- Tremor
- Tachycardia
- Pulmonary Edema
- Hyperglycemia
2 mins
Oxytocin (Pitocin)
- Mechanism of Action
- Increase Uterine Contractions
- Indications
- Labor Induction
- Control Postpartum Hemorrhage
- Side Effects
- Uterine Rupture
- Water Intoxication
- Contraindications
- Fetal Lung Immaturity
- Cervix Not Ripened
- Active Genital Herpes Infection
- Considerations
- Use Lowest Dose
- IV Pump
3 mins
APGAR Score
- 1 and 5 Minutes
- Appearance
- Pulse
- Grimace
- Activity and Muscle Tone
- Respiration
- Total Scores
- Gentle Stimulation
- Oxygen
2 mins
Postnatal Circulation
- Infant Breathes
- Decreased Pressure in Pulmonary Vasculature
- Decreased Right Heart Pressure
- Increased Left Atrial Pressure
- Closes Foramen Ovale
- Increased O2
- Decreased Prostaglandins
- Closed Ductus Arteriosus
- Pharmacologic Intervention of Ductus Arteriosus
- Open with Prostaglandins
- Closed with Indomethacin
3 mins
Newborn Assessment
- APGAR
- Umbilical Cord
- 2 Arteries 1 Vein
- Eye Prophylaxis
- Fontanels
- Vitamin K Injection (Phytonadione)
- Gestational Age Assessment (GAA)
- Measurements
- Birth Weight
- Head Circumference
- Length
- Considerations
- Keep Warm
- ID Bands
3 mins
Imperforate Anus
- Mechanism
- Congenital Anorectal Malformation
- Signs and Symptoms
- No Anal Opening
- Absence of Meconium
- Gradual Increase in Abdominal Distention
- Considerations
- Surgical Repair
- Bowel Management
2 mins
Neonatal Respiratory Distress Syndrome
- Cause/Mechanism
- Fetal Lung Immaturity
- Lack of Surfactant
- Assessment
- Respiratory Distress
- Nasal Flaring
- Retractions
- Grunting
- Interventions
- Surfactant
- Oxygen
- Mechanical Ventilation
- Considerations
- Total Parenteral Nutrition (TPN)
2 mins
Developmental Dysplasia of the Hip
- Cause
- Abnormal Femoral Head in Acetabulum
- Newborn Assessment
- Positive Barlow Sign
- Clicking with Adduction
- Positive Ortolani Sign
- Clicking with Abduction
- Asymmetrical Limb Lengths and Folds (Gluteal and Thigh)
- Older Child Assessment
- Trendelenburg Sign
- Interventions
- Abduction Device
- Pavlik Harness
- Closed Reduction
3 mins
Hyperbilirubinemia
- Cause/Mechanism
- Increased Unconjugated Bilirubin
- Assessment
- Jaundice
- Kernicterus
- Interventions
- Early Feedings
- Heme Oxygenase Inhibitors
- Phototherapy
- Protect Eyes
- Monitor for Dehydration
- Considerations
- Monitor Bilirubin Levels
3 mins
Incompetent Cervix
- Mechanism
- Premature Cervical Dilation
- Assessment
- Recurring Miscarriage
- Short Cervix
- Considerations
- Cervical Cerclage
- Rest
- Labor
1 min
Prolapsed Umbilical Cord
- Mechanism
- Cord Prolapses
- Signs and Symptoms
- Visualization of Cord
- Prolonged or Variable Decelerations
- Considerations
- Hips Elevated
- Insert 2 fingers in Vagina
- Saline Towel on Cord
- Oxygen
2 mins
Sheehan's Syndrome
- Postpartum Pituitary Gland Necrosis
- Agalactorrhea
- Amenorrhea
- Secondary Hypothyroidism with Cold Intolerance
1 min
Chorioamnionitis
- Fever
- Maternal or fetal tachycardia
- Leukocytosis
- Foul Odor to Amniotic Fluid
- Treatment: Antibiotics
- Monitor uterine tenderness, contractions and fetal activity
- Monitor maternal vital signs & FHR
2 mins
RhoGam [Rho(D) Immune Globulin]
- Indications
- Antepartum Prevention at 28 weeks
- Suppress Antibody Production
- Mechanism of Action
- Lysis of Fetal RBC in Maternal Bloodstream
- Side Effects
- Myalgia and Lethargy
- Considerations
- Negative Coombs Test
- Standard Dose 300 mcg
- Microdose 50 mcg
- Blood Product
2 mins
Spontaneous Abortion Overview
- Assessment
- Bleeding < 20 weeks Gestation
- Interventions
- Identify Type
- Bed Rest
- Monitor for Hemorrhage
- Save Pads and Linens
- RhoGAM
- Dilation and Curettage (DandC)
- Cerclage
- Emotional Support
2 mins
Hydatidiform Mole (Molar Pregnancy)
- Cause/Mechanism
- Abnormal Fertilization
- Assessment
- Symptoms of Pregnancy
- Elevated hCG
- Vaginal Bleeding
- Inappropriate Uterine Growth
- No Fetal Heart Rate (FHR)
- Interventions
- Dilation and Curettage (D&C)
- Emotional Support
- Considerations
- No Pregnancy 1 Year
- Hysterectomy
3 mins
Pyelonephritis Assessment
- Cause/Mechanism
- Ascending Urethral Bacteria
- Assessment
- Dysuria
- Fever
- Fatigue
- Flank Pain
- Costovertebral Tenderness
- Nausea and Vomiting
1 min
Pyelonephritis Interventions
- Urinalysis
- NSAIDs
- Antibiotics
- Increase Fluid Intake
- Avoid Catheterization
- Consideration
- Urosepsis
1 min
Placental Implantation Abnormalities
- Mechanism
- Placenta Adheres Directly to Myometrium
- Placenta Accreta
- Placenta Increta
- Placenta Percreta
- Caused by Scar Tissue
- Hemorrhage
- Diagnosis
- Ultrasound is First-line, then MRI
- Treatment
- C-section Delivery
- Artery Ligation or Embolization
2 mins
Placenta Previa
- Mechanism
- Placenta Covers Cervical Os
- Assessment
- Painless
- Bright Red Vaginal Bleeding
- Interventions
- Stable Fetus
- Bed Rest
- Observation
- Unstable Fetus
- C-section Delivery
- Considerations
- Risk for Shock
- Magnesium Sulfate
- Tocolysis
3 mins
Pregnant Cardiac Patient Interventions
- Prenatal
- Monitor for Cardiac Decompensation
- Stool Softener
- Calcium Channel Blockers
- Labor
- ECG Monitor
- Open Glottis Pushing
- Pulmonary Artery Catheter
- No Beta-Adrenergic Medications
- Penicillin Prophylaxis
- Postpartum
- Stress on Heart
2 mins
Abruptio Placentae
- Mechanism
- Premature Separation of Placenta
- Assessment
- Tearing Pain
- Bleeding (Often Concealed)
- Rigid Uterus
- Contractions
- Interventions
- Corticosteroids as Needed
- Emergent Delivery
- Considerations
- Increased Risks for Neonate
- Rh (Rhesus) Incompatibilities
- Increased Risk for Shock
- Monitor Fetal Heart Rate
3 mins
Ectopic Pregnancy
- Signs and Symptoms
- Lower Abdominal Pain
- Delayed Menses
- Abnormal Vaginal Bleeding
- Shock
- Referred Shoulder Pain
- Cullen Sign
- Considerations
- Methotrexate
- Surgery
- RhoGAM
2 mins
Severe Preeclampsia
- Mechanism of Action
- Vasospasm and Decreased Organ Perfusion
- Intravascular Coagulation
- Increased Permeability and Capillary Leakage
- Signs and Symptoms
- Hypertension
- Proteinuria or End-Organ Dysfunction
- HELLP Syndrome
- Hepatic Dysfunction and Hemolysis
- Elevated Liver Enzymes
- Low Platelet Counts
3 mins
TORCHeS Screening
- TORCHES
- Toxoplasmosis
- Other
- Rubella
- Cytomegalovirus (CMV)
- Herpes Simplex Virus (HSV)
- Syphilis
- Considerations
- Diagnostic Testing
3 mins
Cytomegalovirus (CMV) TORCH
- Signs and Symptoms
- Nonspecific TORCH symptoms
- Intrauterine Growth Restriction (Retardation)
- Deafness
- Microcephaly
- Seizures
- Periventricular Calcifications
- Petechial Rash
- Blueberry Muffin Rash
- Chorioretinitis
- Diagnosis
- Urine Viral Culture or PCR
2 mins
Syphilis TORCH
- Signs and Symptoms
- Nonspecific TORCH Symptoms
- Often Results in Stillbirth
- Hydrops Fetalis
- Saber Shins
- Notched Teeth
- Saddle Nose
- Blindness
- Deafness
- Hepatitis
3 mins
Rubella TORCH
- Signs and Symptoms
- Nonspecific TORCH Symptoms
- Patent Ductus Arteriosus
- Pulmonary Artery Hypoplasia
- Cataracts
- Deafness
- Blueberry Muffin Rash
- Glaucoma
1 min
Toxoplasma gondii TORCH
- Signs and Symptoms
- Congenital TORCH Infection
- Mom Usually Asymptomatic
- Rarely Lymphadenopathy
- Nonspecific TORCH Signs
- Intrauterine Growth Retardation
- Hepatosplenomegaly
- Deafness
- Chorioretinitis
- Hydrocephalus
- Diagnosis
- Calcifications
1 min
Postpartum Infection
- Diagnosis
- Fever > 100.4F After 24 Hours (38 C)
- Risk Factors
- Multiple Vaginal Examinations
- Vaginal Trauma
- Prolonged Rupture of Membranes
- Cesarean Birth
- Anemia of Pregnancy
- Retained Placental Fragments
- Poor Health Status
3 mins
Postpartum Nursing Assessment
- BUBBLE - LE
- Breasts
- Uterus
- Bladder
- Bowels
- Lochia
- Episiotomy (Laceration)
- Lower Extremities
- Emotions
3 mins
Postpartum Hemorrhage
- Mechanism
- Uterine Atony
- Lacerations
- Retained Placenta
- Signs and Symptoms
- Bleeding
- Hypotension
- Boggy Uterus
- Considerations
- Oxytocin
- Bimanual Compression of Uterus
- Surgery
- Blood Transfusion
2 mins
Breastfeeding
- Benefits
- Complete Nutrition
- Antibody Protection
- Bonding
- Convenient
- SIDS Risk Reduced
- Possible Enhanced Cognitive Development
- Long-Term Health Benefits
2 mins
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