Stephane Begg

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Stephane Begg BSN, ER RN

❤️ Chest pain + suspected MI = MONA (an NCLEX favorite mnemonic).M — Morphine: relieves pain and anxietyO — Oxygen: only...
10/17/2026

❤️ Chest pain + suspected MI = MONA (an NCLEX favorite mnemonic).
M — Morphine: relieves pain and anxiety
O — Oxygen: only if O2 saturation is low
N — Nitroglycerin: sublingual, dilates the coronary arteries
A — Aspirin: chewable 162–324 mg, antiplatelet
Sequence matters:
STOP activity, sit the patient upright
Nitro SL, repeat every 5 min (max 3)
Have the patient chew the aspirin
12-lead ECG — within 10 minutes
Troponin labs
NCLEX trap: check BP before nitro — hold it if systolic is

LEFT = LUNGS 🫀: crackles, dyspnea, orthopnea, pink frothy sputumRIGHT = REST OF BODY: JVD, edema, enlarged liver, ascite...
10/17/2026

LEFT = LUNGS 🫀: crackles, dyspnea, orthopnea, pink frothy sputum
RIGHT = REST OF BODY: JVD, edema, enlarged liver, ascites, weight gain
2–3 lb gain in a day? notify! save this 💾

🧠 The Glasgow Coma Scale — the most important number in neuro nursing.Eye (1–4): 4 spontaneous, 3 to voice, 2 to pain, 1...
10/17/2026

🧠 The Glasgow Coma Scale — the most important number in neuro nursing.
Eye (1–4): 4 spontaneous, 3 to voice, 2 to pain, 1 none
Verbal (1–5): 5 oriented, 4 confused, 3 inappropriate words, 2 incomprehensible sounds, 1 none
Motor (1–6): 6 obeys commands, 5 localizes pain, 4 withdraws, 3 abnormal flexion, 2 abnormal extension, 1 none
Total: 3–15.
GOLDEN RULE: 8 or less = INTUBATE (the patient cannot protect the airway).
Nursing points:
• Painful stimulus: trapezius squeeze or sternal rub
• Report: a sudden drop of 2+ points = emergency
• Document E/V/M separately (E4 V5 M6)

DI vs SIADH — fluid opposites 💧DI: LOTS of dilute urine → HIGH sodium, dehydrated → DDAVP + fluidsSIADH: barely peeing →...
10/16/2026

DI vs SIADH — fluid opposites 💧
DI: LOTS of dilute urine → HIGH sodium, dehydrated → DDAVP + fluids
SIADH: barely peeing → LOW sodium, overloaded → FLUID RESTRICTION
DI = DRY inside, SIADH = SOAKED. save this 💾

🩺 AHA blood pressure categories — every nursing student should know these by heart:• Normal:
10/16/2026

🩺 AHA blood pressure categories — every nursing student should know these by heart:
• Normal:

ADDISON'S vs CUSHING'S ⚖️ADDISON'S (LOW cortisol): bronze skin, LOW BP, LOW Na + HIGH K, LOW sugar → crisis? hydrocortis...
10/16/2026

ADDISON'S vs CUSHING'S ⚖️
ADDISON'S (LOW cortisol): bronze skin, LOW BP, LOW Na + HIGH K, LOW sugar → crisis? hydrocortisone!
CUSHING'S (HIGH cortisol): moon face, buffalo hump, HIGH BP, HIGH Na + LOW K, HIGH sugar
ADD = DOWN (everything low except K). save this 💾

👶 Every newborn's first score — APGAR, at 1 and 5 minutes.A — Appearance (color): pink 2, blue extremities 1, pale/blue ...
10/16/2026

👶 Every newborn's first score — APGAR, at 1 and 5 minutes.
A — Appearance (color): pink 2, blue extremities 1, pale/blue 0
P — Pulse: >100 = 2,

STROKE vs BELL'S PALSY 🧠 the forehead test• Can wrinkle forehead = SPARED → STROKE → call 911, time-critical!• Cannot wr...
10/16/2026

STROKE vs BELL'S PALSY 🧠 the forehead test
• Can wrinkle forehead = SPARED → STROKE → call 911, time-critical!
• Cannot wrinkle = AFFECTED → Bell's palsy, only face, limbs fine, steroids help
⚠️ When in doubt, always treat as stroke. save this 💾

💉 Two anticoagulants — the difference is an NCLEX favorite:HEPARIN:• IV or subcutaneous, works FAST• Monitor: aPTT• Anti...
10/16/2026

💉 Two anticoagulants — the difference is an NCLEX favorite:
HEPARIN:
• IV or subcutaneous, works FAST
• Monitor: aPTT
• Antidote: protamine sulfate
• Risk: HIT (heparin-induced thrombocytopenia) — platelets drop → STOP it
WARFARIN:
• By mouth, takes DAYS to work
• Monitor: PT/INR (target 2–3)
• Antidote: vitamin K
• Don't suddenly eat lots of leafy greens (vitamin K)
• UNSAFE in pregnancy (teratogenic)
Memory trick: "Heparin = Hospital (fast), Warfarin = Home (slow)"

🚨 Scenario: IV penicillin ke kuch minutes baad hives, stridor, low BP.Answer: B — EPINEPHRINE IM, sab se pehle!Kyun? Ana...
10/16/2026

🚨 Scenario: IV penicillin ke kuch minutes baad hives, stridor, low BP.
Answer: B — EPINEPHRINE IM, sab se pehle!
Kyun? Anaphylaxis me airway minutes me band ho sakti hai. Epi:
• 0.3–0.5 mg IM, anterolateral thigh
• Har 5–15 min repeat kar sakte ho
• Vasoconstriction + bronchodilation ek saath
Phir: ABCs, IV fluids (hypotension ke liye), diphenhydramine/steroids SECOND line, provider notify, allergy band lagao.
NCLEX logic: hamesha AIRWAY/BREATHING sab se pehle — epi dono bachata hai.
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