@hedied976: “Chờ đợi…”#youthofmay #xindunglangim #tamtrang #xuhuong #hanhsuri

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Saturday 02 May 2026 10:16:10 GMT

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Huy234 :

cảnh đẹp đó nhưng nhạc k nên tiếng nghe k hút

2026-05-02 10:31:14

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hermann.gemeiner :

chờ đợi

2026-06-03 12:49:18

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Quick clinical & NCLEX-style nursing tips — RCA occlusion / Right-sided (inferior) MI ✍️✍️ECG localization: Inferior leads II, III, aVF — think RCA most commonly. Consider right-sided leads (V4R) if RV infarction suspected. 🫀🫀Common signs of RCA / right-sided involvement: Hypotension, bradycardia, AV block (RCA supplies AV node in many patients), jugular venous distention, clear lungs (if RV infarct). 💊💊Nitrates: Use cautiously — nitrates decrease preload and can precipitate severe hypotension in RV infarct. If RV infarction suspected, avoid nitrates until RV infarct is excluded or fluids have corrected preload and prescriber authorizes. Immediate management priorities: Stabilize ABCs, give oxygen if hypoxic, obtain 12-lead ECG (include right-sided leads if inferior MI), establish IV access, prepare for reperfusion (PCI), treat brady/heart block (atropine for symptomatic bradycardia; pacing if high-degree block), and give IV fluids for RV infarct if hypotensive. ✅✅Complications to monitor: AV blocks (1st–3rd degree), cardiogenic shock (less common but possible), arrhythmias, RV failure. Test-taking tip: For an inferior MI patient with hypotension and JVD + clear lungs, avoid nitrates and think fluids and pacing/atropine if brady/blocks present. Quick clinical & 🧠🧠✍️✍️✍️NCLEX-style nursing tips — Nitroglycerin Indications: Chest pain from suspected ischemia, angina, acute MI (as ordered). Routes & common dosing: Sublingual tablet/spray: 0.3–0.4 mg SL q5 minutes × up to 3 doses (common standard on tests). IV infusion: start low (e.g., 5–10 mcg/min) and titrate for chest pain/BP — institutional protocols vary. (On the NCLEX they often expect knowledge of SL dosing q5 min up to 3 doses.) Assessment before giving: Check blood pressure (SBP). Hold NTG if SBP < 90 mmHg or if patient is symptomatic hypotensive. Confirm recent use of PDE-5 inhibitors — do not give if recently used (sildenafil within ~24 hours; tadalafil longer) — hold and notify provider. Adverse effects: Headache, flushing, orthostatic hypotension, reflex tachycardia. Monitor BP and pain relief closely. Interactions to memorize: PDE-5 inhibitors (sildenafil, tadalafil) + nitrates = severe hypotension; also caution with other vasodilators. If pain not relieved: For chest pain unrelieved by 3 SL doses (and SBP acceptable), notify provider; IV NTG and emergent reperfusion (PCI) may be next steps per protocol. Patient teaching: Sit or lie down when taking SL nitro due to orthostatic risk; place under tongue and allow to dissolve; expect possible headache and flushing.#nurse #medicalstudent #nclex #heart #icu

Quick clinical & NCLEX-style nursing tips — RCA occlusion / Right-sided (inferior) MI ✍️✍️ECG localization: Inferior leads II, III, aVF — think RCA most commonly. Consider right-sided leads (V4R) if RV infarction suspected. 🫀🫀Common signs of RCA / right-sided involvement: Hypotension, bradycardia, AV block (RCA supplies AV node in many patients), jugular venous distention, clear lungs (if RV infarct). 💊💊Nitrates: Use cautiously — nitrates decrease preload and can precipitate severe hypotension in RV infarct. If RV infarction suspected, avoid nitrates until RV infarct is excluded or fluids have corrected preload and prescriber authorizes. Immediate management priorities: Stabilize ABCs, give oxygen if hypoxic, obtain 12-lead ECG (include right-sided leads if inferior MI), establish IV access, prepare for reperfusion (PCI), treat brady/heart block (atropine for symptomatic bradycardia; pacing if high-degree block), and give IV fluids for RV infarct if hypotensive. ✅✅Complications to monitor: AV blocks (1st–3rd degree), cardiogenic shock (less common but possible), arrhythmias, RV failure. Test-taking tip: For an inferior MI patient with hypotension and JVD + clear lungs, avoid nitrates and think fluids and pacing/atropine if brady/blocks present. Quick clinical & 🧠🧠✍️✍️✍️NCLEX-style nursing tips — Nitroglycerin Indications: Chest pain from suspected ischemia, angina, acute MI (as ordered). Routes & common dosing: Sublingual tablet/spray: 0.3–0.4 mg SL q5 minutes × up to 3 doses (common standard on tests). IV infusion: start low (e.g., 5–10 mcg/min) and titrate for chest pain/BP — institutional protocols vary. (On the NCLEX they often expect knowledge of SL dosing q5 min up to 3 doses.) Assessment before giving: Check blood pressure (SBP). Hold NTG if SBP < 90 mmHg or if patient is symptomatic hypotensive. Confirm recent use of PDE-5 inhibitors — do not give if recently used (sildenafil within ~24 hours; tadalafil longer) — hold and notify provider. Adverse effects: Headache, flushing, orthostatic hypotension, reflex tachycardia. Monitor BP and pain relief closely. Interactions to memorize: PDE-5 inhibitors (sildenafil, tadalafil) + nitrates = severe hypotension; also caution with other vasodilators. If pain not relieved: For chest pain unrelieved by 3 SL doses (and SBP acceptable), notify provider; IV NTG and emergent reperfusion (PCI) may be next steps per protocol. Patient teaching: Sit or lie down when taking SL nitro due to orthostatic risk; place under tongue and allow to dissolve; expect possible headache and flushing.#nurse #medicalstudent #nclex #heart #icu

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