lOMoARcPSD| 62788957
ATI MedSurg Final Exam Study Notes for Nursing Students
ATI medsurg note
FUNDAMENTAL
Precaution
- Airborne : TB, measles, varicella, chicken pox,
rubeola, o N95, private room
- Droplet : Flu, mumps, rubella, pneumonia, strep,
- Contact pertussis, : RSV, C.diff, herpes,
Nationally reportable infection
- Botulism (food born)
- Chlamydia, Gonorrhea, Chancroid,
- Lyme disease
ABG
- Compensated normal PH
- Uncompensated
Types of preventions -
Primary:
o Screening for STI, Immunization
o Day care center Secondary:
- o Screening for STI, testing for TB
exposure o Crisis center reduce complication
for pt who already have illness
- Third: o Proving treatment for pt who have
COPD
o Outpatient rehabilitation center o
Community recreational center
Antidots
- Opioid
Naloxone
-
Acetaminophen (Tylenol) Acetylcysteine
-
Aspirin (Salicylate) Vit K
- Digoxin
Digoxin immune fab
- Warfarin
Vitamin K
-
Aspirin (Salicylate) Vitamin
- Heparin
K Protamine sulfate
Lab value
, lOMoARcPSD| 62788957
– 12 – 18gravity
Hgb Specific Hct 1.005 – 1.030
–
WBC – 5K – 12K
0.5-0.8
Albumin – 3.5 -5.5
1.5
Digoxin
Lithium < o Toxicity causes: AV blocks, Vfib, Vtach
- LDL <100
- Total cholesterol <200
- HDL >40
- Triglyceride <135 – 150
Aortic valve 2nd ICS to right of sternum - aortic stenosis heard
Pulmonic valve 2nd ICS to left of sternum
Erbus 3rd ICS – left
Tricuspid valve – 5th ICS left of sternum
Mitral valve – 5th ICS medial to midclavicular
BP Cuff must cover 40% of circumference of arm
Electrolyte
- Hypernatremia: dry mucous membrane, agitation, thrist, hyperflexia, convulsion - Hypomagnesemia
(1.3-2.1): hyperthyrodism neuro
Brain
- Basal ganglia – motor control and learning
- Cerebral cortex – higher brain function
- Hypothalamus – temperature
- Wernicke’s – language and speech
Basilar skull fraction
- Leakage of cerebral spinal fluid - Open injury ICP
- Rigid skill prevents expansion – closed injury
- Can cause brain herniation
- Sign DVJ, Decelerate and decorticate o Early: HA, Nausea, sleepiness
o Late: Bradycardia, Cheyne strokes respiration, extension posture, papilledema, decreased
motor response, flexion, dull painful stimuli, coma,
o Infant: bulging fontanel, restless, high-pitched cry, setting sun sign, distended scalp vein o
Children: forced vomit, diplopia, seizure, lethargy, trouble following command, decreased
activity and school performance Cerebral palsy
- Abnormal muscle tone, seizure, Painful muscle spasms, cognitive delay, chronic constipation, UTI, GI
reflux
Stroke
, lOMoARcPSD| 62788957
- Left sided weakness – due to right side injury o Provide support
o Avoid massaging
o Place bedside table on the right and hold cane on right hand
-
Sepsis
- Elevated lactate indicate cellular hypoxia
Cardiac
- SVT atrial
o Prior to cardioversion: withhold digoxin 48hr can cause V.fib
Withhold
- Metformin for catheterization or anything with dye = kidney injury
Seizure - Sign: jkk
- Care: turn to side* to prevent hypoxia and aspiration o Loosen restrictive
clothes, check pupillary response, move furniture’s away o
Wound
- Irrigate and clean dressing o Use 30-60 mL syringe with 18-19G
catheter to deliver pressure o Use Hydrocolloid dressing and transplant
film dressing o Avoid wet-to-dry dressing and hydrogen peroxide and
povidone iodine
ONCOLOGY Treatment
, lOMoARcPSD| 62788957
Common cancers Radiation Teletherapy, Brachytherapy,
- Prostate, ovarian, colorectal, breast - Avoid direct sunlight during radiation
Leukemia treatment and for at least 1yr
- Malignant WBC disorder - May cause metallic taste – use mint
- Acute myeloid leukemia uncontrolled perforation - Complication: stomatitis
of myeloblasts Teletherapy
- Bone pain, petechiae, purpura, epistaxis, hematoma, - External radiation
hematuria, GI bleed, fatigue, pallor, HA, stomatitis, - Dry gently and wash with hand
anorexia, dyspnea - AVOID sunscreen, powder, lotion, ointment,
- Impaired oral mucus membrane, Unbalanced cream, rubbing, washcloths
nutrition, ineffective protection -
- Bleeding and thrombocytopenia Brachytherapy
Breast cancer - Implanted or infused radiations
- Nontender, fixed, hard, irregular shape lump - Bed rest with limited motion
- RF: >50yrs, Dense breast, postmenopausal obesity, - 2-5 treatments per week
oral contraceptive or hormone replacement therapy, - Visitors 6ft away and only for 30min
early menarche and late menopause, late pregnancy - Wear dosimeter badges but NEVER borrow
- Annual mammogram starting 40 years old from another nurse
- Start self-examination in early 20s - Complication: hematuria
- Can metastasize to bones Radiotherapy
Multiple myeloma - Precise delivery of high dose radiation after
- Cancer of plasma cells in the bone marrow and tumor imaging
crowed healthy blood cells Chemotherapy
- Bone and joint pain - Chemically kill cancer but kill more health cell
- Bone and kidney damage, immune deficiency, - Expected: memory loss, alopecia, mucositis
osteolytic lesion, osteopenia, fracture, - Sore throat: priority indicate infection
- High Ca and uric acid o Hypercalcemia cause - Care: hydrate, cognitive training, soft
PPP, muscle cramps, constipation, change MS toothbrush,
- Avoid raw fruits, - Complication: pancytopenia, stomatitis,
thrombocytopenia, myelosuppression,
ATI MedSurg Final Exam Study Notes for Nursing Students
ATI medsurg note
FUNDAMENTAL
Precaution
- Airborne : TB, measles, varicella, chicken pox,
rubeola, o N95, private room
- Droplet : Flu, mumps, rubella, pneumonia, strep,
- Contact pertussis, : RSV, C.diff, herpes,
Nationally reportable infection
- Botulism (food born)
- Chlamydia, Gonorrhea, Chancroid,
- Lyme disease
ABG
- Compensated normal PH
- Uncompensated
Types of preventions -
Primary:
o Screening for STI, Immunization
o Day care center Secondary:
- o Screening for STI, testing for TB
exposure o Crisis center reduce complication
for pt who already have illness
- Third: o Proving treatment for pt who have
COPD
o Outpatient rehabilitation center o
Community recreational center
Antidots
- Opioid
Naloxone
-
Acetaminophen (Tylenol) Acetylcysteine
-
Aspirin (Salicylate) Vit K
- Digoxin
Digoxin immune fab
- Warfarin
Vitamin K
-
Aspirin (Salicylate) Vitamin
- Heparin
K Protamine sulfate
Lab value
, lOMoARcPSD| 62788957
– 12 – 18gravity
Hgb Specific Hct 1.005 – 1.030
–
WBC – 5K – 12K
0.5-0.8
Albumin – 3.5 -5.5
1.5
Digoxin
Lithium < o Toxicity causes: AV blocks, Vfib, Vtach
- LDL <100
- Total cholesterol <200
- HDL >40
- Triglyceride <135 – 150
Aortic valve 2nd ICS to right of sternum - aortic stenosis heard
Pulmonic valve 2nd ICS to left of sternum
Erbus 3rd ICS – left
Tricuspid valve – 5th ICS left of sternum
Mitral valve – 5th ICS medial to midclavicular
BP Cuff must cover 40% of circumference of arm
Electrolyte
- Hypernatremia: dry mucous membrane, agitation, thrist, hyperflexia, convulsion - Hypomagnesemia
(1.3-2.1): hyperthyrodism neuro
Brain
- Basal ganglia – motor control and learning
- Cerebral cortex – higher brain function
- Hypothalamus – temperature
- Wernicke’s – language and speech
Basilar skull fraction
- Leakage of cerebral spinal fluid - Open injury ICP
- Rigid skill prevents expansion – closed injury
- Can cause brain herniation
- Sign DVJ, Decelerate and decorticate o Early: HA, Nausea, sleepiness
o Late: Bradycardia, Cheyne strokes respiration, extension posture, papilledema, decreased
motor response, flexion, dull painful stimuli, coma,
o Infant: bulging fontanel, restless, high-pitched cry, setting sun sign, distended scalp vein o
Children: forced vomit, diplopia, seizure, lethargy, trouble following command, decreased
activity and school performance Cerebral palsy
- Abnormal muscle tone, seizure, Painful muscle spasms, cognitive delay, chronic constipation, UTI, GI
reflux
Stroke
, lOMoARcPSD| 62788957
- Left sided weakness – due to right side injury o Provide support
o Avoid massaging
o Place bedside table on the right and hold cane on right hand
-
Sepsis
- Elevated lactate indicate cellular hypoxia
Cardiac
- SVT atrial
o Prior to cardioversion: withhold digoxin 48hr can cause V.fib
Withhold
- Metformin for catheterization or anything with dye = kidney injury
Seizure - Sign: jkk
- Care: turn to side* to prevent hypoxia and aspiration o Loosen restrictive
clothes, check pupillary response, move furniture’s away o
Wound
- Irrigate and clean dressing o Use 30-60 mL syringe with 18-19G
catheter to deliver pressure o Use Hydrocolloid dressing and transplant
film dressing o Avoid wet-to-dry dressing and hydrogen peroxide and
povidone iodine
ONCOLOGY Treatment
, lOMoARcPSD| 62788957
Common cancers Radiation Teletherapy, Brachytherapy,
- Prostate, ovarian, colorectal, breast - Avoid direct sunlight during radiation
Leukemia treatment and for at least 1yr
- Malignant WBC disorder - May cause metallic taste – use mint
- Acute myeloid leukemia uncontrolled perforation - Complication: stomatitis
of myeloblasts Teletherapy
- Bone pain, petechiae, purpura, epistaxis, hematoma, - External radiation
hematuria, GI bleed, fatigue, pallor, HA, stomatitis, - Dry gently and wash with hand
anorexia, dyspnea - AVOID sunscreen, powder, lotion, ointment,
- Impaired oral mucus membrane, Unbalanced cream, rubbing, washcloths
nutrition, ineffective protection -
- Bleeding and thrombocytopenia Brachytherapy
Breast cancer - Implanted or infused radiations
- Nontender, fixed, hard, irregular shape lump - Bed rest with limited motion
- RF: >50yrs, Dense breast, postmenopausal obesity, - 2-5 treatments per week
oral contraceptive or hormone replacement therapy, - Visitors 6ft away and only for 30min
early menarche and late menopause, late pregnancy - Wear dosimeter badges but NEVER borrow
- Annual mammogram starting 40 years old from another nurse
- Start self-examination in early 20s - Complication: hematuria
- Can metastasize to bones Radiotherapy
Multiple myeloma - Precise delivery of high dose radiation after
- Cancer of plasma cells in the bone marrow and tumor imaging
crowed healthy blood cells Chemotherapy
- Bone and joint pain - Chemically kill cancer but kill more health cell
- Bone and kidney damage, immune deficiency, - Expected: memory loss, alopecia, mucositis
osteolytic lesion, osteopenia, fracture, - Sore throat: priority indicate infection
- High Ca and uric acid o Hypercalcemia cause - Care: hydrate, cognitive training, soft
PPP, muscle cramps, constipation, change MS toothbrush,
- Avoid raw fruits, - Complication: pancytopenia, stomatitis,
thrombocytopenia, myelosuppression,
