Acute Conditions — NCLEX-PN

A stroke is the sudden loss of brain function from ischemia (a clot) or hemorrhage in the cerebral circulation. Use FAST — Face drooping, Arm weakness, Speech difficulty, Time to call for help — and establish the exact time of onset, since it determines eligibility for clot-busting thrombolytics. Keep the client NPO until a swallow evaluation is done, because aspiration is a major early complication.

An infarct is tissue death from prolonged ischemia; a myocardial infarction is death of heart muscle when a coronary artery is blocked. Classic presentation is crushing chest pain with diaphoresis and nausea, treated per protocol with measures such as oxygen, nitroglycerin, and aspirin. Women, people with diabetes, and older adults may present atypically with only fatigue, shortness of breath, or epigastric pain.

Diabetes is chronic hyperglycemia resulting from insufficient insulin production or action. Learn the contrasting emergencies: hypoglycemia presents cold and clammy and is treated with fast-acting sugar, while hyperglycemia presents hot and dry and is treated with insulin. Foot care, regular glucose monitoring, and a consistent carbohydrate-controlled diet are core teaching points to prevent complications.

Pneumonia is a lung infection that fills the alveoli with fluid or pus, impairing gas exchange and causing hypoxia. Encourage coughing, deep breathing, and incentive spirometry, and elevate the head of bed to ease the work of breathing and mobilize secretions. Older adults may present only with new confusion, weakness, or decreased appetite rather than the classic fever and productive cough.

An embolism is a clot, fat globule, or air bubble that travels through the bloodstream and lodges in a vessel, cutting off flow. Sudden dyspnea, tachycardia, and chest pain in a post-op or immobile client suggests a pulmonary embolism — sit the client up, apply oxygen, and notify the provider immediately. Prevention centers on early ambulation, sequential compression devices, and prophylactic anticoagulants.

A fracture is a break in the continuity of bone, ranging from a hairline crack to a displaced or open break. Perform neurovascular checks distal to the injury using the 5 P’s — pain, pallor, pulse, paresthesia, paralysis — and always compare to the opposite limb. Watch for compartment syndrome, where increasing pain unrelieved by analgesics is a red-flag emergency requiring immediate provider notification.

Paralysis is the loss of voluntary muscle movement, which may follow stroke, spinal cord injury, or neurologic disease. Position the client to prevent contractures and pressure injuries, and perform passive range of motion until active movement returns. Bladder and bowel programs, skin care, and prevention of the complications of immobility are central to long-term nursing care.