MED SURG 2 HESI TOPICS
• Critical Care/ Basic Nursing Skills/ Safety/ ICU Confusion 480, 618
• People on ventilation are more prone to ICU confusion b/c of
sleep deprivation, secluded rooms.
• Drug calc mL/hr to mcg/min Nitroglycerin
• Cardiovascular/ sinus bradycardia/ recognize
• Rate are less than 60
• P and QRS width are within normal limits
• Low heart rate is normal for some people but with people
with decreased cardiac output, treatment is needed.
• Assess patient for syncope, dizziness, confusion,
hypotension, diaphoresis, SOB, chest pain
• TX: Find out the cause of the bradycardia (maybe their meds), Admin
O2 if needed, admin atropine sulfate to increase heart rate, monitor
for hypotension and admin fluids IV.
• The client might need a pacemaker
• Cardiovascular/ V-fib/ Interpret
• Ventricles fire in a totally disorganized manner.
• Client lacks a pulse, BP, respirations, and heart sounds
• Cardiac emergency
• Irregular undulations of varying amplitudes
• No cardiac output
• TX: CPR, defib, anti-dysrhythmic drugs
• Neuro and Resp/ Subdural Hematoma/ ET Suction
• No more than 3 times; 10- 15 Seconds; May need hyperventilation
for up to 3 minutes before suction to prevent hypoxia.
, • In patients with severe head trauma, ET suctioning may cause
adverse reactions including cough, systemic HTN, increased ICP and
reduced cerebral perfusion pressure (Found on the internet)
• ET Suction is used to clear airway of secretions when the cough
reflex is suppressed by the ET tube.
• Resp/ Chest tube/ deep breathing
• You want to encourage coughing and deep breathing
• Assist pt. to deep breathe, cough, perform maximal
sustained inhalations and use incentive spirometry.
• Asses breathing effectiveness by pulse ox
• Professional issues/ Document/ Leadership/ STEMI Post
thrombolysis/ Lidocaine
• Before administering lidocaine, always check the vial label to
prevent administering a form that contains epinephrine or
preservatives because these solutions are used for local anesthesia
only.
• May need double verification
• Monitor ECG strip, VS
• Drug Calc/ units/kg/ heparin bolus
• Basic Nursing Skills/ HIV/ Candidiasis
• Standard precautions include washing hands even if gloves have
been worn to give care.
• Wear exam gloves for touching blood or body fluids or any non-
intact body surface
• Mouth care can improve appetite; rinse pt. mouth with sodium bicarb
w/ sterile H2O or NS several times a day. Use soft toothbrush and
drink plenty of fluids. Avoid using alcohol-based mouthwashes.
• Critical Care/ Basic Nursing Skills/ Safety/ ICU Confusion 480, 618
• People on ventilation are more prone to ICU confusion b/c of
sleep deprivation, secluded rooms.
• Drug calc mL/hr to mcg/min Nitroglycerin
• Cardiovascular/ sinus bradycardia/ recognize
• Rate are less than 60
• P and QRS width are within normal limits
• Low heart rate is normal for some people but with people
with decreased cardiac output, treatment is needed.
• Assess patient for syncope, dizziness, confusion,
hypotension, diaphoresis, SOB, chest pain
• TX: Find out the cause of the bradycardia (maybe their meds), Admin
O2 if needed, admin atropine sulfate to increase heart rate, monitor
for hypotension and admin fluids IV.
• The client might need a pacemaker
• Cardiovascular/ V-fib/ Interpret
• Ventricles fire in a totally disorganized manner.
• Client lacks a pulse, BP, respirations, and heart sounds
• Cardiac emergency
• Irregular undulations of varying amplitudes
• No cardiac output
• TX: CPR, defib, anti-dysrhythmic drugs
• Neuro and Resp/ Subdural Hematoma/ ET Suction
• No more than 3 times; 10- 15 Seconds; May need hyperventilation
for up to 3 minutes before suction to prevent hypoxia.
, • In patients with severe head trauma, ET suctioning may cause
adverse reactions including cough, systemic HTN, increased ICP and
reduced cerebral perfusion pressure (Found on the internet)
• ET Suction is used to clear airway of secretions when the cough
reflex is suppressed by the ET tube.
• Resp/ Chest tube/ deep breathing
• You want to encourage coughing and deep breathing
• Assist pt. to deep breathe, cough, perform maximal
sustained inhalations and use incentive spirometry.
• Asses breathing effectiveness by pulse ox
• Professional issues/ Document/ Leadership/ STEMI Post
thrombolysis/ Lidocaine
• Before administering lidocaine, always check the vial label to
prevent administering a form that contains epinephrine or
preservatives because these solutions are used for local anesthesia
only.
• May need double verification
• Monitor ECG strip, VS
• Drug Calc/ units/kg/ heparin bolus
• Basic Nursing Skills/ HIV/ Candidiasis
• Standard precautions include washing hands even if gloves have
been worn to give care.
• Wear exam gloves for touching blood or body fluids or any non-
intact body surface
• Mouth care can improve appetite; rinse pt. mouth with sodium bicarb
w/ sterile H2O or NS several times a day. Use soft toothbrush and
drink plenty of fluids. Avoid using alcohol-based mouthwashes.
