🩺 MED-SURG NURSING: THE ULTIMATE PRIORITY STUDY GUIDE
Subject: Medical-Surgical Nursing (Critical Care & Management)
Author: Arctic Blueprints
I. FLUIDS & ELECTROLYTES (The Basics)
Hyponatremia (< 135 mEq/L): Watch for Seizures! (Priority: Seizure precautions).
Hypocalcemia: Positive Chvostek’s sign (facial twitching) and Trousseau’s sign (hand spasm
with BP cuff).
Isotonic Fluids (0.9% NS, LR): Used for dehydration and blood loss.
II. PERIOPERATIVE CARE (Safety First)
Informed Consent: Nurse’s role is only to WITNESS the signature. The doctor must explain the
procedure.
Post-Op Priority: Always check Airway first, then surgical site for bleeding.
III. GASTROINTESTINAL SYSTEM
GERD: Sleep with head elevated, avoid spicy food/caffeine, eat small meals.
Appendicitis: Pain at McBurney’s Point (RLQ). NPO immediately (Never apply heat!).
Cirrhosis: High ammonia levels lead to Asterixis (flapping hand tremors).
IV. RENAL SYSTEM (Kidneys)
Chronic Kidney Disease (CKD): Low protein, low potassium, low sodium diet.
Dialysis: Check for Bruit (sound) and Thrill (vibration) at the AV fistula site.
V. NEUROLOGICAL SYSTEM
Increased ICP (Intracranial Pressure): Cushing’s Triad (Widening pulse pressure, Bradycardia,
irregular breathing).
Seizures: Turn patient to the side, protect head, DO NOT put anything in the mouth.
VI. MUSCULOSKELETAL
Fractures: Watch for Compartment Syndrome (The 6 P’s: Pain, Pallor, Pulselessness,
Paresthesia, Paralysis, Poikilothermia).
Hip Surgery: Use an abduction pillow to prevent dislocation.
VII. PHARMACOLOGY SNIPPETS
Digoxin: Hold if Pulse < 60 bpm. Watch for yellow-green halos (Toxicity).
Warfarin: Monitor INR/PT. Antidote: Vitamin K.
Heparin: Monitor aPTT. Antidote: Protamine Sulfate.
VIII. THE IMMUNE SYSTEM & INFECTION
Anaphylactic Shock: Priority is Epinephrine (IM), then oxygen and IV fluids.
Subject: Medical-Surgical Nursing (Critical Care & Management)
Author: Arctic Blueprints
I. FLUIDS & ELECTROLYTES (The Basics)
Hyponatremia (< 135 mEq/L): Watch for Seizures! (Priority: Seizure precautions).
Hypocalcemia: Positive Chvostek’s sign (facial twitching) and Trousseau’s sign (hand spasm
with BP cuff).
Isotonic Fluids (0.9% NS, LR): Used for dehydration and blood loss.
II. PERIOPERATIVE CARE (Safety First)
Informed Consent: Nurse’s role is only to WITNESS the signature. The doctor must explain the
procedure.
Post-Op Priority: Always check Airway first, then surgical site for bleeding.
III. GASTROINTESTINAL SYSTEM
GERD: Sleep with head elevated, avoid spicy food/caffeine, eat small meals.
Appendicitis: Pain at McBurney’s Point (RLQ). NPO immediately (Never apply heat!).
Cirrhosis: High ammonia levels lead to Asterixis (flapping hand tremors).
IV. RENAL SYSTEM (Kidneys)
Chronic Kidney Disease (CKD): Low protein, low potassium, low sodium diet.
Dialysis: Check for Bruit (sound) and Thrill (vibration) at the AV fistula site.
V. NEUROLOGICAL SYSTEM
Increased ICP (Intracranial Pressure): Cushing’s Triad (Widening pulse pressure, Bradycardia,
irregular breathing).
Seizures: Turn patient to the side, protect head, DO NOT put anything in the mouth.
VI. MUSCULOSKELETAL
Fractures: Watch for Compartment Syndrome (The 6 P’s: Pain, Pallor, Pulselessness,
Paresthesia, Paralysis, Poikilothermia).
Hip Surgery: Use an abduction pillow to prevent dislocation.
VII. PHARMACOLOGY SNIPPETS
Digoxin: Hold if Pulse < 60 bpm. Watch for yellow-green halos (Toxicity).
Warfarin: Monitor INR/PT. Antidote: Vitamin K.
Heparin: Monitor aPTT. Antidote: Protamine Sulfate.
VIII. THE IMMUNE SYSTEM & INFECTION
Anaphylactic Shock: Priority is Epinephrine (IM), then oxygen and IV fluids.
