NUR 201 Med Surg Midterm 2019 Study Guide - Jersey College

Mid-Term Study Guide (Med-Surg) Chapter 1 1. Conduct a cultural assessment prior to initiating health teaching (patient driven) 2. Education- teach patient about modifiable and non-modifiable risk factors; Modifiable = weight, smoking, sex practices, and diet. Non-modifiable = age, genetics and sex. 3. QSEN – the quality and safety education for nurse’s institute seeks to strengthen he knowledge, skills, and attitudes of nurses in providing continuous quality improvement in health care. 4. The purpose of nursing = to treat the patient’s response to illness and use evidence-based practices to improve outcomes. 5. Bundle – a set of three to five evidence-based practices that, when implemented appropriately can measurable improve patient outcomes. 6. Health – Is a state of complete physical, mental, and social wellbeing and not merely the absence of disease. 7. wellness – is a state of mind, the ability to perform, adjust, and adapt to varying situations. 8. Determine how to prioritize the needs of patients by using Maslows hierarchy of needs. Physiological integrity – food, water, warmth, rest, pain relief. Safety and security – personal security, employment, resources, shelter, stability Belongingness and affection – Intimate relationships, friendships. Esteem and self-respect – Prestige and feeling of accomplishment, recognition. Self-actualization – achieving one’s full potential, including creative activities. 9. Joint commission – non profit organization that accredits hospitals and health care organizations. Chapter 12 1. Pain is whatever the patient says it is. The single most reliable indicator of pain is the patients (self-report) and intensity. Self -report – the ability of an individual to give a report – in this case pain – especially intensity; the most essential component of pain assessment. 2. Pain stimulates the sympathetic nervous system and can result in an increase in vitals. (blood pressure, heart rate, and respiration. 3. Pain is associated with actual or potential damage. (nociceptive pain) 4. Unrelieved pain increase glucagon production, decreases insulin secretion, depresses immune function, and can lead to addictive behaviors (over use of pain medications. 5. Prostaglandins initiate inflammation and contribute to tissue swelling and pain. (prostaglandins = inflammation) 6. Tissue damage stimulates the inflammatory response and puts the patient at risk for pain. 7. Nerve route injury or pain can lead to allodynia (pain that is associated with non-noxious stimulus) Allodynia – pain due to a stimulus that does not normally provoke pain. Such as touch; typically experienced in the skin around areas affected by the nerve. 8. The wong-baker faces scale (3yrs and up) consist of cartoon faces that the patient selects to report their own pain. (should never be used by the provider to match the patient’s facial expression.) 9. A comprehensive pain assessment includes – duration, type, associated factors, influencing factors, and location. 10. Nonsteroidal anti-inflammatory medications could lead to acute renal failure in patients with volume depletion or take it for chronic pain. (these medications are filtered via the kidney.) 11. Non-pharmacological pain management strategies – physical modalities, mind-body methods, biologic and energy-based therapies. (distraction) 12. Provide patient controlled analgesia (PCA pump) to help reduce complications related to pain, only used if the patient can control the pump themselves. 13. ATC = around the clock administration of analgesics- provided for chronic and postoperative pain, never wait for the patients pain to reoccur. 14. Mild to moderate pain = aspirin or acetaminophen 15. Moderate pain = non-steroidal anti-inflammatory drugs 16. severe pain = morphine, opioids 17. Acetaminophen does not have anti-inflammatory properties and can result in hepatoxicity and should not exceed 4,000 mg/day 18. Avoid rectal route for medication administration (can cause rectal bleeding) 19. Topical effects produce a local effect (felt on skin) whereby the transdermal route produces drug absorption (into systemic circulation) Never apply heat over transdermal patches since this could increase absorption and result in lethal complications. (over dose)