NCLEX Success Consult

19/03/2026

🫀 What is CABG?
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CABG (Coronary Artery Bypass Grafting) is a surgery used to improve blood flow to the heart by bypassing blocked coronary arteries using a graft (vein or artery).

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🧠 Indications (WHY it’s done)
• Severe coronary artery disease (CAD)
• Left main coronary artery blockage
• Failed stent/angioplasty
• Persistent angina not relieved by meds

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🔪 Graft Sites (NCLEX favorite)
• Saphenous vein (leg)
• Internal mammary artery (best long-term patency)
• Radial artery

👉 NCLEX tip:
If leg vein used → assess leg + heart

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⚠️ Pre-Op Nursing Care
• Informed consent ✔️
• Baseline vitals, ECG
• Stop anticoagulants as ordered
• Teach:
• Incentive spirometer
• Coughing & deep breathing
• Splinting chest with pillow

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🏥 Post-Op PRIORITIES (VERY HIGH-YIELD)

1. ❤️ Cardiac Monitoring
• Continuous ECG
• Watch for dysrhythmias (most common: atrial fibrillation)

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2. 🫁 Respiratory Care
• Early extubation (within hours)
• Incentive spirometer EVERY 1–2 hrs
• Prevent atelectasis & pneumonia

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3. 💉 Chest Tubes
• Drain blood/fluid from mediastinum

🚨 Report if:
• Sudden ↑ drainage (>100 mL/hr)
• Bright red blood
• Tube stops draining suddenly

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4. 🩸 Hemodynamic Stability
• Monitor:
• BP
• Cardiac output
• Urine output (>30 mL/hr)

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5. 🦵 Graft Site Care (LEG)

If saphenous vein used:
• Elevate leg
• No crossing legs
• Wear compression stockings

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🚨 COMPLICATIONS (TESTED A LOT)

❗ Early Complications
• Bleeding
• Cardiac tamponade (↓ BP, JVD, muffled heart sounds)
• Dysrhythmias (AFib)
• Hypothermia

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❗ Later Complications
• Infection (sternal wound)
• Graft occlusion
• Pulmonary embolism
• Stroke

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🛑 Sternal Precautions (VERY IMPORTANT)

For 6–8 weeks:
• ❌ No pushing/pulling
• ❌ No lifting >5–10 lbs
• ❌ No driving
• ✔️ Hug pillow when coughing

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💊 Medications After CABG
• Antiplatelets (e.g., aspirin)
• Beta-blockers
• Statins
• Pain control

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🧠 NCLEX TRICKS
• Most important priority post-op → airway & hemodynamic stability
• Leg swelling after graft? → elevate, NOT emergency unless severe
• Chest pain post-CABG? → report immediately (possible graft failure)
• Decreased urine output → think LOW CARDIAC OUTPUT

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⭐ One-Line Memory Trick:

👉 “CABG = Fix heart flow, protect lungs, watch bleeding, prevent clots”

15/03/2026

13/03/2026

🧠 Brain Aneurysm (Simple NCLEX Review)

A brain aneurysm is a weak, bulging area in the wall of an artery in the brain. The pressure of blood flowing through the vessel causes the weak area to balloon outward like a small sac.

If the aneurysm ruptures (bursts), it causes bleeding in the brain called a Subarachnoid Hemorrhage, which is a medical emergency.

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Causes / Risk Factors

Common factors that increase the risk include:
• Hypertension (high blood pressure)
• Smoking
• Family history of aneurysm
• Head trauma
• Drug abuse (especially co***ne)
• Congenital weakness in blood vessels

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Signs & Symptoms (Before Rupture)

Many aneurysms do not show symptoms until they grow or rupture. When symptoms appear, they may include:
• Severe headache
• Blurred or double vision
• Pain behind or above the eye
• Dilated pupil
• Drooping eyelid
• Weakness on one side of the face

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Signs of Ruptured Aneurysm ⚠️

Classic symptom is:

“Worst headache of my life.”

Other signs:
• Sudden severe headache
• Nausea and vomiting
• Stiff neck
• Sensitivity to light
• Seizures
• Loss of consciousness
• Confusion

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Diagnosis

Common tests include:
• CT scan of the brain
• Lumbar puncture (if CT is negative but bleeding suspected)
• Cerebral angiography
• MRI / MRA

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Treatment

Treatment depends on whether it has ruptured.

1️⃣ Surgical Clipping

A surgeon places a clip at the base of the aneurysm to stop blood flow.

2️⃣ Endovascular Coiling

A catheter is inserted through the artery and tiny coils are placed inside the aneurysm to prevent rupture.

13/03/2026

📞0248554550 to Join upcoming class

Apply the BP Cuff
• Wrap the cuff snugly around the upper arm.
• The lower edge of the cuff should be about 2.5 cm (1 inch) above the antecubital fossa (bend of the elbow).
• The artery marker on the cuff should align with the brachial artery (inner side of the arm).

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3️⃣ Place the Stethoscope
• Locate the brachial artery in the antecubital fossa.
• Place the diaphragm of the stethoscope directly over the brachial artery.
• Do not place the stethoscope under the cuff.

11/03/2026

WOUND DRAINAGE
📞0248554550 to join our upcoming class in April

1. Serous Drainage
• Clear
• Watery
• Pale yellow or straw-colored

Meaning:
Usually normal in early wound healing.

NCLEX tip: Common in blisters and clean surgical wounds.

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2. Sanguineous Drainage
• Bright red
• Mostly blood

Meaning:
Indicates active bleeding.

⚠️ NCLEX alert: May occur if a blood vessel is damaged.

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3. Serosanguineous Drainage
• Light red
• Pink
• Thin watery blood

Meaning:
A mixture of serum and blood.

NCLEX tip: Very common after surgery and usually normal.

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4. Purulent Drainage
• Thick
• Yellow, green, brown, or white
• May have foul odor

Meaning:
Indicates infection.

Often seen with infections such as Staphylococcal Infection.

⚠️ NCLEX priority: Report to the provider.

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Quick NCLEX Memory Trick 🧠

SSSP
• S – Serous → clear
• S – Sanguineous → blood
• S – Serosanguineous → pink
• P – Purulent → pus (infection)

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✅ NCLEX exam tip:
If the question says “thick yellow drainage with odor” → infection → purulent drainage.

10/03/2026

Leopold Maneuvers 📞0248554550
four systematic abdominal palpations used during pregnancy to determine the fetal position, presentation, lie, and engagement in the uterus. They are commonly performed after 24–28 weeks of gestation.

They are very important for NCLEX and maternity nursing because they help the nurse identify how the baby is positioned before labor. 👶

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1️⃣ First Maneuver – Fundal Grip

Purpose: Identify which fetal part is in the uterine fundus.

Procedure
• Nurse faces the client’s head.
• Palpate the top of the uterus (fundus) with both hands.

Findings
• Head: hard, round, movable.
• Buttocks (breech): soft, irregular.

Helps determine: Fetal presentation.

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2️⃣ Second Maneuver – Umbilical Grip (Lateral Grip)

Purpose: Locate the fetal back and small parts.

Procedure
• Hands placed on both sides of the abdomen.

Findings
• Back: smooth, firm surface.
• Extremities: small, irregular movements.

Helps determine: Fetal position (where the back lies).

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3️⃣ Third Maneuver – Pawlik’s Grip

Purpose: Identify the presenting part above the pelvic inlet.

Procedure
• Use thumb and fingers just above the symphysis p***s to grasp the lower abdomen.

Findings
• Head: firm, round, movable.
• Buttocks: softer and irregular.

Helps determine: Presentation and engagement.

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4️⃣ Fourth Maneuver – Pelvic Grip

Purpose: Determine fetal descent and attitude (head flexion).

Procedure
• Nurse faces the client’s feet.
• Both hands palpate downward toward the pelvis.

Findings
• Helps confirm if the head is engaged in the pelvis.

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✅ Simple Memory Trick for Students

F – B – P – D
1. Fundal grip → what is in the Fundus
2. Back → locate fetal Back
3. Pawlik’s → Presenting part
4. Descent → Descent/engagement

06/03/2026

Acknowledging students GO FOR THAT 🇺🇸🇺🇸🇺🇸LICENSE, RN Jennifer we can’t wait to celebrate you my dear.

06/03/2026

🇬🇭 Happy Independence Day – Ghana! 🎉📞0248554550

On behalf of NCLEX Success Consult, we proudly celebrate the freedom, resilience, and strength of our beloved motherland, Ghana, on this special Independence Day. Today reminds us of the courage and determination that led to our nation’s independence and inspires us to continue striving for excellence in all we do.

As we celebrate this historic day, we encourage all our students to take a moment to reflect on our national pride, unity, and progress. May the spirit of independence motivate us to pursue our dreams and achieve greater heights in our nursing journeys.

Happy Independence Day, Ghana! 🇬🇭
Freedom and Justice. ✨