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Ground Zero
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Mechanisms of Labor

Mechanisms of Labor

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Included In This Lesson

Study Tools
Outline
ADPIE Related Lessons
Transcript
Additional Lessons

Study Tools For Mechanisms of Labor

Stages of Labor (Cheatsheet)
Stages of Childbirth-Head (Image)
Engagement of Fetus (Image)
Stages of Childbirth (Image)
Mechanism of Labor (Picmonic)
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Outline

Overview

  1. Cardinal movements-specific movements the baby does, in this specific order, to exit mom successfully
    1. This all happens fluidly during the process of delivery
  2. Fetus has to be well engaged and mom in true labor to be successful
  3. Membranes must rupture or be ruptured

Nursing Points

General

  1. Occasionally referred to as the Cardinal Movements
    1. Engagement
    2. Descent and flexion
    3. Internal rotation
    4. Extension
    5. Restitution and external rotation
    6. Expulsion
  2. True labor vs. false labor
    1. The uterus is a muscle and it contracts to prepare for childbirth
      1. False labor-can feel like true labor
      2. It is important to be able to differentiate between true vs. false labor.

Assessment

  1. Cardinal Movements explained
    1. Engagement:  where the presenting part descends through the pelvic inlet
      1. May be called lightening or dropping
      2. Occurs approximately 2 weeks before delivery
    2. Descent and flexion: process of presenting part (typically the head) going through mom’s pelvis, occur simultaneously as a fluid movement
      1. Baby flexes head down
      2. Descent is measured by station, continuous process until delivery
      3. 0 station = presenting part at ischial spine
      4. Minus station is up
      5. Plus station is closer to delivery
    3. Internal rotation: baby rotates within the birth canal
      1. Baby’s face in line with mom’s rectum
    4. Extension: baby’s head extends
      1. Begins after crowning
      2. Complete when chin is out of perineum
    5. Restitution and external rotation: occur simultaneously as a fluid movement
      1. Baby re-aligning its head with body
    6. Expulsion: baby’s entire body is out
  2. True labor vs. false labor
    1. True labor is progressive, regular, and becomes stronger
    2. If mom changes activity (going from resting to walking) and the contractions stop, it is FALSE labor
    3. True labor produces dilation, effacement, engagement and descent
      1. False labor does not do any of the above
    4. Other events that occur just before labor occurs
      1. Lightening
      2. Vaginal discharge increases
      3. Brown/blood tinged cervical mucus passes
      4. Cervix gets ready by ripening, potentially dilating/effacing
      5. Burst of energy can occur 24-48 hrs before (“nesting”)
      6. Estrogen and progesterone levels fluctuate, causing a fluid shift and subsequent weight loss of 2.2-6.6 kg approximately 24-48 hrs prior to labor
      7. Rupture of Membranes
  3. Rupture of membranes
    1. PPROM: Preterm premature rupture of membranes
      1. Greatest risk to baby occurs when this occurs before 37 weeks
      2. High risk for infection
        1. Bacteria gets in because prolonged rupture
    2. PROM: premature rupture of membranes
      1. Rupture prior to labor
      2. Can be gush of fluid or steady leak
    3. ROM: spontaneous rupture of membranes at full term
      1. AROM: artificial rupture of membranesDone with a tool or hand of physician

Therapeutic Management

  1. Rupture of membrane
    1. Might need to perform AROM
    2. Described as “water breaking”
    3. Absence of the buffer of the amniotic fluid in uterus. Fetal head will be on cervix and will stimulate uterine contractions and therefore labor
    4. Can be anywhere from 50-300 ml
  2. May need to perform Nitrazine test to determine if mother has urinated or ruptured membranes
    1. Tests pH of fluid
    2. Amniotic fluid has a pH of 7-7.5 and will turn test strip blue
      1. Alkaline

Nursing Concepts

  1. Reproduction
  2. Comfort

Patient Education

  1. True vs. False labor
    1. True: contractions can be timed regular, get stronger and closer together, do not stop with rest or activity
    2. False: Contractions are not regular, do not get stronger or closer together, stop with rest, hydration, and activity
  2. When to call MD
    1. Rupture of membranes
    2. Contractions 5 minutes apart
    3. bleeding
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Transcript

In this lesson I will explain how labor and the delivery occurs and your role in assisting the patient in a successful delivery.

The mechanisms of labor are known as the cardinal movements. These are the movements that the fetus does to find its way out. So first the fetus has to be engaged. This is the head in the pelvis engaged in and not moving back up. This can happen a few weeks before delivery and is also known as “lightening”. Now descent, so the fetus is moving further towards the “exit” and flexion of the head occurs. Flexion is that chin to chest to help the fetus move it’s way out. Descent is spoken in terms of the station that the fetus is in. This is discussed in the module on process of labor but basically you can see in this image that zero station means the fetus is at the ischial spines of the pelvis. As the baby gets closer to delivery it will be lower which is measured in centimeters and described as +1, +2 and so on. If the fetus is higher up above the ischial spines then it is -1,-2 and so on. The fetus will then have internal rotation. So it is going to rotate itself around then extend itself.

So after internal rotation we have extension. It will extend its neck so it is not chin to chest anymore to better get itself under those pelvis bones. The face is aligned with the maternal rectum and extends its head. This movement ends with the head delivering. Then there will be external rotation. So the head is delivered and it will rotate to realign its body. Sometimes the physician will help to do this. Last is expulsion. That fetus is going to expel the rest of its body out. In this image you can see the head is applied to the cervix and the cardinal movements start. The head is engaged and there is descent of the fetus. The fetus internal rotates and extends. External rotation can now occur to deliver or expel the rest of the body. There is also a great youtube video attached to this lesson that you can watch to visualize each movement.

For mechanisms of labor the patient needs to be in true labor. So let’s look at true labor versus false labor. True labor are contractions that are regular and can be timed. They are contractions that cause cervical change so dilation and effacement. Nothing stops them. False labor occurs because the uterus is a muscle and it contracts to prepare for childbirth. So it has to get the body ready. Sometimes false labor can feel like true labor. False labor are contractions that are not strong or regular. They make no cervical change. False labor can be stopped by hydrating and resting. Patients will also be told to walk to see if contractions are true labor. Walking will either cause them to get stronger and closer together because they are true labor but in false labor they will stop or not increase.

Now let’s look at the other items that occur prior to labor. Lightening is when the fetus drops, this just means the fetus descends further into the pelvis. When this happens two things occur. The patient can breath better because the fetus is lower and off the lungs. So that is a plus! But now it is lower and puts pressure on the bladder so the patient will have to void more. Vaginal discharge increases because of the cervix ripening and getting softer. There might be brown or blood tinged cervical mucus passing. This is pieces of the mucus plug. If you are a labor nurse then you will no doubt will have a patient at some point show up with a tupperware container and her mucus plug in it! They think this thing comes out and it means it is baby time. It can occur a few weeks prior to delivery though. Some woman won’t lose the plug as a whole. Some women will just have increased discharge and this is still the plug thinning out. The cervix is going to be softening and ripening possibly making some slight dilation and effacement. The patient might have a burst of energy known as nesting where the patient is quickly cleaning everything and getting ready for the baby. A fluctuation in hormones can cause a fluid shift and so weight loss might occur.

For delivery the bag of water must break. This can occur in several ways and different times. A PPROM means preterm premature rupture of membranes. This occurs prior to 37 weeks and the patient is at risk for infection. PROM is premature rupture of membranes. This occurs prior to labor. So she ruptures but is not in contracting. This could be a gush of fluid or a steady leak. Patients can either SROM, which is a spontaneous rupture of membranes at full term or AROM, which is an artificial rupture of membranes. This is done by the physician with an instrument to break the water. Infection is a risk for any rupture because that barrier is gone. PPROM patients are at the greatest risk because they are not in labor, which means they will be pregnant longer with no barrier.

Our management might involve rupturing the membranes or bag of water. This would be when the physician performs an AROM. When this occurs it gets rid of the buffer of the amniotic fluid in uterus. Fetal head will be able to drop and be on cervix and will stimulate uterine contractions and then labor. For a patient that comes in thinking that her water has broken then we may need to perform a Nitrazine test. This will determine if mother has urinated or ruptured membranes. Pregnant patients pee on themselves, it just happens so it is not an uncommon thing to have occur. The test is a strip of paper that is vagincally swabbed and it will turn blue if it is the amniotic fluid. The fluid is alkaline so it will turn blue in the presence of amniotic fluid.
The patient is going to need to be educated on true versus. false labor. In true labor the contractions can be timed regular, get stronger and closer together. and they do not stop with rest or activity. False labor is when contractions are not regular, do not get stronger or closer together, they stop with rest, hydration, and activity. They need to also know when to call the physician. SO for things like rupture of membranes, contractions 5 minutes apart, and bleeding.

Reproduction is reproduction has occurred and comfort to be provided during labor.
Ok so let’s look at our key points. The cardinal movements are engagement, descent and flexion, internal rotation, extension, restitution and external rotation, and expulsion. Labor can be true or false so we need to ask are they regular contractions? Is there cervical change? Do they go away or stay? And last our rupture of membranes. If it happens prior to 37 weeks it’s PPROM. PROM is rupture prior to labor. SROM is when the patient ruptures on her own at term and AROM is when the physician does it. It is artificial rupture.

Make sure you check out the resources attached to this lesson and look at each movement for the cardinal movements. Now, go out and be your best selves today. And, as always, happy nursing.

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Ground Zero

Concepts Covered:

  • Communication
  • Fundamentals of Emergency Nursing
  • Intraoperative Nursing
  • Documentation and Communication
  • Legal and Ethical Issues
  • Emergency Care of the Cardiac Patient
  • Delegation
  • Perioperative Nursing Roles
  • Preoperative Nursing
  • Community Health Overview
  • Prioritization
  • Studying
  • Factors Influencing Community Health
  • Concepts of Population Health
  • Understanding Society
  • Test Taking Strategies
  • Medication Administration
  • Adult
  • Microbiology
  • Cardiac Disorders
  • Anxiety Disorders
  • Depressive Disorders
  • Vascular Disorders
  • Nervous System
  • Upper GI Disorders
  • Central Nervous System Disorders – Brain
  • Gastrointestinal Disorders
  • Immunological Disorders
  • Dosage Calculations
  • Circulatory System
  • Concepts of Pharmacology
  • Hematologic Disorders
  • Newborn Care
  • Adulthood Growth and Development
  • Disorders of Pancreas
  • Respiratory Disorders
  • Postoperative Nursing
  • Pregnancy Risks
  • Neurological
  • Postpartum Complications
  • Substance Abuse Disorders
  • Noninfectious Respiratory Disorder
  • Bipolar Disorders
  • Peripheral Nervous System Disorders
  • Learning Pharmacology
  • Psychotic Disorders
  • Prenatal Concepts
  • Tissues and Glands
  • Basics of Chemistry
  • Gastrointestinal
  • Newborn Complications
  • Labor Complications
  • Fetal Development
  • Terminology
  • Labor and Delivery
  • Postpartum Care
  • EENT Disorders
  • Infectious Disease Disorders
  • Lower GI Disorders
  • Integumentary Disorders
  • Neurologic and Cognitive Disorders
  • Hematologic Disorders
  • Integumentary Disorders
  • Cardiovascular Disorders
  • Musculoskeletal Disorders
  • Endocrine and Metabolic Disorders
  • Renal and Urinary Disorders
  • Urinary System
  • Oncologic Disorders
  • Renal Disorders
  • Infectious Respiratory Disorder
  • Urinary Disorders
  • Sexually Transmitted Infections
  • EENT Disorders
  • Behavior
  • Emotions and Motivation
  • Growth & Development
  • Psychological Disorders
  • State of Consciousness
  • Health & Stress

Study Plan Lessons

Communicating with Other Nurses
Conflict Management (Patient, Perioperative Team, Family) for Certified Perioperative Nurse (CNOR)
CRNA
Daily Charting
Day in the Life of a Labor Nurse
Day in the Life of a Med-surg Nurse
Day in the Life of a NICU Nurse
Day in the Life of a Postpartum Nurse
Day in the Life of an ICU (Intensive Care Unit) Nurse
Day in the Life of an Operating Room Nurse
Delegation and Personnel Management for Certified Perioperative Nurse (CNOR)
Delegation of Tasks to Assistive Personnel for Certified Emergency Nursing (CEN)
HCIR Management (Healthcare Industry Representative) for Certified Perioperative Nurse (CNOR)
Interdisciplinary Team Participation for Certified Perioperative Nurse (CNOR)
Joint Commission
MSN (Masters) vs. DNP (Doctorate)
Oncology nurse
Patient Consent for Treatment for Certified Emergency Nursing (CEN)
Patient Education
Patient Satisfaction for Certified Emergency Nursing (CEN)
Safety Checks
SBAR Practice Scenarios
Shift change and Patient handoff
The Medical Team
Time Management
Transition To Practice
Access to Care
Age and Culturally Appropriate Health Assessment Techniques for Certified Perioperative Nurse (CNOR)
Care of Vulnerable Populations
Child Abuse/Neglect – Warning Signs Nursing Mnemonic (CHILD ABUSE)
Communicable Diseases
Community Health Nursing Theories
Continuity of Care
Epidemiology
Levels of Prevention
Giving the Best Patient Education
Health Promotion Assessments
Health Promotion & Disease Prevention
High-Risk Behaviors
High Risk Behavior Nursing Mnemonic (HEADSS)
Health Promotion Model
Patient Education
Planning Community Health Interventions Nursing Mnemonic (PRECEDE-PROCEED)
Technology & Informatics
12 Points to Answering Pharmacology Questions
6 Rights of Medication Administration
ACLS (Advanced cardiac life support) Drugs
Adenosine (Adenocard) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Anesthetic Agents
Anti-Infective – Antifungals
Anti-Platelet Aggregate
Antianxiety Meds
Antidepressants
Atenolol (Tenormin) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Barbiturates
Bariatric: IV Insertion
Basics of Calculations
Benztropine (Cogentin) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Combative: IV Insertion
Complex Calculations (Dosage Calculations/Med Math)
Cyclosporine (Sandimmune) Nursing Considerations
Dark Skin: IV Insertion
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Drawing Blood from the IV
Drawing Up Meds
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Epoetin Alfa
Eye Prophylaxis for Newborn
Fentanyl (Duragesic) Nursing Considerations
Geriatric: IV Insertion
Giving Medication Through An IV Set Port
Glipizide (Glucotrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Hanging an IV Piggyback
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Hydralazine
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
IM Injections
Injectable Medications
Insulin
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin Drips
Insulin Mixing
Interactive Pharmacology Practice
Interactive Practice Drip Calculations
IV Catheter Selection (gauge, color)
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Infusions (Solutions)
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
IV Pump Management
IV Push Medications
Ketorolac (Toradol) Nursing Considerations
Labeling (Medications, Solutions, Containers) for Certified Perioperative Nurse (CNOR)
Lidocaine (Xylocaine) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Maintenance of the IV
Mannitol (Osmitrol) Nursing Considerations
MAOIs
Medication Errors
Medication Reconciliation Review for Certified Perioperative Nurse (CNOR)
Medications in Ampules
Meds for Postpartum Hemorrhage (PPH)
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Methylergonovine (Methergine) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Mood Stabilizers
Nalbuphine (Nubain) Nursing Considerations
Needle Safety
Neostigmine (Prostigmin) Nursing Considerations
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nitro Compounds
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
Nystatin (Mycostatin) Nursing Considerations
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Olanzapine (Zyprexa) Nursing Considerations
Opioid Analgesics in Pregnancy
Oral Medications
Oxycodone (OxyContin) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Pain Management Meds – Live Tutoring Archive
Parasympathomimetics (Cholinergics) Nursing Considerations
Patient Controlled Analgesia (PCA)
Pediatric Dosage Calculations
Pentobarbital (Nembutal) Nursing Considerations
Pharmacodynamics
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
Pharmacology Course Introduction
Phenobarbital (Luminal) Nursing Considerations
Phytonadione (Vitamin K) for Newborn
Pill Crushing & Cutting
Positioning
Procainamide (Pronestyl) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Rh Immune Globulin in Pregnancy
Sedatives-Hypnotics
Sedatives-Hypnotics
Selecting THE vein
Spiking & Priming IV Bags
Starting an IV
Streptokinase (Streptase) Nursing Considerations
Struggling with Dimensional Analysis? – Live Tutoring Archive
SubQ Injections
Supplies Needed
Tattoos IV Insertion
TCAs
The SOCK Method – C
The SOCK Method – K
The SOCK Method – O
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method of Pharmacology 1 – Live Tutoring Archive
The SOCK Method of Pharmacology 2 – Live Tutoring Archive
The SOCK Method of Pharmacology 3 – Live Tutoring Archive
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations
Acids & Bases (acid base balance)
05.03 Jaundice for CCRN Review
Abortion in Nursing: Spontaneous, Induced, and Missed
Abruptio Placenta for Certified Emergency Nursing (CEN)
Abruptio Placentae (Placental abruption)
Acyclovir (Zovirax) Nursing Considerations
Addicted Newborn
Adult Vital Signs (VS)
Alpha-fetoprotein (AFP) Lab Values
Ampicillin (Omnipen) Nursing Considerations
Anemia in Pregnancy
Antepartum Testing
Antepartum Testing Case Study (45 min)
Anti-Infective – Aminoglycosides
Anti-Infective – Lincosamide
Aspiration for Certified Emergency Nursing (CEN)
Babies by Term
Behind The Red Line – Live Tutoring Archive
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone in Pregnancy
Bicarbonate (HCO3) Lab Values
Blood Cultures
Blood Glucose Monitoring
Blood Transfusions (Administration)
Body System Assessments
Breastfeeding
Butorphanol (Stadol) Nursing Considerations
Cardiac (Heart) Disease in Pregnancy
Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)
Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)
Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)
Certified Nurse Midwife
Chorioamnionitis
Clindamycin (Cleocin) Nursing Considerations
Congestive Heart Failure (CHF) Labs
Day in the Life of a Labor Nurse
Day in the Life of a Postpartum Nurse
Dexamethasone (Decadron) Nursing Considerations
Direct Bilirubin (Conjugated) Lab Values
Discomforts of Pregnancy
Disseminated Intravascular Coagulation (DIC)
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Dystocia
Ectopic Pregnancy
Ectopic Pregnancy Case Study (30 min)
Ectopic Pregnancy for Certified Emergency Nursing (CEN)
Emergent Delivery (OB) (30 min)
Emergent Delivery for Certified Emergency Nursing (CEN)
Epidural
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Erythroblastosis Fetalis
Eye Prophylaxis for Newborn
Eye Prophylaxis for Newborn (Erythromycin)
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Family Planning & Contraception
Family Planning & Signs of Pregnancy – Live Tutoring Archive
Fertilization and Implantation
Fetal Alcohol Syndrome (FAS)
Fetal Circulation
Fetal Development
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Environment
Fetal Heart Monitoring (FHM)
Fetal Heart Monitoring Like A Pro – Live Tutoring Archive
Fetal Heart Monitoring Like A Pro 2 – Live Tutoring Archive
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fundal Height Assessment for Nurses
Furosemide (Lasix) Nursing Considerations
Gestation & Nägele’s Rule: Estimating Due Dates
Gestational Diabetes (GDM)
Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive
Gestational HTN (Hypertension)
Glucagon Lab Values
Glucose Tolerance Test (GTT) Lab Values
Gravidity and Parity (G&Ps, GTPAL)
HELLP Syndrome
HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hemodynamics
Hemoglobin A1c (HbA1C)
Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)
Hepatitis B Vaccine for Newborns
Homocysteine (HCY) Lab Values
Hydatidiform Mole (Molar pregnancy)
Hydralazine (Apresoline) Nursing Considerations
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Hyperbilirubinemia (Jaundice)
Hyperemesis Gravidarum
Hyperemesis Gravidarum for Certified Emergency Nursing (CEN)
Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)
Hypovolemic Shock Case Study (OB sim) (60 min)
Incompetent Cervix
Infections in Pregnancy
Initial Care of the Newborn (APGAR)
Inserting a Foley (Urinary Catheter) – Female
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Isotonic Solutions (IV solutions)
Labor Progression Case Study (45 min)
Leopold Maneuvers
Lung Surfactant
Lung Surfactant for Newborns
Magnesium Sulfate
Magnesium Sulfate
Magnesium Sulfate (MgSO4) Nursing Considerations
Magnesium Sulfate in Pregnancy
Mastitis
Maternal Risk Factors
Mechanisms of Labor
Meconium Aspiration
Meds for Postpartum Hemorrhage (PPH)
Meds for PPH (postpartum hemorrhage)
Menstrual Cycle
Methylergonovine (Methergine) Nursing Considerations
Newborn of HIV+ Mother
Newborn Physical Exam
Newborn Reflexes
Nifedipine (Procardia) Nursing Considerations
Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Chorioamnionitis
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Dystocia
Nursing Care Plan (NCP) for Ectopic Pregnancy
Nursing Care Plan (NCP) for Gestational Diabetes (GDM)
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for Hyperemesis Gravidarum
Nursing Care Plan (NCP) for Hypertension (HTN)
Nursing Care Plan (NCP) for Incompetent Cervix
Nursing Care Plan (NCP) for Mastitis
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Meconium Aspiration
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Newborns
Nursing Care Plan (NCP) for Placenta Previa
Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)
Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)
Nursing Care Plan (NCP) for Preterm Labor / Premature Labor
Nursing Care Plan (NCP) for Process of Labor
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)
Nursing Care Plan for Newborn Reflexes
Nursing Case Study for Maternal Newborn
Nutrition Assessments
Nutrition in Pregnancy
Nutritional Requirements
OB (Labor) Nurse Report to OB (Postpartum) Nurses
OB Course Introduction
OB Non-Stress Test Results Nursing Mnemonic (NNN)
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Obstetric Trauma for Certified Emergency Nursing (CEN)
Obstetrical Procedures
Opioid Analgesics in Pregnancy
Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)
Oxytocin (Pitocin) Nursing Considerations
Pediatric Vital Signs (VS)
Physiological Changes
Phytonadione (Vitamin K)
Phytonadione (Vitamin K) for Newborn
Placenta Previa
Placenta Previa for Certified Emergency Nursing (CEN)
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Postpartum Discomforts
Postpartum Hematoma
Postpartum Hemorrhage (PPH)
Postpartum Interventions
Postpartum Physiological Maternal Changes
Postpartum Thrombophlebitis
Precipitous Labor
Preeclampsia (45 min)
Preeclampsia, Eclampsia, and HELLP Syndrome for Certified Emergency Nursing (CEN)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Pregnancy Labs
Pregnancy Outcomes Nursing Mnemonic (GTPAL)
Preload and Afterload
Premature Rupture of the Membranes (PROM)
Preterm Labor
Preterm Labor for Certified Emergency Nursing (CEN)
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Process of Labor
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Process of Labor – Baby Nursing Mnemonic (ALPPPS)
Process of Labor – Live Tutoring Archive
Process of Labor 2 – Live Tutoring Archive
Prolapsed Umbilical Cord
Promethazine (Phenergan) Nursing Considerations
Prostaglandins
Prostaglandins in Pregnancy
Protein (PROT) Lab Values
Retinopathy of Prematurity (ROP)
Rh Immune Globulin (Rhogam)
Rh Immune Globulin in Pregnancy
Signs of Pregnancy – Live Tutoring Archive
Signs of Pregnancy (Presumptive, Probable, Positive)
Spironolactone (Aldactone) Nursing Considerations
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Subinvolution
Terbutaline (Brethine) Nursing Considerations
Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)
Tips & Advice for Newborns (Neonatal IV Insertion)
Tocolytics
Tocolytics
Top 5 Misunderstood OB Concepts – Live Tutoring Archive
Transient Tachypnea of Newborn
Umbilical Cord Vasculature Nursing Mnemonic (2A1V)
Uterine Stimulants (Oxytocin, Pitocin)
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)
What the Heck is Antepartum Testing? – Live Tutoring Archive
Abdomen (Abdominal) Assessment
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Acetaminophen (Tylenol) Nursing Considerations
Acute Bronchitis
Acute Otitis Media (AOM)
Airborne Precaution Diseases Nursing Mnemonic (MTV)
Albuterol (Ventolin) Nursing Considerations
Alveoli & Atelectasis
Amoxicillin (Amoxil) Nursing Considerations
Anti-Infective – Antivirals
Anti-Infective – Macrolides
Anti-Infective – Penicillins and Cephalosporins
Anti-Infective – Fluoroquinolones
Appendicitis
Appendicitis – Assessment Nursing Mnemonic (PAINS)
Appendicitis Case Study (Peds) (30 min)
Appendicitis for Certified Emergency Nursing (CEN)
Assessment of a Burn Nursing Mnemonic (SCALD)
Asthma
Asthma Concept Map
Asthma management Nursing Mnemonic (ASTHMA)
Attention Deficit Hyperactivity Disorder (ADHD)
Autism Spectrum Disorders
Base Excess & Deficit
Bisacodyl (Dulcolax) Nursing Considerations
Blood Brain Barrier (BBB)
Blood Type O Nursing Mnemonic (Universally Odd)
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Bronchodilators
Bupropion (Wellbutrin) Nursing Considerations
Burn Injuries
Burn Injury Case Study (60 min)
Burns for Certified Emergency Nursing (CEN)
Cardiac Glycosides
Care of the Pediatric Patient
Casting & Splinting
Cefaclor (Ceclor) Nursing Considerations
Celiac Disease
Cerebral Palsy (CP)
Cimetidine (Tagamet) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Cleft Lip and Palate
Cleft Lip Repair – Post Op Care Nursing Mnemonic (CLEFT LIP)
Clubfoot
Congenital Heart Defects (CHD)
Conjunctivitis
Constipation and Encopresis (Incontinence)
Corticosteroids
Coumarins
Cyanotic Defects Nursing Mnemonic (The 4 T’s)
Cystic Fibrosis (CF)
Day in the Life of a NICU Nurse
Day in the Life of a Peds (Pediatric) Nurse
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Dehydration
Diarrhea – Treatment Nursing Mnemonic (BRAT)
Digoxin (Lanoxin) Nursing Considerations
Diphenhydramine (Benadryl) Nursing Considerations
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Eczema
EENT Assessment
Enuresis
Epiglottitis
Epiglottitis – Signs and Symptoms Nursing Mnemonic (AIR RAID)
Epispadias and Hypospadias
Famotidine (Pepcid) Nursing Considerations
Fever
Fever Case Study (Pediatric) (30 min)
Flu Symptoms Nursing Mnemonic (FACTS)
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Fluid Volume Deficit
Fluticasone (Flonase) Nursing Considerations
Gas Exchange
Gentamicin (Garamycin) Nursing Considerations
Glucose Lab Values
Gluten Free Diet Nursing Mnemonic (BROW)
Guaifenesin (Mucinex) Nursing Considerations
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hematocrit (Hct) Lab Values
Hemoglobin (Hbg) Lab Values
Hemophilia
Hierarchy of O2 Delivery
Hydrocephalus
Hypoxia – Signs and Symptoms (in Pediatrics) Nursing Mnemonic (FINES)
Ibuprofen (Motrin) Nursing Considerations
Immunizations (Vaccinations)
Imperforate Anus
Impetigo
Indomethacin (Indocin) Nursing Considerations
Influenza – Flu
Integumentary (Skin) Assessment
Intussusception
Intussusception for Certified Emergency Nursing (CEN)
Iron Deficiency Anemia
Isolation Precaution Types (PPE)
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Lactulose (Generlac) Nursing Considerations
Leukemia
Levels of Consciousness (LOC)
Levetiracetam (Keppra) Nursing Considerations
Lung Sounds
Marfan Syndrome
Meningitis
Meningitis Assessment Findings Nursing Mnemonic (FAN LIPS)
Meningitis for Certified Emergency Nursing (CEN)
Methylphenidate (Concerta) Nursing Considerations
Mixed (Cardiac) Heart Defects
Mumps
Nephroblastoma
Nephrotic Syndrome
Nephrotic Syndrome Case Study (Peds) (45 min)
Neuro Assessment
NSAIDs
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Appendicitis
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Attention Deficit Hyperactivity Disorder (ADHD)
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Burn Injury (First, Second, Third degree)
Nursing Care Plan (NCP) for Celiac Disease
Nursing Care Plan (NCP) for Cerebral Palsy (CP)
Nursing Care Plan (NCP) for Cleft Lip / Cleft Palate
Nursing Care Plan (NCP) for Clubfoot
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Constipation / Encopresis
Nursing Care Plan (NCP) for Cystic Fibrosis
Nursing Care Plan (NCP) for Decreased Cardiac Output
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Eczema (Infantile or Childhood) / Atopic Dermatitis
Nursing Care Plan (NCP) for Enuresis / Bedwetting
Nursing Care Plan (NCP) for Epiglottitis
Nursing Care Plan (NCP) for Fluid Volume Deficit
Nursing Care Plan (NCP) for Hemophilia
Nursing Care Plan (NCP) for Hydrocephalus
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care Plan (NCP) for Imperforate Anus
Nursing Care Plan (NCP) for Impetigo
Nursing Care Plan (NCP) for Infective Conjunctivitis / Pink Eye
Nursing Care Plan (NCP) for Influenza
Nursing Care Plan (NCP) for Intussusception
Nursing Care Plan (NCP) for Marfan Syndrome
Nursing Care Plan (NCP) for Meningitis
Nursing Care Plan (NCP) for Mumps
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Omphalocele
Nursing Care Plan (NCP) for Otitis Media / Acute Otitis Media (AOM)
Nursing Care Plan (NCP) for Pediculosis Capitis / Head Lice
Nursing Care Plan (NCP) for Pertussis / Whooping Cough
Nursing Care Plan (NCP) for Phenylketonuria (PKU)
Nursing Care Plan (NCP) for Reye’s Syndrome
Nursing Care Plan (NCP) for Rheumatic Fever
Nursing Care Plan (NCP) for Rubeola – Measles
Nursing Care Plan (NCP) for Scoliosis
Nursing Care Plan (NCP) for Sickle Cell Anemia
Nursing Care Plan (NCP) for Tonsillitis
Nursing Care Plan (NCP) for Varicella / Chickenpox
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan for (NCP) Autism Spectrum Disorder
Nursing Case Study for Pediatric Asthma
Obstructive Heart (Cardiac) Defects
Ocular Infections (Conjunctivitis, Iritis) for Certified Emergency Nursing (CEN)
Omphalocele
Opioid Analgesics
Pancrelipase (Pancreaze) Nursing Considerations
Pediatric Bronchiolitis Labs
Pediatric Gastrointestinal Dysfunction – Diarrhea
Pediatric Oncology Basics
Pediatrics Course Introduction
Pediculosis Capitis
Pertussis – Whooping Cough
Phenylketonuria
Phenytoin (Dilantin) Nursing Considerations
Platelets (PLT) Lab Values
Pneumonia
Promotion and Evaluation of Normal Elimination Nursing Mnemonic (POOPER SCOOP)
Pulmonary Function Test
Red Blood Cell (RBC) Lab Values
Respiratory Acidosis (interpretation and nursing interventions)
Reye’s Syndrome
Reyes Syndrome Case Study (Peds) (45 min)
Rheumatic Fever
ROME – ABG (Arterial Blood Gas) Interpretation
Rubeola – Measles
Salmeterol (Serevent) Nursing Considerations
Scoliosis
Selegiline (Eldepyrl) Nursing Considerations
Sickle Cell Anemia
Spina Bifida – Neural Tube Defect (NTD)
Steroids – Side Effects Nursing Mnemonic (6 S’s)
Stoma Care (Colostomy bag)
Strabismus
Sudden Infant Death Syndrome (SIDS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Thorax and Lungs Assessment
Tonsillitis
Topical Medications
Tracheal Esophageal Fistula – Sign and Symptoms Nursing Mnemonic (The 3 C’s)
Transient Incontinence – Common Causes Nursing Mnemonic (P-DIAPERS)
Treatment of Sickle Cell Nursing Mnemonic (HOP to the hospital)
Umbilical Hernia
Vaccine-Preventable Diseases (Measles, Mumps, Pertussis, Chicken Pox, Diphtheria) for Certified Emergency Nursing (CEN)
Varicella – Chickenpox
Varicella Case Study (Peds) (30 min)
Vitals (VS) and Assessment
Vomiting
White Blood Cell (WBC) Lab Values
X-Ray (Xray)
ADLs (Activity of Daily Living) Nursing Mnemonic (BATTED)
Emotions and Motivation
Growth & Development Theories
Maslow’s Hierarchy of Needs in Nursing
Psychological Disorders
State of Consciousness
Stress and Crisis