OB/GYN topics include those of female reproductive care including reproductive organ health, pregnancy, birth, postpartum and newborn care include postpartum and neonatal emergencies.
Here are some common mnemonics to help remember those obscure OB/GYN terms for your NCLEX exam.
1. APGAR score = Baby’s health at 1 and 5 minutes after birth
Scores 7 and above are normal, 4 to 6 fairly low, and 3 and below are regarded as critically low. If a baby scores below 3 for more than three APGARs then they are at risk for severe neurological damage.
2. Causes of Secondary Amenorrhea = SOAP
Oral Contraceptive Pill
Anorexia or Athlete Triad
Many women seek gynecological care for secondary amenorrhea or cessation of their menstrual cycle after obtaining it as an adolescent. There are several causes of this. One can be stress that causes an imbalance of cortisol, affecting how the body maintains itself. Oral contraceptive pills can change the timing and length in between menstrual cycles. Third, is anorexia (an eating disorder) resulting in a decreased intake of calories and lack of energy to have a cycle. Similarly, the female athlete triad is a woman who trains so hard as an athlete that her body stops its cycle to conserve energy. Finally, pregnancy is often diagnosed as secondary amenorrhea until a positive pregnancy test and ultrasound are done to confirm the presence of fetal life.
3. TPAL = Parity of a woman
“To Pregnancy And Love”
T: Number of Term pregnancies or pregnancy over 37 weeks
P: Number of Premature births under 37 weeks
A: Number of Abortions (spontaneous or elective). Spontaneous abortions are commonly known as miscarriages.
L: Number of Live births
The parity of a woman is commonly charted in the OB-GYN history section during intake as an outpatient or inpatient. This notation would include T1, P1, A1, L3, or 1-1-1-3. This would indicate a woman that had 1 term pregnancy, 1 premature birth resulting in twins, 1 miscarriage or abortion, and 3 living children as a result.
4. ABCDEFGH: Breastfeeding benefits
Allergic conditions reduced
Best food for an infant due to immunity transference
Close relationship with mother
Fitness: increased calorie expenditure for mom results in weight loss
Guards against maternal cancer
Hemorrhage (postpartum) reduced
Breastfeeding is highly encouraged as the most beneficial form of nutrition for the infant if the pair can sustain it. It conveys both benefits for the infant such as reducing allergies, providing immunity, encouraging development, and a close bond with mom. It helps the mother by decreasing the monthly budget – formula for the first year can cost over $3000.00. It increases mom’s calorie expenditure, resulting in weight loss. Research has shown a lower incidence of maternal cancer of the breast and ovaries later in the life of women that breastfeed. Breastfeeding helps contract the uterus resulting in decreased risk of postpartum hemorrhage.
NCLEX Tip: It was once thought that new mothers could not get pregnant after birth, however, this is untrue. Because breastfeeding mothers can not utilize medication contraceptives, parents should be counseled on alternative forms of contraception and family planning.
5. “Rubber Ducky, I’m so blue!” = Congenital signs of Rubella (German Measles)
Ducky = Patent Ductus Arteriosus, Deafness
I’m = Eyes (cataracts, retinopathy, microphthalmia, glaucoma)
So = Slow or growth and developmental retardation
Blue = Blueberry Muffin” purpura on skin
German measles is also called Rubella. If a mom contracts this during the first 20 weeks of pregnancy, then the child can be born with congenital rubella syndrome (CRS) which can be serious and devastating. Miscarriage results in up to 20% of cases. The Rubber Ducky I’m So Blue rhyme can help point out significant symptoms in neonates born with CRS.
6. HELLP Syndrome.
EL: Elevated Liver Enzymes
LP: Low Platelet Count
HELLP syndrome is a life-threatening complication usually considered to be a variant of pre-eclampsia. It can occur in late pregnancy or after childbirth. These are the three major symptoms of the syndrome. The main problem is the activation of the coagulation cascade which can lead to disseminated intravascular coagulation (DIC) making intervention difficult. DIC can lead to hemorrhage and liver failure.
7. Causes of IUGR = Intrauterine Growth Restriction
Inherited: fetal genetic disorders
Uterus: placental insufficiency, multiple gestations
General: maternal malnutrition, smoking, drug use, gestational diabetes
Rubella and other congenital infections
IUGR refers to poor growth of the baby while in utero. This is typically from a decrease in oxygenation level or lack of nutrition for the fetus. It typically results in a child that is SGA or small for gestational age (<10th percentile) but not always. It can increase fetal demise and cause issues such as the increased risk for heart disease, stroke, or hypertension into adulthood.
8. Pelvic Inflammatory Disease (PID): “PID CAN be EPIC”
Painful intercourse or urination
Chronic lower back/pelvic pain
Pelvic inflammatory disease is a gynecological complication when bacteria moves up into a woman’s uterus, ovaries, and causes inflammation of her sexual organs. Women commonly complain of lower back pain. PID causes are combined in the “CAN” or chlamydia, actinomycetes, and Neisseria gonorrhea – all sexually transmitted diseases. PID can cause “EPIC” or ectopic pregnancies, painful intercourse/urination, infertility, and chronic lower back/pelvic pain.
9. Cardinal Movements of Fetus “Don’t Forget I Enjoy Expensive Equipment”
Fetuses move through a typical stage of 7 cardinal movements during the birthing/labor process. These describe the movement of the fetal head. The first is engagement of the fetus into the pelvis. Then descent of the prominent fetal part through the pelvis. The head then flexes to allow for presentation through the pelvis. Internal rotation refers to the turning of the fetus to allow for the easiest passage through the pelvis. Extension refers to the fetal neck extension that happens as the head starts to push out of the birth canal. External rotation happens as the baby’s torso realigns with the head as it pushes out of the birth canal. Expulsion refers to the delivery of the rest of the fetus after the shoulders push through and the body follows naturally.
10. Prenatal care questions = ABCDE
Amniotic fluid leakage?
Dysuria? (painful urination)
These are common intake questions to ask on outpatient or inpatient intake for pregnant women. These common factors can alert a health professional that more detailed assessment needs to be performed.
Each letter in VEAL stands for a type of heart rate pattern the baby demonstrates on the fetal heart monitor. The letters in CHOP are likely causes of the change.
- Variable deceleration – Cord compression (danger)
- Early deceleration – Head compression (danger)
- Acceleration – Okay (expected finding with activity)
- Late acceleration – Placental Insufficiency (danger)
12. ABCDEF – Prenatal Care Assessment: Essential things to look for during a prenatal care assessment. NCLEX questions often focus on safety so be sure to understand the dynamics of these common complications.
- Amniotic fluid leakage
- Bleeding vaginally
- Dysuria or difficulty urinating
- Edema or swelling
- Fetal immobility
13. BUBBLE HE: The essential aspects of the postpartum assessment
- Breast: Assess for infection, skin integrity, and comfort breastfeeding
- Uterus: Assess the fundus with palpation
- Bowel: Prevent constipation and assess for hemorrhoids
- Bladder: Assess for distention, retention, and UTI
- Lochia: Assess appearance and amount
- Episiotomy: Assess for infection, hematoma, and dehiscence
- Homan’s Sign: Detects deep venous thrombosis in some patients (not to be used when DVT is known to be present)
- Emotional Status: Postpartum depression screening
14. INMT – It’s Not My Time: Lists the medications most commonly used to relax the uterus during early contractions.
- Indomethacin (NSAID)
- Nifedipine (CA Channel Blocker)
- Magnesium Sulfate
- Terbutaune (Adrenergic Agonist)
15. 4 T’s – Most Causes of Postpartum Hemorrhage
- Tissue – Retained Placenta
- Tone – Uterine Atony
- Traumatic Delivery
- Thrombin – Coagulation Disorders