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Cardiovascular

Cardiovascular System Review

Educational Use Only. This app is not intended to replace instructor guidance, institutional policies, clinical judgment, or professional medical training.

Overview

The cardiovascular system delivers oxygen and nutrients throughout the body. NCLEX focuses on heart failure, hypertension, coronary artery disease, dysrhythmias, and post-MI care. Understanding hemodynamics, medication effects, and recognizing deterioration are critical skills.

Key Concepts

  • 1

    Heart failure: left-sided (pulmonary congestion, crackles, orthopnea, cough) vs right-sided (peripheral edema, JVD, hepatomegaly, weight gain)

  • 2

    Coronary artery disease: stable angina (relieved by rest/nitro) vs unstable angina (occurs at rest, new onset, worsening pattern)

  • 3

    STEMI vs NSTEMI: STEMI shows ST elevation, requires immediate reperfusion (PCI within 90 min); NSTEMI managed medically first

  • 4

    Hypertension staging: Normal <120/80, Elevated 120-129/<80, Stage 1 130-139/80-89, Stage 2 ≥140/90

  • 5

    Dysrhythmia recognition: atrial fibrillation (irregularly irregular, no P waves), ventricular tachycardia (wide QRS, life-threatening), asystole (flatline, non-shockable)

  • 6

    Cardiac output = heart rate × stroke volume; affected by preload, afterload, and contractility

  • 7

    The 5 P's of peripheral vascular disease: Pain, Pallor, Pulselessness, Paresthesia, Poikilothermia

Nursing Interventions

  • Monitor vital signs, heart rhythm, and hemodynamic status continuously for acute cardiac patients

  • Administer nitroglycerin SL every 5 min × 3 doses for angina; check BP before each dose

  • Position patient with HOB elevated 30-45 degrees for heart failure to improve breathing

  • Monitor daily weights at same time, same scale, same clothing for fluid retention

  • Assess for signs of fluid overload: crackles, edema, JVD, weight gain >2 lb/day or >5 lb/week

  • Administer beta-blockers, ACE inhibitors, and diuretics as ordered; monitor for hypotension

  • Encourage cardiac rehab, low-sodium diet (<2g/day), and smoking cessation

  • For MI: MONA — Morphine, Oxygen, Nitroglycerin, Aspirin (though oxygen only if SpO2 <90%)

Critical Red Flags

  • Crushing chest pain radiating to jaw, arm, or back — possible MI

  • Sudden severe dyspnea with pink frothy sputum — acute pulmonary edema

  • Systolic BP <90 or >180, or symptomatic hypotension

  • New onset irregular pulse with chest pain or syncope

  • Cold, clammy, pale skin with altered mental status — cardiogenic shock

  • Sudden severe back or abdominal pain — possible aortic dissection

Key Lab Values

Troponin I: <0.04 ng/mL (elevated indicates myocardial injury)

BNP: <100 pg/mL (elevated indicates heart failure)

Total cholesterol: <200 mg/dL

LDL: <100 mg/dL (ideal), <70 for high-risk patients

HDL: >40 men, >50 women

Triglycerides: <150 mg/dL

Potassium: 3.5-5.0 mEq/L (critical for cardiac function)

Patient Teaching

  • Take blood pressure medications exactly as prescribed; do not stop abruptly

  • Report chest pain lasting >15 min, not relieved by nitroglycerin, to emergency services immediately

  • Follow a low-sodium, low-fat diet; limit alcohol and caffeine intake

  • Engage in regular moderate exercise as approved by provider

  • Monitor and record daily weights; report sudden weight gain (2+ lb in a day or 5+ lb in a week)

  • Keep nitroglycerin in original container, away from light; replace every 6 months

Educational Use Only — Not a substitute for professional training.