generaly nursing knowlege

What is happening mechanically during the P wave, QRS complex, and T wave?

P wave

• Atrial depolarisation

• Electrical signal spreads through the atria

• Atria contract (squeeze)

• Blood moves into the ventricles

QRS complex

• Ventricular depolarisation

• Ventricles receive the electrical signal

• Ventricles contract strongly

• Blood is pumped out of the heart

T wave

• Ventricular repolarisation

• Ventricles recover / reset electrically

• Prepares for the next heartbeat

What are the key components of a respiratory assessment?

• Respiratory rate

• Work of breathing (use of accessory muscles)

• Oxygen saturation (SpO₂)

• Breath sounds

• Skin colour (cyanosis)

• Ability to speak full sentences

• Level of consciousness

🫀 Simple understanding

You are checking:

“Is the patient getting enough oxygen and working too hard to breathe?”

⚠ Red flags

• RR >20 or low

• Low SpO₂

• Confusion (early hypoxia sign)

What is acute myocardial ischaemia?

• Reduced blood flow to heart muscle

• Usually due to blocked coronary artery

• Causes chest pain and heart muscle damage if

🫀 Simple understanding

Heart muscle is starving of oxygen because blood supply is blocked.

⚠ Red flags

• Crushing chest pain

• Pain radiating to arm/jaw

• Sweating, nausea

• Abnormal ECG changes

• Raised troponin

What is a stroke?

• Interruption of blood flow to the brain

• Either blockage (ischaemic) or bleeding (haemorrhagic)

• Causes sudden neurological deficits

🫀 Simple understanding

Part of the brain is not getting oxygen → brain cells start dying quickly.

⚠ Red flags (FAST)

• Face droop

• Arm weakness

• Speech difficulty

• Time critical emergency

What is sepsis?

• Life-threatening response to infection

• Causes organ dysfunction

• Medical emergency

🫀 Simple understanding

Body overreacts to infection → damages its own organs.

⚠ Red flags

• Fever or hypothermia

• Fast heart rate

• Fast breathing

• Confusion

• Low blood pressure

What is pneumonia?

• Infection of lung tissue (alveoli)

• Causes fluid/pus in lungs

• Reduces oxygen exchange

🫀 Simple understanding

Lungs are filled with fluid so oxygen can’t get in properly.

⚠ Red flags

• Fever

• Cough with sputum

• Low oxygen

• Crackles on auscultation

What is hypoxia?

• Low oxygen supply to body tissues

• Can occur even if oxygen is being given

🫀 Simple understanding

The body is not getting enough oxygen where it matters (organs/tissues).

⚠ Red flags

• Confusion (early sign)

• Cyanosis (late sign)

• Restlessness

• Low SpO₂

What is a pulmonary embolism?

• Blockage in pulmonary artery

• Usually a blood clot from legs (DVT)

• Stops blood flow to lungs

🫀 Simple understanding

A clot travels to the lungs and blocks blood flow → oxygen can’t get into blood properly.

⚠ Red flags

• Sudden shortness of breath

• Chest pain (sharp, worse on breathing)

• Tachycardia

• Low oxygen

• Possible collapse

What are signs of respiratory distress?

• Increased respiratory rate

• Use of accessory muscles

• Difficulty speaking

• Low oxygen saturation

• Anxiety/restlessness

🫀 Simple understanding

The patient is working too hard to breathe.

⚠ Red flags

• Silent chest (very serious)

• Exhaustion

• Falling RR after being high (fatigue sign)

What happens in an asthma attack?

• Airways narrow due to inflammation and bronchospasm

• Air gets trapped in lungs

• Breathing becomes difficult

🫀 Simple understanding

Airways tighten like a squeezed tube → air can’t move properly.

⚠ Red flags

• Wheeze or silent chest

• Difficulty speaking

• Low SpO₂

• Poor response to inhalers

What is a COPD exacerbation?

• Sudden worsening of chronic lung disease

• Increased breathlessness and sputum

• Often triggered by infection

🫀 Simple understanding

Long-term damaged lungs suddenly get worse (often infection-related).

⚠ Red flags

• Increased CO₂ retention

• Drowsiness (CO₂ narcosis)

• Low oxygen

• Increased sputum/purulence

What is a pneumothorax?

• Air in pleural space

• Lung collapses partially or fully

• Stops normal breathing on affected side

🫀 Simple understanding

Air leaks outside the lung → lung can’t stay expanded.

⚠ Red flags

• Sudden chest pain

• Sudden breathlessness

• Reduced breath sounds on one side

• Tracheal deviation (tension pneumothorax = emergency)

What is respiratory failure?

• Inability of lungs to maintain oxygen or remove CO₂

• Can be acute or chronic

🫀 Simple understanding

Lungs are failing at gas exchange.

⚠ Red flags

• Very low SpO₂

• Rising CO₂

• Confusion/drowsiness

• Exhaustion

What is Acute Coronary Syndrome (ACS)?

• Umbrella term for reduced blood flow to the heart

• Includes: unstable angina, NSTEMI, STEMI

• Caused by coronary artery blockage

🫀 Simple understanding

Part of the heart is not getting enough oxygen because a coronary artery is narrowed or blocked.

⚠ Red flags

• Chest pain (crushing, central)

• Radiates to arm/jaw/back

• Sweating, nausea

• Shortness of breath

• ECG changes + raised troponin (MI)

What is a myocardial infarction?

• Death of heart muscle due to lack of oxygen

• Usually caused by blocked coronary artery

🫀 Simple understanding

Part of the heart muscle is dying because blood flow is blocked.

⚠ Red flags

• Persistent chest pain (>20 min)

• Raised troponin

• ECG changes (ST elevation in STEMI)

• Diaphoresis (sweating), collapse risk

🩺 Nursing actions (UK focus)

• MONA principles (often used in teaching):

  • Morphine (pain)

  • Oxygen (if hypoxic)

  • Nitrates

  • Aspirin

• Continuous ECG monitoring

• Prepare for PCI (angioplasty)

What is angina?

• Chest pain caused by temporary reduced blood flow to heart

• No permanent heart muscle damage

🫀 Simple understanding

Heart is temporarily “short of oxygen” during exertion or stress.

⚠ Red flags

• Pain triggered by exertion

• Relieved by rest or GTN spray

• If NOT relieved → may be MI

What is heart failure?

• Heart cannot pump blood effectively

• Leads to fluid build-up and poor circulation

🫀 Simple understanding

The heart is too weak to pump properly → fluid backs up into lungs/body.

⚠ Red flags

• Breathlessness (especially lying flat)

• Swollen legs (oedema)

• Fatigue

• Crackles in lungs

• Weight gain (fluid retention)

🩺 Nursing focus

• Fluid balance monitoring

• Daily weights

• Diuretics (e.g., furosemide)

• Oxygen if needed

What is cardiac arrest?

• Sudden stop in effective heart function

• No circulation or pulse

• Medical emergency

🫀 Simple understanding

The heart stops pumping blood → organs stop receiving oxygen.

⚠ Red flags

• Unresponsive

• Not breathing normally

• No pulse

🩺 Nursing action (UK resus)

• Call emergency response

• Start CPR immediately

• Defibrillation (AED) ASAP

• Follow ALS guidelines

What is an arrhythmia?

• Abnormal heart rhythm

• Can be too fast, too slow, or irregular

🫀 Simple understanding

The heart’s electrical system is not working in a normal pattern.

⚠ Red flags

• Dizziness

• Chest pain

• Palpitations

• Collapse risk

What is atrial fibrillation?

• Irregular, rapid atrial activity

• Poor atrial contraction

• Blood stasis increases clot risk

🫀 Simple understanding

Atria “quiver” instead of squeezing properly → irregular heartbeat.

⚠ Red flags

• Irregular pulse (“irregularly irregular”)

• Stroke risk

• Fatigue, breathlessness

🩺 Nursing focus

• Rate control (e.g., beta blockers)

• Anticoagulation (warfarin/DOACs)

• Stroke prevention

What is a TIA?

• Temporary interruption of brain blood flow

• Symptoms resolve within 24 hours

🫀 Simple understanding

“Mini stroke” warning sign.

⚠ Red flags

• Stroke symptoms that resolve

• High risk of future stroke

What is a seizure?

• Sudden abnormal electrical activity in the brain

• Causes involuntary movements or loss of consciousness

🫀 Simple understanding

Brain “electrical overload” causing uncontrolled activity.

⚠ Red flags

• Loss of consciousness

• Jerking movements

• Post-ictal confusion (after seizure)

🩺 Nursing actions

• Protect airway

• Time seizure

• Protect from injury

• Do NOT restrain patient

What is meningitis?

• Infection of meninges (brain coverings)

• Can be bacterial (life-threatening) or viral

🫀 Simple understanding

Infection around the brain → inflammation and pressure.

⚠ Red flags

• Fever

• Neck stiffness

• Photophobia

• Rash (non-blanching in bacterial meningitis)

• Altered consciousness

🩺 Nursing actions

• Emergency antibiotics (bacterial)

• Isolation if suspected infectious

• Rapid escalation

What is raised intracranial pressure?

• Increased pressure inside the skull

• Can damage brain tissue

🫀 Simple understanding

Brain is swelling or something is taking up space inside skull.

⚠ Red flags

• Headache

• Vomiting

• Reduced consciousness

• Unequal pupils

• Cushing’s triad (late sign)

What is diabetes mellitus?

• Disorder of blood glucose regulation

• Either lack of insulin (Type 1) or insulin resistance (Type 2)

🫀 Simple understanding

Body cannot control blood sugar properly.

⚠ Key issues

• Hyperglycaemia

• Hypoglycaemia risk (especially with insulin)

• Long-term organ damage

What is hypoglycaemia?

• Low blood glucose (<4 mmol/L)

• Can be life-threatening

🫀 Simple understanding

Not enough sugar in blood → brain cannot function properly.

⚠ Red flags

• Sweating

• Shaking

• Confusion

• Irritability

• Seizures (severe)

🩺 Nursing actions

• Give fast-acting glucose (if conscious)

• IV glucose if unconscious

• Recheck blood glucose

What is hyperglycaemia?

• High blood glucose levels

• Can lead to DKA or HHS

🫀 Simple understanding

Too much sugar in blood → dehydration and metabolic imbalance.

⚠ Red flags

• Thirst

• Frequent urination

• Fatigue

• Confusion (severe cases)

What is Diabetic ketoacidosis DKA?

• Severe insulin deficiency

• Body breaks down fat → ketones build up

• Causes acidosis

🫀 Simple understanding

No insulin → body burns fat → toxic acids build up.

⚠ Red flags

• Fruity breath

• Deep rapid breathing (Kussmaul respirations)

• Abdominal pain

• Vomiting

• Dehydration

🩺 Nursing actions

• IV insulin

• IV fluids

• Electrolyte monitoring

What is hyperosmolar hyperglycaemic state (HHS)?

• Severe hyperglycaemia (usually Type 2 diabetes)

• Extreme dehydration

• No significant ketones

🫀 Simple understanding

Very high sugar → blood becomes very thick → severe dehydration.

⚠ Red flags

• Extreme thirst

• Confusion

• Very high glucose levels

• Dehydration

What is frailty in older adults?

• Reduced physiological reserve

• Increased vulnerability to illness, falls, and stress

• Slower recovery from illness

🫀 Simple understanding

The body has less “backup capacity,” so small illnesses can cause big problems.

⚠ Key nursing risks

• Falls

• Delirium

• Polypharmacy (too many meds)

• Dehydration

• Pressure ulcers

🩺 Nursing focus (UK)

• Falls risk assessment

• Hydration monitoring

• Skin integrity checks

• Medication review

• Mobility support

What is delirium?

• Acute confusion due to illness

• Fluctuating mental state

• Often reversible

🫀 Simple understanding

Sudden brain “malfunction” usually triggered by infection, meds, or dehydration.

⚠ Red flags

• Sudden confusion

• Reduced awareness

• Fluctuating attention

• Agitation or drowsiness

What increases fall risk in older adults?

• Frailty

• Poor balance

• Medications (sedatives, antihypertensives)

• Low blood pressure

• Vision problems

🫀 Simple understanding

Body stability + reflexes are weaker, so small imbalance causes falls.

⚠ Nursing actions

• Bed low, call bell within reach

• Non-slip footwear

• Regular toileting

• Review medications

What is palliative care?

• Care for patients with life-limiting illness

• Focus on comfort, dignity, and symptom control

• Not focused on cure

🫀 Simple understanding

Not trying to cure — trying to make the patient as comfortable as possible.

⚠ Key priorities

• Pain control

• Breathlessness management

• Anxiety relief

• Emotional + family support

🩺 Nursing focus

• Symptom control (opioids, antiemetics)

• Holistic care

• Communication + dignity

What are the “rights” of medication administration?

• Right patient

• Right drug

• Right dose

• Right route

• Right time

🫀 Simple understanding

Always make sure the correct drug is given safely to the correct person at the correct time.

⚠ safety priorities

• Allergy checks

• Double checking high-risk meds

• Documentation immediately

• Avoid interruptions during meds round

🚨 High-risk meds (important)

• Insulin

• Anticoagulants (e.g. warfarin)

• Opioids

• IV potassium

What does the kidney do?

• Filters blood

• Removes waste and excess fluid

• Controls electrolytes

• Regulates blood pressure

🫀 Simple understanding

Kidneys are the body’s “filter system.”

⚠ When kidneys fail

• Fluid overload

• Electrolyte imbalance

• Toxin build-up

• Reduced urine output

What is AKI?

• Sudden loss of kidney function

• Often reversible if treated early

🫀 Simple understanding

Kidneys suddenly stop filtering properly.

⚠ Causes

• Dehydration

• Sepsis

• Medications (NSAIDs)

• Low blood pressure

🩺 Nursing focus

• Monitor urine output

• Fluid balance charts

• Check creatinine/urea

• Stop nephrotoxic drugs

What is CKD?

• Long-term, progressive kidney damage

• Irreversible decline in function

🫀 Simple understanding

Kidneys slowly lose function over time.

⚠ Signs

• Fatigue

• Fluid retention

• Itching

• Anaemia

🩺 Nursing focus

• Blood pressure control

• Diet/fluid management

• Dialysis preparation if advanced

Why is sepsis dangerous?

• It reduces blood flow to organs

• Causes low oxygen delivery

• Leads to organ failure

🫀 Simple understanding

Organs start shutting down because they are not getting enough oxygen and blood.

What are early signs of sepsis?

• Fever or low temperature

• Fast heart rate (tachycardia)

• Fast breathing (tachypnoea)

• Confusion or reduced alertness

• Feeling very unwell

🫀 Simple understanding

The body is “panicking” trying to fight infection.

What are late signs of sepsis?

• Low blood pressure

• Reduced urine output

• Cold, mottled skin

• Severe confusion or unconsciousness

🫀 Simple understanding

The body is now failing to maintain circulation.

What is a deteriorating patient?

• A patient whose condition is worsening over time

• Often shown by abnormal vital signs

🫀 Simple understanding

The body is moving from “coping” → “failing”

What is NEWS2 used for?

• National Early Warning Score system

• Detects patient deterioration

• Uses vital signs to trigger escalation

🫀 Simple understanding

A scoring system that tells nurses when a patient is getting worse.

⚠ What it looks at

• Respiratory rate

• Oxygen saturation

• Blood pressure

• Pulse

• Temperature

• Consciousness level

Why is early recognition of sepsis important?

• Early treatment improves survival

• Delayed treatment increases organ failure risk

🫀 Simple understanding

The earlier you act, the more reversible it is.

What is Sepsis 6?

Six urgent interventions:

• Oxygen

• Blood cultures

• IV antibiotics

• IV fluids

• Lactate measurement

• Urine output monitoring

🫀 Simple understanding

A fast treatment bundle to stop sepsis progressing.

What is anaphylaxis?

• Severe, life-threatening allergic reaction

• Causes airway, breathing, and circulation problems

• Rapid onset

🫀 Simple understanding

The body overreacts massively to an allergen and starts shutting down breathing and circulation.

What can trigger anaphylaxis?

• Food (nuts, shellfish)

• Medications (antibiotics, NSAIDs)

• Insect stings

• Latex

🫀 Simple understanding

Something harmless triggers an extreme immune reaction.

What happens physiologically in anaphylaxis?

• Airway swelling (laryngeal oedema)

• Bronchoconstriction

• Blood vessels dilate → low blood pressure

• Fluid leaks into tissues

🫀 Simple understanding

Airways tighten, face/throat can swell, and blood pressure drops.

What are the signs of anaphylaxis?

• Difficulty breathing / wheeze

• Swollen face, lips, tongue

• Rash or hives

• Low blood pressure

• Dizziness or collapse

🫀 Simple understanding

Breathing becomes hard AND circulation starts failing.

Why is anaphylaxis life-threatening?

• Airway can close

• Blood pressure can drop

• Can lead to cardiac arrest

🫀 Simple understanding

The patient can suffocate and collapse within minutes.

What is the first-line treatment for anaphylaxis?

• Intramuscular adrenaline (epinephrine)

🫀 Simple understanding

Adrenaline reverses swelling, opens airways, and raises blood pressure.

What else is given in anaphylaxis management?

• Oxygen

• IV fluids

• Antihistamines

• Steroids (supportive, not immediate lifesaving)

🫀 Simple understanding

Support breathing, circulation, and reduce allergic response.

What should a nurse do in suspected anaphylaxis?

• Call emergency help immediately

• Give IM adrenaline

• Lay patient flat (raise legs if possible)

• Give oxygen

• Monitor vital signs

🫀 Simple understanding

Act fast — don’t wait for it to “confirm itself.”

What is hypovolaemic shock?

• Shock caused by low blood volume

• Due to fluid or blood loss

🫀 Simple understanding

Not enough “fluid in the system” to circulate blood properly.

⚠ Causes

• Bleeding (trauma, surgery)

• Severe dehydration

• Vomiting/diarrhoea

🚨 Signs

• Fast heart rate

• Low blood pressure

• Cold, clammy skin

• Low urine output

What is cardiogenic shock?

• Heart fails to pump effectively

• Leads to poor circulation

🫀 Simple understanding

The pump is weak, so blood can’t move around the body.

⚠ Causes

• Myocardial infarction (heart attack)

• Severe heart failure

• Arrhythmias

🚨 Signs

• Low blood pressure

• Pulmonary oedema (fluid in lungs)

• Breathlessness

• Cold, clammy skin

What is septic shock?

• Severe infection causing dangerous drop in blood pressure

• Body-wide inflammation leads to organ failure

🫀 Simple understanding

Infection causes blood vessels to widen and leak → circulation collapses.

⚠ Causes

• Severe sepsis

• Pneumonia

• UTI

• Abdominal infections

🚨 Signs

• Fever or low temp

• Very low blood pressure

• Confusion

• Fast heart rate

• High lactate

What is anaphylactic shock?

• Severe allergic reaction causing circulatory collapse

• Blood vessels widen + leak

🫀 Simple understanding

Massive allergic reaction → blood pressure crashes + airways tighten.

🚨 Signs

• Swelling (face, throat)

• Wheeze

• Rash

• Severe hypotension

• Collapse

What are the different shocks?

organs not getting enough oxygen

But the causes differ:

• 💧 Hypovolaemic = not enough fluid

• ❤ Cardiogenic = pump failure

• 🧪 Septic = infection causes vasodilation + leak

• ⚠ Anaphylactic = allergic vasodilation + airway swelling

🧩 SIMPLE MEMORY TRICK

Think:

• 💧 “Empty tank” = hypovolaemic

• ❤ “Weak pump” = cardiogenic

• 🧪 “Infected system” = septic

• ⚠ “Allergic explosion” = anaphylac

What is a UTI?

• Infection of urinary system (usually bladder)

• Caused by bacteria (often E. coli)

🫀 Simple understanding

Bacteria enter the urinary tract → causes irritation and infection.

⚠ Signs

• Burning when urinating

• Frequent urination

• Confusion in older adults

• Fever (if severe)

What is C. difficile infection?

• Bacterial infection of the bowel

• Often after antibiotic use

🫀 Simple understanding

Gut bacteria is disrupted → harmful bacteria take over → severe diarrhoea.

⚠ Signs

• Severe watery diarrhoea

• Abdominal pain

• Fever

• Dehydration

What is MRSA?

• Antibiotic-resistant bacterial infection

• Difficult to treat

🫀 Simple understanding

Infection that does not respond to common antibiotics.

⚠ Nursing focus

• Hand hygiene

• Isolation precautions

• Correct antibiotic use

What is cellulitis?

• Bacterial skin infection

• Causes redness, swelling, heat

🫀 Simple understanding

Infection spreads in skin and soft tissue.

What is dementia?

• Progressive loss of memory and cognition

• Irreversible condition

🫀 Simple understanding

Brain function slowly declines over time.

⚠ Features

• Memory loss

• Confusion

• Behaviour changes

What is Parkinson’s disease?

• Degenerative disorder affecting movement

• Dopamine deficiency in brain

🫀 Simple understanding

Brain loses control of smooth movement.

⚠ Signs

• Tremor

• Stiffness

• Slow movement (bradykinesia)

What is a spinal cord injury?

• Damage to spinal cord affecting movement/sensation

• Can cause paralysis

🫀 Simple understanding

Nerve signals between brain and body are disrupted.

What is oxygen therapy used for?

• Treats hypoxia (low oxygen levels)

• Delivered via devices (nasal cannula, mask)

🫀 Simple understanding

Increases oxygen available to the lungs and blood.

⚠ Key point

• Oxygen is a drug

• Needs correct target saturation

• Especially important in COPD patients

What are ABGs used for?

• Measure oxygen, CO₂, and blood pH

• Assess respiratory and metabolic status

🫀 Simple understanding

Shows how well lungs and kidneys are balancing oxygen and acid levels.

What are the main types of insulin?

• Rapid-acting (meal time)

• Short-acting

• Intermediate-acting

• Long-acting (background)

🫀 Simple understanding

Different insulins act at different speeds to control blood sugar.

What are complications of diabetes?

• Kidney disease

• Eye damage (retinopathy)

• Nerve damage (neuropathy)

• Heart disease

What is chemotherapy?

• Drug treatment that kills cancer cells

• Also affects healthy fast-growing cells

⚠ Side effects

• Hair loss

• Nausea

• Low immunity (neutropenia)

What is neutropenia?

• Low white blood cell count

• Increased infection risk

🫀 Simple understanding

Body has weak immune defence.

What causes pressure ulcers?

• Prolonged pressure on skin

• Reduced blood flow to tissue

🫀 Simple understanding

Skin breaks down due to constant pressure.

What is polypharmacy?

• Use of multiple medications

• Common in older adults

⚠ Risk

• Drug interactions

• Falls

• Confusion

What is inclusive nursing care?

• Providing care that meets individual needs

• Adapting communication and support

🫀 Simple understanding

Care is adjusted so everyone can understand and access it.

What is community nursing?

• Healthcare provided outside hospitals

• Includes home care and chronic disease management

🫀 Simple understanding

Supporting patients to live safely at home.

What is priority in trauma bleeding?

• Stop bleeding

• Maintain circulation

• Prevent shock

What is perforated diverticulitis?

• Rupture of inflamed bowel pouches

• Causes infection in abdomen (peritonitis)

🫀 Simple understanding

A hole forms in the bowel → contents leak → severe infection.

🚨 Signs

• Severe abdominal pain

• Fever

• Rigid abdomen

• Sepsis risk

What are the main oxygen delivery devices?

• Nasal cannula

• Simple face mask

• Venturi mask

• Non-rebreather mask

When is a nasal cannula used?

For mild oxygen support (low to moderate oxygen needs).

Why is a Venturi mask important?

It delivers a fixed oxygen concentration, important for COPD patients.

When is a non-rebreather mask used?

In emergencies where high oxygen levels are needed (e.g. severe hypoxia).

What are normal oxygen saturation targets?

Usually 94–98%

What is the oxygen target for COPD patients?

88–92%