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Registered Nurse (RN)
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HESI®
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HESI®-RN Comprehensive Review
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The Normal Newborn

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HESI®-RN Comprehensive Review | Registered Nurse (RN) School Study Aid

The Normal Newborn
25 Picmonics to Learn | 51 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
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3 mins
APGAR Score
1 and 5 Minutes
Appearance
Pulse
Grimace
Activity and Muscle Tone
Respiration
Total Scores
Gentle Stimulation
Oxygen
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2 mins
Mechanism of Labor
Engagement
Descent
Flexion
Internal Rotation
Extension
External Rotation (Restitution)
Expulsion of Infant
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2 mins
Cesarean Section - Indications
Maternal Indications
Active Genital Herpes Infection
Cervical Cancer
Eclampsia (Preeclampsia)
History of Uterine Surgery
History of C-section (Vertical)
Fetal Indications
Malpresentation
Fetal Distress
Cord Compression/Prolapse
Other Indications
Failed Vaginal Delivery
Cephalopelvic Disproportion
Abruptio Placentae or Placenta Previa
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2 mins
Magnesium Sulfate
Mechanism
Muscle Relaxant
Indications
Preterm Labor Contractions
Preeclampsia
Side Effects
Warm Feeling
Hypotension
Decreased Deep Tendon Reflexes (DTRS)
Decreased Respiratory Rate
Decreased Urine Output
Paralytic Ileus
Antidote
Calcium Gluconate
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2 mins
Routes of Administration Part Two (Parenteral)
Parenteral Administration
Intradermal
Subcutaneous
Intramuscular (IM)
Intravenous
Epidural
Intrathecal
Intraosseous
Intraperitoneal
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2 mins
TORCHeS Screening
TORCHES
Toxoplasmosis
Other
Rubella
Cytomegalovirus (CMV)
Herpes Simplex Virus (HSV)
Syphilis
Considerations
Diagnostic Testing
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3 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)
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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
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3 mins
Vitamin K1 (Phytonadione)
Mechanism
Synthesizes Clotting Factors II, VII, IX, X
Indications
Hypoprothrombinemia
Newborn Prophylaxis
Bleeding from Warfarin Overdose
Side Effects
Shock
Kernicterus
Cardiac Arrest
Considerations
Bile Salts required for Intestinal Absorption
Increased Risks with IV Administration
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2 mins
Hepatitis C
Characteristics
Enveloped
RNA Virus
Flavivirus
Icosahedral
SS positive Linear
Clinical Features
Most Cases are Due to IV Drug Use
Turns to Chronic Hepatitis in Over 70% of Cases
Cirrhosis
Hepatocellular Carcinoma
Most Common Indication for Liver Transplantation
Associated With Type I MPGN
Porphyria Cutanea Tarda
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2 mins
Primitive Reflexes
Integrated Reflexes
Rooting Reflex
Sucking/Swallowing Reflex
Traction
Moro Reflex
Palmar Reflex
Spinal Galant Reflex
Plantar Grasp
Asymmetrical Tonic Neck Reflex (ATNR)
Tonic Labyrinthine Reflex (TLR)
Symmetric Tonic Neck (STNR)
Landau
Neck Righting
Body Righting
Babinski Reflex
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3 mins
Reflexes Assessment
Grading
Hyperactive
Hypoactive
Deep Tendon Reflexes (DTRs)
Biceps
Triceps
Brachioradialis
Patellar (Quadriceps)
Achilles Tendon
Cutaneous (Superficial) Reflexes
Plantar Reflex (Babinski Sign)
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3 mins
Hemoglobin
Hemoglobin Has Four Iron Hemes
Lots Of Hemoglobin In Red Blood Cells
High O2 Levels Increase O2 Binding
High Temperature Reduces O2 Binding
High CO2 Levels Reduce O2 Binding
Low pH Reduces O2 Binding
Myoglobin Binds Oxygen in Muscle
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2 mins
Hematocrit (Hct) Lab Values
Women: 36% - 46%
Men: 41% - 53%
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1 min
Red Blood Cell Count (RBC) Lab Values
Women: 3.5-5.5 million cells/ MuL
Men: 4.3-5.9 million cells/ MuL
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1 min
Platelet Lab Value
150,000-400,000 Micro L
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40 secs
WBC Differential Lab Value
White Blood Cells (WBC)
5-10 (5,000-10,000)
Leukocyte Differential
Neutrophils (50%-70%)
Bands (2%-5%)
Segs (50%-70%)
Lymphocytes (20%-40%)
Monocytes (4%-8%)
Eosinophils (2%-4%)
Basophils (0.5%-1.5%)
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2 mins
Bilirubin Lab Value
0.2-1.2 mg/dL
Increased Bilirubin Causes Jaundice
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54 secs
Alveolar Gas Exchange
Characteristics
Pulmonary Artery Blood is O2-Poor, CO2-Rich
Two-Cell Thick Air-Blood Barrier
CO2 Diffuses Into Air
O2 Diffuses Into Blood
Gases Equilibrate
Pulmonary Vein is O2-Rich, CO2-Poor
Thermoregulation
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2 mins
pH - Blood and Urine Lab Value
Blood
7.35 - 7.45
Urine
4.0 - 8.0
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1 min
Hypoglycemia Assessment
Mechanism
Too much insulin
Decreased glucose
Assessment
< 70 mg/dL
Change in LOC
Lethargic
Confusion and Irritability
Tremors
Diaphoresis
Tachycardia
Vision Changes
Weakness
Seizures
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2 mins
Blood Glucose Lab Value
70-100 mg/dL
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25 secs
Hypoglycemia Intervention
Interventions
Mild to Moderate Hypoglycemia
Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
Complex Carbohydrate (Whole Grains, Vegetables)
Severe Hypoglycemia or Unconscious
50% Dextrose
Glucagon
Considerations
Monitor Blood Glucose Q 10-15 Minutes
Give Small Meal After Intervention
Patient Education
Hypoglycemia Prevention
Encourage Self-Monitoring
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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
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3 mins

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