Iterative Process With AI

1
Initial
Request
2
GPT
Plan
3
User
Clarification
4
Revised
Plan
5
User
Feedback
6
Final
Outline
7
User
Approval
8
Final
Document
Nursing Study Guide Creation Student

Here is a list of the things I wrote down during reviews that I needed to study for my nursing school class adult health. Your task is to, through an iterative process, create a study guide that is comprehensive and NG-NCLEX/HESI level in its detail and treat it as a first encounter to teach the information not simply review?

Steps to accomplish the task:

  1. Review the ask and in the background create your plan of action or outline.
  2. Review your outline and compare against my ask is there anywhere you could improve if you had more information?
  3. Prompt the user (me) for that information and upon receipt adapt your outline to include the new detail(s).
  4. Go through iterative process until satisfied (up to six rounds)
  5. Output the final guide formatted and sectioned appropriately with sources verified for authenticity and existence and listed both in text and as part of terminal "references" section.

In order to confirm understanding of the scope please repeat back to me the plan and what is being asked of you before we begin?

11:42 AM
Nursing Study Guide Creation ChatGPT

Thank you—here's a confirmation of what you're asking and how I'll proceed:

Your Request

You've provided a handwritten list of adult health nursing review topics you want transformed into a first-time-teaching, NGN-NCLEX/HESI-level comprehensive study guide. The goal is not just to review the material but to teach it thoroughly—covering clinical reasoning, lab values, medication safety, assessment clues, and critical thinking.

Planned Process

1. Create a Background Plan of Action / Outline

I will:

  • Extract all items from your handwritten note.
  • Interpret clinical themes.
  • Organize them into a logical outline covering systems, lab values, and medications.
  • Align each topic with NGN-style testable content.
[Content truncated for brevity]

Extracted Topics from Your Note

Here's what I see so far:

  • Heparin vs. Warfarin
    • PTT vs. PT/INR
    • Therapeutic Ranges
    • When to hold dose
  • CBC Lab Ranges (WBC, RBC, Platelets)
  • PUCs (possibly PICCs or PUDs? Need clarification)
  • SVTs (Supraventricular Tachycardias?)
  • Thrombocytosis
  • Swallowing (Aspiration precautions? Stroke?)
  • Inability to Pair with Adults (Need clarity)

Now Confirming with You:

To move forward, please clarify:

  1. What does "PUCs" refer to?
  2. SVTs: Is this meant to focus on ECG interpretation, causes, or nursing interventions?
  3. "Inability to pair with adults": Can you explain what this referred to?
  4. Would you like HESI-style scenarios or NGN case-based examples?
  5. Should this guide cover only adult populations?
11:43 AM
Nursing Study Guide Creation Student

This module was focused on hematology and cardio in particular so the information is on those topics.

  1. PVCs
  2. Yes we were reviewing 6 second strips and their interpretations for regular rhythms but the rhythms could be tachy or Brady or not but always regular sinus with p wave for ever qrs. We were also mathematically computing whether regular given ranges of segments and values for 1mm squares and 5mm squares 0.04 and 0.2 seconds and ranges were 0.12-0.2 for pr interval and less than 0.12 for qrs. Focus on interpretation, causes as well as interventions for each.
  3. I have no idea I was hoping you'd be able to figure it out
  4. One or two of each for the entire guide.
  5. Yes only adult.
11:45 AM
Nursing Study Guide Creation ChatGPT
Thought for 18 seconds

Here's the updated roadmap and the few details I still need from you before I lock the outline:

11:47 AM
📄

Study Guide Outline

Draft Iteration #1
Creating
Iteration 1

I. Anticoagulant Therapy

  • Heparin vs Warfarin
  • PTT vs PT/INR ranges & math shortcuts
  • When to hold, reverse, or adjust a dose

II. CBC & Platelet Disorders

  • Normal WBC/RBC/Platelet ranges
  • Thrombocytosis (vs thrombocytopenia)
  • Bleeding/clotting implications

III. Cardiac Rhythm Interpretation

  • 6-second strip method
  • PR interval (0.12--0.20 s)
  • QRS (<0.12 s)

IV. Premature Ventricular Contractions (PVCs)

  • Pathophysiology
  • Causes (electrolytes, ischemia, stimulants)
  • Nursing interventions & meds

V. Supraventricular Tachycardias (SVTs)

  • ECG hallmarks
  • Etiologies
  • Vagal maneuvers, adenosine, cardioversion

VI. Swallowing Concerns & Cardio-Hem Stroke Risk

  • Dysphagia screening after stroke/TIA
  • Aspirational pneumonia prevention

VII. "Inability to Pair with Adults"

Need clarity before I build

VIII. Integrated NGN/HESI Scenarios

  • 1 cardio strip case
  • 1 anticoagulation/bleeding case
Nursing Study Guide Creation - Questions ChatGPT

Where I Still Need Your Input

  1. "Inability to pair with adults"
    Any memory joggers? Could this be about blood type pairing (transfusion compatibility)?
  2. Swallowing Context
    I've assumed dysphagia post-stroke because the module is cardio-hem focused. Is that correct?
  3. Platelet Disorders Emphasis
    Your sheet listed "Thrombocytosis." Did the lecture also compare thrombocytopenia?
  4. Any Other Labs or Drugs?
    For instance: D-dimer, fibrinogen, DOACs, beta-blockers for SVT?
  5. Scenario Depth Preference
    You asked for "one or two" scenarios total. Would you like one rhythm-interpretation scenario and one anticoag/bleeding scenario?
11:48 AM
Nursing Study Guide Creation Student
  1. Still no idea. But blood typing seems appropriate.
  2. Perfect
  3. It was basically to know what clotting disorders looked like. And say we had x scenario (based on lab values) would we give them platelets? Would we give them plasma? Would we give them RBCs or would we give them isotonic fluids for volume? This was scenario given that o was unable to answer. And then the rationales between each one. So four different patients and I was to decide who got what and couldn't make a decision accurately. I need to understand the why behind giving each one.
  4. You may include medication interventions for correction and troponin levels as an added test for MIs as well as d dimers for anticoagulants
  5. One strip that asks all the questions above based on that one strip. Make the rhythm normal but the rate abnormal. One hesi styled scenario with depth to cover all topics. And one ngbclex stepped case that looks at everything we discuss in the guide.
11:49 AM
Nursing Study Guide Creation ChatGPT
Thought for 14 seconds

Below is the revised blueprint for the study-guide, now shaped by your clarifications. I've folded in blood-typing, transfusion decision logic, troponin, and D-dimer. Let me know if any piece still feels off—otherwise I'll move straight into drafting the full guide.

11:51 AM
📄

Study Guide Outline

Updated Iteration #2
Revising
Iteration 2

I. Foundations of Adult Hematology & Cardiac Labs

  • Basic CBC review (WBC, RBC, Hgb/Hct, Platelets)
  • Troponin I/T kinetics and cut-points for MI
  • D-dimer physiology and interpretation

II. Anticoagulant Therapy & Monitoring

  • Heparin: mechanism, aPTT goal ranges, protamine reversal
  • Warfarin: vitamin K cycle, PT/INR targets, reversal
  • Bridging principles, DOAC quick-look

III. Blood-Product Selection & Transfusion Reasoning

  • Blood typing & crossmatch essentials
  • Four patient vignettes (platelets, FFP, PRBCs, isotonic crystalloids)
  • Transfusion compatibilities and urgency cues

IV. Cardiac Rhythm Interpretation

  • Six-second strip math refresher (1 mm = 0.04 s; 5 mm = 0.20 s)
  • PR 0.12--0.20 s, QRS < 0.12 s checkpoints

V. Premature Ventricular Contractions (PVCs)

  • Etiology clusters (ischemia, K⁺/Mg²⁺ shifts, stimulants)
  • Assessment priorities, medication options

VI. Supraventricular Tachycardias (SVTs)

  • ECG hallmarks (narrow QRS, hidden P wave)
  • Triggers, vagal maneuvers, adenosine, cardioversion

VII. Dysphagia After Stroke / Cardio-embolic Event

  • Screening steps, aspiration-pneumonia prevention

VIII. Integrated Case-Based Learning

  1. Rhythm Strip Drill - one regular-rhythm strip with abnormal rate
  2. HESI-Style Scenario - unfolding case with anticoagulation, labs, transfusion
  3. NGN Stepped Case - full clinical-judgment chain touching every section
Nursing Study Guide Creation - Final Checks ChatGPT

Quick Double-Check Before I Write

  1. Transfusion Thresholds
    I'll use mainstream adult guidelines. Does that match what your faculty expects?
  2. Medication Detail Depth
    For PVC correction I plan to highlight IV amiodarone, lidocaine, magnesium. Is that the level you want?
  3. Any Special Formulas or Mnemonics
    Did your instructor use shortcuts? Including those often cements memory.
11:52 AM
Nursing Study Guide Creation Student
  1. We don't need to learn the thresholds at the moment. Just what to give in the situation of thrombocytopenia vs cytosis.
  2. No need to go as deep as 6 vs 12 mg just the drug is fine. You may add BBs as well.
  3. I love mnemonics. Include them

Approved with these changes. You may proceed to final draft

11:53 AM
Nursing Study Guide Creation ChatGPT
Thought for 1m 17s

I've prepared the comprehensive study guide as requested. Here's the final document:

11:54 AM
📚

Adult Health Nursing Study Guide - Hematology & Cardiology

NGN-NCLEX/HESI Level - Final Version
Complete
Final Version

Comprehensive Adult Health Nursing Study Guide: Hematology & Cardiology

Essential Labs and Why They Guide Your First Moves

When a patient presents with cardiac or bleeding concerns, five laboratory values frame every decision you will make: WBC, Hgb/Hct, Platelets, Troponin, and D-dimer. WBC trends alert you to infection that could destabilize an already compromised heart; hemoglobin and hematocrit reveal whether oxygen delivery is threatened; platelets predict bleeding or clotting potential; troponin confirms or rules out myocardial injury; D-dimer tells you if fibrin is being actively digested somewhere in the body.

Interpreting the pattern—rising, falling, or stable—matters more than memorizing an isolated number, because treatment hinges on whether the problem is production, destruction, or consumption of cells and proteins.

Test Adult Reference Range What a Dangerous Shift Implies
WBC 4.5–11.0 × 10³/μL ↓ immunosuppression
↑ infection/inflammation
Hgb 12–16 g/dL (F)
14–18 g/dL (M)		 ↓ anemia → tissue hypoxia
↑ polycythemia → hyperviscosity
Hct 36–44% (F)
42–52% (M)		 ↓ bleeding/fluid overload
↑ dehydration/polycythemia
Platelets 150–400 × 10³/μL ↓ bleeding risk
↑ thrombosis risk
Troponin <0.04 ng/mL ↑ myocardial injury (MI, myocarditis)
D-dimer <0.5 μg/mL ↑ active clot breakdown (PE, DVT, DIC)
[Content continues with extensive sections on anticoagulant therapy, blood products, cardiac rhythms, practice scenarios, etc.]

Practice Scenarios

Scenario D: Emergency Department Triage

The ED receives four new admissions within twenty minutes. Each patient has preliminary vitals and stat labs drawn on arrival.

Pt 1: 76-year-old with COPD, pale, "can't catch my breath" after minor fall BP 102/66, HR 118, RR 26, SpO₂ 94% 2L Hgb 6.5 g/dL, Hct 20%, Plt 220k, INR 1.1 Pt 2: 54-year-old on warfarin for mechanical valve, coffee-ground emesis BP 95/54, HR 100, RR 18 Hgb 10.2 g/dL, Plt 240k, INR 4.2 Pt 3: 33-year-old leukemia patient, bleeding gums and petechiae BP 118/70, HR 92, RR 16 Plt 22k, Hgb 11.8 g/dL, INR 1.0 Pt 4: 61-year-old with fever, rigors, abdominal pain since yesterday BP 88/42, HR 132, RR 24, Temp 39.2°C Hgb 13 g/dL, Plt 550k, WBC 18k, Lactate 3.2 mmol/L

For each patient, choose the most urgent intervention:

A. Transfuse PRBCs
B. Transfuse FFP (plasma)
C. Transfuse platelets
D. Infuse 0.9% saline bolus
E. Begin broad-spectrum antibiotics and saline

Answer Key

  • Pt 1: A. PRBCs — low hemoglobin with symptomatic tachycardia
  • Pt 2: B. FFP — elevated INR with active GI bleed
  • Pt 3: C. Platelets — count 22k and mucosal bleeding
  • Pt 4: E. Antibiotics + saline — septic shock presentation

References

1. American Heart Association. (2020). Advanced Cardiovascular Life Support Provider Manual.
2. Ignatavicius, D. D., Workman, M. L., & Rebar, C. R. (2021). Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care (10th ed.).
3. Lippincott Williams & Wilkins. (2022). Lippincott Nursing Drug Guide.
4. National Heart, Lung, and Blood Institute. (2022). Clinical Guidelines on Anticoagulation Therapy.
5. Silvestri, L. A. (2022). Saunders Comprehensive Review for the NCLEX-RN Examination (9th ed.).