NUR242 / NUR 242 MED-SURG
EXAM 1, 2, 3, 4 & 5 REVIEW
(LATEST ) EXAM
LATEST NEWEST UPDATE WITH
ACTUAL QUESTIONS AND
DETAILED VERIFIED ANSWERS
WITH RATIONALES (100%
CORRECT) //BRAND NEW!!
/ALREADY GRADED A+ WITH
GUARANTEED SUCCESS AFTER
DOWNLOAD (ALL YOU NEED TO
PASS YOUR EXAMS
Post-OP:
, -in PACU, nurse immediately assess pt airway, LOC
-RR <10 may indicate respiratory depression due to anesthesia
-Sanguineous to serosanguineous drainage is normal
-Crusting at incision line and swelling is normal
Malignant hyperthermia:
-life threatening
-you will see HIGH TEMPERATURE
-early sign is tachycardia, muscle rigidity
-Dantrolene is used to treat
Pain Management:
Pain management referral for pts in chronic pain unrelieved
-Pain after abdominal sx is from trapped carbon dioxide, ambulate pt as soon as possible
-Use FACES scale in pts with dementia
PCA Pump:
-Lockout interval of 5-15 minutes
-Pt cannot be cognitively impaired
-Only the pt can press the button
If incision opens:
-cover with wet sterile gauze
-Do not try to reinsert protruding organ
-Reassure pt
-Supine position with knees bent
IV:
-20G 1-1.5" needle is adequate for most therapies
-Huber needle should be placed at 90 degree angle to access port (chemo pt)
TPN:
- Check each bag twice
-If TPN is unavailable, hang 10% dextrose/water or 20% D/W until TPN is available
-If TPN not administered on time, do not increase the rate
-Change IV tubing q24 hours when new bag is hung
, -Dressing change around IV site changed 2 48-72 hours
Sickle Cell:
-Pain is the most common problem
-Requires large doses of opioid analgesics
-Hydrate with NS IV fluids, encourage oral fluids without caffeine
-Administer O2
-Remove restrictive clothing, No BP with external cuff
-Sickle Cell crisis: pain meds and IV fluids
Vitamin B12 Deficiency:
-Smooth, beefy red tongue
MRSA:
-Sleep in separate beds until infection clears
-Wash clothes in HOT water
Standard precautions:
-Hand hygiene
-Gloves
Contact precautions:
-Private room
-Wear gloves when entering room
-Wash hands with soap and water
-Dedicated equipment
Airborne Precautions:
-Private room with negative airflow
-Keep door closed
-N95 respirator
Cane:
-Appropriate height (at wrist level when arm is at side)
-Pt strong hand on cane
MOVE CANE WITH WEAKER LEG
At risk for falls due to:
incontenience
, Transferring pt to WC:
-Place WC on strong side angled to bed
-Strong hand to armrest, then pivot
Safe pt handling:
-Keep pt directly in front of you and as close as possible to prevent back injuries
Skin integrity:
-dont wear restrictive clothing
-WC pt lift themselves off buttock for 10 seconds q1hr
Pressure Ulcer stages:
Stage 2- skin is not intact; open or fluid blister
Wet-to-damp wound care:
mechanically removes necrotic tissue
does more damage than good bc it removes the good tissue as well
Informed consent:
-surgeon is responsible for having consent signed
-Pt who can not sign can sign with an "X" but must be witnessed by two people
-If the pt doesn't understand the surgery, the surgeon has to be notified
-A blind pt can sign the consent, has to be witnessed by 2 people
-Nurses DO NOT clarify orders/procedure/risks, must call the MD to explain to pt
Pre-OP:
-Report these to surgeon:
-increased PT/INR/aPTT/Creatinine
-Verify operative permit is signed
-Side rails up, bed down, call light within reach
Intra-OP:
-Pts are lifted into position onto the OR table to prevent shearing
-Gel pads are placed on the OR table to prevent pressure ulcers
-Warming blankets are used
EXAM 1, 2, 3, 4 & 5 REVIEW
(LATEST ) EXAM
LATEST NEWEST UPDATE WITH
ACTUAL QUESTIONS AND
DETAILED VERIFIED ANSWERS
WITH RATIONALES (100%
CORRECT) //BRAND NEW!!
/ALREADY GRADED A+ WITH
GUARANTEED SUCCESS AFTER
DOWNLOAD (ALL YOU NEED TO
PASS YOUR EXAMS
Post-OP:
, -in PACU, nurse immediately assess pt airway, LOC
-RR <10 may indicate respiratory depression due to anesthesia
-Sanguineous to serosanguineous drainage is normal
-Crusting at incision line and swelling is normal
Malignant hyperthermia:
-life threatening
-you will see HIGH TEMPERATURE
-early sign is tachycardia, muscle rigidity
-Dantrolene is used to treat
Pain Management:
Pain management referral for pts in chronic pain unrelieved
-Pain after abdominal sx is from trapped carbon dioxide, ambulate pt as soon as possible
-Use FACES scale in pts with dementia
PCA Pump:
-Lockout interval of 5-15 minutes
-Pt cannot be cognitively impaired
-Only the pt can press the button
If incision opens:
-cover with wet sterile gauze
-Do not try to reinsert protruding organ
-Reassure pt
-Supine position with knees bent
IV:
-20G 1-1.5" needle is adequate for most therapies
-Huber needle should be placed at 90 degree angle to access port (chemo pt)
TPN:
- Check each bag twice
-If TPN is unavailable, hang 10% dextrose/water or 20% D/W until TPN is available
-If TPN not administered on time, do not increase the rate
-Change IV tubing q24 hours when new bag is hung
, -Dressing change around IV site changed 2 48-72 hours
Sickle Cell:
-Pain is the most common problem
-Requires large doses of opioid analgesics
-Hydrate with NS IV fluids, encourage oral fluids without caffeine
-Administer O2
-Remove restrictive clothing, No BP with external cuff
-Sickle Cell crisis: pain meds and IV fluids
Vitamin B12 Deficiency:
-Smooth, beefy red tongue
MRSA:
-Sleep in separate beds until infection clears
-Wash clothes in HOT water
Standard precautions:
-Hand hygiene
-Gloves
Contact precautions:
-Private room
-Wear gloves when entering room
-Wash hands with soap and water
-Dedicated equipment
Airborne Precautions:
-Private room with negative airflow
-Keep door closed
-N95 respirator
Cane:
-Appropriate height (at wrist level when arm is at side)
-Pt strong hand on cane
MOVE CANE WITH WEAKER LEG
At risk for falls due to:
incontenience
, Transferring pt to WC:
-Place WC on strong side angled to bed
-Strong hand to armrest, then pivot
Safe pt handling:
-Keep pt directly in front of you and as close as possible to prevent back injuries
Skin integrity:
-dont wear restrictive clothing
-WC pt lift themselves off buttock for 10 seconds q1hr
Pressure Ulcer stages:
Stage 2- skin is not intact; open or fluid blister
Wet-to-damp wound care:
mechanically removes necrotic tissue
does more damage than good bc it removes the good tissue as well
Informed consent:
-surgeon is responsible for having consent signed
-Pt who can not sign can sign with an "X" but must be witnessed by two people
-If the pt doesn't understand the surgery, the surgeon has to be notified
-A blind pt can sign the consent, has to be witnessed by 2 people
-Nurses DO NOT clarify orders/procedure/risks, must call the MD to explain to pt
Pre-OP:
-Report these to surgeon:
-increased PT/INR/aPTT/Creatinine
-Verify operative permit is signed
-Side rails up, bed down, call light within reach
Intra-OP:
-Pts are lifted into position onto the OR table to prevent shearing
-Gel pads are placed on the OR table to prevent pressure ulcers
-Warming blankets are used
