Electrolyte imbalances are NCLEX favorites. Here's a complete breakdown of the big 4 — what to watch for and what to do:

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🔵 POTASSIUM (K+) — Normal: 3.5 – 5.0 mEq/L

Hypokalemia (< 3.5):

• Causes: Diuretics (furosemide), vomiting, diarrhea, NG suction

• Signs: Muscle weakness, leg cramps, shallow respirations, decreased bowel sounds, U waves on ECG

• Nursing: Give K+ supplements (NEVER IV push — always dilute), monitor ECG, encourage potassium-rich foods (bananas, oranges, potatoes, spinach)

Hyperkalemia (> 5.0):

• Causes: Renal failure, ACE inhibitors, K-sparing diuretics, tissue destruction

• Signs: Muscle twitching → weakness, bradycardia, tall peaked T waves, risk of cardiac arrest

• Nursing: Calcium gluconate (cardiac stabilizer), insulin + glucose (drives K+ into cells), kayexalate, restrict K+ foods, prepare for dialysis

Memory trick: "The HEART doesn't like high K+" — think cardiac arrest risk

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🟡 SODIUM (Na+) — Normal: 136 – 145 mEq/L

Hyponatremia (< 136):

• Causes: SIADH, water intoxication, diuretics, heart failure

• Signs: Confusion, headache, nausea, seizures, muscle cramps

• Nursing: Restrict fluids, give hypertonic saline (3% NaCl) SLOWLY, monitor for cerebral edema, seizure precautions

Hypernatremia (> 145):

• Causes: Dehydration, diabetes insipidus, excess sodium intake

• Signs: Thirst, dry mucous membranes, restlessness, confusion, elevated temperature

• Nursing: Give hypotonic fluids (0.45% NaCl), encourage water intake, monitor I&O, daily weights

Memory trick: "Water follows salt" — where sodium goes, water follows

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🟢 CALCIUM (Ca²+) — Normal: 9.0 – 10.5 mg/dL

Hypocalcemia (< 9.0):

• Causes: Thyroidectomy (parathyroid damage), pancreatitis, vitamin D deficiency, renal failure

• Signs: Numbness/tingling, muscle spasms, positive Chvostek's sign (face twitch), positive Trousseau's sign (hand spasm), seizures, prolonged QT

• Nursing: Give IV calcium gluconate, seizure precautions, vitamin D supplement

Hypercalcemia (> 10.5):

• Causes: Hyperparathyroidism, cancer, prolonged immobility, excess vitamin D

• Signs: Muscle weakness, constipation, kidney stones, confusion, shortened QT, cardiac arrest risk

• Nursing: Hydrate aggressively (NS), loop diuretics (furosemide — flushes calcium), weight-bearing exercise, limit calcium/vitamin D intake

Memory trick: Chvostek's = Cheek (tap face), Trousseau's = Tourniquet (BP cuff)

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🔴 MAGNESIUM (Mg²+) — Normal: 1.3 – 2.1 mEq/L

Hypomagnesemia (< 1.3):

• Causes: Alcoholism, malnutrition, diuretics, diarrhea

• Signs: Tremors, hyperactive reflexes, seizures, cardiac dysrhythmias (similar to hypokalemia)

• Nursing: Give magnesium sulfate IV (slowly — watch for decreased reflexes/respiratory depression), increase dietary Mg (nuts, whole grains, green leafy vegetables)

Hypermagnesemia (> 2.1):

• Causes: Renal failure, excess Mg intake (antacids), MgSO4 overdose

• Signs: Decreased deep tendon reflexes (FIRST sign), drowsiness, hypotension, respiratory depression, cardiac arrest

• Nursing: Stop Mg administration, give calcium gluconate (antidote), mechanical ventilation if needed

Memory trick: Always check reflexes before giving MgSO4 — lost reflexes = STOP

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NCLEX Tip: When you see an electrolyte question, go straight to the cardiac effects. The NCLEX loves testing ECG changes and life-threatening complications.

Which electrolyte trips you up the most? Let's review it 👇

Priority and delegation questions make up a HUGE chunk of the NCLEX. Here's your complete framework:

The Priority Framework (Use in This Order):

1. ABCs — Airway, Breathing, Circulation

Always address in this order. A patient with a compromised airway comes before everything else.

• Airway: obstruction, stridor, swelling, unconscious patient

• Breathing: O2 sat dropping, dyspnea, absent breath sounds

• Circulation: hemorrhage, no pulse, shock, severe hypotension

2. Maslow's Hierarchy

After ABCs, prioritize by human needs:

• Physiological (oxygen, fluids, nutrition, elimination, pain)

• Safety (fall risk, infection control, med safety)

• Love/belonging → Esteem → Self-actualization

3. Acute vs. Chronic

New/acute/unstable problems come before chronic/stable ones. A patient with new-onset chest pain is priority over a patient with chronic stable angina.

4. Least Expected / Worst Finding

The patient whose assessment finding is MOST unexpected or dangerous gets seen first.

Delegation Rules — The 5 Rights:

1. Right Task — Can this task be delegated? (Only stable, predictable, routine tasks)

2. Right Circumstance — Is the patient stable enough?

3. Right Person — Does the delegate have the skill/scope?

4. Right Direction — Did you give clear, specific instructions?

5. Right Supervision — Are you following up?

Who Can Do What:

• RN Only: Assessment, teaching, evaluation, care planning, IV push meds, blood transfusions, unstable patients

• LPN/LVN: Stable patients, routine meds (PO, IM, SQ), wound care, trach suctioning, data collection

• UAP/CNA: Vitals (stable patients), ADLs, ambulation, I&O, specimen collection, feeding

NCLEX Trick: If the question asks "which patient should the nurse see FIRST?" — pick the one who could die or deteriorate fastest. If it asks "which patient can be assigned to the LPN?" — pick the most stable, predictable patient.

Which priority/delegation questions trip you up? Post them below and let's work through them together 👇

ABGs show up on the NCLEX and they WILL show up in clinical. Here's the fastest way to interpret them every single time:

Normal Values (memorize these):

• pH: 7.35 – 7.45

• PaCO2: 35 – 45 mmHg

• HCO3: 22 – 26 mEq/L

The 3-Step Tic-Tac-Toe Method:

Step 1: Look at the pH

• Below 7.35 → Acidosis

• Above 7.45 → Alkalosis

Step 2: Check CO2 (respiratory component)

• CO2 above 45 → Respiratory acidosis

• CO2 below 35 → Respiratory alkalosis

Remember: CO2 is an ACID, and it moves OPPOSITE to pH

Step 3: Check HCO3 (metabolic component)

• HCO3 below 22 → Metabolic acidosis

• HCO3 above 26 → Metabolic alkalosis

Remember: HCO3 is a BASE, and it moves WITH the pH

Compensation Check:

• If BOTH CO2 and HCO3 are abnormal → the body is compensating

• If pH is normal with abnormal CO2 and HCO3 → FULLY compensated

• If pH is still abnormal → PARTIALLY compensated

Quick Practice:

pH 7.30, CO2 50, HCO3 24

→ Acidosis (pH low) → CO2 high (respiratory cause) → HCO3 normal (no compensation yet)

→ Uncompensated Respiratory Acidosis ✅

Memory Trick — ROME:

Respiratory = Opposite (pH and CO2 go opposite directions)

Metabolic = Equal (pH and HCO3 go the same direction)

Practice 5 ABG problems a day for one week and this becomes automatic. Trust the process.

Drop your ABG practice answers below and I'll check them 👇

Whether you're studying for the NCLEX or deep in clinical rotations, mnemonics are your best friend. Here are 12 that every nursing student needs saved:

1. MONA — Acute MI treatment

Morphine, Oxygen, Nitroglycerin, Aspirin

2. ABCDE — Assessment priority

Airway, Breathing, Circulation, Disability, Exposure

3. RACE — Fire emergency

Rescue, Alarm, Contain, Extinguish

4. PASS — Fire extinguisher use

Pull, Aim, Squeeze, Sweep

5. ADPIE — Nursing Process

Assessment, Diagnosis, Planning, Implementation, Evaluation

6. OLDCARTS — Pain assessment

Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors, Treatment, Severity

7. SBAR — Communication handoff

Situation, Background, Assessment, Recommendation

8. TICA — Troponin, CK (isoenzyme), Creatine Kinase — Cardiac markers

9. MAD RAT — Left-sided heart failure signs

M: Dyspnea on exertion

A: Anxiety

D: Decreased urine output

R: Rapid heart rate

A: Adventitious breath sounds (crackles)

T: Tachypnea

10. HOB UP — Left-sided heart failure positioning

Head Of Bed UP (high Fowler's)

11. LEAN — Metabolic acidosis causes

Lactic acidosis, Ethanol/Ethylene glycol, Aspirin, Nausea/renal failure (uremia)

12. MUDPILES — Anion gap metabolic acidosis

Methanol, Uremia, DKA, Propylene glycol, Isoniazid/Iron, Lactic acidosis, Ethylene glycol, Salicylates

💾 Save this post. You'll thank yourself on test day.

Drop your favorite mnemonic in the comments — let's build the ultimate list together 👇

Welcome again to everyone! If there are any questions, please feel free to post here. I am an open book and will do the best I can to answer your questions. If I do not have an answer, I will find the best solution that I know and offer resources to assist you in finding the best answer!

I passed the NCLEX and got my RN license — and looking back, the stuff that actually made the difference wasn't in any textbook. Here's what I wish someone told me:

1. Stop memorizing, start reasoning.

The NCLEX doesn't care if you memorized 500 flash cards. It cares if you can think like a nurse. When you study, ask yourself: "What's the PRIORITY here?" That one question will carry you through 90% of the exam.

2. SATA questions aren't the enemy.

Select All That Apply questions freak everyone out. The trick? Treat each option as its own true/false question. Don't think about how many you're selecting — evaluate each choice independently.

3. Delegation = know your scope.

If you see a delegation question, remember: RNs assess, evaluate, and teach. LPNs do stable/predictable tasks. UAPs handle ADLs. If it involves assessment or judgment, it stays with the RN. Every. Single. Time.

4. Pharm doesn't have to be overwhelming.

Learn drug classes, not individual drugs. If you know what ACE inhibitors do as a group, you can answer questions about any "-pril" they throw at you. Same with beta blockers ("-olol"), statins ("-statin"), etc.

5. Your mental game matters more than your study hours.

I've seen students study 12 hours a day and fail, and students who studied 3 focused hours and passed. Sleep. Move your body. Take breaks. A burned-out brain can't think critically.

If you're in the thick of NCLEX prep right now — you got this. It's not about being perfect. It's about being safe.

Drop a 🩺 in the comments if you're currently studying. I see you.

I remember walking onto the floor for my first shift as an RN thinking nursing school prepared me. It didn't.

Here's what actually matters that nobody teaches you:

1. Your first code will terrify you — and that's normal.

Textbook ACLS and real-life ACLS are two different things. The beeping, the chaos, the attending yelling orders. You won't feel ready. But you'll act anyway. That's the job.

2. Time management is THE skill.

You can know every drug mechanism in the world, but if you can't manage 6 patients, 14 meds, 3 new admits, and a discharge by 1900 — you're drowning. Start building systems NOW, not after orientation.

3. The NCLEX is a mindset game, not a knowledge game.

I watched brilliant students fail and average students pass because of one difference: how they handled test anxiety. If you're prepping, practice under pressure. Timed. Uncomfortable. That's where the real prep happens.

4. Your first year will humble you.

You'll cry in the parking lot. You'll question if you chose the right career. You'll feel like an imposter surrounded by nurses who seem to know everything. They felt the same way their first year. I promise.

5. The nurses who thrive are the ones who invest in themselves early.

Not just CEUs — I mean mentorship, career planning, financial literacy. The ones who build a plan beyond "get a job and survive" are the ones who end up in leadership, travel nursing, or building something of their own.

That's exactly why I built The Nurse Blueprint — to give nursing students the roadmap I never had.

If any of this hit home, come check it out. ✌️