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NCLEX PART 2

CH 05. Cardiovascular & Respiratory

Welcome to Adult Health! We start with the ABCs.

Cardio and Respiratory questions are often "Priority" questions.
If the heart stops or the lungs fail, nothing else matters.
Let's master Heart Failure, MI, and ABGs.

1. Heart Failure: Left vs. Right

The symptoms depend on where the blood is backing up.

Side Pathology Key Symptoms
Left-Sided
(Lung)		 The Left ventricle fails to pump forward.
Blood backs up into the LUNGS. 		Pulmonary Congestion:
- Crackles / Rales
- Dyspnea / Orthopnea (Can't lie flat)
- Pink, Frothy Sputum (Pulmonary Edema)
- Cough
Right-Sided
(Rest of Body)		 The Right ventricle fails.
Blood backs up into the BODY (Systemic). 		Systemic Congestion:
- JVD (Jugular Vein Distension)
- Peripheral Edema (Legs, Ankles)
- Ascites (Abdominal swelling)
- Weight Gain
[Image of Left vs Right Heart Failure Diagram]

2. Myocardial Infarction (MI)

Time is muscle. Recognize the signs and act fast.

  • Symptoms:
    - Crushing chest pain (radiating to jaw/arm), Diaphoresis, Nausea.
    - Women/Diabetics: May just have jaw pain or fatigue (Silent MI).
  • Intervention (MONA):
    Morphine (Pain/Anxiety)
    Oxygen (if O2 < 94%)
    Nitroglycerin (Vasodilation)
    Aspirin (Antiplatelet)
    *(Note: Order depends on hospital protocol, but ABCs come first!)*

3. Respiratory Emergencies

① COPD (Chronic Obstructive Pulmonary Disease)

  • Hypoxic Drive:
    Their drive to breathe is Low Oxygen (not high CO2 like healthy people).
    Do not give high-flow oxygen! Keep O2 Sat around 88-92%.
  • Pursed-Lip Breathing:
    "Smell the roses (inhale nose), blow out the candles (exhale mouth)."
    Prevents airway collapse.

② Chest Tubes

  • Troubleshooting:
    - Continuous Bubbling in Water Seal Chamber = AIR LEAK (Bad).
    - Intermittent Bubbling = Normal (Air is leaving).
    - Tidaling (Water moves up/down) = Normal.
    - No Tidaling = Lung re-expanded OR Tube blocked.

Remember: Left = Lungs, Right = Rest of Body.
And never crank up the oxygen for a COPD patient!
Next, we tackle the Neuro & Musculoskeletal systems.

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