ATI MEDICAL
SURGICAL STUDY
GUIDE WITH
IMPORTANTS TERMS
TO REMEMBER AND
FINAL EXAM
QUESTIONS AND
ANSWERS. 100%
USEFUL FOR A PASS
LATEST UPDATE 2022
, During a seizure: Position client on the floor
Seizures and Epilepsy: Seizure
and provide a patent airway, turn client to
precautions
side and loosen restrictive clothing
If WBC drops below 1,000, place the client in a private room and initiate neutropenic precautions.
Cancer treatment options: Protective
- Have client remain in his room unless be needs to leave for a diagnostic procedure, in case of transport
place a mask on him
- Protect from possible sources of infection (plants, change water in equipment daily)
Isolation (999) - Have client, staff and visitors perform frequent hand hygiene, restrict ill visitors
- Avoid invasive procedures (rectal temps, injections)
- Administer (neupogen, neulasta) to stimulate WBC production
Standard Precautions:
1. applies to all patients
2. Hand washing
Infection control: Appropriate room
a. alcohol based preferred unless hands visually soiled
3. Gloves - when touching anything that has the potential to contaminate.
4. Masks, eye protection & face shields when care may cause splashing or spraying of body fluids
assignment Droplet:
1. private room or with someone with same illness
2. masks
Airborne:
1 private room
-Wear an N95 or HEPA respirator
TB: Priority action for a client in the -Place client in negative airflow room and implement airborne
precautions
emergency department (249) -use barrier protection when the risk of hand or clothing
contamination exists
Adults age 50 or older:
-Pneumococcal Vaccine (PPSV)
Immunizations: Recommended - Influenza vaccine
- Herpes Zoster Vaccine
vaccinations for older adult clients (943) -Hepatitis A
- Hepatitis B
- Meningococcal Vaccine
-Long term immobility
- Oral contraceptives
- Pregnancy
Pulmonary Embolism: Risk factors for - Tobacco use
- Hypercoagulabilty
- Obesity
DVT (258)
- Surgery
- Heart failure or chronic A-Fib
- Autoimmune hemolytic anemia (sickle cell)
-Long bone fractures
-Advanced age
Disorders of the male reproductive system: -Urethral trauma
-Urinary retention
Complications of continuous irrigation - Bleeding
following Trans-urethral Resection (743) - Infection
- Observe extremities for injury
Stroke: Caring for a client who has left - Apply an arm sling if client is unable to care for the affected extremity
- Ensure foot rest is on wheel chair and ankle brace is on the affected foot
sided hemiplegia (155) - Instruct client to dress the affected side first
-Assess neurovascular status of the affected body part for every hour for 24 hours and Q4
hours after that
Fractures and immobilization devices: - Maintain body alignment
- avoid lifting or removing weights
Prevent complications (787) -Monitor pain level
- Monitor for signs of infection
- Support nutrition
- Cutaneous (skin) stimulation- TENS, heat, cold, therapeutic touch and
massage
Pain Management: use of non - Distraction (deep breathing, ambulation, visitors, TV and music)
- Relaxation (meditation, yoga and progressive muscle relaxation
pharmacological methods of pain relief -Imagery (focus on pleasant thoughts)
- Elevation of extremities to promote venous return
, -Restrict dietary intake of potassium, phosphate and magnesium
Acute Kidney injury and chronic kidney during oliguric phase
disease: Evaluating teaching about -K and Na is regulated according to stage of kidney injury
- high protein diet to replace the high rate of protein breakdown
nutrition due to the stress from the illness. Possible TPN
Heart failure and pulmonary edema: Maintain fluid and sodium restriction
Dietary teaching about sodium restriction Increase dietary intake of potassium
-Assess for contraindications (active bleeding, peptic ulcer
Pulmonary Embolism: Planning care for a disease, history of stroke, recent trauma)
-Monitor bleeding times (PT, aPTT and INR)
client who is receiving enoxaparin -Monitor for side effects such as thrombocytopenia, anemia and
hemmorhage
-Positive Anti- cyclic citrullinated peptide
-RF Antibody (Diagnostic level for RA is 1:40-1:60) expected reference range 1:20
Rheumatoid Arthritis: Reviewing - Elevated ESR
20-40 mild inflammation
40-70 moderate
Laboratory Values
70-150 severe
- Positive C-reactive protein
- Positive ANA titier
- Elevated WBC's
Medications affecting coagulation:
Avoid NSAIDS while on heparin
Heparin Contraindications
-Ototoxicity: cochlear damage (hearing loss) and vestibular damage (loss of
balance).
Antibiotics affecting protein synthesis:
-Nephrotoxicity (proteinuria, elevated BUN, creatinine levels).
Adverse effects of gentamicin
-Hypersensitivity ( rash, pruritis, parathesia of hands and feet, and urticaria).
Weak, irregular pulse, hypotension, respiratory distress
Electrolyte imbalance: manifestations of Premature ventricular contractions, bradycardia, inverted T waves, ST depression
Decreased GI motility, abdominal distension, constipation, n/v, anorexia, polyuria
hypokalemia Decreased K (<3.5)
ABG: Metabolic alkalosis (pH > 7.45)
Electrolyte imbalance: Priority
Assessing for a patent and open airway
assessment for hypokalemia
Initiate a large bore IV access: 20 gauge needle
Complete transfusion withing 2-4 hours time frame
Blood and blood product transfusions: If reaction occurs:
Administering Fresh Frozen Plasma -Stop transfusion immediately
- Initiate 0.9% NaCl in a separate line
- Save blood bag and blood tubing
-Assessing site every 8 hours. Note redness, swelling, drainage, tenderness
Cardiovascular Diagnostic and and condition of dressing
-Change tube and positive pressure cap per facility protocol
Therapeutic Procedures: Caring for a -Using 10mL or larger syringe to flush the line
-Cleanse with alcohol for 3 seconds before accessing it
client who has a PICC -Use transparent dressing
, Cardiovascular Diagnostic and -Advise client not to immerse arm in water, to
Therapeutic Procedures: Teaching about cover dressing site to avoid water exposure
a PICC -Avoid BP in the arm with PICC
- Apply an initial dressing of gauze and replace with transparent
Cardiovascular Diagnostic and dressing within 24 hours
Therapeutic Procedures: PICC care
- An initial x-ray should be taken to ensure proper placement
-Kale, spinach
Cardiovascular and Hematologic -Brussels sprouts
Disorders: teaching client about food -collard greens, mustard greens
-green tea
interaction with Warfarin -grapefruit juice, alcohol
Nitrogylcerin prevents coronary artery vasospasm and reduces preload and afterload.
Used to treat angina and help with BP.
Angina and MI: Client teaching about - Place nitro under tongue to dissolve
- Take up to two more doses of nitro at 5-min intervals
nitroglycerin - Stop activity and rest
Headache is a common side effect
Orthostatic hypotension
Take with 8oz water in the early morning before
Osteoporosis: Teaching about self
eating
administration of Alendronate Remain upright for 30 minutes after taking medication
- Rotate injection sites
- Inject at a 90 degree angle. Aspiration is not necessary
Diabetes Mellitus Management: teaching - Advise client to eat at regular intervals, avoid alcohol intake and adjust
insulin to exercise and diet to avoid hypoglycemia
about self administration of insulin - When mixing insulin's, draw up the shorter acting insulin into the syringe first
and then the longer acting insulin.
a 22-24 gauge catheter is best to use on older adults
IV therapy: Performing Venipuncture on
Tie the tourniquet sparingly and try to avoid veins in
an older adult client the hand
Ex: nurse is preparing to administer dextrose 5% in water 500 mL
Dosage calculations: Calculating IV IV to infuse over 4 hours. The nurse should set the IV infusion
pump to deliver how many mL/hr>
infusion rate -Volume (mL)/Time (hr) = X
-500 mL/5hr = 125 mL/hr
Know
-Right Patient
-Right drug
IV therapy: Medication administration -Right Dose
-Right Time
-Right Route
Analgesics - opiods (epidural, PCA, IV, Oral) NSAIDS
Continuous peripheral nerve block
Ice or cold therapy to reduce swelling
Arthoplasty: Pain control Head of bed slightly elevated and the affected leg in a neutral position.
place a pillow or abduction device between the legs when turning to the
unaffectedNe side
SURGICAL STUDY
GUIDE WITH
IMPORTANTS TERMS
TO REMEMBER AND
FINAL EXAM
QUESTIONS AND
ANSWERS. 100%
USEFUL FOR A PASS
LATEST UPDATE 2022
, During a seizure: Position client on the floor
Seizures and Epilepsy: Seizure
and provide a patent airway, turn client to
precautions
side and loosen restrictive clothing
If WBC drops below 1,000, place the client in a private room and initiate neutropenic precautions.
Cancer treatment options: Protective
- Have client remain in his room unless be needs to leave for a diagnostic procedure, in case of transport
place a mask on him
- Protect from possible sources of infection (plants, change water in equipment daily)
Isolation (999) - Have client, staff and visitors perform frequent hand hygiene, restrict ill visitors
- Avoid invasive procedures (rectal temps, injections)
- Administer (neupogen, neulasta) to stimulate WBC production
Standard Precautions:
1. applies to all patients
2. Hand washing
Infection control: Appropriate room
a. alcohol based preferred unless hands visually soiled
3. Gloves - when touching anything that has the potential to contaminate.
4. Masks, eye protection & face shields when care may cause splashing or spraying of body fluids
assignment Droplet:
1. private room or with someone with same illness
2. masks
Airborne:
1 private room
-Wear an N95 or HEPA respirator
TB: Priority action for a client in the -Place client in negative airflow room and implement airborne
precautions
emergency department (249) -use barrier protection when the risk of hand or clothing
contamination exists
Adults age 50 or older:
-Pneumococcal Vaccine (PPSV)
Immunizations: Recommended - Influenza vaccine
- Herpes Zoster Vaccine
vaccinations for older adult clients (943) -Hepatitis A
- Hepatitis B
- Meningococcal Vaccine
-Long term immobility
- Oral contraceptives
- Pregnancy
Pulmonary Embolism: Risk factors for - Tobacco use
- Hypercoagulabilty
- Obesity
DVT (258)
- Surgery
- Heart failure or chronic A-Fib
- Autoimmune hemolytic anemia (sickle cell)
-Long bone fractures
-Advanced age
Disorders of the male reproductive system: -Urethral trauma
-Urinary retention
Complications of continuous irrigation - Bleeding
following Trans-urethral Resection (743) - Infection
- Observe extremities for injury
Stroke: Caring for a client who has left - Apply an arm sling if client is unable to care for the affected extremity
- Ensure foot rest is on wheel chair and ankle brace is on the affected foot
sided hemiplegia (155) - Instruct client to dress the affected side first
-Assess neurovascular status of the affected body part for every hour for 24 hours and Q4
hours after that
Fractures and immobilization devices: - Maintain body alignment
- avoid lifting or removing weights
Prevent complications (787) -Monitor pain level
- Monitor for signs of infection
- Support nutrition
- Cutaneous (skin) stimulation- TENS, heat, cold, therapeutic touch and
massage
Pain Management: use of non - Distraction (deep breathing, ambulation, visitors, TV and music)
- Relaxation (meditation, yoga and progressive muscle relaxation
pharmacological methods of pain relief -Imagery (focus on pleasant thoughts)
- Elevation of extremities to promote venous return
, -Restrict dietary intake of potassium, phosphate and magnesium
Acute Kidney injury and chronic kidney during oliguric phase
disease: Evaluating teaching about -K and Na is regulated according to stage of kidney injury
- high protein diet to replace the high rate of protein breakdown
nutrition due to the stress from the illness. Possible TPN
Heart failure and pulmonary edema: Maintain fluid and sodium restriction
Dietary teaching about sodium restriction Increase dietary intake of potassium
-Assess for contraindications (active bleeding, peptic ulcer
Pulmonary Embolism: Planning care for a disease, history of stroke, recent trauma)
-Monitor bleeding times (PT, aPTT and INR)
client who is receiving enoxaparin -Monitor for side effects such as thrombocytopenia, anemia and
hemmorhage
-Positive Anti- cyclic citrullinated peptide
-RF Antibody (Diagnostic level for RA is 1:40-1:60) expected reference range 1:20
Rheumatoid Arthritis: Reviewing - Elevated ESR
20-40 mild inflammation
40-70 moderate
Laboratory Values
70-150 severe
- Positive C-reactive protein
- Positive ANA titier
- Elevated WBC's
Medications affecting coagulation:
Avoid NSAIDS while on heparin
Heparin Contraindications
-Ototoxicity: cochlear damage (hearing loss) and vestibular damage (loss of
balance).
Antibiotics affecting protein synthesis:
-Nephrotoxicity (proteinuria, elevated BUN, creatinine levels).
Adverse effects of gentamicin
-Hypersensitivity ( rash, pruritis, parathesia of hands and feet, and urticaria).
Weak, irregular pulse, hypotension, respiratory distress
Electrolyte imbalance: manifestations of Premature ventricular contractions, bradycardia, inverted T waves, ST depression
Decreased GI motility, abdominal distension, constipation, n/v, anorexia, polyuria
hypokalemia Decreased K (<3.5)
ABG: Metabolic alkalosis (pH > 7.45)
Electrolyte imbalance: Priority
Assessing for a patent and open airway
assessment for hypokalemia
Initiate a large bore IV access: 20 gauge needle
Complete transfusion withing 2-4 hours time frame
Blood and blood product transfusions: If reaction occurs:
Administering Fresh Frozen Plasma -Stop transfusion immediately
- Initiate 0.9% NaCl in a separate line
- Save blood bag and blood tubing
-Assessing site every 8 hours. Note redness, swelling, drainage, tenderness
Cardiovascular Diagnostic and and condition of dressing
-Change tube and positive pressure cap per facility protocol
Therapeutic Procedures: Caring for a -Using 10mL or larger syringe to flush the line
-Cleanse with alcohol for 3 seconds before accessing it
client who has a PICC -Use transparent dressing
, Cardiovascular Diagnostic and -Advise client not to immerse arm in water, to
Therapeutic Procedures: Teaching about cover dressing site to avoid water exposure
a PICC -Avoid BP in the arm with PICC
- Apply an initial dressing of gauze and replace with transparent
Cardiovascular Diagnostic and dressing within 24 hours
Therapeutic Procedures: PICC care
- An initial x-ray should be taken to ensure proper placement
-Kale, spinach
Cardiovascular and Hematologic -Brussels sprouts
Disorders: teaching client about food -collard greens, mustard greens
-green tea
interaction with Warfarin -grapefruit juice, alcohol
Nitrogylcerin prevents coronary artery vasospasm and reduces preload and afterload.
Used to treat angina and help with BP.
Angina and MI: Client teaching about - Place nitro under tongue to dissolve
- Take up to two more doses of nitro at 5-min intervals
nitroglycerin - Stop activity and rest
Headache is a common side effect
Orthostatic hypotension
Take with 8oz water in the early morning before
Osteoporosis: Teaching about self
eating
administration of Alendronate Remain upright for 30 minutes after taking medication
- Rotate injection sites
- Inject at a 90 degree angle. Aspiration is not necessary
Diabetes Mellitus Management: teaching - Advise client to eat at regular intervals, avoid alcohol intake and adjust
insulin to exercise and diet to avoid hypoglycemia
about self administration of insulin - When mixing insulin's, draw up the shorter acting insulin into the syringe first
and then the longer acting insulin.
a 22-24 gauge catheter is best to use on older adults
IV therapy: Performing Venipuncture on
Tie the tourniquet sparingly and try to avoid veins in
an older adult client the hand
Ex: nurse is preparing to administer dextrose 5% in water 500 mL
Dosage calculations: Calculating IV IV to infuse over 4 hours. The nurse should set the IV infusion
pump to deliver how many mL/hr>
infusion rate -Volume (mL)/Time (hr) = X
-500 mL/5hr = 125 mL/hr
Know
-Right Patient
-Right drug
IV therapy: Medication administration -Right Dose
-Right Time
-Right Route
Analgesics - opiods (epidural, PCA, IV, Oral) NSAIDS
Continuous peripheral nerve block
Ice or cold therapy to reduce swelling
Arthoplasty: Pain control Head of bed slightly elevated and the affected leg in a neutral position.
place a pillow or abduction device between the legs when turning to the
unaffectedNe side
