Connetics USA Video Media

Cardiovascular NCLEX Questions Class for Nurses

Guian Miguel Banta, NCLEX expert: My name is Guian Banta, and I'm one of the NCLEX experts of Aspire RN. And I usually teach Pediatric nursing and Muscular skeletal health disorders and orthopedic nursing for Aspire RN. Okay, so that would be our topic for tonight. We will have a very, very exciting topic for tonight. Okay, so we have a lot of students coming in. I'm very happy to see a lot of my former students joining us for our live class here at Connetics. And may you also allow me to thank Connetics for giving me this opportunity to pay forward to a lot of RN students who will be planning to take their exam in the next few months or probably the next few weeks. Okay. So that I hope this topic will eventually help you, of course, pass your examination. Okay.

And going back, I'm currently based here in Baguio City, here in the Philippines. Okay. But I do have plans of migrating very soon. Yeah. Together with Connetics, we can help a lot of aspiring USRNs to migrate to the US. In the near future. Okay, so I don't know why, but I'm a bit nervous right now. Not because of the number of students, but I know that a lot of you are taking the exam pretty soon, and I know that a lot of you have been reviewing very well, and a lot of you have been preparing, of course, for the NCLEX.

So I'm a bit nervous, and at the same time, I'm a bit excited because I know a lot of you will be able to pass the NCLEX. Okay? Yeah. We have a lot of students joining us for today. Okay, so our topic would now be your congenital heart defects, and this is primarily part of your physiologic adaptation. Okay?

So let's just have a brief introduction of our topic for tonight. Okay, so your congenital heart defects under your pediatric nursing would now be under your physiologic adaptation. Okay, so this is primarily 14% of the total number of items you might probably get in your NCLEX.

This is a very substantial amount of items which can, of course, help you out pass. That's why Connetics, together with Aspire RN, are giving these types of classes, free classes for everyone for you to be able to prepare, of course, for your upcoming exam. Okay?

So, again, your pediatric nursing, specifically your congenital heart defects, would be under your physiological adaptation. Okay? So if you're ready, I hope you're settled down, of course, on your study desk and your study areas or work tables. And if you're ready, guys, I'd like you to put the word ready inside our or in our chat box for us to be able to start with our lecture. Okay?

So this is 1 hour of discussion where we will talk about congenital heart defects. Okay? All right. If you're ready, put the word ready inside our chat box. Okay? I noticed I see a lot of very familiar names here, and welcome, of course, to our Connetics class, by the way, for everyone who would be interested.

Okay, working, of course, with Aspire RN, or is offering a scholarship program that would help you out eventually pass your exam. Okay? So we're putting a link right now on your screens where you can look into the scholarship program that we are offering, okay?

So you'll be seeing that link right now where you can just look at it or you can browse into it so that you'll be able to apply for a scholarship program in partnership, of course, with Connetics USA. Okay? All right, I think everyone here is ready, so let's start off with our topic. So let's now talk about your congenital heart defects.

Please do understand that congenital heart defects, rather, is one of the most common types of defects or birth defects rather, affecting nearly 1% of all babies born in the United States. If I'm correct in remembering, this would be an estimated 40,000 infants in the US. Born each year with this type of disorder. Okay? So when we talk about your CHC or congenital heart defects, rather, this is an abnormality of the structures or functions of the heart or the circulatory system or even both, okay?

And when you read your books, ladies and gentlemen, the cost of your CHDs or congenital heart defects would be unknown. However, there are several risk factors that would bring about this type of disorder. Okay? So I'd like you to remember the word vital. I'd like you to remember the word vital. So this would be my mnemonic for the risk factors for congenital heart defects. Later on, I'll be also discussing a brief summary of how you can better remember the certain clusters, the shunt or blood movement, and even the possible interventions that we can give for patients with congenital heart defects. Okay, so let's go back.

What would be the risk factors risk factors for congenital heart defects? Let's make use of the word vital. Okay? Vital. That's vital. Okay, let's start off with letter V. V would now be your viral infections. Okay, so viral infections such as your rubella, cytomegaly viruses would be a risk factor, especially in the early pregnancy, which is very significant and associated with the development of your congenital heart defects. Okay? So it's very important for your mothers, especially in the early period of pregnancy, for them not to be acquiring such viral infections.

Okay, moving forward, letter I infants of diabetic mothers are also predisposed or at risk for your congenital heart defects. Letter T. Of course, taking drugs during pregnancy isn't really recommended. However, if you have a current maintenance drugs being taken, of course, or being prescribed by your doctor, you have to be very cautious and be very careful of how to take in your medications. Okay?

Second to the last, of course, alcohol intake can be a risk factor for congenital heart defects, and there are also evidences that your lineage, your herd of familial or even genetical predisposition can bring about your congenital heart defects. All right?

So these are your risk factors and the definition of your congenital heart defects. Okay, moving forward, let's now also talk about the common let's now talk about the common commonality between the two types of your congenital heart defects. What would not be the common features of congenital heart defects. Everything here would start with the letter f, okay? For us to better remember each one. So patients or children with congenital heart defects would often be very tired or they are easily fatigable. So fatigue is a common feature in both types of your congenital heart defects, okay?

Number two, we also have a change in your vital signs, and the change would be an increase, of course, in your carburetor rate, in your respiratory rate. So eventually, when you have patients with these type of defects, it's very common that they may manifest tachiai and tachycardia.

Another one would not be feeding problems. So feeding problems is another common feature, arachnogenic heart defects. Together with that, they're very prone to frequent upper respiratory tract infections, okay? So we already have four. We have one more common feature. We have one more common feature for your congenital heart defects.

This would now be failure to thrive, being that you have feeding problems in your newborn, okay, failure to thrive and poor weight gain will eventually follow. So these are five common things that you see in these patients, okay? Either in your synoptic, congenital heart disorders, and your congenital heart disorders, okay?

These are two types of your congenital heart defects. We have your synoptic, and we have your cyanotic.

So that would be the two types. Ladies and gentlemen, the more important details will be shown to you in our next slide. Okay, so before I forget, all the problems that you are seeing here right now are obviously seen soon after birth. Although these common features are commonly tolerated by our patients, and if they have mild defects, congenital heart defects, it may not cause any problem until later in life, okay? So they may be tired, they may have changes in their vital signs, feeding problems, but somehow, if they have mild defects, like I said, they can tolerate it, but problems may arise later in life, okay?

So I'd like to give you a summary of your congenital heart defects right now, of which we will now highlight and streamline the following or specific conditions under these two types, okay? So we have, of course, your asyntactic, and we have your cyanotic conditions, okay? So for your cyanotic guys, we have six. In your cyanotic conditions, we have five, okay? So in your cyanotic conditions, we have what you call your atrial septal defect. Another term for atrial septal defect would now be your patent form in of valley. Okay?

This is one of your asymptotic types. Another would not be your ventricular septal defect. One very distinct feature or one very distinct fact about your ventricular cephalic defect. It's the most common asymptotic condition, okay? Please remember that your ventricular cephalic defect is the most common cyanotic condition.

We have four more, okay? To enumerate the third one, we have your patent ductus arteriosis, or what you call your PDA. We also have your pulmonary stenosis. We also have your aortic stenosis. And lastly, we have your coordination of the Aorta, okay?

These six disorders may either present with an abnormal opening or a septal defect or a narrowing of any valve in the heart, okay? So if you'll notice later on, okay, this six specific conditions are classified into two type of disorders. It's either a separate defect or a stenotic disorder, okay? It's a stenotic disorder.

Now, moving on to your synaptic conditions, we have five we will talk about. Five, you have your tertiary of palo, okay? And in contrast with your VSD, like I said a while ago, your tetralogy of palo would now be the most common Psyonautic condition, okay? The trilogy of below is the most common cyanotic condition. Together with your ToF, we have here your transposition of great arteries, okay?

Number three, we have your tricuspidatritia.

Number four, we have your trunk of Arthur Joseph.

And number five, we have your top DC, or what we call your total anomalous pulmonary venous connection, okay? Right, okay, so this is a simple enumeration, by the way. I'm just enumerating these specific conditions both in your Ace initiative and your cyanotic conditions.

But what's more important would be the four things that usually comes out in our exam or in our inputs, which are okay, so I'll give you a few seconds. Of course, if you have a laptop ready, your iPad or tablet ready, you can take a screenshot of this. And I think this would be, of course, a recorded lecture where you can go back under iPad, our Aspire RN and Connetics USA Facebook page, all right?

Okay, so here is the important thing that I'd like you to remember when we talk about your congenital heart defects. So this is a very brief summary that really helped me out when I took my NCLEX a few years back, okay?

So here's a summary of both your Asion and Scionic condition. And please just remember two words for this, okay? Two words, okay? So for your Asymptic conditions, as I know the conditions,

I'd like you to remember the word clears, okay? And when you write the word clears on your notebook or when you write it down on your notes, I'd like you to put the word clears having all the consonants in capital letters and all the vowels in small letters, okay? So I'd like you to remember clears for your assyonautic conditions, okay?

However, for the conditions which are cyanotic, I'd like you to remember the word trouble, okay? Again, let me remind you to write all the consonants in capital letters and all the vowels in small letters. So there are four things that we have to summarize here, okay? One, let's talk about the shunt. Shunt pertains to the movement of your blood from chamber to chamber, okay?

So number two, the second thing that we have to remember here would now be the clusters or the specific groups that each type may belong to. Okay? And the third thing that we'd like to remember here would not be the classical sign or the distinct feature of your synoptic and cyanotic conditions.

And lastly, let's talk about the complications of each type of congenital heart disorder, okay? So let's talk about the shunt first. Let's talk about the shunt of your asynautic conditions, okay? So kindly encircle the letter L. I'd like you to encircle the letter L in your assay notic. And together with that, I'd like you to encircle the letter R, okay?

So let's talk about the shunt here. Please encircle letter L, and please encircle letter R, because in the word clears, L comes first before the letter R, okay? Therefore, when we talk about the shunt of your asynotic conditions from chamber to chamber, this would now be from left to right chambers, okay? This would not be from left to right chambers when we talk about their asynotic conditions, however, when we talk about their synaptic conditions, let's make the word let's make use of the word trouble, okay? Kind in circle the letter R and in circle the letter L, because in the word trouble, letter R comes first before the letter L.

Therefore, the shunting here would not be starting from the right chambers going to the left chambers of the heart, okay? So I hope that's very clear to everyone. Left to right for asynaptic, right to left for scionic conditions, okay?

Now let's go to your clusters. Let's now talk about your clusters. Let's just make use of a different color of pen here. Kyleen, circle the letter S for your assignment conditions, okay, Kyleen, in circle the letter S for your asynotic conditions. Okay? All of your asyonotic conditions here are either stenotic in futures or they may present as aceptal defect.

So all the six that we have highlighted a while ago or enumerated are either stenotic in feature or they are septal defects. Okay? So they start with the letter S, but this is quite coincidental where when we talk about the synaptic conditions, kindly in circle the letter T here. Kindly circle the letter T for synaptic conditions. It's quite incidental or coincidental rather than everything that we've highlighted a while ago starts with the letter T. So this would not be your T group or T disorders. So if you are not really used to memorizing or you're not really used to remembering a lot of terms, as long as it starts with a letter T, it's automatically cyanotic. It's automatically cyanotic.

So when we talk about to F, transposition, upgrade arteries, truncus arteryosus, okay? Tricuspidatricia. Okay, thomas thomas bernard is saying here thomas Thomas and somewhat, okay, so everything that starts with letter T here would now be cyanoty, okay?

Now, moving forward, let's go to third summary of your congenital heart defects. Okay? Let's encircle the letter C this time, okay, let's encircle the letter C this time for your asymptotic conditions. Letter c kind in circle letter c there, okay? The classical sign of patients with asynaptic conditions would not be congestion, okay? Whenever you have hypertrophy of a certain chamber of the heart, okay, there may be a pulling of that there, and that would now be an ominous sign already of congestion, okay? So congestion is the classical sign of your assignment condition. But when we talk about your synaptic condition, kind in, circle the letter b here.

Nurses, okay, USRN kind and circle the letter b here. So it's very obvious that when you have a scientific patient, the patient here is bluish, okay? So it's very obvious that synaptic conditions present with a bluish discoloration of the body, okay?

So the patient here will eventually experience hypersynaptic, spells, chronic hypocrisy, when they have your cyanotic conditions, okay?

And lastly, let's talk about your complications, okay? Kindly use the letter c again for your assign optic. Let's use the letter c again for cyanotic. So if you have congestion, definitely the end effect here would not be your congestive heart failure, okay? Your patient here will eventually have your congestive heart failure, okay?

Now, for cyanotic conditions, chronic hypoxia may lead to a certain condition which we call your polysythemia. And polysyethemia would now have an effect in the viscosity of your blood, where our blood eventually thickens.

So when your blood eventually thickens, kindly in circle the letter b here once again for scientific conditions b, let's encircle the letter b once again for synaptic conditions, because the complication here would now be your brain in forks and your blood guts, okay?

So patients with synaptic conditions will eventually develop your brain in parks and your blood guts. Okay? So this summary really helped me when I took my NCLEX back then. If you remember these two words, you won't get wrong, okay? This is more than enough, of course, to answer all your questions regarding this topic correctly.

So just remember the two words that I've mentioned clears for cyanotic and trouble for your psychic. All right? So did you learn something with the summary? Okay, let me just look into our chat box right now, okay? I hope this would now help you, of course, in your inputs.

This is a very creative way, of course, to remember your concepts in pediatric nursing. And I urge everyone, of course, to be very creative, imaginative in how you review for your exam. So this is a very challenging test that you'll take. So the more creative you are and the more imaginative you can review and prepare for your test, okay? This would help you out, of course, pass the NCLEX. Okay?

All right, so you're very welcome. So moving forward, ladies and gentlemen, let's talk about the nursing management. Let's talk about the nursing management for patients with congenital heart defects. Okay? So I'd like you to remember two letters this time. I'd like you to remember two letters this time, okay? So for asy nautic, conditions for your assignment. Conditions, I'd like you to remember the letter D. Before we proceed to your management, I'd like you to remember the letter d. Please remember the letter d for your assignment d. Okay? And for your synaptic conditions, I'd like you to remember the letter p, because everything here would either start with the letter d, okay, and letter p, it would either start with the letter D or letter p. So let's remove this first, okay, so let's start off with your asyonotic conditions, okay, so patients with asymptic conditions should be given your digoxin, okay? Your patients with asynaptic conditions should be given your digoxin.

So these are your cargotonics, okay, with an accompanied positive and negative effect to the heart. Of course, if we're administering this type of medication, there are two things that you have to take into consideration of. Okay?

So can you help me out, guys? Can you help out? All would be test takers here. What are the two things that you have to check first, prior to prior to giving your digoxin? What do we give? What do we give, or what do we check?

Rather, what do we check? Okay, what do we check when we talk about your deduction are two things that we have to check, okay? One, of course, would now be your take card. Very good. That would now be your carjack rate. And of course, you have to check for your potassium level. Okay? So when you talk about your potassium level, it should be within a range of 3.5 to 5.3. In some books, that's 3.5 to 5.5. Okay?

So, yeah, we have to check for your potassium level first. But more importantly, when you give your digoxin, being it's a cardio tonic, we have to look into your patient's cardiocrate. Now, in an adult patient, you withhold or. You do not give your digestion if your patient has a heart rate of less than 65. But in your pediatric patients, if you have a heart rate of less than 100, this is where we have to withhold this drug. Like I said, okay, it's a different thing when you talk about your adults. In your adult patients, a cardiac rate of less than 65, you would hold your digoxin. But when you talk about your pediatric patients, if you have a heart rate of 100, you again withhold your digoxin. So two things to remember for digoxin, always check for potassium level, and always check, of course, for your card degree, okay? Now, moving forward, besides your digestion, and you have to also manage your patient by giving your potassium sparing diuretics, okay? Because your patient is prone to digoxin toxicity, you have to correspond potassium intact within the body, okay? So diuretics such as your spiralactone or aldactone should be given for patients with asyonautic conditions, okay?

Now, number three, another thing that we have to consider for your asymptotic condition is provide a low sodium diet for your patient because everyone knows where sodium is, okay? Water follows, so you wouldn't want your patient to develop, of course, your congestive heart failure, so you lessen or you trim down, of course, the intake of your soldier by your patient. Okay?

Now let's go now to the fourth and last nursing management for asymptic conditions. Because this has a card affectation, you have to decrease, of course, your oxygen demand for your patient, okay? And the basic and the fundamental management here as nurses would now be to cluster your patients activities, okay? So decrease your patients who do demands, all right? So that would now be the nursing management for your asynotic conditions, okay? Now let's now go to your cyanotic conditions. Everything here starts with letter P.

Now, because your patient has cyanosis, your patient is experiencing chronic hypoxia. This would now have an effect over your blood. Your patient will now develop your polycyphemia, okay? So monitoring is very vital here because you wouldn't want your patient to have very thick and viscous blood that would develop into blood clots. That would obstruct, of course, your musculature. Okay? So polysizedmia monitoring is essential for patients with scientific conditions, okay?

Number two, you have to provide pacifiers to your patients, especially to our babies, to keep them calm. An increase in their activity would increase eventually their vital signs, which can affect, of course, their condition. Okay? So let's now go to the third one.

The third one here is you want to provide oxygen and fluids to your patient with cyanotic conditions. So it's very obvious that if you have chronic hypoxia, oxygen supplementation must be given. And because you have viscous blood, okay, juter, polycyphemia, hydration, and fluids would also be helpful. But among the four things that I'll be talking about here that I already enumerated here, I already numerated three. There's one more, by the way, I'd like you to put a star on this one, because this is a very immediate management or intervention that we have to do for patients with scientific conditions, OK? Please take note, OK? If a patient has a cyanopic condition immediately, or you have to put the patient accordingly, either in knee, chest, or a squatting position, or you can also put the patient in a fetal position, all right?

So the position of choice for cyanotic heart disorders would not be your knee, chest, and your squatting position. So the main reason here, by the way, okay, the main reason here why you put your patients in a knee, chest, or squatting position is you want to increase your venous resistance. So you wouldn't want your unoxygenated blood to enter both your IVC and SVC. That's why you put your patient in a knee, chest, or squatting position. So let me repeat what I said. The reason why we put them in this position is you want to increase your venous flow resistance in order for your UN oxygenated blood to decrease its flow into your IVC and of course, your SVC. Okay? So with that, we have four basic nursing management for your Asynotic conditions and your scionatic conditions. Okay? So I hope this is another thing that would help you out in your NCLEX.

That would be for your nursing management. You have more by the way, we have more things that we can discuss that can come out in your exam. So let's now talk about your Asymptotic disorders. Okay, so here again, I'm flashing to you right now all the six Asymptic disorders, and I'll be also discussing here what would be the distinct or classical feature specifically for each one. Specifically for each one. So in the NCLEX, they would often ask you, you have a patient diagnosed with atrial septal defect. What would now be an expected symptom of this order? So that would be the approach that you'll be getting when you take your NCLEX. Okay? So please remember the distinct and classical feature of each one, as there may be a possibility that you'll get these questions when you sit in for your exam, okay? So please do remember that your acidotic conditions are classified into two types of defects. It's either aceptile defect and at the same time as the defect rather.

So the first three, namely your ASD, your VSD, and your PDA, are all set up to defects, okay? So there's an opening, okay, there's an opening within the chambers of the heart or within the branches of the heart. Okay, so that would now be your ASD, VSD, and PDA. However, the three others here, namely your pulmonic stenosis, your auretic stenosis, and corruption of the Ayotta are what we call your stenortic defects. Okay? So when we say stenosis, this is a narrowing of either a bulb or a branch of the heart. Okay? So let's now talk about the distinct practical features of each one. Okay, let me also add, when you have patients with congenital heart defects, majority of them upon Auscultation, you'll be hearing abnormal heart sounds or what we call your murmurs, okay, so you'll hear distinct murmurs when you oscillate your patience. Okay? So let's talk about your ASD.

Okay, the distinct and classical feature of your ASD, or your patent forum in oval, would not be a systolic murmur heard over the second to third ICS upper sternum. Okay? So that would not be a systolic murmur over the second to third ICS, upper sternum. US stands for upper sternum. Okay? In contrast, when we talk about your VSD, which is the most common asynaptic disorder, this would now be heard over the third 4th ICS lower sternum. So they have systolic murmurs, but the difference between the two would now be their location, okay, second and third ICS, upper sternum for ASD, and third ICS, lower sternum for your BSD. Okay, so the third one would now be your PDA.

PDA stands for your patent ductus arteryosis. Okay, your doctor's arteryosis during your fetal circulation is a connection between your Ayorta and your pulmonary artery.

But once a baby is born, you have to understand that this should naturally close or they should naturally be shut down, okay? But in this case, your doctor's artiosis remains open right after delivery. So the distinct feature here would now be a machinery type murmur. Do remember that your PDA would now have a distinct feature, which is your machinery type murmur, all right?

Moving towards your synonymous defects. So when we talk about your pulmonary stenosis, that would now be a narrowing of your pulmonary artery or pulmonary valve. Therefore, there's a very small percentage of on oxygenated blood that would transcend, of course, to your lungs. Therefore, when you have your pulmonary stenosis, there would not be a pooling within a specific chamber of the heart, okay, which is your right ventricle. Okay? So patients with pulmonary stenosis will develop what you call your right ventricular hypertrophy.

So we have your right ventricular hypertrophy with an accompanied murmur, okay? So remember that there's a pulling of your blood within your right ventricle, okay? That's what you call your RBH with an accompanied murmur. In contrast with your pulmonary stenosis, we now have your auraic stenosis. This would now be a left ventricular hypertrophy, okay? So we will now have a left ventricular hypertrophy of the patient because there's a narrowing this time of your aortic valve. So your oxygenated blood coming from your pulmonary vein entering your left atrium down to your left ventricle pools within this specific chamber, okay? Developing, of course, your LVH, or left ventricular hyperptropy. Okay? All right. I distinctly remember the 6th one, this 6th one, because this six condition came out in my examination, okay? So I got this question back then when I took my NCLEX. So I was asked what would not be the distinct feature of your coordination of the Ayauta? Okay? So there's a narrowing at a specific part of your Ayorta, okay? Right after your aortic branches, OK, so we have three aortic branches. We have your caroted artery, we have, of course, your rhythmic alic artery, and you also have your carotellic. And you have your subclavian artery, by the way. So right after those aortic branches, there would not be a narrowing of your Iota, which leads, of course, to less blood being distributed to your lower extremities, okay?

Therefore, majority of your blood eventually goes to upper extremities. So the distinct feature here, by the way, would now be a very high blood pressure and bounding pulses seen over the upper extremities of the patient, okay? So needless to say, when we talk about your lower extremities, a patient with COA or coordination of the would have a very low BP and at the same time, very weak passes over the lower extremities. Okay? So just remember, when you have your quarter of the upper extremities would be high, including your blood pressure and your pulses.

But in your lower extremities, everything here would be low. You have a low BP, you have hypotension, and at the same time, you have very, very weak bosses over your lower extremities. Okay? So by the way, I'd like to thank everyone who's participating here. I see a lot of students putting in the responses over a chat box.

Currently, we have 150 plus live audience right now over Facebook page, okay? And I hope this summary of your congenital heart defects will eventually help you, of course, pass your NCS. Okay, moving forward so we're done with your assignment conditions. Let's move forward to your scientific conditions. So, like I said a while ago, everything here starts with the 13th. If somehow you're a bit hard up in memorizing and remembering stuff, okay, everything here starts with the letter T. It does not start with the letter T. It's automatically an assayanotic condition. Okay? All right, so let's talk about your cyanotic disorders. To, one of the most common heart defects being asked in the NCLEX.

We have to remember that your tetralogy of Palo has four associated conditions. For associated conditions, okay, let's start with letter P. ToF has what you call your pulmonary stenosis. Okay? The patient with ToF would now have pulmonic stenosis, and together with your pulmonary stenosis, your patient will develop letter R.

This would not be your right ventricular hypertrophy. Okay? We now have your right ventricular hypertrophy. Rather, okay? Letter O would not be your overriding of the Ayotta. So in a normal patient, your Ayorta should be attached over left ventricle. But the problem here in to F, your Ayota is attached to letter V.

This would now be your ventricular septal defect. So these are four distinct features or classical features of your ToF, the four leading to your cyanotic condition in your patient. Don't forget the four features here. Letter P, that's your pulmonary stenosis. Letter R, we have your right ventricular hypertrophy. Letter O, we have your overriding of the aorta. And letter B, we have your ventricular septal defect. Okay?

Now, the distinct feature, however, of your toga, or what we call your transposition of great arteries, would not be your arterial switch in a normal patient, your pulmonary arteries should be attached within your right ventricle, okay? And at the same time, your Ayota should be attached within your left ventricle. But the problem here, it switched. Okay? There was a switching of the possessions of your rate R three.

Now, your aorta is now attached in your right ventricle, and your pulmonary r three would not be attached over your left ventricle. So there's a switching of both right R three. That's the distinct feature of your toga. Your triciapeed attica, however, would now be a closure, a total closure. So whenever you see the word Patricia, or whenever you read the word Patricia, this would now be a closing of an opening or an orifice. Okay? So there's a distinct closing of your tricuspid valve here, wherein blood cannot move from the right atom towards your right ventricle. So the problem here is there would now be a right ventricular hypotenuse of your patient. So your patient will now have a shrinking, of course, or a decrease in size of your right ventricle.

So that's a distinct feature of your tricuspeed. Patricia okay, now let's go to the fourth one. The problem here is not switching of your great arteries. So when you see the word trunca truncas would not be defined as fusing of both great arteries. Unlike your toga a while ago, there is a switching, rather, there's a switching of both great arteries. Here. In your trunk artery, there is a fusing of both arteries. Okay? There's a fusing of both Arthurs, namely your PA and your Ayota. So you would see an arterial fusing where your trunk and your trunk is arteriosus. Okay? The most complicated here, by the way, class, would now be your top VC, or what you call your total anomalous pulmonary venous connection. So this would now be an abnormal Venus conduit, or connection of your pulmonary vein moving towards your superior vena cava. Okay? So in normal patient, your pulmonary vein should be attached to your left atrium. But in this patient with top VC, what happens here would be a connection of your pulmonary vin going to your superior vena cava. Okay? With that being said, with all your synaptic conditions, please do remember this one. Okay?

Please do remember this one. The last thing that I'd like to remind everyone of your scientific conditions. Please remember all cyanotic disorders are mixed cardiac defects.

What do I mean when we say mixed card defects? Both are unoxygenated. Blood and oxygenated blood mix within the chambers and branches of the heart.

Okay, so all scientific conditions or disorders are mixed cards of defects. Please remember that this is one complex question. All right? So I'll give you a few seconds, by the way, to take a screenshot, okay? And again, this is a lecture brought to you by Connetics USA and Aspire RN, this is one way for us to pay forward to a lot of aspiring USRNs, not only in the Philippines, but all over the world. Personally. This is one of my advocacy to help a lot of nurses pass their NCLEX. So if you have the opportunity to watch this one and study the lecture that I'm giving to you right now, I know when you get these questions in your examination, you'll get them correctly, okay?

All right, so that would now be for your Scionic conditions. Okay, so let's now go to we still have around 15 minutes for our Kinetics class for today, all right? So with the things that we have discussed already, let's try to test, of course, your memory of what we've talked about in the past hour. Okay? So try to test yourself with the following questions. I'll be giving you a few seconds, of course, to give your responses just simply write your answers over a chat box. Okay? This is just a review of the concepts that we've discussed. This is not the NCLEX itself, okay? So if you get an incorrect response here, it's totally fine.

This is your opportunity to learn and prepare for your exam. Okay, let's now go to the first question of today. Let's go. All right. Okay, let's test yourself. Okay, let's go to question number one. I'll be reading the question. You can just simply put your answers over a chat box. Let's go. So when creating a teaching program for the parents of Jessica is diagnosed with pulmonary stenosis, nurse Alex would keep in mind that this disorder involved which of the following? So before you answer, by the way, before you answer, let me just ask everyone, is pulmonic stenosis, asyonotic or cyanotic?

Okay, let me ask everyone. Is pulmonary stenosis cyanotic or asynhosis, cyanotic or asyondotic? When we talk about your pulmonic stenosis or PS, is it cyanotic or acionotic? Okay. All right. Answer here is asyanotic. It doesn't start with the letter T. It doesn't start with the letter T.

Therefore it's asyenotic. Very good. Okay, now here's a test taking strategy that you can employ. By the way, if you have two mirror options or you have two opposite options, among all the options given in your test, most probably one of them is already correct. You can simply neglect or you can simply disregard the two other options there. So in this question, you can either answer either B or C. You can either answer letter B or C for this question.

So when we talk about your pulmonary stenosis, is it an obstruction of blood flow of your left ventricle or your right ventricle? Okay, answer is it letter B or letter C? This is very easy question to answer. Again, a test taking strategy that you can employ. If you have two mere options there or two opposite options, one of them is highly probable to be the correct answer already. You can disregard the two others. Okay, so the answer here would now be letter C.

Okay, very good. That would now be letter C for this question. That would now be an obstruction of blood flow from your right ventricles. Do remember that what happens here would now be a right ventricular hypertrophy with accompanied murmurs. Okay, let's now go to the second one. Let's go to the second question. Nurses. Okay, here's a question. You have a patient named Bryan who is diagnosed with coercion of the Ayurta. While assessing him, nurse Jane would expect to find which of the following what would be the expected manifestation of a patient with coal or coordination of the Ayura? So we know for a fact that this is not a scientific condition, right? So COA or corruptation of the aorta is not a scionatic condition.

So you can already disregard your two options. You can disregard letter C, and you can disregard letter D. OK, another test taking strategy in your NCLEX. If you have two options, guys, if you have two options with almost the same context or with the same concept or meaning, you can already automatically disregard these two options. So disregard letter C and letter B because Koa is never a scionic condition. Okay? So C and B can be removed there and you have to choose between letter A and B. Okay? All right, so our answer here would not be letter B. So coba would now have diminished or absent process over the lower extremities and expectations there would not be very high blood pressure and at the same time very bounding pulses over upper extremities. Okay, so answer here would not be letter A. Very good.

Let's now go to the third question. Okay, what is considered a mix card defect or what is considered a mixed card defect? What is considered a mixed card defect? Okay, so I've emphasized this a while ago over one type of our congenital heart defects. We have two types asynautic and cyanotic.

Which among the four would now be considered a mixed cardio defect? Again, a mixed card defect is specifically a cyanotic condition. It's specifically a cyanotic condition. So there are three conditions here that are asyonautic, namely A, B and C. You have A, B and C. They are asyanotic conditions.

The only synaptic condition here would not be letter D. That would not be your transposition of the great arteries or what you call your toga. Very good. Let's move to more questions. Right, so what is typical to a patient with your patent doctors? Arthriosis, what is typical to a patient with patent doctors? arteriosis. So you have a loud machinery type murmur. Letter B is stolic murmur. Letter C, we have your bounding pulses over the upper extremities. Or letter D, we have your hyper cyanotic spells.

Well, of course you can automatically remove letter D there because patent ductus arteriosus is an asymptotic condition. So we can remove letter D. Bounding pulses would not be seen for a patient with quaration of the Ayorta systolic murmurs, by the way, would not be seen in patients with both ASD and DSD.So what's very typical of a patient with patent dr? So, terrors answer, there would not be letter A. OK?

Answer here would not be letter A. Very good. Okay, let's move on to more. I hope you did learn something in our kinetics class tonight. Okay, we have a few more we have a couple more questions here. So this would now be the dreaded SATA that a lot of students fear. But please do remember that these are your best friends, okay? So if you have SATA questions, if you have SATA questions, please have this mindset that SATA questions are your friends or are your best friends. So our question states the nurse is assessing a toddler diagnosed with ToF.

Now to sign up the condition which assessment and clinical findings should the nurse determine as being consistent with the child's diagnosis? Okay, so again, let's try to remember what are the four manifestations or associated disorders here? Letter P. We have problem. P would not be your pulmonary stenosis. P would not be a pulmonary stenosis. R, we have your right ventricular hypertrophy. Okay, we have your right ventricular hypertrophy. Letter O. We have your overriding of the overriding of your iorta. And letter V, we have your ventricular septal defect. Okay, we have your ventricular septal defect. Therefore, among the options here, what would now be the answer? Okay, we have letter A. We have your pulmonary bubble stenosis. That's correct.

Okay, letter C, that would now be our overriding of the aorta. That's correct. Okay, we have your right ventricular enlargement. That would be letter D, and you also have your sceptile defect of the ventricles. Okay, we have your sceptical defect of the ventricles. But if you just simply answered AC, D, and F.

Okay, that's an incorrect response to this question, because please do remember that the trilogy of palo is cyanotic, okay? So we're not limited only to the four conditions there. Okay? So if you have the trilogy of palo, you can also include their letter G. You can include their letter G. So it's not only a CD and F, okay, but if we analyze it deeper, you can also include the letter G that would now be chronic hypocrisy and clubbing of fingers, being that this is a cyanotic condition. So you can include their letter G as part of your response. Our answer here is ACDF and GDF and G. Okay? So don't limit yourself to the four conditions alone. There are other options there. There's another option there that can be added. That would be letter G. All right, thank you very much. Okay, let's now go to the last item. This would not be the last item for your questions tonight.

Okay, so you see a child I think it's not the last item. It's the second to the last, by the way. Okay, so you see a child diagnosed with ToF in bed scionic and in fetal position.

What is your first option? Okay, what is your first option here? So there's a thin line between your first and your best options.

Okay, so as a nurse, the first option is often the independent function of nurses, but the best action here would most likely be actions provided by your Hcp. Okay, so what would now be your answer here?

What would not be your answer for this question? What would now be your first action as a nurse with a patient with T-O-F? What would now be your first option? What would not be your first option here?

Okay, now look at the key term here. The patient is already in fetal position. The patient is already in fetal position. Okay, if I restructure this question and I change the word first to best.

Okay, if I change the word to best, I can administer your oxygen, not per nasal canula, but rather I would give the patient oxygen per face mask. So letter C is correct here. Because of the word nasal cannula, I would prefer giving a patient o two via your face mask. Okay? But when I see a patient with COF already in a fetal position, all I have to do here is do nothing but observe the patient.

There's no need for CPR or calling a code for the patient. Okay? Positioning the patient in a high faltered position is not really helpful. What's helpful here would not be a fetal position. So answer here would not be letter A. What makes letter C incorrect is simply giving oxygen per nasal canula. What would be better would not be giving them oxygen per face mass. OK? Per face mask. Right? So that would be the answer there. Letter A. Right?

And this is the last item for tonight nurses. All right, so here's the question. The nurse provides discharge instructions to the parents of a child recovering from surgery to repair congenital heart defect, OK? What statements indicate the teaching provided to these parents have been effective? Okay? All right.

So what would now be our response to this question? That's with the letter A, our child should be restricted in play and activity for at least six months. Okay? By the way, restrictions, when we talk about words such as restriction, elimination, avoidance, these are options in the NCLEX that are not really positive. Okay? So if you see words such as restriction, avoidance, elimination, these are not good options. In the NFL, you don't restrict play. You don't restrict play in a child following a surgery or a repair of your congenital heart defects. So we can remove letter A automatically.

Okay, let's go to letter B. Our child should not return to normal activities for at least two years. So this is more. Okay, this is worse compared to letter D. Like I said, you can automatically remove options there with almost same context or same thought. So A and B are almost the same. Okay? So you're either choosing between letter B and letter C here. Okay? So our answer here, nurses, would now be letter C. Okay, let me just correct myself. Our answer here should be letter B. Letter B. Okay, let me just correct myself there. It should be letter B again.

Letter C has the word restriction, which is not really a good response in your exam. Okay? So when you see these words, these are somehow bad or negative responses already in our exam.

All right? Okay, so that ends our kinetics class for tonight. But before anything else, I'd like to promote, of course, the programs provided by Aspire RN. So you can follow us on our website.

This would now be www.aspirern.com. You can also follow our CEO, Mr. Paul Beloved, by looking into his Instagram, his TikTok and even his Facebook account. So that's at Dr. Nurse Paul.

Okay, and our program, by using our code, yes, you can. You can have our short pass starter course at $200, our short pass pro at $360, our short pass plus at $520. And we also have our Hit final coaching. It's a crash course, of course, for those who would be having their exam in the next few weeks or in a couple of months. You can get this for $140.

So just make use of the code here. Yes, you can. Okay. Please disregard the validity here, which is June 30. We'll be extending our Promo up to July 31. Okay? This would not be extended up to July 31. So if you're interested to enroll in our program, you may do so. And of course, Connetics USA is offering a scholarship program to anyone interested here.

You can look into the link. I think this would be flash again. All right, so we have a link to be shown here. You can check into the scholarship program given by Connetics USA. Right?

So this is being shown to you right now. So you can apply for a scholarship with Connetics USA and as per our end, will be your review provider there. Okay? So, yes, 20% off on all our programs here at Aspire RN would have the following features. If you're taking the starter program, this is good for three months. Our short pass pro would not be good for one year, but what most students would get would now be the short pass. Plus this is a year's subscription in our program with an added okay, you world Cuban good for 90 days. So you can avail of program any of our program of your preference.

Okay, so also I'd like to promote our upcoming schedule for NCLEX Hit final coaching. So we have a high intensity tutoring or tutorial for those taking the NCLEX in the next few weeks and a couple of months. So the next schedule would be start actually, we started today. This would now be from July 4, the 15th. Okay.

The upcoming batch would now be on August 18 to 19th. And eventually we'll have another batch on September 5 to 16th. Okay, so this is a ten day class of high impact tutoring.

We have over 1000 questions here that you can answer. And this will be rationalized by our NCLEX experts. And you'll be having a one on one final coaching session. This is a two hour session with our mentors where we will eventually give you a tailor fitted coaching of how you can take your NCLEX and pass it with flying callers, of course.

Okay, so this also includes exclusive access to surpulse NCLEX secrets. Okay, so we can also give you a month access to all of our lectures in our e library. Okay, so the help of our student advisors that can focus, of course, to your specific and personalized needs for your review. Okay, so I'd like to, of course, invite everyone to enroll and join our courses here at Asparagus. And before we end, I'd like to, of course, thank Connetics USA for this opportunity of letting me share what I know for the exam for the NCLEX. And this is my way, of course, of paying it forward to a lot of aspiring USRNs watching this video.

Okay? So with that, thank you very much for your time. I'll be seeing you again in the near future. Hopefully, I'll be seeing you inside our classes here at Aspire RN. Just enjoy the journey, and I know that you'll be able to pass your influence. God bless everyone, keep safe, and thank you very much. Bye.