IDCardiac
Sterile blood samples collected to identify bloodstream infection.
NCLEX focus
- If ordered and safe, collect cultures before antibiotics; do not delay emergency sepsis care.
Before
- Verify order, timing, site prep, labels, and whether multiple sites are required.
- Assess fever, chills, and antibiotic timing.
After
- Send promptly.
- Document collection sites/times.
- Monitor for bleeding or contamination issues.
Priority complications
- Delayed antibiotics in unstable sepsis
- Contaminated specimen
- Bleeding in anticoagulated clients
Bone marrow biopsy
Procedure
Heme
Needle sample of marrow, often from posterior iliac crest, to evaluate blood cell production or malignancy.
NCLEX focus
- Bleeding, infection, positioning, anxiety, and post-procedure pressure dressing are NCLEX cues.
Before
- Check consent, CBC/platelets/coagulation risk, allergies, and sedation plan.
- Explain positioning and pressure sensation.
After
- Apply pressure dressing per policy.
- Monitor bleeding, pain, vital signs, and infection signs.
- Keep site clean/dry per instructions.
Priority complications
- Bleeding
- Infection
- Uncontrolled pain
- Sedation reaction
Cardiac catheterization
Procedure
CardiacRenal
Catheter-based heart and vessel study or intervention.
NCLEX focus
- Contrast allergy, kidney function, distal pulses, bleeding, and chest pain after procedure are priority cues.
Before
- Check consent, allergies, kidney labs, anticoagulants, pregnancy status when relevant, and baseline distal pulses.
- Maintain NPO status if ordered.
After
- Monitor access site bleeding/hematoma.
- Check distal pulses, color, temperature, sensation, and pain.
- Promote fluids if ordered for contrast clearance.
Priority complications
- Bleeding
- Arterial occlusion
- Dysrhythmia
- Contrast reaction
- Kidney injury
Chest tube insertion and care
Procedure
RespCardiac
Tube placed into pleural space to remove air, blood, fluid, or pus.
NCLEX focus
- Respiratory status, drainage changes, air leak, water seal, occlusive dressing, and never clamping casually are key safety points.
Before
- Assess breath sounds, oxygenation, pain, allergies, consent, and emergency status.
- Prepare sterile setup and drainage system per policy.
After
- Keep system below chest.
- Monitor drainage amount/color, tidaling, bubbling, insertion dressing, and respiratory response.
- Keep emergency dressing supplies available.
Priority complications
- Tension pneumothorax
- Tube dislodgement
- Hemorrhage
- Infection
- Subcutaneous emphysema
Skin
Removal of dead or infected tissue from a wound or burn.
NCLEX focus
- Pain control, bleeding, infection prevention, and sterile/clean technique per wound type are testable.
Before
- Assess pain, circulation, wound appearance, allergies, and ordered analgesia.
- Verify wound-care order and supplies.
After
- Reassess pain and bleeding.
- Document wound bed, drainage, odor, size, and dressing.
- Monitor infection signs.
Priority complications
- Bleeding
- Uncontrolled pain
- Exposed structures
- Infection
CardiacPedsOB
Ultrasound of heart structure, valves, movement, and blood flow.
NCLEX focus
- Common diagnostic for valve disease, tamponade, cardiomyopathy, and congenital defects.
Before
- Explain painless ultrasound process.
- For TEE, check consent, NPO status, gag reflex plan, and sedation risk.
After
- For standard echo, routine care.
- For TEE, monitor airway, gag reflex return, sedation recovery, and sore throat.
Priority complications
- Aspiration after TEE
- Sedation reaction
- Delayed recognition of tamponade or poor perfusion
Electrocardiogram / telemetry
Procedure
CardiacRenal
Electrical tracing or monitoring of heart rhythm.
NCLEX focus
- Symptomatic rhythm changes, chest pain, electrolyte abnormalities, and rate-slowing meds are priority contexts.
Before
- Place leads on clean dry skin.
- Check client identity and symptoms.
- Compare to baseline when available.
After
- Report acute ischemic changes or dangerous rhythms promptly.
- Keep telemetry leads attached and alarms set per policy.
Priority complications
- Missed dysrhythmia
- Lead misplacement
- Artifact mistaken for rhythm
SkinResp
Surgical cuts through tight burn eschar to restore breathing or circulation.
NCLEX focus
- Circumferential chest or extremity burns with impaired ventilation or distal perfusion are emergency cues.
Before
- Assess distal pulses, capillary refill, pain, sensation, movement, chest expansion, and oxygenation.
- Prepare sterile setup and pain control per emergency plan.
After
- Reassess neurovascular status or chest expansion.
- Monitor bleeding, pain, infection, and dressing needs.
Priority complications
- Bleeding
- Persistent compartment compromise
- Infection
Exchange transfusion
Procedure
OBHeme
Removal and replacement of newborn blood in severe hyperbilirubinemia or selected hemolytic disease.
NCLEX focus
- Used when bilirubin is dangerously high or not responding; monitor thermoregulation, glucose, calcium, infection, and hemodynamics.
Before
- Verify consent, blood product checks, bilirubin trend, baseline vitals, glucose, and temperature.
- Maintain cardiorespiratory monitoring.
After
- Monitor bilirubin rebound, glucose, calcium, temperature, bleeding, and infection signs.
Priority complications
- Hypocalcemia
- Hypoglycemia
- Dysrhythmia
- Infection
- Bleeding
Gastric decompression
Procedure
GIOBPeds
NG or OG tube used to remove stomach or bowel contents and reduce distention/vomiting.
NCLEX focus
- Airway protection, tube placement verification, output monitoring, and electrolyte/fluid balance are priority.
Before
- Assess vomiting, distention, aspiration risk, nares/oral route, and contraindications.
- Verify order and placement-check policy.
After
- Monitor output amount/color, abdominal assessment, electrolytes, mucosa, and tube security.
- Keep suction settings as ordered.
Priority complications
- Aspiration
- Tube misplacement
- Fluid/electrolyte imbalance
- Mucosal injury
Gluten-free diet teaching
Teaching
Auto/GenGIPeds
Diet education to eliminate gluten sources for celiac disease.
NCLEX focus
- Wheat, barley, rye, hidden gluten, cross-contamination, and lifelong adherence are the major teaching points.
Before
- Assess baseline diet, reading level, food access, and cultural preferences.
- Verify diagnosis and dietitian referral.
After
- Reinforce label reading.
- Monitor weight, symptoms, iron/vitamin levels, and growth in children.
Priority complications
- Malnutrition
- Persistent diarrhea
- Anemia
- Poor growth
Auto/GenPedsCardiac
Intravenous immune globulin given for selected immune, inflammatory, or infectious indications.
NCLEX focus
- Watch for infusion reaction, fluid status, renal risk, and vaccine timing teaching after IVIG when applicable.
Before
- Check allergies, baseline vitals, renal risk, hydration, and ordered rate/premeds.
- Verify product and dose.
After
- Monitor fever, chills, headache, back pain, dyspnea, hypotension, and urine output.
- Teach follow-up instructions, including vaccine timing if relevant.
Priority complications
- Anaphylaxis
- Thrombosis
- Renal injury
- Fluid overload
Renal
Procedure that breaks kidney stones into smaller pieces.
NCLEX focus
- Pain, hematuria, stone fragments, hydration, and obstruction/infection signs are testable.
Before
- Check pregnancy status when relevant, anticoagulants, infection signs, pain, and kidney function.
- Teach procedure expectations.
After
- Strain urine if ordered.
- Encourage fluids if not contraindicated.
- Monitor pain, fever, urine output, and hematuria.
Priority complications
- Obstruction
- Infection/sepsis
- Bleeding
- Uncontrolled pain
NeuroID
Needle procedure to collect cerebrospinal fluid or measure pressure.
NCLEX focus
- Neuro status, infection precautions, anticoagulants, positioning, and post-procedure headache/CSF leak are key cues.
Before
- Check consent, neuro status, platelets/anticoagulants, allergies, and if imaging is required before procedure.
- Position correctly and maintain sterile field.
After
- Monitor neuro status, headache, drainage, pain, and infection signs.
- Follow ordered positioning and fluid instructions.
Priority complications
- Herniation risk with increased ICP
- Bleeding
- Infection
- CSF leak
Nasal suctioning
Procedure
RespPedsOB
Clearing nasal secretions to improve infant breathing and feeding.
NCLEX focus
- Use before feeds when congestion limits intake; avoid aggressive suctioning that causes trauma or bradycardia.
Before
- Assess work of breathing, oxygen saturation, feeding ability, and secretion burden.
- Use correct device and gentle technique.
After
- Reassess breathing, feeding, mucosal trauma, and tolerance.
- Stop if distress or bradycardia occurs.
Priority complications
- Bradycardia
- Mucosal trauma
- Worsening distress
Needle decompression
Procedure
RespCardiac
Emergency needle placement to release trapped pleural air in tension pneumothorax.
NCLEX focus
- Severe respiratory distress, absent unilateral breath sounds, hypotension, JVD, and tracheal deviation are emergency cues.
Before
- Recognize tension physiology quickly.
- Prepare oxygen, emergency equipment, and provider/rapid response support.
After
- Reassess breathing and circulation.
- Prepare for chest tube.
- Monitor recurrence and site complications.
Priority complications
- Persistent tension pneumothorax
- Bleeding
- Organ injury
- Respiratory arrest
Neutropenic precautions
Infection control
HemeID
Infection-prevention practices for clients with low neutrophils.
NCLEX focus
- Fever is emergency; hand hygiene, avoiding sick contacts, and policy-specific diet/environment rules matter.
Before
- Check ANC, temperature, mucosa, lines, skin, and current symptoms.
- Clarify facility policy for food, flowers, visitors, and room placement.
After
- Continue temperature and infection surveillance.
- Teach fever reporting and safe hygiene habits.
Priority complications
- Sepsis
- Pneumonia
- Line infection
- Mucositis infection
Pericardiocentesis
Procedure
Cardiac
Needle drainage of fluid from the pericardial sac.
NCLEX focus
- Used for tamponade; monitor hemodynamics, rhythm, pain, and recurrence.
Before
- Assess vitals, pulse pressure, heart sounds, JVD, oxygenation, ECG, consent/emergency status, and IV access.
- Prepare sterile setup and echo guidance if ordered.
After
- Monitor blood pressure, rhythm, breath sounds, pain, drainage, and signs of recurrent tamponade.
- Send fluid specimens if ordered.
Priority complications
- Dysrhythmia
- Cardiac puncture
- Bleeding
- Recurrent tamponade
- Pneumothorax
OBPeds
Light treatment that helps break down bilirubin in newborn jaundice.
NCLEX focus
- Eye protection, skin exposure, hydration, stooling, temperature, and bilirubin trends are key.
Before
- Check bilirubin level, age in hours, weight, temperature, hydration, and eye protection setup.
- Undress to diaper as ordered.
After
- Monitor temperature, stools, urine output, skin, hydration, and bilirubin rebound.
- Support feeding.
Priority complications
- Dehydration
- Temperature instability
- Eye injury if unprotected
- Worsening bilirubin
Prostaglandin infusion
Procedure
OBCardiacPeds
Medication infusion used to keep the ductus arteriosus open in ductal-dependent congenital heart disease.
NCLEX focus
- Maintains systemic or pulmonary blood flow but can cause apnea, hypotension, fever, or flushing.
Before
- Assess oxygenation, perfusion, glucose, temperature, IV access, and emergency airway readiness.
- Verify dose and pump settings carefully.
After
- Monitor apnea, respiratory status, blood pressure, temperature, pulses, and perfusion.
- Keep resuscitation equipment available.
Priority complications
- Apnea
- Hypotension
- Ductal closure if interrupted
- Shock
Skin
Surgical placement of skin over a wound or burn area.
NCLEX focus
- Immobilization/protection of graft, infection prevention, donor-site pain, and perfusion are key.
Before
- Assess wound bed, infection signs, nutrition, consent, and pain control plan.
- Prepare donor and recipient site teaching.
After
- Protect graft from shear/pressure.
- Monitor color, adherence, drainage, odor, and temperature.
- Manage donor-site pain and dressing per order.
Priority complications
- Graft failure
- Infection
- Bleeding
- Fluid loss
RespID
Respiratory specimen collected to identify infectious organisms.
NCLEX focus
- Collect before antibiotics when ordered; specimen should be sputum from lower airway, not saliva.
Before
- Explain deep cough collection.
- Perform oral care if ordered.
- Use correct container and isolation precautions.
After
- Send promptly.
- Document specimen quality and timing.
- Monitor respiratory status.
Priority complications
- Poor specimen quality
- Delayed antibiotics when unstable
- Exposure risk
Resp
Needle removal of fluid or air from pleural space for diagnosis or relief.
NCLEX focus
- Positioning, respiratory assessment, post-procedure pneumothorax signs, and specimen handling are key.
Before
- Check consent, coagulation risk, allergies, baseline breath sounds, oxygenation, and positioning.
- Instruct not to cough or move during needle insertion.
After
- Monitor breath sounds, oxygen saturation, cough, chest pain, bleeding, and puncture site.
- Send specimens and obtain chest x-ray if ordered.
Priority complications
- Pneumothorax
- Bleeding
- Re-expansion pulmonary edema
- Infection
Blood transfusion
Procedure
HemeOB
Administration of blood products such as packed RBCs, platelets, plasma, or cryoprecipitate.
NCLEX focus
- Correct client/product check, first 15 minutes, reaction recognition, and stopping transfusion are core NCLEX points.
Before
- Verify consent, type/screen, IV access, baseline vitals, product, two-person check, and transfusion history.
- Prime with normal saline per policy.
After
- Monitor vital signs and response.
- Stop transfusion and keep IV open with saline for suspected reaction per policy.
- Document volume and tolerance.
Priority complications
- Acute hemolytic reaction
- Fluid overload
- TRALI
- Fever/allergy
- Infection
Ventriculoperitoneal shunt
Procedure
NeuroPedsOB
Shunt drains excess CSF from ventricles to the peritoneal cavity.
NCLEX focus
- Monitor for shunt infection or malfunction: fever, vomiting, lethargy, irritability, headache, bulging fontanel, or redness along tract.
Before
- Assess neuro status, head circumference/fontanel in infants, infection signs, and consent.
- Prepare caregiver teaching.
After
- Monitor neuro status, vitals, incision/shunt tract, abdominal signs, and signs of increased ICP.
- Position per order and protect incision.
Priority complications
- Shunt obstruction
- Shunt infection
- Increased ICP
- Overdrainage
Cardiac pacing and pacemaker care
Procedure
Cardiac
Temporary or implanted pacing supports heart rate and perfusion when conduction is unsafe.
NCLEX focus
- Assess symptoms first, monitor rhythm capture, pulses, blood pressure, and report loss of capture or unstable bradycardia.
Before
- Assess pulse, blood pressure, mental status, chest pain, and rhythm strip.
- Prepare emergency equipment and consent/status requirements per setting.
After
- Monitor capture/sensing, insertion site, distal perfusion, pain, and infection signs.
- Teach movement restrictions and when to report dizziness, hiccups, or syncope.
Priority complications
- Failure to capture
- Failure to sense
- Bleeding
- Infection
- Pneumothorax
Valve repair or replacement care
Procedure
Cardiac
Procedure or surgery to repair or replace a damaged heart valve.
NCLEX focus
- Monitor perfusion, bleeding, rhythm changes, anticoagulation teaching, and endocarditis-prevention instructions.
Before
- Assess baseline vitals, heart sounds, activity tolerance, anticoagulants, allergies, and consent.
- Review expected post-procedure monitoring and mobility plan.
After
- Monitor rhythm, blood pressure, pulses, bleeding, lung sounds, and infection signs.
- Reinforce anticoagulant and dental/procedure notification teaching when ordered.
Priority complications
- Bleeding
- Stroke
- Dysrhythmia
- Valve dysfunction
- Endocarditis
Cardiac surgery post-op care
Procedure
CardiacPedsOB
Post-operative monitoring after heart or congenital cardiac repair.
NCLEX focus
- Trend perfusion, oxygenation, chest drainage, rhythm, pain, temperature, and signs of low cardiac output.
Before
- Verify consent/status, allergies, baseline pulses, labs, teaching needs, and family support.
- Prepare for lines, drains, and intensive monitoring.
After
- Monitor airway, perfusion, rhythm, chest tube output, temperature, urine output, and incision status.
- Report sudden drainage increase, hypotension, muffled heart sounds, or worsening cyanosis.
Priority complications
- Bleeding
- Tamponade
- Low cardiac output
- Dysrhythmia
- Infection
Ureteral stent care
Procedure
Renal
Temporary tube that helps urine drain from kidney to bladder after obstruction or urologic procedures.
NCLEX focus
- Monitor urine output, pain, fever, hematuria pattern, and obstruction or infection cues.
Before
- Assess pain, fever, urine output, allergies, anticoagulants, and kidney function.
- Teach expected urinary urgency or mild hematuria if appropriate.
After
- Monitor urine output, flank pain, fever, dysuria, and worsening bleeding.
- Encourage fluids if not contraindicated and follow removal instructions.
Priority complications
- Obstruction
- Infection
- Sepsis
- Migration
- Heavy bleeding
Genetic counseling
Teaching
Auto/GenOBPeds
Education and risk discussion for inherited conditions, carrier status, testing, and family planning.
NCLEX focus
- Support informed consent, privacy, psychosocial response, and referral rather than making decisions for the client.
Before
- Assess understanding, cultural needs, family history, and readiness for information.
- Confirm referral and testing consent requirements.
After
- Reinforce follow-up plan and available support.
- Clarify that the client chooses how to use the information.
Priority complications
- Misunderstanding risk
- Emotional distress
- Privacy breach
Lymph node biopsy
Procedure
Heme
Removal of lymph tissue to help diagnose lymphoma, infection, or malignancy.
NCLEX focus
- Bleeding, infection, pain control, and pathology follow-up are key nursing concerns.
Before
- Verify consent, allergies, anticoagulants, platelet/coagulation risk, and biopsy site.
- Explain pressure or incision expectations.
After
- Monitor bleeding, swelling, pain, fever, and incision drainage.
- Keep dressing care and follow-up instructions clear.
Priority complications
- Bleeding
- Infection
- Airway or vascular compromise depending on site
Chemotherapy safety
Med safety
HemeID
Precautions and monitoring for antineoplastic therapy and body fluid handling per policy.
NCLEX focus
- Monitor infection risk, bleeding risk, nausea, mucositis, vesicant injury, and when fever is urgent.
Before
- Check labs, consent, dose verification process, IV access, pregnancy precautions, and baseline symptoms.
- Use required PPE and handling policy.
After
- Monitor fever, bleeding, mucositis, nausea, hydration, and extravasation signs.
- Teach infection prevention and fever reporting.
Priority complications
- Neutropenic fever
- Bleeding
- Extravasation
- Tumor lysis syndrome
- Severe dehydration
Fall precautions
Assessment
MSKHemeNeuro
Safety bundle to reduce fall and injury risk in clients with weakness, bleeding risk, dizziness, or bone disease.
NCLEX focus
- Call light, assistive devices, bed position, non-skid footwear, toileting plan, and medication review are common test cues.
Before
- Assess gait, mentation, orthostasis, pain, medications, toileting needs, and injury risk.
- Set environment and assistive devices before mobilizing.
After
- Reassess after medication changes, procedures, or new weakness.
- Document fall-risk interventions and response.
Priority complications
- Fracture
- Head injury
- Bleeding
- Delayed escalation after fall
Burn dressing change
Procedure
Skin
Dressing care for burn wounds to protect tissue, reduce infection, and monitor healing.
NCLEX focus
- Premedicate pain as ordered, maintain temperature, use ordered technique, and report infection or circulation changes.
Before
- Assess pain, circulation, wound appearance, allergies, and ordered topical therapy.
- Prepare supplies before exposing the wound.
After
- Reassess pain, drainage, color, temperature, odor, pulses, and capillary refill.
- Document wound appearance and tolerance.
Priority complications
- Infection
- Hypothermia
- Uncontrolled pain
- Compartment compromise
Transmission-based precautions
Infection control
IDRespPedsSkin
Additional PPE and room practices used with standard precautions for contagious organisms.
NCLEX focus
- Match PPE and room needs to transmission route; protect the client, staff, and other patients.
Before
- Identify ordered isolation type and required PPE before entry.
- Gather supplies to reduce unnecessary room traffic.
After
- Remove PPE correctly, perform hand hygiene, and clean shared equipment.
- Teach visitors the required PPE and hand hygiene.
Priority complications
- Exposure
- Wrong PPE
- Transport without precautions
- Delayed isolation
Epinephrine auto-injector teaching
Teaching
RespCardiacSkin
Education for recognizing anaphylaxis and using prescribed epinephrine promptly.
NCLEX focus
- Airway, breathing, circulation, rapid epinephrine use, and emergency follow-up are priority concepts.
Before
- Assess allergy history, prior reactions, device expiration, and client/caregiver demonstration needs.
After
- Teach to call emergency services after use and monitor for recurrent symptoms.
- Review storage, carrying two devices when prescribed, and avoiding known triggers.
Priority complications
- Delayed epinephrine
- Rebound symptoms
- Airway compromise
- Shock
Emergency airway assessment and management
Assessment
RespPedsNeuro
Focused evaluation and support of airway patency, breathing effort, oxygenation, and need for escalation.
NCLEX focus
- Stridor, drooling, severe retractions, fatigue, altered mental status, or cyanosis makes airway the first priority.
Before
- Assess work of breathing, breath sounds, oxygen saturation, positioning, secretions, and mental status.
- Call for help early when airway obstruction is possible.
After
- Reassess breathing and perfusion after positioning, oxygen, suction, or medication.
- Prepare advanced airway support if deterioration continues.
Priority complications
- Airway obstruction
- Respiratory arrest
- Aspiration
- Hypoxia
Nebulized medication administration
Med safety
RespPeds
Inhaled medication delivery through aerosolized mist.
NCLEX focus
- Assess breath sounds and work of breathing before and after; monitor tachycardia, tremor, or poor response.
Before
- Check medication, dose, allergies, baseline respiratory status, heart rate, and equipment setup.
After
- Reassess lung sounds, oxygenation, heart rate, tremor, and respiratory effort.
- Escalate if distress continues after ordered therapy.
Priority complications
- Worsening distress
- Tachycardia
- Incorrect medication setup
- Delayed escalation
GIPeds
Tissue sampling used to help diagnose Hirschsprung disease.
NCLEX focus
- Monitor for bleeding, perforation signs, fever, and abdominal changes after the procedure.
Before
- Verify consent, allergies, bowel prep instructions, bleeding risk, and baseline abdominal assessment.
After
- Monitor rectal bleeding, fever, abdominal distention, pain, and feeding tolerance.
- Report rigid abdomen or worsening distress.
Priority complications
- Bleeding
- Perforation
- Infection
- Delayed diagnosis
Bowel surgery post-op care
Procedure
GIPedsOB
Post-operative care after bowel repair, resection, or obstruction-related surgery.
NCLEX focus
- Monitor airway, pain, abdominal distention, bowel function, incision, ostomy if present, fluids, and infection cues.
Before
- Assess baseline abdomen, hydration, electrolytes, consent, allergies, and family teaching needs.
After
- Monitor vitals, pain, distention, bowel sounds per policy, output, incision, and signs of sepsis.
- Maintain NPO/NG/IV fluid orders as prescribed.
Priority complications
- Peritonitis
- Sepsis
- Bleeding
- Obstruction recurrence
- Fluid imbalance
Focused neurologic assessment
Assessment
NeuroOBPeds
Focused assessment of consciousness, pupils, movement, sensation, tone, reflexes, and age-appropriate neurologic cues.
NCLEX focus
- A new change in LOC, pupils, movement, tone, or feeding/cry in newborns is a priority finding.
Before
- Establish baseline LOC, pupils, movement, sensation, pain, fontanel/head circumference when age-appropriate, and vital signs.
After
- Trend changes and report deterioration promptly.
- Pair neuro changes with oxygenation, glucose, infection, and perfusion checks.
Priority complications
- Increased ICP
- Seizure
- Worsening injury
- Missed newborn deficit
Throat culture
Labs/diagnostics
IDPedsCardiac
Throat specimen collected to identify group A strep or other ordered organisms.
NCLEX focus
- Collect correctly before antibiotics when ordered and reinforce antibiotic completion for confirmed strep.
Before
- Verify order, allergies, symptoms, and whether antibiotics were already started.
After
- Send specimen promptly.
- Teach infection prevention and follow-up for fever, rash, or worsening symptoms.
Priority complications
- Delayed antibiotics when unstable
- Poor specimen quality
- Rheumatic fever risk after untreated strep
Range-of-motion teaching
Teaching
MSKNeuroOB
Teaching safe passive or active movement to maintain mobility and prevent contractures.
NCLEX focus
- Protect injured tissue, avoid forced movement, and follow provider or therapy restrictions.
Before
- Assess pain, restrictions, neurovascular status, caregiver readiness, and therapy plan.
After
- Reassess pain, color, movement, sensation, and tolerance.
- Document teaching and return demonstration.
Priority complications
- Pain escalation
- Joint injury
- Neurovascular compromise
- Caregiver misunderstanding
Sterile dressing care
Procedure
SkinOBPeds
Sterile protection of open wounds, surgical sites, or exposed tissue.
NCLEX focus
- Maintain moisture/protection as ordered, prevent contamination, and monitor infection, perfusion, and tissue integrity.
Before
- Assess wound, drainage, pain, allergies, ordered solution/dressing, and required sterile supplies.
After
- Monitor drainage, odor, bleeding, pain, temperature, and dressing integrity.
- Report exposed tissue drying, infection signs, or perfusion changes.
Priority complications
- Infection
- Tissue drying
- Bleeding
- Contamination
Surgical repair post-op care
Procedure
OBPedsGI
General post-operative monitoring after repair or closure of a structural defect.
NCLEX focus
- Airway, perfusion, pain, incision, bleeding, infection, and return of function drive priority decisions.
Before
- Verify consent/status, allergies, baseline assessment, labs, NPO status if ordered, and family teaching needs.
After
- Monitor vitals, pain, incision/drainage, perfusion, infection signs, and ordered activity restrictions.
- Escalate bleeding, respiratory compromise, or worsening pain.
Priority complications
- Bleeding
- Infection
- Dehiscence
- Respiratory compromise
- Perfusion change
Specialty feeding teaching
Teaching
OBPedsResp
Feeding support for infants or children with structural, surgical, or respiratory feeding concerns.
NCLEX focus
- Protect airway, use ordered nipples/positioning, monitor weight, hydration, fatigue, and aspiration cues.
Before
- Assess respiratory status, suck/swallow coordination, hydration, weight, and ordered feeding plan.
After
- Monitor intake, emesis, fatigue, aspiration signs, and caregiver return demonstration.
- Follow post-op restrictions on suction, utensils, or positioning.
Priority complications
- Aspiration
- Dehydration
- Poor weight gain
- Wound disruption
Cleft repair care
Procedure
OBPeds
Post-operative care after cleft lip or palate repair.
NCLEX focus
- Protect the surgical site, maintain airway, support feeding plan, and avoid trauma to the repair.
Before
- Assess airway, feeding status, hydration, consent, and caregiver understanding of post-op restrictions.
After
- Monitor airway, bleeding, pain, hydration, and incision integrity.
- Use ordered restraints or positioning and avoid prohibited utensils/suction.
Priority complications
- Airway compromise
- Bleeding
- Dehydration
- Repair disruption
Air enema reduction
Procedure
GIPeds
Radiology-guided enema used to reduce selected intussusception cases.
NCLEX focus
- Monitor pain relief, stool pattern, perforation signs, shock, and recurrence after reduction.
Before
- Assess abdominal pain, vomiting, stool, hydration, vitals, and perforation/peritonitis signs.
After
- Monitor abdominal distention, fever, pain recurrence, bloody stool, and hydration.
- Prepare for surgery if reduction fails or deterioration occurs.
Priority complications
- Perforation
- Peritonitis
- Shock
- Recurrence
Hernia repair care
Procedure
GIPeds
Surgical repair of hernia defect or trapped tissue risk.
NCLEX focus
- Before repair, strangulation signs are priority; after repair, monitor pain, swelling, voiding, and incision.
Before
- Assess reducibility, pain, vomiting, fever, abdominal/scrotal swelling, and perfusion concerns.
After
- Monitor incision, pain, swelling, fever, voiding, and activity restrictions.
- Teach to report increasing pain, vomiting, or irreducible bulge.
Priority complications
- Incarceration
- Strangulation
- Bleeding
- Infection
Pyloromyotomy care
Procedure
GIPeds
Surgical correction for pyloric stenosis.
NCLEX focus
- Correct dehydration/electrolytes pre-op, then monitor feeding tolerance, vomiting, pain, and incision.
Before
- Assess hydration, weight, vomiting pattern, electrolytes, glucose, and urine output.
- Prepare IV fluid correction and NPO status as ordered.
After
- Advance feeds as ordered.
- Monitor emesis, incision, pain, hydration, and weight gain.
Priority complications
- Dehydration
- Electrolyte imbalance
- Persistent vomiting
- Infection
Airway clearance therapy
Procedure
RespAuto/GenPeds
Techniques that help mobilize and remove respiratory secretions.
NCLEX focus
- Assess work of breathing, hydration, infection signs, and tolerance before and after therapy.
Before
- Assess lung sounds, oxygenation, cough strength, secretions, pain, and meal timing.
After
- Reassess breath sounds, oxygen saturation, sputum, fatigue, and hydration.
- Stop and escalate for distress or cyanosis.
Priority complications
- Hypoxia
- Fatigue
- Hemoptysis
- Missed infection
GIAuto/Gen
Scope procedure used to view or sample the GI tract.
NCLEX focus
- Consent, NPO, sedation safety, gag reflex return, bleeding, perforation, and biopsy follow-up are key.
Before
- Verify consent, NPO status, allergies, anticoagulants, airway/sedation risk, and baseline vitals.
After
- Monitor airway, gag reflex return, pain, bleeding, fever, and perforation cues.
- Keep NPO until swallowing is safe per policy.
Priority complications
- Aspiration
- Bleeding
- Perforation
- Sedation reaction
External ventricular drain care
Procedure
NeuroID
Care of a drain that removes CSF and may monitor intracranial pressure.
NCLEX focus
- Leveling, clamping rules, drainage amount/color, infection prevention, and neuro changes are priority cues.
Before
- Assess neurologic baseline, order parameters, drain level, collection system, and infection risk.
- Verify clamping/transport instructions before moving the client.
After
- Trend drainage, ICP if ordered, neuro status, temperature, insertion site, and system integrity.
- Report sudden drainage changes, waveform loss, fever, or neuro decline.
Priority complications
- Infection
- Overdrainage
- Underdrainage
- Increased ICP
- Accidental removal