Oxygenation, Ventilation, and Perfusion
Respiratory care, chest tubes, oxygen safety, cardiac basics, anticoagulants, and perfusion problems.
Topic Card
Heart Failure - "Pump weak, fluid backs up"
The heart cannot pump strongly enough, so fluid backs into the lungs, legs, or belly.
What the NCLEX Wants You to Know
- Priority: breathing problems first. Watch crackles, low SpO2, and pink frothy sputum.
- Common trap: giving extra fluids unless clearly ordered. Fluid overload worsens heart failure.
Causes
- Long-term hypertension
- Heart attack damage
- Valve disease
- Cardiomyopathy
- Too much sodium or fluid
Signs & Symptoms by Body System
- Lungs: shortness of breath, crackles, cough, orthopnea
- Fluid: weight gain, edema, neck vein swelling
- Body: fatigue, fast heart rate, weak activity tolerance
Lab Value + Danger Zone
BNP often rises. Danger zone: SpO2 dropping, severe dyspnea, pink frothy sputum, new confusion.
Nursing Actions - In Priority Order
- Sit the client upright
- Check SpO2 and lung sounds
- Give oxygen if ordered/protocol allows
- Administer ordered diuretic
- Monitor daily weight, I&O, potassium, and kidney labs
Patient Teaching
- Weigh every morning.
- Report sudden weight gain, swelling, or worse breathing.
- Limit sodium if prescribed.
Memory Trick
FAIL = Fluid backs up, Activity intolerance, Increased weight, Lungs crackle.
NCLEX-Style Challenge
A client with heart failure has crackles and SpO2 of 88%. What is the priority?
Answer: Sit upright, assess breathing/O2, apply oxygen if allowed, and report worsening respiratory status.
Compare
| Feature | Left-sided failure | Right-sided failure |
|---|---|---|
| Backs up into | Lungs | Body/veins |
| Main clue | Crackles, dyspnea, cough | Leg swelling, JVD, weight gain |
| Priority | Improve oxygenation | Manage fluid overload |
| Memory hook | Left = Lungs | Right = Rest of body |
Rapid Review
Find "What Do I Do First?" in Under 5 Seconds
- Sit the client upright
- Check SpO2 and lung sounds
- Give oxygen if ordered/protocol allows
Memory Trick
FAIL = Fluid backs up, Activity intolerance, Increased weight, Lungs crackle.
Challenge Replay
A client with heart failure has crackles and SpO2 of 88%. What is the priority?
Answer: Sit upright, assess breathing/O2, apply oxygen if allowed, and report worsening respiratory status.