MED SURG II HESI REVISION HANDBOOK 2026
PATHOPHYSIOLOGY AND PATIENT CARE
PRIORITIZATION
◉ when should a patient stop smoking prior to a scheduled surgery?
why?
Answer: 4-8 wks to reduce pulmonary and wound healing
complications
◉ what are some indications to postpone a schedule surgery?
Answer: -uncontrolled HTN
-pt intoxicated
-current infection
◉ first intention wound healing
Answer: granulation not visible & scar formation minimal; cover w/
dry sterile dressing
◉ second intention wound healing
Answer: granulation occurs in infected wounds or wounds w/ edges
not approximated; pack w/ moist sterile dressing & cover w/ dry
sterile dressing
,◉ third intention wound healing
Answer: deep wounds not sutured early or break down & re-suture
later; pack w/ moist gauze & cover w/ dry sterile dressing
◉ anemia
Answer: a low hemoglobin or RBC count that results in dec
oxygenation carrying capability of the blood
◉ s/s of anemia
Answer: -pallor
-tachycardia
-fatigue
-s/s bleeding - hematuria, melena, menorrhagia
-dyspnea
-spoon nails
◉ what diagnostics indicate anemia?
Answer: Hgb < 10
Hct < 30
RBC < 4 x 10^12
,◉ how does the body compensate for a Hgb that drops below 7?
Answer: increase in cardiac output
◉ food sources w/ iron
Answer: -meats, spinach, carrots
◉ food sources w/ folic acid
Answer: -green leafies, liver, & citrus fruits
◉ food sources w/ vitamin B12
Answer: meats, green leafies, milk, & cheese
◉ administration of iron?
Answer: -give with meals to dec gastric irritation
◉ administration B12 & folic acid?
Answer: -administer orally
◉ when should B12 be given parenterally?
Answer: if the patient has pernicious anemia -- use the Z track
method to avoid skin staining; d/n use the deltoid & d/n massage
the injection site
, ◉ leukemia
Answer: a malignant neoplasm of the blood-forming organs
characterized by an abnormal over-production of immature forms of
any leukocytes & an interference w/ normal blood production
resulting in dec # of erythrocytes & platelets
◉ complications of leukemia
Answer: -anemia: dec RBC & bld loss
-immunosuppression: immature WBCs & neutropenia
-hemorrhage: thrombocytopenia
◉ types of leukemia: acute myelogenous leukemia
Answer: -inability of leukocytes to mature
-poor prognosis
-death by infection
◉ types of leukemia: chronic myelogenous leukemia
Answer: -abnormal production of granulocytic cells
-poor prognosis
◉ types of leukemia: acute lymphocytic leukemia
PATHOPHYSIOLOGY AND PATIENT CARE
PRIORITIZATION
◉ when should a patient stop smoking prior to a scheduled surgery?
why?
Answer: 4-8 wks to reduce pulmonary and wound healing
complications
◉ what are some indications to postpone a schedule surgery?
Answer: -uncontrolled HTN
-pt intoxicated
-current infection
◉ first intention wound healing
Answer: granulation not visible & scar formation minimal; cover w/
dry sterile dressing
◉ second intention wound healing
Answer: granulation occurs in infected wounds or wounds w/ edges
not approximated; pack w/ moist sterile dressing & cover w/ dry
sterile dressing
,◉ third intention wound healing
Answer: deep wounds not sutured early or break down & re-suture
later; pack w/ moist gauze & cover w/ dry sterile dressing
◉ anemia
Answer: a low hemoglobin or RBC count that results in dec
oxygenation carrying capability of the blood
◉ s/s of anemia
Answer: -pallor
-tachycardia
-fatigue
-s/s bleeding - hematuria, melena, menorrhagia
-dyspnea
-spoon nails
◉ what diagnostics indicate anemia?
Answer: Hgb < 10
Hct < 30
RBC < 4 x 10^12
,◉ how does the body compensate for a Hgb that drops below 7?
Answer: increase in cardiac output
◉ food sources w/ iron
Answer: -meats, spinach, carrots
◉ food sources w/ folic acid
Answer: -green leafies, liver, & citrus fruits
◉ food sources w/ vitamin B12
Answer: meats, green leafies, milk, & cheese
◉ administration of iron?
Answer: -give with meals to dec gastric irritation
◉ administration B12 & folic acid?
Answer: -administer orally
◉ when should B12 be given parenterally?
Answer: if the patient has pernicious anemia -- use the Z track
method to avoid skin staining; d/n use the deltoid & d/n massage
the injection site
, ◉ leukemia
Answer: a malignant neoplasm of the blood-forming organs
characterized by an abnormal over-production of immature forms of
any leukocytes & an interference w/ normal blood production
resulting in dec # of erythrocytes & platelets
◉ complications of leukemia
Answer: -anemia: dec RBC & bld loss
-immunosuppression: immature WBCs & neutropenia
-hemorrhage: thrombocytopenia
◉ types of leukemia: acute myelogenous leukemia
Answer: -inability of leukocytes to mature
-poor prognosis
-death by infection
◉ types of leukemia: chronic myelogenous leukemia
Answer: -abnormal production of granulocytic cells
-poor prognosis
◉ types of leukemia: acute lymphocytic leukemia
