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• C-Choking
• C-Coughing
• C-Cyanosis

A tracheal esophageal fistula (TEF) is a congenital abnormality in which there is an opening between the trachea and the esophagus. Surgery is required to repair the opening before a baby can receive oral nutrition. Signs and symptoms to identify TEF are choking, coughing, and cyanosis.

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• F-Feeding difficulty
• I-Inspiratory Stridor
• N-Nares Flares
• E-Expiratory Grunting
• S-Sternal Retractions

The above signs are indications that the patient is attempting to draw in more oxygen. The patient will begin to compensate for the decreased tissue oxygenation by exhibiting the following signs and symptoms.

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• C-Choking
• L-Lie on back
• E-Evaluate Airway
• F-Feed Slowly
• T-Teaching
• L-Larger nipple opening
• I-Increased incidence in males
• P-Prevent crust formation and aspiration

Cleft lip is a congenital slit in the skin above the lip, typically also associated with a cleft palate. The typical treatment is reconstructive surgery. Post op care includes monitoring for choking. Baby should lie on their back during sleep to prevent trauma to sutures. Make sure to evaluate the airway and ensure it is open and monitor for aspiration. Feed the baby slowly in an upright position with a larger nipple opening. Prevent crust formation. Lastly, provide teaching to parents regarding feeding and common care.

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• C-Child’s excessive knowledge of sex and abusive words
• H-Hair growth in various lengths
• I-Inconsistent stories from the child and parent/s
• L-Low self-esteem
• D-Depression
• A-Apathy, no emotion
• B-Bruised
• U-Unusual injuries
• S-Serious injuries
• E-Evidence of old injuries

Child abuse can be in many forms; physical, sexual, emotional, or neglect. Any act of commission or omission by a caregiver that harms or may cause harm to a child is child abuse. As a healthcare professional it is important to be in-tune with the preceding warning signs or indicators of child abuse.

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• 2A-Two Areolas, Two Arteries
• 1V-One Vagina, One Vein

To remember the vasculature in the umbilical cord, remember that the mom has: Two areolas; One Vagina. So, there are Two umbilical arteries, one umbilical vein.

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• A-Abdominal Pain
• C-Chest Pain
• H-Headache
• E-Eye Problems
• S-Severe Leg Pain

Because oral contraceptives can cause clots, we should monitor for the following serious complications in patients taking oral contraceptives: abdominal pain, chest pain, headache, eye problems, swelling or aching in the legs or thighs.

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• N-Non-reactive
• N-Non-Stress test is
• N-Not good

A non-reactive result in a non-stress test is not good. During a non-stress test the fetal heart rate is monitored during movement. A reactive result is a good sign indicating intact central and autonomic nervous system. A reactive non-stress test result would be 2 accelerations to a certain level for greater than 15 seconds within a 20 minute period. If this does not occur the test is non-reactive.

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• P-Period (menstrual: late, spotting, bleeding)
• A-Abdominal pain, dyspareunia (painful intercourse)
• I-Infection (abnormal vaginal discharge)
• N-Not feeling well, fever or chills
• S-String missing

An intrauterine device is inserted into the uterus and is used to prevent pregnancy. There are two different types: hormonal and copper IUD.

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• H-Hemolysis
• E-Elevated
• L-Liver function tests
• L-Low
• P-Platelet count

HELLP syndrome is a severe and life-threatening complication, typically related to preeclampsia. It typically occurs in the third trimester.The defining characteristics are hemolysis (breakdown of red blood cells), elevated liver enzymes, and low platelet count.

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• A-Amniocentesis
• L-L/S Ratio
• O-Oxytocin Test
• N-Non-Stress Test
• E-Estriol Level

An amniocentesis is performed during the prenatal period. A needle is inserted to obtain a sample of amniotic fluid, which can be used to identify chromosomal abnormalities. L/S ratio compares lecithin– phosphatidyl choline to sphingomyelin to identify infant lung maturity. The oxytocin test measures fetal heart rate during contractions induced by oxytocin. A non-stress test measures fetal heart rate while baby is at rest and while baby is moving. Estriol levels in mother’s blood can be a marker for fetal well-being.

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• V-Variable
• E-Early
• A-Accelerations
• L-Late
• C-Cord Compression
• H-Head Compression
• O-Okay
• P-Placental Insufficiency

A fetal acceleration is an abrupt increase in fetal heart rate above the established baseline. A fetal deceleration is a decrease in fetal heart rate below the established fetal heart rate. The VEAL CHOP nursing mnemonic can be used to help remember how to interpret fetal heart rate during labor. For example, early decelerations in FHR (fetal heart rate) indicate head compression. It is typical for decels in FHR during a contraction because of head compression, but FHR should return to normal when contraction ends.