Med Surg Final
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| This was discussed in both IV and Med Surg: What does the nurse do if patient is showing signs of hypersesitivity to I.V. Administration? | show 🗑
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| ABC's | show 🗑
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| show | Physical, Safety, Psychological...
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| show | Acute beats chronic
Fresh post-op beats other surgical client
unstable beats stable
The more vital the organ - the higher the priority (brain, lungs, heart, liver, pancreas, kidney)
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| show | Notify the RN or physician, then do assessment
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| show | Assess, diagnose, plan, implement, evaluate
In a question, remember to assess before you implement.
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| show | Removal or amputation
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| show | Preoperatively
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| show | Inspire and hold for 5 seconds
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| show | Every 15 minutes or less until stable, then every 1 hour for 4 hours, then every 4 hours for 2 days (or as often as needed)
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| What is contraindicated in surgeries involving intracranial, eye, ear, nose, throat, or spine? | show 🗑
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| What is the purpose for incentive spirometry? | show 🗑
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| show | Q2H (turn is side-back-side/repositioning)
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| show | Leg exercises, antiembolism stockings (TED HOSE), sequential compression devices.(Q2H)
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| From the cardiac quiz: What do you instruct your patient NOT to do with something or other? | show 🗑
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| What safety precautions do you need to take with a patient about to receive a pain med? | show 🗑
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| When your patient is transferred from post op to their room on your floor should you be there? | show 🗑
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| show | HOB up 45 degrees or position on side (to prevent aspiration)
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| show | increased HR, increased respirs, decreased BP, thready pulse, cool clammy skin, restlessness (#1 reason for hypovolemic shock is blood loss)
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| show | After the first 24 hours. During the first 24H reinforce, circle the drainage and date and time. (should be assessed every 2-4 hours)(more than 300 ml of drainage in first 24H is ABNORMAL) Normal for slight increase in drainage when patient ambulates
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| What is your first action with evisceration? | show 🗑
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| show | Q2H (turn them from side to back and then to side to prevent pneumonia)
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| What are the S & S of pulmonary embolism? | show 🗑
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| show | HOB up 45 degrees, oxygen, notify doctor PE-POD (position, oxygen, doctor)
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| What non-mendical interventions can you do to comfort post op patient? | show 🗑
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| show | 30 ml (50ml is average) (post-op report no urine output after 8 hours)
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| show | Singultus (hiccups) this could be a reaction to anesthesia
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| show | 2000-2400 ml
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| How is infection process evidenced? This was on IV too. | show 🗑
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| show | Using sterile technique, clean middle, farthest, closest (cleanse in the direction of least contaminated to most contaminated)
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| show | to mechanically debride the wound
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| Phases of wound healing: | show 🗑
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| What pre-procedure and post procedure do you need to do with patient scheduled for lumbar puncture? | show 🗑
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| show | Do you have any allergies to iodine or shellfish? NPO after midnight (probably force fluids 3 liters but slides didn't say)
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| What do you assess prior to MRI? | show 🗑
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| show | PRE-Hold antidepressants and anticonvulsants for 24-48 hours
POST- Wash the stinky sticky glue out of the hair.
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| What is the early phase of migraine headache? | show 🗑
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| What are the S & S of increased intracranial pressure (IICP)? (normal pressure 0-15) | show 🗑
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| What's in cerebrospinal fluid? | show 🗑
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| what is status epilepticus? | show 🗑
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| tonic phase | show 🗑
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| show | jerky twitching
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| show | protect the head, maintain airway (turn them on their side), doc time length and type of movement. After seizure you may need to suction r/t increased secretions
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| M.S. | show 🗑
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| show | dopamine deficiency. 1st symptom painful muscle cramps. shuffling, propulsive gait, risk for falls, movement decreases tremors, inactivity worsens tremors
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| Myasthenia gravis | show 🗑
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| Amyotrophic lateral sclerosis (ALS) (Michael Keaton "My Life") | show 🗑
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| show | overactivity of dopamine pathways. Genetic, abnormal excessive involutary movements(chorea). No cure. Patient safety!Promote self care.
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| Trigeminal Neuralgia (5th cranial nerve) | show 🗑
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| Bell's Palsey (7th cranial nerve) | show 🗑
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| show | auto-immune response to viral infection (viral infection 10-14 days before onset). This one starts at lower extremities and goes up the body. Patient may need vent before symptoms begin to improve. may need skin care, ROM exercises.
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| Tourette's Syndrome | show 🗑
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| Encephalitis | show 🗑
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| Meningitis | show 🗑
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| show | mild brain injury. Nausea, vomiting. post concussive syndrome can occcur 1 week to 1 year after injury
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| show | bruising of the surface of the brain r/t accelleration and deceleration injuries
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| show | 1-15. 8 indicates coma.
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| show | subdural - under the dura/covering - has highest mortality rate r/t not catching it in time.
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| Autonomic Dysreflexia | show 🗑
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| show | chronic disease of inner ear. vertigo, N/V, 8th cranial nerve, bedrest, restrict fluids, low salt diet
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| shilling test | show 🗑
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| show | 12-18 (dozen to a dozen and a half)
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| show | fatigue, SOB. (Check hemoglobin in COPD, emphysema pt's) Give O2, fluids, monitor VS
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| show | bone marrow not making enough RBC's. congenital or r/t chemo, radiation
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| show | bone marrow stops making everything. Infections common. May require splenectomy to stop destruction of RBC's. Don't bring patients fruit or flowers r/t bacteria
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| Sickle Cell Anemia | show 🗑
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| show | too many RBC's. Blood becomes thick, static, clots, increases heart workload. S & S HTN, chest pain, CHF, risk for DVT, MI, CVA
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| show | WBC's less than 200. No fruit or flowers! Handwashing, Asepsis
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| 4 types Leukemia | show 🗑
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| Thrombocytopenia | show 🗑
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| show | Men only, missing clotting factor 8, hereditary. Protect from internal (food) and external trauma. No asprin
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| Hemophelia B | show 🗑
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| show | swiss cheese bones. Ca+ comes out of bones into bloodstream. Bone pain, fracture, hypercalcemia. #1 safety-prevent falls.
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| Lymphangitis | show 🗑
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| Lymphedema | show 🗑
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| Malignant Lymphoma - NON-Hodgkin's Lymphoma | show 🗑
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| Hodgkin's Disease | show 🗑
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| show | 1. allow patient to rest. encourage quiet activity. 2. Handwashing and protect from infection 3. No one with S & S of infection can visit.
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| Leukocytosis & Leucopenia | show 🗑
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| show | active - body's own immune response
passive - breastmilk
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| show | active - immunizations
passive - immunoblobulins
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| show | weakened like virus e.g. flumist
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| show | abnormal or excessive response to stimulus e.g. pollens, danders, foods
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| 4 classes of hypersensitivities | show 🗑
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| show | life threatening reaction e.g. venoms, penicillin, iodine, stings, food
(stridor, swelling, hives, wheezing)
Tx: benadryl, epi, O2, medical alert ID
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| Blood hypersensitivity | show 🗑
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| show | Immunosupressive drugs given so protect patient from infection!
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| show | assess for skin lesions, avoid sun
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| show | abnormal growth of connective tissue, skin hardens causing contractures, organd will harden as well. Pain management
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| Normal immune response | show 🗑
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| HIV Immune dysfunction CD4 counts | show 🗑
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| show | 95% test positive in 3 months
99% test positive in 6 months
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| HIV early S & S | show 🗑
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| show | 2 ELISA then Western Blot
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| show | wear gown, mask, gloves, fever, night sweats, productive cough, SOB. TX: ATB's
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| Second most common AIDS disease: Carposi's Sarcoma | show 🗑
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| HIV Tx: | show 🗑
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| Carcinoma | show 🗑
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| sarcoma | show 🗑
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| Cancer staging | show 🗑
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| show | colorectal cancer
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