#NurseNatNCLEXStudy: 8 Fundamental Tips for Passing the NCLEX-RN

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A few days after the delivery of my baby girl, I found out that I passed the NCLEX-RN on the second attempt! I was so happy and relieved. Having written the exam twice now, I definitely have a few tips to share for those who are either preparing to write the exam or have recently failed and can’t figure out what to do. Trust me, I’ve been there. In this post, I will be talking about the top 8 fundamental tips I used to help me pass my NCLEX on the second attempt.

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Tip numbero uno, purchase a review guide! I cannot stress enough how helpful it was to review an NCLEX guide.

Nursing school does not prepare you for the exam, so don’t just rely on your old notes and textbooks. Alone, they won’t do you any good.

Here is why you should purchase a review guide:

  • Large practice question bank and tests that are just as challenging as the actual exam
  • Study strategies and tips
  • Test taking strategies and tips
    • strategies that do and don’t work on the exam
    • critical thinking strategies
  • Online resources (such as timed practice tests that mimic the NCLEX CAT format)
  • Some guides are very comprehensive if your nursing foundation is shaky; other guides offer short and concise nursing content review and focus more on practice questions and test taking skills
  • Everything you need to know about the NCLEX-RN
    • how to apply and schedule your exam
    • how the computer adaptive test (CAT) works
    • the different types of questions you will see
    • breakdown of what categories will be covered on the exam
    • NCLEX answers vs. real-world nursing answers

It is also important to understand that the questions you come across on the exam are very different from the ones you see in nursing school. In fact, lots of test takers have to relearn how to read a question and figure out what the question is actually asking. Also, it may be impossible to know everything so when you come across a question that you can’t really answer with confidence, you’ll need to use those test taking skills and strategies to help you through it.

My favourite review guide is Saunders Comprehensive Review for the NCLEX-RN Examination and Kaplan NCLEX-RN Prep Plus.

I chose Saunders for the comprehensive component. The explanations are very detailed and thorough but just concise enough to not take up too much of your time. It covers a lot of nursing content with review questions and explanations at the end of each chapter. Make sure to schedule your exam months ahead because this is quite a hefty book to finish!

Kaplan focuses more on test-taking strategies and practice questions.

The test taking strategies truly made all the difference on my second attempt at the exam.

Plus, it provides explanations for wrong and right answers and gives you the most for you money.

Besides Kaplan and Saunders, there are many other guides that you can chose from:

  1. Kaplan NCLEX-RN Prep Plus
  2. NCLEX-RN Questions & Answers made Incredibly Easy
  3. Lippincott Q&A Review NCLEX-RN
  4. Mosby’s Comprehensive Review of Nursing for the NCLEX-RN Examination
  5. HESI Comprehensive Review for the NCLEX-RN Examination
  6. DAVIS’s Q7A Review for NCLEX-RN
  7. …many more!

Developing a schedule and setting short & long term goals is very important to keep you on track and make sure that you have covered everything you need to know for the NCLEX. If you want to go even further, daily checklists are great too.

This is an example of my monthly study schedule when I was preparing for the exam.

And here is an example of a daily study checklist and schedule.

And here is a checklist that breaks down the exam content into categories and the percentages of each category that will appear on the exam. As I go on to study each chapter and answer practice questions, I make sure to check off any areas of the exam that I have covered. This helps me manage my time with each category so that I can cover everything before the exam date.

Feel free to use these templates or create something similar yourself!

On another note, I highly recommend reading the 2019 NCLEX-RN Test Plan for a breakdown of the NCLEX exam on the NCSBN website.

Do you know your learning style?

Identifying your learning style helps you develop a study plan and optimize your learning and retention of information. My learning style is visual. When I read a question, I tend to create a scene in my head. I benefit best from watching youtube videos and images.

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There are 7 different learning styles:

  1. Visual (Spatial)
  2. Aural (auditory-musical)
  3. verbal (linguistic)
  4. Physical (kinesthetic)
  5. Logical (mathematical)
  6. Social (interpersonal)
  7. Solitary (intrapersonal)

Everyone learns differently. In fact, some people learn through a combination of learning styles. Get to know your learning style, understand it and utilize it to your advantage when preparing for the NCLEX.

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It’s true what they say, practice, practice, practice!

You have to do at least 100 questions per day for you to feel comfortable with the way the NCLEX formats their questions. And I can assure you that the more questions you answer, the more you will get right.

Aside from answering questions from your review guides mentioned in tip #1, I also recommend using online question banks such as UWorld. I love UWorld, and this is why:

  • 2000+ questions that are just as challenging as the NCLEX
    • Two self-assessments that are timed (100 questions each)
    • Lots of different question formats such as “select-all-that-apply”, “placing the answers in the correct order” type questions that are pretty tricky to master
    • You can also create your own customizable exams
  • In-depth rationales for both wrong and right answers
  • Create your own flash cards
  • Great illustrations for visual learners
  • Performance and improvement tracking
    • Identifies your strengths and weaknesses in easy to read graphs
    • Compares progress with others
  • Flexible subscriptions for your needs
    • 60 day, 90 day, or 180 day Qbank subscriptions
    • Renewals of subscriptions at a lower price

Whatever your resource may be, make sure to answer as many questions as you can!

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If you’re hoping that question about tracheostomy suctioning won’t show up on your exam, think again! That’s called “relying on false hope.” The NCLEX covers a wide range of nursing content using many different question formats.

If you are aware that you’re a little shady on an area of nursing practice, don’t avoid it! Identify your problem areas, learn about them and check them off your list! You’ll be glad you did.

Not only do you need to identify your weaknesses in nursing content, but you also need to know your weaknesses in test-taking skills. For example, if you know you’re terrible at select-all-that-apply type questions, focus more on answering those types of questions. Take them head on!

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And by that I mean, don’t just memorize the content!

Yes, lab values such as electrolytes or the therapeutic drug levels for digoxin are good to memorize but go deeper.

The NCLEX-RN won’t just test you on knowledge and comprehension level questions that involve recall or recognition. It is designed to test your ability to make competent nursing judgments.

Understand what happens if the patient were to experience an overdose on digoxin and what to do in those situations. As a entry level nurse, you need to show them that you will safely know what to do if those ranges or levels are not within limits.

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Invite some former classmates or good friends you’ve made in nursing school for a study session a few times per week. Sharing information and insight from others really improves your understanding on the content.

Here are some benefits to studying in a group:

  • Prevents Procrastination: You are accountable to show up with your notes to the study group. Now that your group members are depending on you, it makes it harder to put off your studying to last minute.
  • Fills in missing information or notes: Share information, gain insight, and ask or answer questions. Communication between your group members is key to effective learning.
  • Makes studying more fun and interesting: Joining a study group can help eliminate the lonely study blues you get when you’re at home all by yourself. Change your study environment and find some motivation and inspiration from your study peers.
  • Faster learning: Difficult concepts might be time consuming to understand alone. Who knows, maybe someone in your group might be an expert on that subject. It wouldn’t hurt to show up and ask.
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That being said, aside from using the review guides and study groups mentioned above, you can also enroll in NCLEX-RN Prep Courses offered by colleges and universities. If you enjoy learning in a classroom with others, this might be best for you.

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Last and arguably most important, self-care. It can be easy to neglect your self when it comes to preparing for your nursing boards. Make sure to create a study schedule that gives you time to eat a nutritious meal, meet with friends, take naps or indulge in your favourite hobbies.

Deal with your stress if you’re an anxious test taker. Here are some ways to help reduce stress and keep you healthy for your big day:

  • Exercise, Yoga, Take a walk
  • Take supplements
  • Aroma therapy such as lighting a candle
  • Soothing music
  • Reduce caffeine intake – consider decaf or a healthy fruit
  • Journaling or other forms of self-expression such as painting
  • Talk and/or laugh with a friend or loved one and share your feelings
  • Deep breathing exercises
  • Mindfulness
  • Meditation
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Extra Notes: “Passing the NCLEX in 75 Questions.

You don’t have to pass the NCLEX with the minimum amount of questions and it doesn’t make you any less of a nurse if you pass with the entire 265 questions.

Sure, your butt might be a little sore from sitting there for the whole 6 hours but what matters is that you passed! I found that I got slumped trying to pass the NCLEX in 75 questions to the point where that was all I focused on. When I wrote my exam and answered more than 75 questions, I started to get nervous and upset – almost as if I had already failed the exam.

As long as the computer continues to give you questions, you still have a chance at passing. Do not be discouraged. Keep answering those questions with that same confidence and determination you had with the first 75 questions and I assure you, you will do just fine.

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And of course, no one wants to pay another $300 to do this exam again! And don’t get me started on all those feelings that accompany failure… I’ve been through it too.

But I can’t stress enough how important it is to not put yourself down if you don’t pass on the first try. This “failure” does not mean that you are not a good enough nurse or person. Do not give up. Take those 45 days to reassess your study techniques and test taking strategies. Give some of the tips mentioned above a try, and don’t forget to allocate some time everyday during your 45 days to indulge in self-care and forgiveness.

To those who are preparing to write the NCLEX-RN, I wish you the best of luck!

And as always, thanks for reading.

Everything You Need to Know About Caffeine, Pregnancy & Breastfeeding

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One morning, I was grabbing a coffee at a coffee shop just around the corner from my workplace. I go there sometimes, when I leave my house and arrive early to work. I would spend the extra 15 minutes to drink my coffee and study a bit of my nursing material. At the time, I was preparing for my NCLEX-RN (National Council Licensure Examination).

Everyone could see that I was visibly pregnant. Of course, at 32 weeks, I was definitely showing, and you can also tell by all the stares that came my way when I stepped foot into the shop.

No, I didn’t order decaffeinated coffee. I ordered a regular one. And I just have one cup per day, but not every day.

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When the barista took my order, he was hesitant. He looked at my swelling belly, then at my face, and then at his coworker. I was waiting for him to say something, and he did. He simply said,

oh, you know we also have decaffeinated coffee and espresso too.”

I was empathetic and tried to understand that this man’s concern came from a good place. So I kindly declined his offer and asked for a regular coffee. Then I proceeded to say that one cup a day is fine.

And although it looked like he didn’t believe me, he went ahead and poured me a cup of caffeinated coffee anyway.

I will say that this did bother me. I’m sure he thought very little of me to be drinking caffeine while carrying a child. But seriously? Did he think I was drinking alcohol everyday too?

I respect his concern but he didn’t respect the fact, that I did my research and that if he wanted to correct me about something, maybe he should have done his research too.

Obviously, I am not the first pregnant woman to experience this. In fact, my experience was pretty mild compared to others.

Have you heard about the one where a grandmother literally snatched and threw away a pregnant woman’s cold brew coffee?! Mamma-mia…

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Is it safe to drink caffeinated coffee during pregnancy?

After the first trimester, it is safe to drink ONE CUP of caffeinated coffee per day and by one cup, I mean 200 mg of caffeine or a 10-12 ounce cup depending on where you go.

I know, research can make this all very confusing. New studies continue to combat each other. Some say it’s not okay to have a cup a day, and then other studies refute these results and claim that these conventional pregnancy theories are a thing of the past.

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But one fact is true – there is some sort of link between caffeine and miscarriages, stillbirths, and low weight births, especially when consumed in the first trimester.

The problem with this fact is that we cannot apply a quantity of how much caffeine to these risks or determine the true cause and effect relationship between the two.

However, studies do show that consumption of caffeine over the recommended 200 mg per day results in double the risk of miscarriages and low birth weights.

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How does caffeine affect the human body?

Caffeine is a central nervous system stimulant. In the brain, caffeine causes alertness which is why many of us consume caffeine.

Basically, the stimulant blocks adenosine from connecting to adenosine receptors in the brain. (Adenosine is an inhibitory neurotransmitter in the brain that causes relaxation and sleepiness.) The chemical structure of caffeine is very similar to the structure of adenosine. Caffeine therefore, binds to the adenosine receptors and blocks adenosine from binding to it. This blocks feelings of sleepiness formerly brought on by adenosine, and the release of other natural stimulants such as dopamine. (Dopamine is also a neurotransmitter released by nerve cells and contributes to feelings of pleasure and satisfaction.)

We use caffeine to:

  • manage drowsiness
  • manage headaches
  • increase metabolism
  • enhance exercise performance
  • boost your mood
  • increase concentration
  • increases motivation to work

The peak effect of this stimulant occurs after approximately 30 minutes after consumption.

Consuming too much caffeine can cause:

  • insomnia
  • nervousness
  • restlessness
  • irritability
  • upset stomach
  • increased heart rate
  • increased blood pressure
  • muscle tremors

It is also a diuretic, meaning it increases urination. This causes the body to release more fluids through urine possibly resulting in dehydration.

How is caffeine addictive?

Caffeine can be physically addictive and behaviourally addictive, especially in those who consume caffeine on a regular and sustained basis.

Physical addiction to caffeine occurs when the body produces more adenosine receptors to make up for the ones that are blocked by caffeine. This means that there are now more receptors that caffeine can bind to, requiring you to drink more coffee to “fill” those additional receptors. This also explains how coffee drinkers build up a tolerance and require more coffee over time.

Behavioural addiction occurs through the repetition of drinking the coffee in a social environment and the positive feelings involved in that environment, rather than the caffeine itself.

Withdrawal from caffeine can cause:

  • headaches
  • lack of concentration
  • drowsiness
  • irritability

How does caffeine affect the growing fetus?

Caffeine can directly and easily pass through the placenta to the fetus. Adults can metabolize caffeine but the fetus cannot, especially in the early phases of development.

As mentioned above, caffeine binds to our receptors altering the chemistry of our brains and effecting our cells, membranes and tissue. This change in chemistry may interfere with proper development of the fetus.

Another theory proposes that the vaso-constricting (constriction of blood vessels) properties of caffeine may cause increased blood pressure in the mother, leading to decreased blood flow to the fetus. The lack of blood flow to the placenta deprives the fetus of the oxygen and nutrients it needs to grow.

Caffeine not only increases blood pressure but also blood glucose levels as well. And it increases the workload of the liver that is already dealing with the increased hormonal demands of pregnancy.

Is it safe to consume caffeine while breastfeeding?

It is safe to drink caffeinated coffee while breastfeeding. Keep in mind that caffeine does pass through to your baby through breast milk, but only in trace amounts (approximately 1% of what you take in).

When breastfeeding, it is recommended that you should consume no more than 3 to 5 cups of coffee per day or no more than 300 mg daily.

If you drink about 3-5 cups of coffee, make sure to spread the consumption throughout the day to prevent high concentrations of caffeine in your breast milk.

If you find that your baby is becoming more restless and cranky after you’ve have coffee and breastfed, it may be time to reassess your intake amount.

How do you cut back on caffeine?

For chronic coffee drinkers who are or will be pregnant, it is important to wean yourself off of caffeine rather than stop cold turkey.

Start by mixing half caffeinated coffee with half decaffeinated coffee at first. Then eventually work towards drinking decaffeinated coffee entirely.

What other foods and drinks contain caffeine?

Besides coffee, caffeine can also be found in the following and should be consumed in moderation:

  • espresso beans
  • tea leaves
  • sodas
  • chocolate (cocoa beans)
  • energy drinks
  • some over the counter medication

As I’ve always mentioned, it is very important that you talk to your doctor about your caffeine consumption during pregnancy or breastfeeding.

We all know that mothers and mothers-to-be must make a lot of sacrifices for their growing babies but luckily, a cup of Joe doesn’t have to be one of them!

Thanks for reading.

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Life Saving Skills Every Parent Should Know: CPR & AED for Infants

Becoming a mother or father encompasses a tremendous responsibility, and that involves keeping your children safe from harm. This is why I decided to write a post about CPR and the use of the AED for infants (newborn to one year old) in hopes of raising awareness of this important life saving skill (that hopefully, you never have to use).

This is a in-depth step by step guide on how to perform CPR and use the AED on your infant if a situation ever arises.

It is important to note that this post does not replace courses with licensed first aid & CPR instructors. Instead, this post is meant to encourage you to enroll in a licensed class and supplement your learning. I have taken classes with the Red Cross and St. John Ambulance and their instructors are passionate and informative. I highly recommend them.

What is CPR?

CPR stands for cardiopulmonary resuscitation. CPR is needed when the heart, circulation, and respiration cease. The goal of CPR is to provide adequate blood perfusion to the brain, the heart, and vital organs by manually compressing the heart to pump blood. In doing so, you will decrease the likelihood of organ damage due to lack of oxygen.

Steps on How to Perform CPR on an Infant

Note: An infant is considered a newborn to one year old.

Scene: You find your baby unconscious in the play room.

Photo by Piotr Janus on Unsplash

Step 1: Assess the scene and make sure it is safe to approach.

As you approach your infant, you need to make sure the scene is safe to enter. Of course, in this situation, you are at home and your infant is in the playroom.

Take note of their environment and the objects around them.

Photo by Shitota Yuri on Unsplash

Assessing the scene and looking for cues will help you figure out what has happened, and guide you in your next steps of action.

Step 2: Try to stimulate the infant to wake up.

Elicit a response by trying the following:

– Flick the bottom of their feet

– Gently stroking the infant

Note: Never shake an infant due to the risk of shaken baby syndrome which can result in severe brain damage.

Step 3: If the infant does not respond, call for help.

If you are alone, call 911 for help and if possible, do not leave the infant’s side.

If someone is with you, get them to call 911 and find an AED (Automated External Defibrillator) while you provide care. In a home setting, finding an AED may be very difficult!

Step 4: Assess for breathing and pulse simultaneously for no more than 10 seconds.

Put your ear to the infants mouth and nose and listen for breathing sounds.

Watch their chest for up and down breathing movement.

At the same time, place your index finger and middle finger together and feel for the brachial or femoral pulse.

The brachial pulse is felt at the inner part of the infant’s arm, just above the elbow.

The femoral pulse can be felt in the inner and upper thigh.

You should be listening for breathing, watching the chest for rise and fall, and feeling for a pulse all at the same time and as quickly as possible.

Step 5: If there is no breathing, give a rescue breath.

Cover the infants mouth and nose entirely with your mouth and deliver one breath to see if the infant’s chest rises.

If it does not rise, the infant may have an obstructed airway (such as chocking). If that is the case, you will give 2 back thrusts with the palm of your hand after delivering compressions using the 2 finger technique (more detail below). Make sure to tilt the infant head downwards to allow gravity to help dislodge the foreign object out of their airway.

If the chest rises, their airway is clear. Deliver a second breath.

Note: Each rescue breath should last 1 second long, and make the chest rise.

Step 6: If the infant remains unresponsive, begin compressions.

Two Types of Compression Techniques for Infants:

1. 2-Finger Compression

Place your index and middle finger of one hand on the lower part of the sternum (in the middle of the chest, just below the nipple line) while your other hand supports the infant’s back. Use this technique when you are delivering back thrusts.

When to use this technique: When you are the only rescuer on site or if your hands are too small to encircle the chest of the infant

2. 2-Thumb Encircling Hands Technique

Preferred compression technique because it results in improved cardiac perfusion

Place both your thumbs on the middle third of the infant’s sternum (just below the nipple line) while encircling and supporting the infant’s back with both hands.

When to use this technique: This is the preferred compression technique. Use this technique if you can encircle the infant’s chest with both your hands. If the infant is very small, or your hands and thumbs are too large, you can put your thumbs on top of each other and compress that way.

Note: Avoid compression of the xyphoid portion of the sternum – compression here can damage the infant’s liver

How to Compress and Ventilate

If you are by yourself, compress 30 times and follow with 2 breaths (compression – ventilation ratio: 30:2)

Compress about 1/3 deep or 1 1/2 inches deep of the infant’s chest at a rate of 100-120 per minute.

If you are with another rescuer, they can help you. Instead of 30 compressions, deliver 15 compressions, and provide 2 breaths. Then you and the other rescuer can take turns compressing and giving rescue breaths at a ratio of 15:2. Also, while one person is performing CPR, the other can find and set up an AED.

Having another rescuer allows you to take turns and rotate. Compressions can get tiring, especially if you are the only rescuer waiting for help. As you get tired, your compressions may become sloppy and ineffective. It is shown that high quality compressions along with the AED are the two most critical interventions in saving a life so make sure you are doing them right. Always use the help whenever it is available.

Step 7: Continue CPR if infant remains unresponsive, and until help or the AED arrives

As you continue compressing and giving 2 breaths, make sure to reassess the infant every 2 minutes (after 5 cycles of CPR) or until help arrives. Which ever comes first.

If you are alone and performing CPR, reassess the infant every 2 minutes. If the infant is still not responsive, try to find an AED. Of course, if you are at home, continue CPR until help arrives.

When the AED arrives, apply the pads and wait for the automated instructions while you continue performing CPR.

How to use an AED on an Infant

AED stands for automated external defibrillator and can be found in public spaces for emergency use. It is a user-friendly and smart portable electronic device. It analyzes the person’s heart rhythm and determines if the heart rhythm is irregular (aka dysrhythmia). If the AED senses that the heart rhythm is irregular, it will deliver an electrical shock to restore the heart’s dysrhythmia to its normal rhythm. AEDs will only shock and correct a dysrhythmia. It will not start one that has already stopped such as in asystole.

In cases where the AED does not sense an irregular rhythm that it can shock, you should resume manual compressions and rescue breaths until the AED senses a shockable rhythm. Then reassess the infant every 2 minutes of CPR until the AED delivers a shock or until you see any spontaneous movement from the infant.

It is important to use the AED immediately when it arrives, even in the middle of performing CPR, and even if the AED that you have is not intended for children. Research has shown that survival rates increase when CPR and defibrillation occurs within 3-5 minutes of cardiac arrest.

When the AED is turned on, it will automatically instruct you. Listen to its instructions as it tries to sense a shockable rhythm. If there is a shockable rhythm, it will notify you to stay clear before shocking. “Clear” means do not touch the infant while the AED is delivering a shock.

AED Pad Placement on an Infant (Newborn to 1 Year old)

If there are pediatric AED pads or a pediatric dose attentuator on the AED you have on hand, it can be used for newborn babies and up to 8 years old.

Adults pads can also be used on children if that is all you have. But it is important to ensure that the AED pads do not overlap or touch each other during placement on the infant or child’s chest. This is due to the way the AED delivers the shock. If the pads overlap or touch, the shock delivered will not pass through the heart as it was intended to. Instead, the shock will just transfer from one pad to the other.

Sandwich the Heart

If all you have is an adult AED, place one adult pad in the middle of the infant’s chest and then place the other pad in the middle of their back, as if you are “sandwiching” the heart.

Cardiac Arrest in Children

Children often go into respiratory distress and bradycardia (heart rate drops to 60 or less beats per minute; normal for an infant is 80-160 beats per minute) before going into cardiac arrest. Even with a pulse, health care professionals will initiate compressions right away in preparation for a potential cardiac arrest. They will treat an infant with respiratory distress and a low heart rate as if they were “pulseless“, despite the presence of a pulse.

Signs & Symptoms of Respiratory Distress in Children

If your child is experiencing any or a combination of the following signs and symptoms, they may be experiencing respiratory distress:

  • Nasal Flaring
  • Noisy breathing
  • Rapid and/or shallow breathing
  • Shortness of breath
  • Brief periods of not breathing (also known as apnea)
  • Bluish colour of the skin and mucous membranes (gums and mouth, eyelids, hands and feet, nail beds) (also known as cyanosis)
  • Clammy skin (cool and sweaty skin)
  • Chest wall retractions (when the infant’s chest pulls in with each breath)
  • Mood Changes (difficult to arouse or keep awake, or fussier than usual)
  • Change in body position (positioning themselves in a way that makes it easier for them to breathe)

What to do if you notice the above signs and symptoms in your infant:

Stay calm, stay with your child, and reassure them.

Call for help (911) or take your child to the nearest emergency department if they are in distress.

Be ready to perform CPR if your infant becomes unconscious.

And my best advice to parents is to trust your instincts! If you feel like something just isn’t right, get help.

I hope you never have to use any of these skills in real life on an infant, especially your own, but these things do happen. Babies can choke on their food or toys, accidentally fall into a pool or slip under the water during bath time… And it can all happen so fast and so suddenly. As a new mom who has taken the CPR course many times, I can sincerely say that I have piece of mind knowing that I am definitely prepared when and if the time ever comes. And you should too.

As always, thanks for reading.

PUPPP: It Began With Stretch Marks…

During my pregnancy, I developed stretch marks all over my body – my thighs, my knees, my butt, and my expanding belly of course. They were even around my chest and arms. I gained more than 40 lbs by the end of it all!

Once I had delivered my baby girl, my stretch marks began to get more intensely red with colour, as well as bumpy and itchy… And then it started to burn and itch even more, to the point where all I could think and do was itch and itch and itch

I didn’t know what was going on at the time. Caring for a newborn, barely sleeping, and dealing with the troubles of breastfeeding and hemorrhoids – and now this!

It was overwhelming to say the least.

Read more about my postpartum hemorrhoid experience here:

“Hemorrhoids – There, I said it!”

What is PUPPP?

I found out that I had developed PUPPPPruritic Urticarial Papules and Plaques of Pregnancy.

PUPPP may also be known as:

  • Polymorphic eruption of pregnancy (PEP)
  • Toxic erythema of pregnancy
  • Bourne’s toxemic rash of pregnancy

Normally, it develops along your stretch marks in the third trimester and disappears after childbirth but in rare cases, the rash develops after childbirth. PUPPP occurs in 1 of every 160 pregnancies and more often to first time mothers or mothers carrying multiple fetuses.

Photo by Kewei Hu on Unsplash

Causes of PUPPP

The cause of this rash is unknown but experts suggest that it may involve a combination of factors listed below:

  • Antigens that belong to the baby enter the mother’s blood circulation and invade her skin causing an immunologic response
  • Excessive and rapid stretching of the skin damages the connective tissue underneath leading to an inflammatory response
  • PUPPP may be passed down genetically and has been shown to trace back to the father’s side
  • 70% of mothers who are expecting boys develop the rash suggesting that the sex of the baby may play a role
  • Cesarean deliveries also have some connection to the development of the rash
  • Hormones related to pregnancy have also been shown to influence the development of the rash
Photo by Ignacio Campo on Unsplash

Prognosis

PUPPP is not dangerous to the mom or baby. And yes, it will go away in a few days to few weeks. Nonetheless, PUPPP contributes to further insomnia and stress of a new mother, and adequate relief is necessary for their well being.

I was struggling with breast feeding at the time of the rash. I felt guilty that I wasn’t producing enough milk to feed my baby and I had to supplement with formula. I felt like a failure already.

Read more about my breastfeeding experiences:

“Breastfeeding – It doesn’t come as naturally as you think…

“Increasing your breast milk supply: What worked and what didn’t for me”

I was desperate to get rid of this rash as soon as possible, so I asked my husband to pick me up some Benadryl from the drugstore. I needed relief, anything. Once he got home with the medicine, I took it right away and later discovered that I wasn’t supposed to breastfeed while taking this drug...

I continued to take the medication anyway because I was in agony. In the meantime, I fed my baby formula while I pumped-and-dumped to maintain my supply. I hoped to be done with the drugs by the end of the week so I could get back into breastfeeding and bonding with my newborn.

Photo by Lisa Hobbs on Unsplash

Treatment and Home Remedies

Although I was better after taking benadryl, the intense itching was still very much present. I still wanted to rip my skin off! So I looked up some home remedies online.

This is what I found:

Antihistamine Medication (Benadryl)

Antihistamines can be taken orally and purchased over the counter without a prescription or even on Amazon. It can also be in the form of a cream which you can directly apply to your inflamed stretch marks. It inhibits histamine receptors to reduce the inflammatory and immune response. In doing so, antihistamines reduce the signs and symptoms related to allergies and pruritus (itching). I used Benadryl (aka diphenhydramine) to help with the itching. Honestly, it did help a little but it wasn’t enough on its own. Also, if you are breastfeeding please make sure to consult your doctor! Some medications can pass through your breast milk to your little one.

Baking Soda or Oatmeal Bath Soaks

You can also try an oatmeal bath or add baking soda to soothe your inflamed and burning skin, aid in healing, and neutralize your pH. On Amazon, you can find the Aveeno Soothing Bath Treatment with 100% Natural Oatmeal that worked wonders for me! Adding baking soda to your bath water worked just as well. For the baking soda bath soak, I filled the bath tub with warm water (but the cooler the water, the better). Warm to hot water tends to irritate rashes and make them worse. Then I add about 1/4 cup of baking soda into the water and soak for about 30 minutes. Repeat at least 2-3 times per week. Whenever I had the chance to even take a bath, I made sure to soak myself thoroughly. Not only did it give my relief, but it was also relaxing and calming.

Topical Steroid Cream

Topical creams can be mild to potent and are often used in combination with oral antihistamine medication such as benadryl. They contain corticosteroids which reduces inflammation. I had to get my steroid cream from my doctor with a prescription. My doctor prescribed a very potent one for me because I had stretch marks nearly everywhere on my body. The cream provided some relief in combination with the benadryl.

Ice Packs Or A Cold Compress

This was by far the most effective home remedy for me! The ice packs helped to numb the area for immediate relief, but a nice cold shower worked just as well. Apply the cold compress to your stretch marks for about 5 to 10 minutes. Don’t leave it on the skin too long! Also, don’t apply the cold compress or ice pack directly to the skin. Cover it with a cloth first. I had 2 ice packs in the freezer and alternated the two whenever I needed them.

Moisturize Your Skin

When your skin is dry, it is prone to become itchy. Prevent dry skin by applying moisturizers as often as possible, especially after a bath or shower. There are also itch-relieving body lotions that can be used as well. I used GOLD BOND Medicated Anti-itch Lotion which contains dimethicone (skin protectant) and menthol to relieve itching. The Aveeno Anti-itch Concentrated Lotion worked very well too. Try to avoid moisturizers that contain the following:

  • Salicylic acids – A type of hydroxy acid (BHA) used in acne prevention products. It dissolves debris that clogs pores called keratin plugs and regulates skin cells. It is generally safe to use salicylic acid containing skincare products during pregnancy (once or twice a day) as long as the amount does not exceed 2%.
  • Retinol – made from vitamin A and is often added to skin care products for its anti-aging properties. It boosts the production of collagen in skin to reduce fine lines and wrinkles, evens out skin tone, improves skin texture, tightens pores, and stimulates blood flow.
  • Vitamin A – an essential nutrient that supports skin, eye and reproductive health and immune function. Often added to skincare products in the form of retinol. During pregnancy, it is recommended that mother avoid high levels of vitamin A intake in food due to the risk of birth defects and liver toxicity. Although the amount of vitamin A added to skin care products is low, doctors still recommend the avoidance of such products.
  • Retinyl-palmitate – composed of palmitic acid (fatty acid) and retinol (vitamin A) and is an effective antioxidant when applied to the skin. Natural enzymes in your skin converts retinyl-palmitate into retinol when applied to the skin producing anti-aging properties.
Photo by Hans Vivek on Unsplash

Other Anti-inflammatory Remedies:

The anti-inflammatory remedies listed below are tips that I heard of but haven’t tried myself. Let me know if these worked for you!

  • Chamomile and/or dandelion root tea – apply the tea directly to the affected areas with a cotton ball. Be careful not to burn yourself! Chamomile and dandelion root contains anti-inflammatory properties
  • Peppermint oil – mix a few drops of peppermint oil with coconut oil and apply directly to the affected areas. Peppermint oil has been shown to relieve itching
  • The Grandpa’s Company – Pine Tar Soap – antiseptic properties commonly used to treat psoriasis (autoimmune condition where your body rapidly overproduces skin cells causing inflammation and scaling) and eczema. Basically, the soap slows skin cell growth
  • Other cooling agents: menthol, calamine containing lotions
Photo by Christin Hume on Unsplash

Don’t Itch!

I’m sure this one is obvious but just to remind you, don’t itch that rash! It will just make it worse. PUPPP should not leave any scars behind once it has healed but you may have some hyperpigmentation or dark spots if you continue to itch. I know I did.

Seek Help

It is so important that you talk to your doctor when you suspect that you may have PUPPP. Sometimes your rash may appear as a PUPPP rash but it could be something much more concerning such as cholestasis of pregnancy or pemphigoid gestationis (PG).

  • Intrahepatic cholestasis of pregnancy (ICP) – Due to liver disease that occurs in the last trimester of pregnancy and causes severe itching. Basically, pregnancy hormones slow and stop the normal flow of bile needed for the breakdown of fats in digestion. The bile is then backed up in the liver causing seepage into the blood stream.
  • Pemphigoid gestationis – (pemphigus means blister of pustule) A rare condition that affects 1 in 50,000 pregnancies and is caused by the immune system mistakenly attacking your own skin.

Unfortunately my PUPPP rash lasted more than a few weeks but with the help of benadryl and the other home remedies, I was able to pull through. Today, the rash is completely gone with very minimal scaring. Of course, only the stretch marks remain.

Have you experienced this rash during your pregnancy? How did you cope with it? I would love to hear your thoughts. Thanks for reading.

xoxo

July Ipsy Glam Bag!

Hi loves! I recently signed up for ipsy’s glam bags! This is my very first subscription to the beauty box fad that’s been filling up my social media feed. I’ve looked into FunFitFab, Boxycharm, Allure, and many other beauty boxes but I could never bring myself to sign up for any of them until now!

It started when I came across an ipsy ad on instagram. I’m not one to fall for these ads but after looking through the comments, I noticed that customers really loved the products and the customer service was exceptional!

I went to their website and it looked promising! So I made an account and did their beauty quiz to personalize the products that will be included in my glam bag each month. The beauty quiz is so thorough, I actually loved doing it. It asks you questions ranging from your favourite brand name products, the colours palettes you prefer for your make up, your skin type, hair type and so forth. If you’ve gotten a tan, for example, and need to update your skin tone, you can totally do that by clicking on the ‘account‘ button on their website.

You can get a glam bag plus which has full sized products or just the regular glam bag which has sample sized products for $10. They arrive monthly. You even get the option to add more products to your bag each month for an extra cost. These extra add-on products can be full sized or sample sized. As well, ipsy allows they’re customers to earn reward points and ipsy cash to redeem for more products to add to your order each month!

Because this is my first beauty bag subscription I decided to try to regular glam bag with the sample products. I thought, if I liked a certain sample product, I can just purchase the full sized product myself rather than receive a full sized product that I didn’t like. Plus, its only $10! I had to give it a try and I’m so glad I did!

In this post, I’m going to share with you my very first July ipsy glam bag!

So firstly, I want to point out that it’s delivered in this dazzling pink package!

And the products come in a stylish make up pouch in the picture below.

For this month of July, I received…

  • Palm tree covered pouch
  • HEMPZ Sweet Pineapple & Honey Melon Herbal Body Moisturizer
  • Midflower Hyaluronic Acid Moisturizing Sheet Masks (two packages)
  • LARITZY Cosmetics Dew Pot in the colour Utopia
  • PACIFICA Beauty Bronzer Blush Duo
  • CUCCIO COLOUR Nail Polish in Mercury Rising

Midflower Hyaluronic Acid Moisturizing Sheet Masks

Just recently I tried the Midflower hyaluronic moisturizing sheet mask and it left my skin so soft and smooth!

The mask contains hyaluronic acid for moisture, and firming, and flower water (ancient practice).

In my beauty quiz, I placed an emphasis on skin care products because I take my skin care very seriously. I love the idea of receiving new face masks and other skin care products to try every month!

HEMPZ Sweet Pineapple & Honey Melon Herbal Body Moisturizer

The first thing I did was flip open the lid and take a big whiff out of the bottle… It smelt soooooooo good! It literally smelt like candy, I almost wanted to lick my hands!

This moisturizer contains hemp seed oil, hydrating pineapple extract, and honey melon extract which is high in antioxidants.

I loved that it’s light weight and absorbs into the skin quickly – not greasy at all. Also, 100% vegan, gluten-free, and THC-free.

PACIFICA Beauty Bronzer Blush Duo

PACIFICA is an award-winning brand for its vegan and cruelty-free products. It’s highly pigmented but also blends beautifully.

I absolutely love this coconut and rose infused bronzer and blush duo. It really smells like roses with a hint of coconut! The blush is in the shade wildrose and has a bit of sparkle to it so I tend to skip my highlighter when I use this blush. The bronzer is in the shade desert and it’s my new go to bronzer!

Great for on the go, especially with the handy little mirror on the back of it.

LARITZY Cosmetics Dew Pot in the colour Utopia

I was a bit iffy with this product at first because my face is normally oily and I have high cheek bones so using highlighters like this one would accentuate those features a bit too much…

For those who love highlighters and dewy make up looks, this might be the right product for you! This product feels like a pomade and blends very smoothly on the skin.

LARITZY is based in Montreal and provides cruelty-free products with the highest quality ingredients for your skin!

CUCCIO COLOR Nail Polish in Mercury Rising

I am terrible at painting my own nails, so when I received this product I was hesitant to use it. The colour however swayed me, so I had to give it a go. It’s a lovely shade of grape purple and very easy to sweep onto your nails. However, on the second day, this nail polish chipped!… I don’t know about you guys but I think I’ll just stick to the professionals at my local nail salon…

But on the plus side, CUCCIO COLOUR is known for their collection of 10-free formulas which are nail polishes free of harmful ingredients to your health.

I’m so glad I signed up for this beauty box subscription and I’m looking forward to sharing the next bundle of samples for August with you all!

Thanks for reading! xoxo

Hemorrhoids – There, I said it!

I never thought I would ever experience hemorrhoids in my life, not even during pregnancy. I mean, I’m young, active, and fairly healthy.  I knew that it was a common occurrence for mothers postpartum but I still thought, “Nope, not me.”

But I’ve since flushed all those naïve thoughts down the toilet… (hah)

You see, I remember my first time pooping after I had given birth. I was bleeding from my butt hole. And if you couldn’t tell, I was mortified.

After many panic-stricken thoughts on the toilet, I flashed back to my pregnant self laying on the hospital bed, pushing so god damn hard that I defecated all over myself while my dear husband watched (front row seats I should mention), and then I knew right then and there, yup, hemorrhoids. Oh yea, definitely.

So there you go. If you didn’t think it could happen to you, well think again momma!

I had to deal with hemorrhoids after birth, along with other postpartum troubles – PUPPP, breast feeding, sleep deprivation, anxiety… You know, the usual.

Read my post about “PUPPP: It Began With Stretch Marks…”

For those who don’t know, hemorrhoids are where the veins around the rectum swell with blood and fluids. This is due to increased pressure in that area such as when you are constipated or in this case, pushing out a tiny human from your vajayjay (aka vaginal delivery)! This increased pressure pushes against the vein walls in the rectum causing it to weaken. Over time blood will collect in pockets where the vein walls are weak and voila – the birth of a hemorrhoid. The weak vein walls can also burst and bleed! It can develop inside the rectum and/or outside around the anus. And fun (not so fun) fact, you can have multiple hemorrhoids inside and outside of your butt hole all at the same time!

Fortunately, I didn’t have to deal with my hemorrhoids for too long. They lasted for about 2 months postpartum which is more than I can say for the other moms out there (my thoughts and prayers are with you). Hemorrhoids can develop anytime during pregnancy, pre- and postpartum! During pregnancy your uterus expands for your growing baby. This applies pressure on the veins in your rectum causing them to weaken and swell. They should go away once you’ve given birth. For those who have hemorrhoids after birth, they can last for a couple of days. If they last longer and you can’t find relief, please speak to your doctor!

Oh, and did I mention they were painful?

There were times where I was literally afraid to use the washroom. I would use any excuse to avoid sitting on the toilet but oh, was I so wrong! You see, the longer you wait, the worse it gets. It was like I was literally passing razor blades through my anus! Oh, how lovely motherhood is!

Photo by Alex Pasarelu on Unsplash

But it’s the truth and it’s all too common. So let’s talk about it. Let’s raise awareness about the glorious hemorrhoids of pregnancy and let’s remind each other that there’s nothing to be embarrassed about.

There were many home remedies along with a topical drug prescription that I used to relieve the pain of hemorrhoids. But my one and only saving grace was WATER. I can’t stress enough how important water is, especially postpartum when your body is out of whack and trying to heal. Water is absolutely essential. Not only is it good for hemorrhoids, but it helps with your milk supply, to reduce the swelling in your feet (edema) and so much more.

In my case, increasing my water intake helped soften my stool so it was waaaay easier to pass and I didn’t have to strain as much. Especially for those suffering from constipation after birth, drink lots of water.

When you’re sitting on the toilet and biting down on a towel, you’ll remember this and thank me.

In combination with increased water intake, here are some other very helpful tips to relieve your poor, poor butt hole:

Our family loves Bragg’s organic, raw and unfiltered apple cider vinegar.

Apple Cider Vinegar

I know what you’re thinking because I thought the exact same thing! You would think that applying an acid to your already burning anus would make it worse, right? Well apple cider vinegar has antibacterial and antiinflammatory properties and many have suggested that it provides immediate pain relief! It’s true, it really works! Apply the apple cider vinegar with a cotton ball or dilute it in your warm (not hot) bath water or your sitz bath. Doctors do warn that excessive use can lead to further irritation and burning so make sure to apply it sparingly and only as needed.

Sitz bath

Soak your bottom in a sitz bath for about 15 minutes! Usually, upon discharge from the hospital, you should have received a sitz bath tub that you can use to soak your bottom in. If not, they are available at your local pharmacy or online.

If you don’t have a sitz bath tub, no worries. A bath tub works just as well. I like to mix in lots of epsom salt into my warm bath water. Epsom salts dissolve into magnesium and sulfate in water which will be absorbed into the skin to soothe the area. You can also use baking soda, or even dilute some apple cider vinegar as well!

Hemorrhoid Ointment

Your doctor may prescribe some hemorrhoid cream which you can apply with an applicator directly in your rectum and around your anus. This cream is a corticosteroid which reduces inflammation such as redness, itching and swelling. The ointment that I was prescribed is called Anodan-HC. It contains 0.5% hydrocortisone acetate (which is the corticosteroid that reduces inflammation) and 0.5% zinc sulfate (which forms a barrier and protects skin from moisture).

Relieving pressure off of your bottom

Sit on a pillow or cushion, rocking chair or recliner that shifts your weight off of your bottom to another part of your body. This decreases pressure off of your bottom.

When duty calls, don’t avoid it!

I’m so guilty for this! I was literally scared sh*tless (hah) to poop because of the pain so I postponed it for as long as I could. Worst decision ever! If you need to go, go right away. Don’t wait! Delaying it will cause your feces to harden which makes it so much more painful to pass. This is because your body is reabsorbing the water from your stool when it sits in your rectum. Trust me, I know it hurts, but it will hurt so much more if you avoid it. Get it over and done with. You will feel so much better.

I hope this post provides help and support to those going through the same troubles I did when I had hemorrhoids!

You’re not alone and remember, it will pass!

Please feel free to share your stories, struggles, or advice in the comments below. We love hearing from our readers! Thanks for reading everyone!

The Truth About Eating Raw Fish During Pregnancy

When I was pregnant, all of my friends and family warned me to avoid eating sushi because sushi was one of my favourite foods! Though devastated, I knew I had to make those sacrifices when I got pregnant – raw fish being one of them. And for the sake of my unborn child, I never bothered to question it.

Literally 2 minutes after I had delivered my baby girl, I joked to my doctor and said, “God, I can’t wait to eat sushi again!” My doctor looked at me and said, “…who said you couldn’t before?” I looked back at her puzzled and realized, I never actually asked my doctor if I had to avoid raw fish during pregnancy! I just assumed that it was the obvious thing to do! 

Photo by Valeria Boltneva from Pexels

So if you didn’t know, now you know. To all my sushi loving friends, it’s generally safe to eat sushi and raw fish when you’re pregnant and when you’re breastfeeding! Hooray!

The FDA does state that pregnant women and young children should stay away from raw fish as they have weaker immune systems and are at more risk for food borne illnesses but raw fish served in sushi and sashimi is not included in this recommendation!

In fact, the FDA states that eating a variety of fish when pregnant or breast feeding can provide health benefits for mom and baby! (Keyword: variety! Don’t just eat the same type of fish every time you do!)

Eating fish provides:

  • Protein
  • Omega 3 fats (aka DHA and EPA)
  • Very high in Vitamin B12 and vitamin D
  • Iron
  • Minerals such as selenium, zinc, iodine

And these nutrients contribute to healthy growth and development of your baby. They even provide heart health benefits and lowers the risk of obesity.

Photo by Sebastian Pena Lambarri on Unsplash

2 Things to look out for when eating raw fish

1. Parasitic worms

It’s the parasitic worms found in raw fish that actually make you sick. Ingesting and getting infected with the worms (aka anisakis) results in a painful condition called anisakidosis. These worms invade and penetrate your stomach lining. Some common signs and symptoms include:

  • Severe abdominal pain
  • Nausea and vomiting
  • Diarrhea
  • Allergic reaction
  • Death in very rare cases!

Other parasitic worms present in fish is tapeworm. Fishes potentially infected with tapeworm include:

  • Pike
  • Perch
  • Anadromous fish (fish that migrate up rivers from the sea to spawn such as salmon)

Learn more about parasites from the Seafood Health Facts website!

2. High levels of mercury

Ingesting high levels of mercury can lead to birth defects specifically affecting the brain and nervous system. Mercury is present in streams, lakes and oceans and are either naturally occurring or man made. Mercury turns into methylmercury which is found in nearly all fish but in different amounts. It is this type of mercury that is harmful to us in high amounts.

These fish have the highest mercury level and should be avoided:

  • King mackerel
  • Marlin
  • Orange roughy
  • Shark
  • Swordfish
  • Tilefish
  • Tuna, big eye 

There is no way to prepare or cook fish to lower its mercury level because the mercury is in the tissue of the fish. But that doesn’t mean you should avoid eating fish entirely during pregnancy due to its considerable health benefits. Just consume fish that are low in mercury and avoid fish with high levels.

Photo by Travis Yewell on Unsplash

Fishes low in mercury that you should eat:

  • Anchovy
  • Atlantic croacker
  • Atlantic, and pacific chub mackerel
  • Black sea bass
  • Butterfish
  • Catfish
  • Cod
  • Flounder
  • Haddock
  • Herring
  • Pickerel
  • Pollock
  • Salmon
  • Sardine
  • Sole
  • Tilapia
  • Freshwater trout
  • Canned light tuna
  • White fish
  • Whiting

… and many more! Learn more about which fish is best to eat here on the FDA website.

Remember, a variety of fish in your diet is key!

Photo by chuttersnap on Unsplash

Farmed Fish and Freezing Methods

Some farmed fish used in sushi such as salmon or tuna are very unlikely to be infected with the parasitic worms because of the methods used to farm these fish for mass human consumption.

Also, freezing raw fish kills any worms present which makes it safe to eat. When preparing sushi in your own home, make sure to freeze the raw fish for at least 4-7 days.

Learn more about farmed fish practices here!

Photo by ray rui on Unsplash

What about shellfish?

Shellfish is totally okay to eat when it is cooked. Raw shellfish contains harmful viruses and bacteria that can cause food poisoning so if you’re pregnant, you should probably avoid that scallop ceviche dish!

Shellfish include:

  • Shrimps
  • Prawns
  • Crawfish
  • Crabs
  • Scallops
  • lobster

Keep these tips in mind when you’re at the sushi restaurant and about to enjoy some delicious sushi rolls with you baby bump! But beware of the concerning stares – they don’t know any better…

Thanks for reading everyone!