Medical Surgical Remediation Virtual ATI| Medical Surgical Remediation, complete latest 2020 (A+ guide)

Medical Surgical Remediation Safety and Infection Control (4 items) Accident/Error/Injury Prevention (2 items) Meningitis: Clarify Prescription With Provider (RN QSEN - Safety, Active Learning Template - Basic Concept, RM AMS RN 10.0 Chp 5) • Repeat prescription back to the provider clearly Handling Hazardous and Infectious Materials (1 item) Cancer Treatment Options: Interventions for Internal Radiation Therapy (RN QSEN - Safety , Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 91) • Place the client in a private room. Keep door closed • Place a sign on the door warning of the radiation source • Wear a dosimeter film badge that records personal amount of radiation exposure • Limit visitors to 30-min and 6 feet • No visitors under 18yrs or who are pregnant • Have a lead apron Health Promotion and Maintenance (2 items) Health Promotion/Disease Prevention (1 item) Osteoporosis: Promoting Musculoskeletal Health (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 70) • Ensure the clients diet has calcium and vitamin D together • Limit carbonated beverages, which contain phosphates and can cause calcium loss • Encourage client to expose area of skin to sun 5-30 minutes twice a week. • Encourage female clients to discuss the pros and cons of hormone replacement therapy postmenopausal • Encourage weight-bearing exercises Basic Care and Comfort (6 items) Mobility/Immobility (2 items) Musculoskeletal Trauma: Caring for a Client in Continuous Buck’s Traction (Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 71) • Assess neurovascular status of the affected part every hour for 24hr and every 4hr after that • Maintain body alignment and realign if the client seems uncomfortable or reports pain • Avoid lifting or removing weights Non-Pharmacological Comfort Interventions (1 item) Osteoarthritis and Low-Back Pain: Potential Contraindications to Chondroitin and Glucosamine (RN QSEN - Safety, Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 72) • Question concurrent use of chondroitin with NSAIDs, heparin, and warfarin Nutrition and Oral Hydration (3 items) Peptic Ulcer Disease: Complications of Dumping Syndrome (RN QSEN - Safety, Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 49) • Client can report full sensation, weakness, diaphoresis, palpitations, dizziness, and diarrhea • Late symps: rapid release of glucose, followed by an increase in insulin production resulting in hypoglycemia Pharmacological and Parenteral Therapies (23 items) Adverse Effects/Contraindications/Side Effects/Interactions (6 items) Blood and Blood Product Transfusions: Manifestation of Allergic Transfusion Reaction (RN QSEN – Safety, Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 40) • Itching, urticaria, and flushing • Anaphylactic transfusion resulting in bronchospasm, laryngeal edema, and shock Medications Affecting Coagulation: Medication Interactions With Warfarin (RN QSEN - Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 25) • Increases effects: heparin, aspirin, acetaminophen, glucocorticoids, sulfonamides, and parenteral cephalosporins • Decreases effects: phenobarbital, carbamazepine, phenytoin, oral contraceptives, and vitamin K Skin Disorders: Teaching About Adverse Effects of Topical Glucocorticoid Therapy (RN QSEN - Safety, Active Learning Template - Medication, RM AMS RN 10.0 Chp 74) • Avoid use if infection is present • Discontinue use when rash clears • Avoid direct sunlight and the use of tanning beds Blood and Blood Products (2 items) Blood and Blood Product Transfusions: Monitoring a Client Receiving a Blood Transfusion (RN QSEN - Safety, Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 40) • Explain the procedure • Assess vital signs and temp prior to transfusion • Remain with client in initial 15-30 min of the transfusion • An 18 or 20 gauge • Y-tubing with a filter Medication Administration (6 items) Antibiotics Affecting the Bacterial Cell Wall: Client Education About Cephalosporins (RN QSEN – Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 44) • Avoid if allergic to penicillin • Avoid alcohol • Oral cephalosporin with food Antilipemic Agents: Teaching About Colesevelam (Active Learning Template - Medication, RM Pharm RN 7.0 Chp 24) • Take other meds 4hr before taking bile sequestrants • Advise client to inform HCP of all meds currently taken • Is pregnancy risk Category B • Contraindicated in bowel obstruction or pancreatitis caused by high triglycerides Hypothyroidism: Client Education About Levothyroxine (RN QSEN - Safety, Active Learning Template - Medication, RM AMS RN 10.0 Chp 79) • Avoid fiber laxatives, which interfere with absorption • Increases the effects of warfarin and can increase the need for insulin and digoxin Medications Affecting Coagulation: Client Teaching About Self-Administration of Enoxaparin (RN QSEN - Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 25) • Advise to observe for bleeding, increased HR, decreased BP, bruising • Use a 20 to 22-gauge needle to withdraw med from the vial, then change to a small needle 25 or 26 gauge, ½ to 5/8 inches long. • Deep subq in the abdomen, ensuring a distance of 2 inches from the umbilicus. Do not aspirate Parenteral/Intravenous Therapies (2 items) Chronic Neurologic Disorders: Administering Phenytoin for Seizure Disorder (RN QSEN - Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 13) • Monitor for manifestation of CNS effects, and notify the HCP if they occur • Teratogenic: Cleft palate, heart defects, developmental deficiencies • For absence seizures and simple seizures too Total Parenteral Nutrition (TPN) (3 items) Gastrointestinal Therapeutic Procedures: Assessing for Fat Overload Syndrome (Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 47) • Monitor for new onset of confusion or seizures • Assess for shallow respirations • Monitor for increased muscular weakness Reduction of Risk Potential (21 items) Changes/Abnormalities in Vital Signs (1 item) Esophageal Disorders: Priority Intervention for Esophageal Variceal Bleeding (RN QSEN - Safety, Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 48)