MED SURG II HESI LEARNING WORKBOOK
2026 SYSTEM BASED DISEASE MANAGEMENT
AND CLINICAL REASONING
◉ what general health condition would be a reason to delay
surgery?
Answer: current upper respiratory infection
◉ what medications can increase surgical risks?
Answer: -anticoagulants
-tranquilizers (hypotension)
-heroin (CNS depression)
-antibiotics
-diuretics
-steroids
-OTC/herbs
-Vitamin E
◉ what post operative plans should a nurse include in her pre-
operative teaching?
Answer: -respiratory care: ventilator? incentive spirometer?
-activity: ROM? early ambulation?
,-pain control: PCA? IM meds?
-dietary restrictions
-ICU or PACU orientation
◉ when is it appropriate for the nurse to mark the operative site on
the patient?
Answer: -right or left distinctions
-multiple structures: fingers/toes
-levels: spinal procedures
◉ what assessments are made immediately of the patient arrival in
the PACU?
Answer: -vitals
-level of consciousness
-skin color & condition
-dressing location & condition
-IV fluids
-drainage tubes
-position
-o2 sat levels
◉ when is a client moved from the PACU to the floor/unit?
,Answer: when the client is stabilized
◉ what should be monitored in the immediate post-operative
period?
Answer: monitor for signs of shock & hemorrhage
-hypotension
-narrow pulse pressure
-rapid weak pulse
-cold moist skin
-increased capillary filling time
◉ what are some post-operative nursing interventions?
Answer: -position client on side to prevent aspiration
-keep warm - heated blanket
-anti-emetics & NG suctioning for N/V
-analgesics for pain
◉ post-op complications: urinary retention
Answer: -occurs 8-12 hrs post op
-monitor hydration status
-encourage oral intake
-offer bedpan or assist to commode
, ◉ post-op complications: pulmonary probs
Answer: -atelectasis, pneumonia, embolus
-occurs 1-2 days post op
-assist pt to TCDB
-keep hydrated
-enable early ambulation
-provide incentive spirometer
◉ post-op complications: wound healing probs
Answer: -occurs 5-6 days post op
-splint incision when coughing
-monitor for s/s of infection, malnutrition, dehydration
-provide high protein diet
◉ wound dehiscence
Answer: the separation of the wound edges that is more likely to
occur with vertical incisions
◉ wound evisceration
Answer: the protrusion of intestinal contents more likely to occur in
older, diabetic, obese, malnourished, or prolonged paralytic ileus pts
2026 SYSTEM BASED DISEASE MANAGEMENT
AND CLINICAL REASONING
◉ what general health condition would be a reason to delay
surgery?
Answer: current upper respiratory infection
◉ what medications can increase surgical risks?
Answer: -anticoagulants
-tranquilizers (hypotension)
-heroin (CNS depression)
-antibiotics
-diuretics
-steroids
-OTC/herbs
-Vitamin E
◉ what post operative plans should a nurse include in her pre-
operative teaching?
Answer: -respiratory care: ventilator? incentive spirometer?
-activity: ROM? early ambulation?
,-pain control: PCA? IM meds?
-dietary restrictions
-ICU or PACU orientation
◉ when is it appropriate for the nurse to mark the operative site on
the patient?
Answer: -right or left distinctions
-multiple structures: fingers/toes
-levels: spinal procedures
◉ what assessments are made immediately of the patient arrival in
the PACU?
Answer: -vitals
-level of consciousness
-skin color & condition
-dressing location & condition
-IV fluids
-drainage tubes
-position
-o2 sat levels
◉ when is a client moved from the PACU to the floor/unit?
,Answer: when the client is stabilized
◉ what should be monitored in the immediate post-operative
period?
Answer: monitor for signs of shock & hemorrhage
-hypotension
-narrow pulse pressure
-rapid weak pulse
-cold moist skin
-increased capillary filling time
◉ what are some post-operative nursing interventions?
Answer: -position client on side to prevent aspiration
-keep warm - heated blanket
-anti-emetics & NG suctioning for N/V
-analgesics for pain
◉ post-op complications: urinary retention
Answer: -occurs 8-12 hrs post op
-monitor hydration status
-encourage oral intake
-offer bedpan or assist to commode
, ◉ post-op complications: pulmonary probs
Answer: -atelectasis, pneumonia, embolus
-occurs 1-2 days post op
-assist pt to TCDB
-keep hydrated
-enable early ambulation
-provide incentive spirometer
◉ post-op complications: wound healing probs
Answer: -occurs 5-6 days post op
-splint incision when coughing
-monitor for s/s of infection, malnutrition, dehydration
-provide high protein diet
◉ wound dehiscence
Answer: the separation of the wound edges that is more likely to
occur with vertical incisions
◉ wound evisceration
Answer: the protrusion of intestinal contents more likely to occur in
older, diabetic, obese, malnourished, or prolonged paralytic ileus pts
