HESI HINTS MEDSURG
HIV HESI HITS
HESI Hint • HIV clients with tuberculosis require respiratory isolation. Tuberculosis is the
only real risk to nonpregnant caregivers that is not related to a break in standard
precautions (e.g., needle sticks).
HESI Hint • An individual exposed to HIV may remain asymptomatic for many years
dependent on various factors and if he or she is actively under a medical regimen of
antiretroviral therapy (ART). The stages of HIV infection are presented in Figure 3-9.
Clients usually are not admitted to the hospital for treatment until their HIV status has
progressed to an “AIDS” diagnosis.
HESI Hint • Standard Precautions
• Wash hands, even if gloves have been worn to give care.
• Wear examination gloves for touching blood or body fluids or any nonintact body
surface.
• Wear gowns during any procedure that might generate splashes (e.g., changing
clients with diarrhea).
• Use masks and eye protection during activity that might disperse droplets (e.g.,
suctioning).
• Do not recap needles; dispose of in punctureresistant containers.
• Use mouthpiece for resuscitation efforts.
HESI Hint • It is recommended that caregivers who are pregnant not provide care for a
client with cytomegalovirus (CMV) because fetal exposure to CMV can be detrimental to
a developing fetus.
HESI Hint • Pediatric HIV is often evidenced by lymphoid interstitial pneumonitis,
pulmonary lymphoid hyperplasia, and opportunistic infections.
HESI Hint • The focus of NCLEX-RN questions is likely to be assessment of early signs
of the disease and management of complications associated with HIV.
HESI Hint • For narcotic-induced respiratory depression, naloxone may be administered
as prescribed by the health care provider.
HESI Hint • Use noninvasive methods for pain management when possible:
Relaxation exercises Distraction Imagery Biofeedback Interpersonal skills Physical care:
altering positions, touch, hot and cold applications
HESI Hint • Narcotic analgesics are preferred for pain relief because they bind to the
various opiate receptor sites in the CNS. Morphine is often thepreferred narcotic
(remember, it causes respiratory depression).
,Another agonist is methadone. Narcotic antagonists block the attachment of narcotics
such as naloxone to the receptors. Once naloxone has been given, additional narcotics
cannot be given until the naloxone effects have passed.
MEDICAL SURGICAL HESI HINTS
HESI Hint • Safety is a priority with all clients. Ascertain the use of complementary
therapies by addressing contraindications and side effects. Safety includes safe
handoff, interprofessional communication, fall prevention, assessing, and reporting
changes in condition, as well as responses to treatments and medications.
HESI Hint • Therapeutic communication is necessary to elicit important information from
clients and their families in all nursing interventions and settings. It is important in crisis
intervention to ascertain cultural awareness/cultural influences on health; to note and
address religious and spiritual influences on health; to assess family dynamics; and to
detect sensory alterations, such as hearing loss or speech deficits.
HESI Hint • Nonverbal communication may be more important than verbal
communication. Body language, use of personal space, and verbal/oral messages
should be congruent. Tone of voice and facial expression are part of body language. An
example of positive body language is leaning in toward a client while talking.
Recognition of cultural differences regarding personal space is an important component
of communication. Most Americans maintain half a meter (1.7 or 1½ feet) distance
between people when talking. Body language and verbal/oral communication should be
congruent; state messages in a positive manner even when providing negative
feedback.
HESI Hint • Clear verbal communication and accurate written records are critical during
care transitions. Care transitions include such times as changes of shift, when the client
moves from unit to unit, or when the client moves to a new care setting.
HESI Hint • The SBAR format is used in many institutions during communication
processes with other nurses, physicians, physician assistants, physical therapists,
social workers, pharmacists, laboratory technicians, etc. SBAR stands for Situation,
Background, Assessment, and Recommendations.
HESI Hint • Therapeutic communication is necessary in eliciting important information
from clients and their families in all nursing interventions and settings, including crisis
intervention, cultural awareness/cultural influences on health, religious and spiritual
influences on health, family dynamics, and sensory alterations.
HESI Hint • Changing unhealthy behaviors can modify or even prevent some chronic
illnesses. Nurses play a major role in helping clients manage their chronic illnesses and
disabilities through behavioral changes. Health teaching and counseling often are the
role of the nurse in helping the client focus on improving health habits.
Areas of behavioral change include:
1. Physical activity
, 2. Nutrition
3. Stress
4. Use of tobacco or marijuana
5. Use of alcohol
6. Spiritual perspective
7. Coping skills
8. Support systems
HESI Hint • To develop a collaborative learning environment between the nurse and the
client, nurses must be acutely aware of their own beliefs and values about the teaching–
learning process, including client empowerment.
HESI Hint • Obtain a cultural and spiritual assessment and include cultural and spiritual
preferences in the plan of care when appropriate and feasible. Nurses are expected to
provide care for all clients. It is important to note that clients are culturally diverse,
regardless of their ethnicity, race, or socioeconomic status and to note that in every
culture subgroups may form. However, culturally diverse clients may be distinguished
from mainstream culture by ethnicity, social class, and/or language. Since the 2000
census there has been a notable change in the cultural, ethnic, and racial alignment of
the United States.
Culture influences how clients seek medical attention or treat themselves.
HESI Hint • Reasons why clients use herbal medications:
• Cultural influence
• Perception that supplements are safer and “healthier” than conventional drugs
• Sense of control over one’s care
• Emotional comfort from taking action
• Limited access to professional care
• Lack of health insurance
• Convenience
• Media hype and aggressive marketing
• Recommendation from family and friends
PMEUMONIA
HESI Hint • Pneumonia affects people of all ages, especially those 65 or older or infants
under age 2 (because their immune systems are still developing).
HESI Hint • Increased temperature also increases metabolism and the demand for O 2 .
Fever can also cause dehydration because of excessive fluid loss due to diaphoresis.
HESI Hint • Clients at High Risk for Pneumonia
• Altered level of consciousness
Brain injury
• Depressed or absent gag and cough reflexes
HIV HESI HITS
HESI Hint • HIV clients with tuberculosis require respiratory isolation. Tuberculosis is the
only real risk to nonpregnant caregivers that is not related to a break in standard
precautions (e.g., needle sticks).
HESI Hint • An individual exposed to HIV may remain asymptomatic for many years
dependent on various factors and if he or she is actively under a medical regimen of
antiretroviral therapy (ART). The stages of HIV infection are presented in Figure 3-9.
Clients usually are not admitted to the hospital for treatment until their HIV status has
progressed to an “AIDS” diagnosis.
HESI Hint • Standard Precautions
• Wash hands, even if gloves have been worn to give care.
• Wear examination gloves for touching blood or body fluids or any nonintact body
surface.
• Wear gowns during any procedure that might generate splashes (e.g., changing
clients with diarrhea).
• Use masks and eye protection during activity that might disperse droplets (e.g.,
suctioning).
• Do not recap needles; dispose of in punctureresistant containers.
• Use mouthpiece for resuscitation efforts.
HESI Hint • It is recommended that caregivers who are pregnant not provide care for a
client with cytomegalovirus (CMV) because fetal exposure to CMV can be detrimental to
a developing fetus.
HESI Hint • Pediatric HIV is often evidenced by lymphoid interstitial pneumonitis,
pulmonary lymphoid hyperplasia, and opportunistic infections.
HESI Hint • The focus of NCLEX-RN questions is likely to be assessment of early signs
of the disease and management of complications associated with HIV.
HESI Hint • For narcotic-induced respiratory depression, naloxone may be administered
as prescribed by the health care provider.
HESI Hint • Use noninvasive methods for pain management when possible:
Relaxation exercises Distraction Imagery Biofeedback Interpersonal skills Physical care:
altering positions, touch, hot and cold applications
HESI Hint • Narcotic analgesics are preferred for pain relief because they bind to the
various opiate receptor sites in the CNS. Morphine is often thepreferred narcotic
(remember, it causes respiratory depression).
,Another agonist is methadone. Narcotic antagonists block the attachment of narcotics
such as naloxone to the receptors. Once naloxone has been given, additional narcotics
cannot be given until the naloxone effects have passed.
MEDICAL SURGICAL HESI HINTS
HESI Hint • Safety is a priority with all clients. Ascertain the use of complementary
therapies by addressing contraindications and side effects. Safety includes safe
handoff, interprofessional communication, fall prevention, assessing, and reporting
changes in condition, as well as responses to treatments and medications.
HESI Hint • Therapeutic communication is necessary to elicit important information from
clients and their families in all nursing interventions and settings. It is important in crisis
intervention to ascertain cultural awareness/cultural influences on health; to note and
address religious and spiritual influences on health; to assess family dynamics; and to
detect sensory alterations, such as hearing loss or speech deficits.
HESI Hint • Nonverbal communication may be more important than verbal
communication. Body language, use of personal space, and verbal/oral messages
should be congruent. Tone of voice and facial expression are part of body language. An
example of positive body language is leaning in toward a client while talking.
Recognition of cultural differences regarding personal space is an important component
of communication. Most Americans maintain half a meter (1.7 or 1½ feet) distance
between people when talking. Body language and verbal/oral communication should be
congruent; state messages in a positive manner even when providing negative
feedback.
HESI Hint • Clear verbal communication and accurate written records are critical during
care transitions. Care transitions include such times as changes of shift, when the client
moves from unit to unit, or when the client moves to a new care setting.
HESI Hint • The SBAR format is used in many institutions during communication
processes with other nurses, physicians, physician assistants, physical therapists,
social workers, pharmacists, laboratory technicians, etc. SBAR stands for Situation,
Background, Assessment, and Recommendations.
HESI Hint • Therapeutic communication is necessary in eliciting important information
from clients and their families in all nursing interventions and settings, including crisis
intervention, cultural awareness/cultural influences on health, religious and spiritual
influences on health, family dynamics, and sensory alterations.
HESI Hint • Changing unhealthy behaviors can modify or even prevent some chronic
illnesses. Nurses play a major role in helping clients manage their chronic illnesses and
disabilities through behavioral changes. Health teaching and counseling often are the
role of the nurse in helping the client focus on improving health habits.
Areas of behavioral change include:
1. Physical activity
, 2. Nutrition
3. Stress
4. Use of tobacco or marijuana
5. Use of alcohol
6. Spiritual perspective
7. Coping skills
8. Support systems
HESI Hint • To develop a collaborative learning environment between the nurse and the
client, nurses must be acutely aware of their own beliefs and values about the teaching–
learning process, including client empowerment.
HESI Hint • Obtain a cultural and spiritual assessment and include cultural and spiritual
preferences in the plan of care when appropriate and feasible. Nurses are expected to
provide care for all clients. It is important to note that clients are culturally diverse,
regardless of their ethnicity, race, or socioeconomic status and to note that in every
culture subgroups may form. However, culturally diverse clients may be distinguished
from mainstream culture by ethnicity, social class, and/or language. Since the 2000
census there has been a notable change in the cultural, ethnic, and racial alignment of
the United States.
Culture influences how clients seek medical attention or treat themselves.
HESI Hint • Reasons why clients use herbal medications:
• Cultural influence
• Perception that supplements are safer and “healthier” than conventional drugs
• Sense of control over one’s care
• Emotional comfort from taking action
• Limited access to professional care
• Lack of health insurance
• Convenience
• Media hype and aggressive marketing
• Recommendation from family and friends
PMEUMONIA
HESI Hint • Pneumonia affects people of all ages, especially those 65 or older or infants
under age 2 (because their immune systems are still developing).
HESI Hint • Increased temperature also increases metabolism and the demand for O 2 .
Fever can also cause dehydration because of excessive fluid loss due to diaphoresis.
HESI Hint • Clients at High Risk for Pneumonia
• Altered level of consciousness
Brain injury
• Depressed or absent gag and cough reflexes
