BIOL 334ATI MEDSURG FOCUSED REVIEW.
Hello
CHAPTE Pain 1. relaxation
R4 Management: 2. distraction
Use of 3. cutaneous stimulation (ie acupressure, massage,
Nonpharmacologi thermal therapy, contralat stimulation)
c Methods of Pain 4. guided imagery
Relief (RN QSEN - 5. hypnosis
Patient-centered 6. biofeedback
Care, Active 7. music therapy
Learning 8. exercise
Template - Basic NSAIDS have analgesic, anti-inflammatory,
Concept, RM AMS antiplatelet, & antipyretic effects.
RN 10.0 Chp 4) - Be aware of Hepatotoxic effects of Acetiminophen.
Pt w/ a healthy liver should take no more than
4g/day.
- prevent GI upset in pt by admin the Rx w/ food or
antacids.
- Monitor pt for bleeding w/ long term NSAID use.
- Monitor pt for "Salicylism" (tinnitus, vertigo,
decreased hearing acuity).
CHAPTE Spinal Cord - Application of Immobilization Devices & Traction
R 16 Injury: Care of a -
Client who has a *Pts who have cervical fractures may be placed
Halo Device (RN in a halo fixation
QSEN - Safety , device or cervical tongs. Purpose is to provide
Active Learning traction &/or
Template - immobilize the spinal column.
Therapeutic
Procedure, RM - NURSING ACTIONS -
AMS RN 10.0 Chp *maintain body alignment & ensure cervical tong
16) weights hang freely.
*Monitor skin integrity by providing pin care &
assessing the skin under the halo fixation vest
as appropriate.
- PT EDUCATION -
*if the pt goes home w/ a Halo fixation
device on, provide instruction on pin &
vest care.
*Teach the pt signs of infection & skin breakdown.
,BIOL 334ATI MEDSURG FOCUSED REVIEW.
Surgical Interventions
CHAPTE Tuberculosis: Tuberculosis: Priority Action for a Client
R 23 Priority Action for in the Emergency Department
a Client in the
Emergency •Heated humidified oxygen administration
Department (RN •N95 HEPA filtered mask for staff
QSEN - Safety , /transportation of client surgical mask
Active Learning •Negative pressure room.
Template - The client should be transported using the
System Disorder, shortest and least busy route.
RM AMS RN 10.0
Chp 23) Cough and expectorate sputum into tissues
that are disposed of by the client should be
put into provided plastic bags or no-touch
receptacles.
Clients are no longer considered infectious
after 3 consecutive negative sputum
cultures.
CHAPTE Pulmonary RISK FACTORS
R 24 Embolism: Risk
Factors for Deep- Long-term immobility
Vein Thrombosis Oral contraceptive use and estrogen
(Active Learning therapy Pregnancy
Template - Tobacco use
System Disorder, Hypercoagulability (elevated platelet
RM AMS RN 10.0 count) Obesity
Chp 24) Surgery (especially orthopedic surgery of the lower extremities or
pelvis)
Central venous catheters
Heart failure or chronic atrial fibrillation
Autoimmune hemolytic anemia (sickle cell)
Long bone fractures
Cancer
Trauma
Advanced age
`` Electrocardiograp
hy and
Dysrhythmia
Monitoring:
Analyzing ECG
(Active Learning
Template -
Diagnostic
Procedure, RM
AMS RN 10.0 Chp
, BIOL 334ATI MEDSURG FOCUSED REVIEW.
28)
Hypertension: Beta blockers
CHAPT Evaluating a Metroprolol and atenolol. For patients with
ER 36 Client Who Takes unstable angina or myocardial infarction.
Lisinopril (RN Decreases cardiac output and blocks the
QSEN - Safety , release of renin, subsequently decreasing
Active Learning vasoconstriction in the peripheral vasculature
Template -
Medication, RM Side effects of beta blockers
AMS RN 10.0 Chp Fatigue, weakness, depression, sexual
36) dysfunction. Stopping abruptly can cause rebound
hypertension. Can mask hypoglycemia
Adverse effect of Lisinopril is persistent dry cough.
CHAPTE Blood and Blood For blood transfusion on the elderly, use no larger than
R 40 Product a 19- gauge needle is used
Transfusions: Assess kidney function, fluid status, and circulation
Treatment for prior to blood product administration. Older adult
patient are at an increased risk for fluid overload
Circulatory
Use blood products that are less than 1 week old.
Overload (Active Assess vital signs every 15 min throughout the
Learning transfusion for fluid overload
Template - Administer the blood transfusion over 2 to 4 hr for
Therapeutic older adult clients.
Procedure, RM Without giving other IV fluid to prevent fluid
AMS RN 10.0 Chp overload Risk for HF and fluid overload
40) 1. Stop transfusion immediately if reaction is suspected
2. Start infusion of NS with separate line
3. Save and send bag and lines of blood to testing lab
4. Maintain patent airway,administer oxygen
5. Give antibiotic and administer vasopressors (dopamine)
1. Monitor daily weights, I and O, edema- may be
indication of worsening
condition.
2. Monitor for cardiac output, blood pressure,
and ejection
fraction.
3. Hemodynamic monitoring using arterial line
can tell us more about patient's condition.
4. Harder for heart failure patient to receive
transfusions- worsening condition is manifested
as dyspnea, chest tightness, tachycardia,
tachypnea, headache, hypertension, jugular
vein distention, peripheral edema, orthopnea,
anxiety and crackles in the bases of
the lungs
5. nursing interventions are to give O2, monitor
VS, slow infusion, give diuretics and contact
provider.
Hello
CHAPTE Pain 1. relaxation
R4 Management: 2. distraction
Use of 3. cutaneous stimulation (ie acupressure, massage,
Nonpharmacologi thermal therapy, contralat stimulation)
c Methods of Pain 4. guided imagery
Relief (RN QSEN - 5. hypnosis
Patient-centered 6. biofeedback
Care, Active 7. music therapy
Learning 8. exercise
Template - Basic NSAIDS have analgesic, anti-inflammatory,
Concept, RM AMS antiplatelet, & antipyretic effects.
RN 10.0 Chp 4) - Be aware of Hepatotoxic effects of Acetiminophen.
Pt w/ a healthy liver should take no more than
4g/day.
- prevent GI upset in pt by admin the Rx w/ food or
antacids.
- Monitor pt for bleeding w/ long term NSAID use.
- Monitor pt for "Salicylism" (tinnitus, vertigo,
decreased hearing acuity).
CHAPTE Spinal Cord - Application of Immobilization Devices & Traction
R 16 Injury: Care of a -
Client who has a *Pts who have cervical fractures may be placed
Halo Device (RN in a halo fixation
QSEN - Safety , device or cervical tongs. Purpose is to provide
Active Learning traction &/or
Template - immobilize the spinal column.
Therapeutic
Procedure, RM - NURSING ACTIONS -
AMS RN 10.0 Chp *maintain body alignment & ensure cervical tong
16) weights hang freely.
*Monitor skin integrity by providing pin care &
assessing the skin under the halo fixation vest
as appropriate.
- PT EDUCATION -
*if the pt goes home w/ a Halo fixation
device on, provide instruction on pin &
vest care.
*Teach the pt signs of infection & skin breakdown.
,BIOL 334ATI MEDSURG FOCUSED REVIEW.
Surgical Interventions
CHAPTE Tuberculosis: Tuberculosis: Priority Action for a Client
R 23 Priority Action for in the Emergency Department
a Client in the
Emergency •Heated humidified oxygen administration
Department (RN •N95 HEPA filtered mask for staff
QSEN - Safety , /transportation of client surgical mask
Active Learning •Negative pressure room.
Template - The client should be transported using the
System Disorder, shortest and least busy route.
RM AMS RN 10.0
Chp 23) Cough and expectorate sputum into tissues
that are disposed of by the client should be
put into provided plastic bags or no-touch
receptacles.
Clients are no longer considered infectious
after 3 consecutive negative sputum
cultures.
CHAPTE Pulmonary RISK FACTORS
R 24 Embolism: Risk
Factors for Deep- Long-term immobility
Vein Thrombosis Oral contraceptive use and estrogen
(Active Learning therapy Pregnancy
Template - Tobacco use
System Disorder, Hypercoagulability (elevated platelet
RM AMS RN 10.0 count) Obesity
Chp 24) Surgery (especially orthopedic surgery of the lower extremities or
pelvis)
Central venous catheters
Heart failure or chronic atrial fibrillation
Autoimmune hemolytic anemia (sickle cell)
Long bone fractures
Cancer
Trauma
Advanced age
`` Electrocardiograp
hy and
Dysrhythmia
Monitoring:
Analyzing ECG
(Active Learning
Template -
Diagnostic
Procedure, RM
AMS RN 10.0 Chp
, BIOL 334ATI MEDSURG FOCUSED REVIEW.
28)
Hypertension: Beta blockers
CHAPT Evaluating a Metroprolol and atenolol. For patients with
ER 36 Client Who Takes unstable angina or myocardial infarction.
Lisinopril (RN Decreases cardiac output and blocks the
QSEN - Safety , release of renin, subsequently decreasing
Active Learning vasoconstriction in the peripheral vasculature
Template -
Medication, RM Side effects of beta blockers
AMS RN 10.0 Chp Fatigue, weakness, depression, sexual
36) dysfunction. Stopping abruptly can cause rebound
hypertension. Can mask hypoglycemia
Adverse effect of Lisinopril is persistent dry cough.
CHAPTE Blood and Blood For blood transfusion on the elderly, use no larger than
R 40 Product a 19- gauge needle is used
Transfusions: Assess kidney function, fluid status, and circulation
Treatment for prior to blood product administration. Older adult
patient are at an increased risk for fluid overload
Circulatory
Use blood products that are less than 1 week old.
Overload (Active Assess vital signs every 15 min throughout the
Learning transfusion for fluid overload
Template - Administer the blood transfusion over 2 to 4 hr for
Therapeutic older adult clients.
Procedure, RM Without giving other IV fluid to prevent fluid
AMS RN 10.0 Chp overload Risk for HF and fluid overload
40) 1. Stop transfusion immediately if reaction is suspected
2. Start infusion of NS with separate line
3. Save and send bag and lines of blood to testing lab
4. Maintain patent airway,administer oxygen
5. Give antibiotic and administer vasopressors (dopamine)
1. Monitor daily weights, I and O, edema- may be
indication of worsening
condition.
2. Monitor for cardiac output, blood pressure,
and ejection
fraction.
3. Hemodynamic monitoring using arterial line
can tell us more about patient's condition.
4. Harder for heart failure patient to receive
transfusions- worsening condition is manifested
as dyspnea, chest tightness, tachycardia,
tachypnea, headache, hypertension, jugular
vein distention, peripheral edema, orthopnea,
anxiety and crackles in the bases of
the lungs
5. nursing interventions are to give O2, monitor
VS, slow infusion, give diuretics and contact
provider.
