Hey Guys, plenty have contacted me regarding having a content-based study guide that can help them pass their NCLEX Exam. Of course I will not going to be able go over all of these review contents in this video. But instead I will try to go over the CARDIAC SYSTEM first, and go over the major diseases that you will most likely encounter in your NCLEX exam.
Lets first look at the Cardiac Diseases which as we all know is essential information to know for the NCLEX.
As I have mentioned before on a previous video, I have went over what I call the Big MAC or Big M.A.C which goes over the 3 biggest main cardiac diseases that you will most likely encounter in your NCLEX Exam.
As we all know, the Cardiac System is one of the most vital system in the body. It is important to study the Cardiac System for the NCLEX.
So let first look at Myocardial Infarction and the important things that we need to know to prepare for the NCLEX. Ok, now as we all learn from nursing school a myocardial infarction is death of myocardial muscle cells due to lack of oxygen from inadequate perfusion in the body.
Major ASSESMENT that we need to know for the NCLEX in relation to Myocardial Infarction is that it USUALLY LONGER THAN 30 MINS and that it *IS UNRELIEVED BY REST OR NITROGLYCERIN, therefore we can differentiate angina from MI through the use of NITROGLYCERIN.
Now lets look at the DIAGNOSTIC TEST RESULTS for MI which can be essential in your NCLEX.
ECG WOULD SHOW AN ENLARGED Q WAVE, AN ELEVATED OR DEPRESSED ST SEGMENT, AND T WAVE INVERSION. and you have to really know this.
Now lets quickly go over a patient with Angina.
– PAIN CAUSED BY INADEQUATE BLOOD FLOW THROUGH THE BLOOD VESSELS OF THE HEART.
♣ IT’S VERY IMPORTANT TO KNOW THE DIFFERENCE BETWEEN ANGINA PECTORIS AND MI.
– A paroxysmal chest pain caused by (ischemia) due to insufficient blood flow to the myocardium.
STABLE ANGINA PECTORIS- OCCURS WITH EXERTION, IT IS RELEIEVED BY REST AND DOES NOT INCREASE IN FREQUENCY OR SEVERITY.
VARIANT OR PRINZMETAL ANGINA- IS USUALLY CAUSED BY CORONARY ARTERY SPASMS.
SILENT ANGINA- IS USUALLY ASYMPTOMATIC MYOCARDIAL ISCHEMIA THAT IS ASSOCIATED WITH DIABETES MELLITUS AND HYPERTENSION.
MAY BE RELIEVED BY REST. (Compared to MI: Very important to know for your NCLEX).
THE ECG WILL SHOW AN ST SEGMENT DEPRESSION AND T WAVE INVERSION DURING THE ANGINAL PAIN.
THE HOLTER MONITOR WILL REVEAL AN ST SEGMENT DEPRESSION AND T WAVE INVERSION.
HOLD NITRATES IF THE BP IS LESS THAN 90 MM HG.
– Store tablets in a dark bottle. Lights lessens its effeciency.
– Place nitroglycerin tablet under the tongue (and let it melt).
– Take up to three tablets 5 min. apart. (If still no relief, go to hospital).
– Now lets go ahead and look at HEART Failure, which is basically An insufficiency and the inability of the pumping ability of the heart. Heart Failure can either be left sided or right sided.
– There is a Failure of the left side of the heart to pump enough blood to meet the metabolic demands of the body.
THERE IS AN IMPAIRED OXYGENATION AND A DECREASE IN MYOCARDIAL WORKLOAD IN THE HEART.
ASSESSMENT FINDINGS in patients with Left Sided heart failure.
What we would usually find in patient with left sided heart failure is that there is an INCREASE IN PULMONARY CONGESTION and there would be a left ventricular hypertrophy.
SEMI FOWLERS POSITION ON PT.
ADMINISTER IV, OXYGEN AND MEDS AS ORDERED.
– Failure of the right side of the heart to pump enough blood to meet the metabolic demands of the body.
ABG’S INDICATES HYPOSEMIA AND HYPERCAPNIA.
WEIGH THE CLIENT DAILY: A WEIGHT GAIN OF 1 TO 2 LBS. INDICATES FLUID GAIN.
Hypertension is a very important diseases that we can easily encounter on the NCLEX Exam, so it is vital that we know and understand HYPERTENSION.
– LIFESTYLE CHANGES IS ALWAYS IMPORTANT: NO SMOKING * REDUCING ALCOHOL INTAKE.
* Remind patient that lifestyle changes such as smoking cessation and proper diet is essential.
– several factors such as the fluid volume within the body, which is regulated by the kidneys through the renin- angiotensin system.
* Remind Patient that smoking is the biggest factor.
* If Diet and exercise is not enough, meds are used.
– Increases the urine output. Decreases the preload and afterload.
As you have learned in Nursing School, beta adrenergic blockers are drugs that help lower blood pressure, pulse rate and cardiac output. Beta Blockers are an important set of drugs to know for the NCLEX. Sometimes, beta blockers are also used to treat migraine headaches an other vascular headaches. Beta blockers are also used to treat glaucoma and used to prevent myocardial infarctions.
Try to remember that what beta blockers do is they act by blocking the sympathetic vasomotor response. For the NCLEX, try to remember that the syllable for beta blockers is usally (olol). Potential side effects of beta blocker that is necessary to know for the NCLEX would include: Orthostatic hypotension, bradycardia, nausea and vomiting, diarrhea and some of the symptoms may MASK hypoglycemia.
Make sure that you monitor the client’s blood pressure, heart rate and rhythm, before administering the beta blocker. Monitor the client for signs of edema. The nurse should also assess the lungs sounds for signs of rales and ronchi. When patient are taking beta blockers, it is also very important to monitor the changes in lab values such as (protien, BUN and creatinine) which can indicate nephrotic syndrome. Nursing teaching for the NCLEX would include: Teaching the Client to rise slowly (ORTHOSTATIC HYPOTENSION) * (A SAFETY ISSUE), report any signs of bradycardia, dizziness, confusion depression or fever. It is also very important to taper off the medication properly.
On the next post and video we will go over the important category that you will most likely encounter in your NCLEX exam which are the major diseases of the Nervous System.
I WILL GO OVER THE NEUROLOGICAL SYSTEM ON THE NEXT VIDEO/POST.
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