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NCLEX-RN · 8 Essential Terms
NCLEX obstetric cues: GTPAL, Naegele's rule, fetal heart rate, early versus late versus variable decelerations, magnesium toxicity, and the postpartum fundus. Study patterns, not bedside orders.
These are licensure study notes, not orders for patient care. Follow your program, your facility policy, and the current test plan.
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An obstetric history: gravida, term births, preterm births, abortions or miscarriages, and living children. Gravida counts the current pregnancy.
Flip cards, the timed match, and the quiz open in this panel. The full glossary below is ready either way.
Every term, pronunciation, definition, memory hook, and exam trap is written out here so you can review the whole set or print it.
GEE tee pee ay el
An obstetric history: gravida, term births, preterm births, abortions or miscarriages, and living children. Gravida counts the current pregnancy.
Mnemonic. GTPAL is pregnancies, term, preterm, abortions, living. The current pregnancy counts in G.
Exam trap. The trap is counting a twin pregnancy as two gravidas. It is one pregnancy and, if both children are living, two under L. Abortions include spontaneous losses before the term cutoff the item is using.
NAY-guh-leez rool
An estimated due date calculated from the first day of the last menstrual period: add seven days, subtract three months, and add one year. It assumes a 28-day cycle.
Mnemonic. Add seven days, subtract three months, add a year. A long or short cycle moves the estimate.
Exam trap. The trap is starting from the day the client thinks she conceived, or from the end of the period. The rule starts on the first day of the last menstrual period.
FEE-tul hart rayt
The textbook baseline fetal heart rate is 110 to 160 beats per minute. A baseline is the rate between contractions, not the rate during a deceleration.
Mnemonic. 110 to 160 is the baseline window. Read it between contractions.
Exam trap. The trap is calling a brief acceleration a new baseline, or calling the bottom of a deceleration the baseline. Tachycardia and bradycardia are statements about the baseline, and each has its own list of causes.
ER-lee dee-sel-uh-RAY-shun
A gradual fetal heart-rate dip that mirrors the contraction and is attributed to head compression. It is usually benign and does not, by itself, call for the late-deceleration rescue cluster.
Mnemonic. Early mirrors the contraction and points to the head.
Exam trap. The trap is treating every deceleration as a late one and stopping a needed labor response. Look at the timing. If the bottom of the dip lines up with the peak of the contraction, think early.
layt dee-sel-uh-RAY-shun
A gradual dip that begins after the contraction peaks and returns after the contraction ends. It is the uteroplacental-insufficiency pattern. The classic cluster is to reposition, stop the oxytocin, give oxygen and fluids, and notify.
Mnemonic. Late means the baby recovers after the contraction. That delay is the bad part.
Exam trap. The trap is more oxytocin because the contractions look strong. Lates mean the placenta is not keeping up. The nursing cluster happens first; staring at the strip is not the action.
VAIR-ee-uh-bul dee-sel-uh-RAY-shun
An abrupt drop in fetal heart rate, often V-shaped, classically caused by cord compression. The first move is to relieve the pressure, usually by changing the mother's position.
Mnemonic. Variable is abrupt and cord-shaped. Change the position.
Exam trap. The trap is calling a variable an early deceleration because both can look harmless at a glance. Abrupt timing is the clue. Recurrent deep variables are not a watch-and-wait item.
mag-NEE-zhee-um tok-SIS-ih-tee
The toxic picture of magnesium sulfate used in preeclampsia care: loss of deep-tendon reflexes, respiratory depression, and low urine output. The exam antidote is calcium gluconate.
Mnemonic. No reflexes, slow breathing, little urine: stop and think magnesium, and remember calcium gluconate.
Exam trap. The trap is continuing the infusion because the blood pressure looks better while the reflexes have disappeared. This card is a licensure pattern, not an order to give either drug.
pohst-PAR-tum FUN-dus
After birth the fundus should be firm and midline. A boggy fundus is massaged. A fundus displaced to the side often means the bladder is full. Heavy bleeding with a firm fundus suggests a laceration rather than atony.
Mnemonic. Firm and midline is the goal. Boggy means massage. Off to the side means empty the bladder.
Exam trap. The trap is massaging a fundus that is already firm while the pad is soaked. A firm uterus that is still bleeding hard points to a laceration or a retained fragment, not to more massage.