ATI_MedSurg.
ATI MedSurg complete test
hypokalemia ECG reading low potassium = Flat T waves
hypercalcemia deep tendon reflexes too much calcium =
Decreased deep tendon reflexes
hyperkalemia too much potassium = tall peaked T waves
Hypocalcemia low calcium = tetany
addisons disease decreased
aldosterone & renin cushings disease
elevated cortisol hypothyroidism
decreased T3 & T4
Diabetes insipidus decreased urine specific gravity
Syndrome of inapproprate secreation of antidiuretic
hormone increased urine osmolarity
diabetes mellitus elevated HbA1c - glycosyated hemoglobin
cataracts progressive , painless loss of
vission Retina detachment sudden
loss of vision open angle glaucoma
loss of peripheral
Stable angina occurs with exercise, stress but relieved by nitro
variant angina due to coronary artery spasm, during periods of
rest Unstable angina occurs with exercise, stress but increases in
severity over time maclar degeneration central loss of vision
,ATI_MedSurg.
angle closure glaucoma increased IOP
appendicitis assessment pain at mcburneys point - diagonal from
appendices to navel
PUD assessment upper eppigastric pain 1-2 hours after eating.
Cholecystitis assessment pain at murphy sign = upper right under rib .
Pancreatitis assessment turners sign = bruising
decorticate rigidity upper extremities flexed ,
lower rigid decerebrate upper extermeties extended
away from cerebrum
Hep A transmission ingestion of contaminated food / water - MEXICO
Hep B transmission
Sex Nonviral Hep Drug
toxicity CHF S&S sob,
fatigue, DVT, S3
hypovolemic shock position supine with legs elevated
continuous bubbling in chest tube water seal chamber
indicated there is a leak. find leak, tighten the connections or replace
drainage system
Stage 3 HIV symptomes -Disseminated or extrapulomonary
histoplasmosis .
-kaposi sarcoma.
-burkitts lymphoma .
cardiac injury labs Myoglobin - 24hr marker. troponin - 7day window.
PH 7.45 - 7.35
PCO2 35 - 45
HCo3 22 - 28
Pericarditis abnormal finding Report paradoxical pulse
,ATI_MedSurg.
Seizure Seizure are abrupt excessive and uncontrolled electrical
discharge of neurons within the brain that can cause LOC, or changes in
motor / sensory ability and behavior. Dx: EEG for region
Interventions = move client to floor, patent airway, suction, turn to side,
loosen clothing, document, check vitals, neuro check, reorient.
Treatment = AEDs like phenytoin(lessen effects of warfarin & contraceptives)
Problems = status epilepticus lasting 30+ mins. Airway, oxygen, IV, ECG, O2
sat, ABG, give loading dose diazepam & IV phenytoin.
Parkinsons Parkinsons is a progressive desease affecting motor function
due to over stimulation of basal ganglia by acetocoline.
Dx: s&S
Interventions : meds, monitor swallowing and nutrition, mobility,
communication, mental and cog status.
Treatment: Increase dopamine or decrease acetocoline. take several weeks.
Dopamine agonists - monitor orthostatic hypotension, dyskenesias,
hallucinations.
Anticcholinergics - monitor dry mouth, constipation, ur.
Alzheimers nonreversable dementia charactorized by memory loss,
judgment problems, and changes in personality.
Dx: apolipoprotien
Interventions : asses S&S, sleep/bowel/bladder program, family support
group, snacks & fingerfoods, verbal/nonverbal communication options,
memory training, avoid overstim, promote consistancy and reorient, speak
direct in short concise sentences.
Treatment: prevent acetylcholine breakdown (ACH) with donepezil, estrogen,
ginko.
Multpiple sclerosis MS is an autommune disorder charactoerized by
plaque in the white matter of CNS. alyloid plaque damages myelin sheath
and interferes with impuse transmission.
Dx: MRI shows plaque, CSF shows elevated protien & WBC.
Intervnetions: monitor swallowing, vision, activity, skin, speech, coping,
encourage fluid to prevent UTIs, bladder/bowel program, communication
board, eye patch for diplopia, exercise, grouping ADLS.
Treatment: Immunosuppressants &
antispasmodics. prednisone= monitor infection,
DM, hypok, gi bleeding. Dantrolene=
antispasmotic liver and muscle weakness.
anticholinergics = bladder dys.
ICP interventions ICP intervnetions:
elevate head of bed 30 degrees. maintain patent airway. O2 sat 92% and higher.
, ATI_MedSurg.
keep PaCO@ 35-38 mm Hg.maintain cervical spine stability until
cleared by xray. seizure precautions. manitol and monitor osmolality
q6 hrs.
Stroke CVA involve disruption in cerebral blood flow due to ischemia,
hemorrahge or embolism.
Dx: MRI, CT, CAT scans.
Interventions: vitals q1-2hrs report b/p over 180.
monitor temp, maintain co2 92% +, cardiac monitor, LOC, ICP, elevate
head of bed 30 degrees, seizure precautions, assist with ADLS, feeding,
mobility.
TX: low dose aspirin 24-48hrs after stroke, retavase within 4.5 hrs.
Pulmonary Embolism PE occurs when a substance enters venous
circulation and forms a blockage in the lungs.
dx: elevated D-dimer. tachycardia/pnea, hypotension, extra heart sounds mumor.
Interventions: Watch for hemorrhage and hypotension.
oxy, high fowlers 90%, IV, meds, LOC.
Tx: enoxaprin, heparin, warfarin, activase & streptase.
MI & Angina imbalance btween mycardial oxgen supply and demand. MI is
pain lasting over 30mins only relieved by opioids, Angina is pain lasting less
than 15 mins relieved by nitro.
Dx: myoglobin - marker 24hrs , CK 3days , troponin I 7 days , troponin T
14-21days. Interventions:
vitals Q15mins until stable, then
every hour. ECG and continuous
monitoring.
Output > 30ml/hr.
admin oxygen 2-4
L/min. IV site.
Heart Failure Heart Failure is when the heart muscle is unable to
pump effectivlely resulting in inadequate cardiac output , hypertrophy,
and congestion.
MADD DOG.
Dx: hBNP over 100 = heart
failure . Interventions:
daily weight , I&O.
assess sob, dyspnea & admin
oxy. monitor vitals.
high fowlers 90%.
monitor agb,
electrolytes(hypokalemia), o2.
restrict h20 & sodium.
Tx: Diuretics -watch for low potassium.
ATI MedSurg complete test
hypokalemia ECG reading low potassium = Flat T waves
hypercalcemia deep tendon reflexes too much calcium =
Decreased deep tendon reflexes
hyperkalemia too much potassium = tall peaked T waves
Hypocalcemia low calcium = tetany
addisons disease decreased
aldosterone & renin cushings disease
elevated cortisol hypothyroidism
decreased T3 & T4
Diabetes insipidus decreased urine specific gravity
Syndrome of inapproprate secreation of antidiuretic
hormone increased urine osmolarity
diabetes mellitus elevated HbA1c - glycosyated hemoglobin
cataracts progressive , painless loss of
vission Retina detachment sudden
loss of vision open angle glaucoma
loss of peripheral
Stable angina occurs with exercise, stress but relieved by nitro
variant angina due to coronary artery spasm, during periods of
rest Unstable angina occurs with exercise, stress but increases in
severity over time maclar degeneration central loss of vision
,ATI_MedSurg.
angle closure glaucoma increased IOP
appendicitis assessment pain at mcburneys point - diagonal from
appendices to navel
PUD assessment upper eppigastric pain 1-2 hours after eating.
Cholecystitis assessment pain at murphy sign = upper right under rib .
Pancreatitis assessment turners sign = bruising
decorticate rigidity upper extremities flexed ,
lower rigid decerebrate upper extermeties extended
away from cerebrum
Hep A transmission ingestion of contaminated food / water - MEXICO
Hep B transmission
Sex Nonviral Hep Drug
toxicity CHF S&S sob,
fatigue, DVT, S3
hypovolemic shock position supine with legs elevated
continuous bubbling in chest tube water seal chamber
indicated there is a leak. find leak, tighten the connections or replace
drainage system
Stage 3 HIV symptomes -Disseminated or extrapulomonary
histoplasmosis .
-kaposi sarcoma.
-burkitts lymphoma .
cardiac injury labs Myoglobin - 24hr marker. troponin - 7day window.
PH 7.45 - 7.35
PCO2 35 - 45
HCo3 22 - 28
Pericarditis abnormal finding Report paradoxical pulse
,ATI_MedSurg.
Seizure Seizure are abrupt excessive and uncontrolled electrical
discharge of neurons within the brain that can cause LOC, or changes in
motor / sensory ability and behavior. Dx: EEG for region
Interventions = move client to floor, patent airway, suction, turn to side,
loosen clothing, document, check vitals, neuro check, reorient.
Treatment = AEDs like phenytoin(lessen effects of warfarin & contraceptives)
Problems = status epilepticus lasting 30+ mins. Airway, oxygen, IV, ECG, O2
sat, ABG, give loading dose diazepam & IV phenytoin.
Parkinsons Parkinsons is a progressive desease affecting motor function
due to over stimulation of basal ganglia by acetocoline.
Dx: s&S
Interventions : meds, monitor swallowing and nutrition, mobility,
communication, mental and cog status.
Treatment: Increase dopamine or decrease acetocoline. take several weeks.
Dopamine agonists - monitor orthostatic hypotension, dyskenesias,
hallucinations.
Anticcholinergics - monitor dry mouth, constipation, ur.
Alzheimers nonreversable dementia charactorized by memory loss,
judgment problems, and changes in personality.
Dx: apolipoprotien
Interventions : asses S&S, sleep/bowel/bladder program, family support
group, snacks & fingerfoods, verbal/nonverbal communication options,
memory training, avoid overstim, promote consistancy and reorient, speak
direct in short concise sentences.
Treatment: prevent acetylcholine breakdown (ACH) with donepezil, estrogen,
ginko.
Multpiple sclerosis MS is an autommune disorder charactoerized by
plaque in the white matter of CNS. alyloid plaque damages myelin sheath
and interferes with impuse transmission.
Dx: MRI shows plaque, CSF shows elevated protien & WBC.
Intervnetions: monitor swallowing, vision, activity, skin, speech, coping,
encourage fluid to prevent UTIs, bladder/bowel program, communication
board, eye patch for diplopia, exercise, grouping ADLS.
Treatment: Immunosuppressants &
antispasmodics. prednisone= monitor infection,
DM, hypok, gi bleeding. Dantrolene=
antispasmotic liver and muscle weakness.
anticholinergics = bladder dys.
ICP interventions ICP intervnetions:
elevate head of bed 30 degrees. maintain patent airway. O2 sat 92% and higher.
, ATI_MedSurg.
keep PaCO@ 35-38 mm Hg.maintain cervical spine stability until
cleared by xray. seizure precautions. manitol and monitor osmolality
q6 hrs.
Stroke CVA involve disruption in cerebral blood flow due to ischemia,
hemorrahge or embolism.
Dx: MRI, CT, CAT scans.
Interventions: vitals q1-2hrs report b/p over 180.
monitor temp, maintain co2 92% +, cardiac monitor, LOC, ICP, elevate
head of bed 30 degrees, seizure precautions, assist with ADLS, feeding,
mobility.
TX: low dose aspirin 24-48hrs after stroke, retavase within 4.5 hrs.
Pulmonary Embolism PE occurs when a substance enters venous
circulation and forms a blockage in the lungs.
dx: elevated D-dimer. tachycardia/pnea, hypotension, extra heart sounds mumor.
Interventions: Watch for hemorrhage and hypotension.
oxy, high fowlers 90%, IV, meds, LOC.
Tx: enoxaprin, heparin, warfarin, activase & streptase.
MI & Angina imbalance btween mycardial oxgen supply and demand. MI is
pain lasting over 30mins only relieved by opioids, Angina is pain lasting less
than 15 mins relieved by nitro.
Dx: myoglobin - marker 24hrs , CK 3days , troponin I 7 days , troponin T
14-21days. Interventions:
vitals Q15mins until stable, then
every hour. ECG and continuous
monitoring.
Output > 30ml/hr.
admin oxygen 2-4
L/min. IV site.
Heart Failure Heart Failure is when the heart muscle is unable to
pump effectivlely resulting in inadequate cardiac output , hypertrophy,
and congestion.
MADD DOG.
Dx: hBNP over 100 = heart
failure . Interventions:
daily weight , I&O.
assess sob, dyspnea & admin
oxy. monitor vitals.
high fowlers 90%.
monitor agb,
electrolytes(hypokalemia), o2.
restrict h20 & sodium.
Tx: Diuretics -watch for low potassium.
