Newborn of HIV+ Mother
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Outline
Overview
- Close monitoring of HIV+ pregnant women is essential
- Current recommendations are for HIV+ mothers to not breastfeed because of transmission risk
Nursing Points
General
- Ongoing assessment of the newborn up to 18 month after birth is necessary, as mother’s antibodies persist that long
- Lab tests
- Modes of transmission
- Across the placenta during pregnancy
- During childbirth
- Through breastmilk
Assessment
- Asymptomatic at birth
- Immunodeficiencies
- CBC with differential (CD4 count)
- Blood test for HIV
Therapeutic Management
- Interventions
- Antiretrovirals
- AZT (zidovudine)
- Watch for signs of immunocompromise (enlarged liver or spleen)
- Immediate bath
- Lab tests
- HIV testing
- Unreliable until around 18 months because of maternal antibodies
- HIV testing
- Antiretrovirals
Nursing Concepts
- Immunity
- Infection control
- Lab values
Patient Education
- Guidelines for breastfeeding
- Guidelines for vaccinations
- No live vaccines until it is confirmed that there is no HIV
- Importance of follow-up and testing
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ADPIE Related Lessons
Related Nursing Process (ADPIE) Lessons for Newborn of HIV+ Mother
Transcript
In this lesson I will explain the significance of a newborn of a HIV+ mom and your role in care for this patient.
So you have a patient that is pregnant and has HIV. Our care will revolve around protecting the newborn as best we can. To do this you need to understand how it is transmitted. So there are a few ways. It could cross the placenta during pregnancy, it could transmit during childbirth and through breast milk. So if it crosses through the placenta we can’t prevent that but things we can do is have the patient deliver by c-section. This will limit the exposure risk. We also want to help limit the exposure risk by encouraging bottle feeding because breastfeeding can continue to expose the newborn. I was once caring for a newborn whose mother was HIV+. I went in her room prior to delivery to let her know everything that would be done after delivery. The reason why I wanted to prep her with what to expect was because I was told that the father of the baby was unaware that she had HIV. It was crazy because the patient was also a lawyer. Right?! Just the whole legal piece to this. So the labor nurse went in and she said she had told the father everything and we were good. So I was thinking, great no more secrets. Well then I walk back to the OR for delivery and the doctor was scrubbing in and the dad was sitting with his head against the wall. I just knew something had gone down. Come to find out the doctor asked him if he had any questions about the HIV. The dad’s response was “she told me about it and that all the babies receive prophylactic medication and treatment” I think as he was saying it he realized how crazy it sounded. The doctor told him “No, she has HIV and you need to be tested immediately” and then in walks me thinking everything is good. So I would fully expect anyone to storm out upset but he stayed for the delivery, took pictures and acted as everything was fine. He left after the delivery and hopefully got tested. It was awful! We all felt so bad for him and also the mom as she explained she got HIV at birth because her mom had a drug problem and she didn’t want to tell him because he wouldn’t love her anymore. I wish I knew the ending to this one but am not sure what went on after.
So now let’s look at our assessment and management. When you have a baby born of an HIV+ mother you really won’t notice anything different. They are asymptomatic of anything at this time. They will have lab work assessment done but most of this is a sent out that won’t be known while in the hospital and will be used for follow up. They will get a CD4 count and be tested for HIV. These patients have a long follow up because they have the mother’s antibodies so if you look at that immediate lab work it does appear that they have HIV but really they just have the antibody and this can take 18 months to really be able to decipher if they truly have HIV too. Before any lab work or medications are started the baby will need a bath. We want to do this as soon as possible after delivery to clean the baby of any of maternal fluids. Antiretrovirals are necessary as prophylaxis with Zidovudine or AZT will be given. This medication will continue for 4-6 weeks so they are on this for a while.
Education is going to include the recommendations for breastfeeding. Breastfeeding should not occur because this increases the exposure risk. We want to educate on the medications that the newborn will receive in the hospitals and vaccination education. So they can not be given any live vaccines until it is confirmed that they don’t have HIV. The newborns are not given any live vaccines during these first few days but education should be given so the mother understands that her baby can not receive any live vaccines. We need to also educate on the Importance of follow-up and testing for this newborn. It will be the mother’s responsibility to ensure this baby gets to the follow up appointments. This newborn will have a lot of testing in the future to confirm a diagnosis or show that there is no HIV so really important for the child to have.
Concepts will be immunity because we are worried about the immune system of the newborn, infection control because we are trying to prevent the exposure and spread of HIV and lab values because this newborn will receive frequent lab tests and monitoring.
So the key points. If you remember these main points you will have a great understanding for the care of this patient. The baby must be delivered by c-section to limit any blood exposure with the mother and will need an immediate bath to clean maternal fluids from the baby as well as prophylactic AZT, zidovudine, and no breastfeeding.
Make sure you check out the resources attached to this lesson and the immediate care that this newborn will receive. Now, go out and be your best selves today. And, as always, happy nursing.
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Study Plan Lessons
Alkalosis and Acidosis Nursing Mnemonic (Kick Up, Drop Down)
Blood Grouping
Blood Plasma
Blood Pressure (BP) Control
Breathing Control
Breathing Movements
Causes of Poor Gas Exchange Nursing Mnemonic (All People Can Value Lungs)
EKG (ECG) Waveforms
Electrolytes – Location in Body Nursing Mnemonic (PISO)
Electrolytes Involved in Cardiac (Heart) Conduction
Fluid & Electrolytes Course Introduction
Fluid Volume Deficit
Hyperkalemia – Causes Nursing Mnemonic (MACHINE)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypernatremia – Causes Nursing Mnemonic (MODEL)
Nursing Care Plan (NCP) for Fluid Volume Deficit
Renal (Kidney) Fluid & Electrolyte Balance
Renal (Kidney) Acid-Base Balance
Respiratory Functions of Blood
Tonicity of Solutions – Live Tutoring Archive
Trach Suctioning
12 Points to Answering Pharmacology Questions
ACLS (Advanced cardiac life support) Drugs
Anti-Infective – Antifungals
Anti-Platelet Aggregate
Antianxiety Meds
Antidepressants
Barbiturates
Buspirone (Buspar) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Cyclosporine (Sandimmune) Nursing Considerations
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Hydralazine
IM Injections
Injectable Medications
Insulin
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin Mixing
Interactive Pharmacology Practice
IV Infusions (Solutions)
IV Push Medications
Maintenance of the IV
Mannitol (Osmitrol) Nursing Considerations
Medication Errors
Meperidine (Demerol) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Mood Stabilizers
Olanzapine (Zyprexa) Nursing Considerations
Parasympathomimetics (Cholinergics) Nursing Considerations
Rh Immune Globulin in Pregnancy
SubQ Injections
The SOCK Method – Overview
Introduction to Metabolism
Anti-Infective – Antifungals
Antiviral Agents for Treatment
Hb (Hepatitis) Vaccine
Infection or Inflammation? The Quick & Dirty on CBCs – Live Tutoring Archive
Infection or Inflammation? The Quick & Dirty on CBCs 2 – Live Tutoring Archive
Infection Stages
Key Nutrients in the Prevention of Chronic Disease
Nursing Care Plan (NCP) for Infection
Tonicity of Solutions – Live Tutoring Archive
Viruses & Fungi
Scientific Notation & Measurement
Care for Asian-Indian Patient Populations
Care for Hispanic Patient Populations
Care for Native American Patient Populations
Care of Vulnerable Populations
Caring for African Patient Populations
Child Abuse/Neglect – Warning Signs Nursing Mnemonic (CHILD ABUSE)
Communicable Diseases
Community Health Course Introduction
Community Health Tool Nursing Mnemonic (MAP-IT)
Continuity of Care
Cultural Care
Environmental Health
Epidemiology
Fire and Electrical Safety
Health Promotion & Disease Prevention
High Risk Behavior Nursing Mnemonic (HEADSS)
Levels of Prevention
Planning Community Health Interventions Nursing Mnemonic (PRECEDE-PROCEED)
Technology & Informatics
Program Planning
1st Degree AV Heart Block
Acute Confusion
Acute Coronary Syndrome (ACS)
Acute Respiratory Distress
Aneurysm & Dissection
Atrial Fibrillation (A Fib)
Calling for RRT, Code Blue
Crush Injuries
Delegation of Tasks to Assistive Personnel for Certified Emergency Nursing (CEN)
Drugs for Bradycardia & Low Blood Pressure Nursing Mnemonic (IDEA)
Dysrhythmia Emergencies
EKG Basics – Live Tutoring Archive
Fall and Injury Prevention
Heart (Heart) Failure Exacerbation
Hypertension (HTN) Concept Map
Hypertensive Emergency
Increased Intracranial Pressure
Legal & Ethical Issues in ER
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Pulmonary Embolism
Rapid Sequence Intubation
Premature Ventricular Contraction (PVC)
Premature Atrial Contraction (PAC)
Safety Check Nursing Mnemonic (MADLE)
Stress and Crisis
Supraventricular Tachycardia (SVT)
Trauma – Complications Nursing Mnemonic (TRAUMATIC)
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Aggressive & Violent Patients
Cultural Awareness and Influences on Development
Developmental Stages and Milestones
Erikson’s Theory of Psychosocial Development
Handling Death and Dying
Kohlberg’s Theory of Moral Development
Overview of Childhood Growth & Development
Overview of Developmental Theories
Growth and Development – Prenatal
Piaget’s Theory of Cognitive Development
Vocabulary
Brief CPR (Cardiopulmonary Resuscitation) Overview
Abortion in Nursing: Spontaneous, Induced, and Missed
Abruptio Placentae (Placental abruption)
Acyclovir (Zovirax) Nursing Considerations
Addicted Newborn
Antepartum Testing
Babies by Term
Betamethasone and Dexamethasone
Bicarbonate (HCO3) Lab Values
Blood Cultures
Blood Transfusions (Administration)
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)
Day in the Life of a Labor Nurse
Congestive Heart Failure (CHF) Labs
Disseminated Intravascular Coagulation (DIC)
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Fetal Alcohol Syndrome (FAS)
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Fundal Height Assessment for Nurses
Gestation & Nägele’s Rule: Estimating Due Dates
Gestational Diabetes (GDM)
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HELLP Syndrome
Hyperbilirubinemia (Jaundice)
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Initial Care of the Newborn (APGAR)
Mastitis
Maternal Risk Factors
Newborn of HIV+ Mother
Nifedipine (Procardia) Nursing Considerations
Nursing Care Plan (NCP) for Dystocia
Nursing Care Plan (NCP) for Mastitis
Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)
OB Non-Stress Test Results Nursing Mnemonic (NNN)
Oxytocin (Pitocin) Nursing Considerations
Pediatric Vital Signs (VS)
Placenta Previa
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Preload and Afterload
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Prolapsed Umbilical Cord
Spironolactone (Aldactone) Nursing Considerations
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Terbutaline (Brethine) Nursing Considerations
Transient Tachypnea of Newborn
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)
Cardiac Terminology
Hematology Oncology & Immunology Terminology
MedTerm Basic Word Structure
Psychiatry Terminology
ACE (angiotensin-converting enzyme) Inhibitors
Acute Renal (Kidney) Module Intro
Addisons Assessment Nursing Mnemonic (STEROID)
Addisons Disease
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Angiotensin Receptor Blockers
Anticonvulsants
Antidiabetic Agents
ASA (Aspirin) Nursing Considerations
Atorvastatin (Lipitor) Nursing Considerations
Azithromycin (Zithromax) Nursing Considerations
Bleeding Precautions Nursing Mnemonic (RANDI)
Blood Flow Through The Heart
Breast Cancer Concept Map
Breast Cancer
Bronchoscopy
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Calcium Channel Blockers
Canes Nursing Mnemonic (COAL)
Cardiac Stress Test
Cardiovascular Disorders (CVD) Module Intro
Cataracts
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
Causes of Pancreatitis Nursing Mnemonic (BAD HITS)
Central Line Dressing Change
Chest Tube Assessment Nursing Mnemonic (Two AA’s)
Chest Tube Management
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Cirrhosis Complications Nursing Mnemonic (Please Bring Happy Energy)
Coagulation Studies (PT, PTT, INR)
Clopidogrel (Plavix) Nursing Considerations
Complications of Immobility
Continuous Renal Replacement Therapy (CRRT, dialysis)
COPD Concept Map
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
Coronary Artery Disease Concept Map
Crohn’s Morphology and Symptoms Nursing Mnemonic (CHRISTMAS)
Cushings Assessment Nursing Mnemonic (STRESSED)
Dementia and Alzheimers
Diabetes Insipidus Nursing Mnemonic (DDD)
Diabetes Management
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diltiazem (Cardizem) Nursing Considerations
Discharge (DC) Teaching After Surgery
Diverticulitis Complications Nursing Mnemonic (Please Fix His Abscess SOon)
DKA Treatment Nursing Mnemonic (KING UFC)
Diabetic Ketoacidosis for Progressive Care Certified Nurse (PCCN)
Dopamine (Inotropin) Nursing Considerations
Encephalopathies
Enoxaparin (Lovenox) Nursing Considerations
Enteral & Parenteral Nutrition (Diet, TPN)
Essential NCLEX Meds by Class
Evaluation of Irregular Moles Nursing Mnemonic (ABCDE)
Fibromyalgia
Fluid Volume Overload
Gastrointestinal (GI) Bleed Concept Map
Genitourinary (GU) Assessment
Glaucoma
Glipizide (Glucotrol) Nursing Considerations
Hearing Loss
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Hemodialysis (Renal Dialysis)
Heparin (Hep-Lock) Nursing Considerations
Hepatic Disorders (Cirrhosis, Hepatitis, Portal Hypertension) for Progressive Care Certified Nurse (PCCN)
HMG-CoA Reductase Inhibitors (Statins)
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Hyperthermia (Thermoregulation)
Hypertonic Solutions (IV solutions)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypoglycemia
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypoparathyroidism
Hypotonic Solutions (IV solutions)
Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
Individualized Physical Assessments for Certified Perioperative Nurse (CNOR)
Informed Consent
Insulin Mnemonic (Ready, Set, Inject, Love)
Intake and Output (I&O)
Integumentary (Skin) Important Points
Interventions for Aphasia Nursing Mnemonic (PROP)
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Isoniazid (Niazid) Nursing Considerations
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)
Losartan (Cozaar) Nursing Considerations
Macular Degeneration
Malignant Hyperthermia
Management of Pressure Ulcers (Pressure Injuries) Nursing Mnemonic (SKIN)
Management of Glomerulonephritis Nursing Mnemonic (Please Help Deliver Diuretics)
Mechanical Aids
Medication Classess for IBD Nursing Mnemonic (Sometimes I Can’t Answer)
Medications to Prevent Seizures Nursing Mnemonic (Pretty Little Liars Forever)
Meniere’s Disease
Metabolic Acidosis (interpretation and nursing diagnosis)
Methylprednisolone (Solu-Medrol) Nursing Considerations
Mobility & Assistive Devices
Montelukast (Singulair) Nursing Considerations
Myocardial Infarction Nursing Mnemonic (MONATAS)
Naproxen (Aleve) Nursing Considerations
Neurogenic Shock for Certified Emergency Nursing (CEN)
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology for Compartment Syndrome
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Epididymitis
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Human Papilloma Virus (HPV STI)
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Osteomyelitis
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Rhabdomyolysis
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Aspiration
Nursing Care Plan (NCP) for Bronchoscopy (Procedure)
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Emphysema
Nursing Care Plan (NCP) for Enuresis / Bedwetting
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Respiratory Failure
Nursing Care Plan (NCP) for Risk for Fall
Nursing Care Plan (NCP) for Skin cancer – Melanoma, Basal Cell Carcinoma, Squamous Cell Carcinoma
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan (NCP) for Thoracentesis (Procedure)
Nursing Care Plan (NCP) for Thrombophlebitis / Deep Vein Thrombosis (DVT)
Nursing Care Plan (NCP) for Thrombocytopenia
Nursing Care Plan for Amputation
Nursing Care Plan for Compartment Syndrome
Nursing Care Plan for Distributive Shock
Nursing Case Study for Pneumonia
Nursing Case Study for Diabetic Foot Ulcer
Oncology Important Points
Oxygen Delivery Module Intro
Pain and Nonpharmacological Comfort Measures
Pain Assessment Questions Nursing Mnemonic (OPQRST)
Patient Consent for Treatment for Certified Emergency Nursing (CEN)
Patient Communication Techniques for Certified Perioperative Nurse (CNOR)
Patients with Communication Difficulties
Perioperative Nursing Course Introduction
Peritoneal Dialysis (PD)
Pneumonia Concept Map
PPE Donning & Doffing
Pressure Ulcers/Pressure injuries (Braden scale)
Propylthiouracil (PTU) Nursing Considerations
Pulmonary edema treatment Nursing Mnemonic (MAD DOG)
Sepsis Concept Map
Sepsis Labs
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Specialty Diets (Nutrition)
Stages of Hepatitis Nursing Mnemonic (PIP)
Strabismus
Stroke Assessment (CVA)
TB Drugs Nursing Mnemonic (RIPE)
The Medical Team
Thrombolytics
Toxicity Sepsis- Signs and Symptoms Nursing Mnemonic (The 6 T’s)
Trach Care
Traction – Nursing Care Nursing Mnemonic (TRACTION)
Trauma – Assessment (Emergency) Nursing Mnemonic (ABCDEFGHI)
Types of Anemia Nursing Mnemonic (Always Introduce Special Patients)
Understanding Blood Pressure Meds! – Live Tutoring Archive
Vaccine-Preventable Diseases (Measles, Mumps, Pertussis, Chicken Pox, Diphtheria) for Certified Emergency Nursing (CEN)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Vasopressin
Warfarin (Coumadin) Nursing Considerations
Who Needs Dialysis Nursing Mnemonic (AEIOU)
Wound Infections for Certified Emergency Nursing (CEN)