JNCLEX-RM (Jordan) flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Naegele's rule

Estimated date of delivery is calculated from the first day of the last menstrual period: subtract 3 months, add 7 days, add 1 year. Assumes a regular 28-day cycle; adjust for cycle length variation.

GTPAL parity notation

Gravida counts all pregnancies including the current one; Term and Preterm count births after 37 weeks and from 20 to 37 weeks; Abortions count losses before 20 weeks; Living counts surviving children.

Fundal height at 20 weeks

At approximately 20 weeks gestation the uterine fundus is palpable at the level of the umbilicus. After 20 weeks, fundal height in centimetres roughly equals gestational weeks, plus or minus two.

Anti-D prophylaxis timing

For unsensitised RhD-negative women, anti-D immunoglobulin is given at 28 weeks gestation and within 72 hours of birthing an RhD-positive infant, plus after any sensitising event such as bleeding or amniocentesis.

Active phase of first stage

Cervical dilatation from 5 cm to full dilatation with regular contractions. A dilatation rate slower than about 1 cm per hour in a nullipara warrants review using the partograph action line.

Uterine tachysystole definition

More than five contractions in any 10-minute period averaged over 30 minutes. It risks fetal hypoxia and, if spontaneous, may require position change, hydration, and tocolysis; if oxytocin-induced, stop the infusion.

Late deceleration significance

A gradual fall in fetal heart rate beginning after the contraction peak, reflecting uteroplacental insufficiency. Recurrent late decelerations require maternal repositioning, intravenous fluids, stopping oxytocin, and obstetric escalation.

Prolonged deceleration definition

A decrease in fetal heart rate of at least 15 beats per minute below baseline lasting 2 minutes or longer but less than 10 minutes. It requires immediate intrauterine resuscitation and exclusion of cord prolapse.

Active third stage management

Administration of a prophylactic uterotonic immediately after birth, controlled cord traction with counter-traction, and uterine tone assessment. It reduces postpartum haemorrhage and shortens the third stage compared with expectant management.

Delayed cord clamping

Clamping the umbilical cord at least 1 minute after birth, or later per local protocol, for infants not requiring immediate resuscitation. It improves neonatal iron stores and reduces anaemia in infancy.

Primary postpartum haemorrhage threshold

Blood loss of 500 mL or more within 24 hours of vaginal birth, or 1000 mL or more after caesarean birth, or any loss causing haemodynamic instability regardless of measured volume.

Apgar score components

Five components scored 0 to 2 each at 1 and 5 minutes: Appearance (colour), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration (effort). Total ranges from 0 to 10.

Newborn thermoregulation targets

Dry the newborn immediately, place skin-to-skin, cover with a hat and warm blanket. Aim for an axillary temperature of 36.5 to 37.5 degrees Celsius; hypothermia increases hypoglycaemia and respiratory distress.

Uterine involution pattern

After birth the fundus is near the umbilicus and midline; it descends roughly 1 cm daily and is usually no longer palpable abdominally by about 2 weeks. A boggy or high fundus suggests atony or bladder distension.

Vitamin K prophylaxis at birth

A single intramuscular dose of 1 mg phytomenadione (vitamin K) for term newborns prevents vitamin K deficiency bleeding, including late-onset intracranial haemorrhage. Preterm infants receive a weight-based dose per protocol.

Shoulder dystocia manoeuvre sequence

Call for help, then McRoberts position with suprapubic pressure. If unresolved, perform internal rotational manoeuvres (Rubin II, Woods screw, reverse Woods). Fundal pressure and excessive head traction are contraindicated.

Cord prolapse first actions

Call for emergency help, elevate the presenting part manually or by filling the bladder, and position the woman knee-chest or Trendelenburg. Avoid handling the cord and prepare for immediate caesarean birth.

Eclampsia magnesium sulfate regimen

Loading dose of 4 g intravenous over at least 20 minutes plus 10 g intramuscularly, then 1 g per hour maintenance. Monitor respiratory rate, deep tendon reflexes, urine output, and consciousness for toxicity.

Magnesium sulfate toxicity antidote

Calcium gluconate 1 g given intravenously slowly is the antidote. Toxicity signs progress from loss of deep tendon reflexes to respiratory depression, oliguria, and cardiac arrest; stop the infusion first.

Placenta praevia presentation

Painless bright red vaginal bleeding in later pregnancy with a soft, non-tender uterus and a high or malpresenting fetal head. Vaginal examination is contraindicated; caesarean birth is usually required.

Placental abruption presentation

Painful vaginal bleeding with a tense, tender uterus; bleeding may be concealed. Risks include fetal distress, maternal shock, and disseminated intravascular coagulation. Resuscitation and urgent birth are indicated.

Oxytocin infusion safety

Start at a low rate and titrate against contraction frequency and fetal heart rate. Stop the infusion for tachysystole or non-reassuring fetal status; oxytocin has antidiuretic effects that can cause hyponatraemia.

Ergometrine contraindications

Ergometrine is contraindicated in hypertension, pre-eclampsia, and cardiac disease because it causes sustained uterine contraction and vasoconstriction. Common adverse effects include nausea, vomiting, and abdominal cramping.

Carboprost contraindication

Carboprost, a prostaglandin F2 alpha analogue used for refractory postpartum haemorrhage, is contraindicated in asthma because it causes bronchoconstriction. It commonly causes diarrhoea, vomiting, and fever.

Antenatal corticosteroid regimen

Dexamethasone 6 mg intramuscularly every 12 hours for four doses, or betamethasone 12 mg intramuscularly every 24 hours for two doses, given between 24 and 34 weeks to accelerate fetal lung maturity.

High-alert maternity medications

Oxytocin, magnesium sulfate, concentrated potassium chloride, and insulin require independent double-checking, standardised concentrations, and clear labelling because administration errors carry severe harm potential.

Informed consent elements

Valid consent requires the woman's capacity, adequate disclosure of benefits, risks, and alternatives, and voluntary choice. It may be withdrawn at any time, including during active labour, and must be documented.

Mandatory reporting obligations

Midwives must report suspected child abuse or neglect and specified notifiable communicable diseases to the relevant Jordanian authority, following Ministry of Health rules, even without the woman's consent.

Midwifery scope of practice

The range of duties a registered midwife may perform, defined by the Jordanian Nursing and Midwifery Council and Ministry of Health regulations. Care beyond that scope requires referral or supervision.

Five moments for hand hygiene

Before touching a patient, before a clean or aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings. Alcohol rub is used unless hands are visibly soiled.

Group B streptococcus prophylaxis

Intrapartum penicillin or ampicillin is indicated for maternal GBS colonisation, GBS bacteriuria in pregnancy, a previous infant with GBS disease, or unknown status with risk factors such as prolonged rupture of membranes.

Sharps injury immediate actions

Encourage bleeding and wash with soap and water, report the incident immediately, assess the source patient's status, and begin post-exposure prophylaxis as soon as possible, ideally within hours of exposure.