MEDICAL SURGICAL NURSING REVIEW NOTES - Download as Word Doc . doc) or read online. MEDICAL SURGICAL NURSING REVIEW NOTES. (MSNCB) of the Academy of Medical Surgical Nurses (AMSN) and the American .. Test centers may not allow books, calculators, food, drinks, notes, cell. AORN JOURNAL in-depth data. As ECG monitoring becomes more frequent, this book could be an excellent reference for students, staff nurses, or nurse e.
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Medical-surgical nursing is a complex and varied field with many You'll need to take some notes so that you can accurately remem-. This is the best collection of lecture notes for Medical Surgical nursing. It composes of everything you will be needing in a lecture. 63 Nursing Management: Musculoskeletal Trauma and Orthopedic Surgery, .. spontaneous abortion at the ambulatory care center, the nurse notes that the.
Pelvic Laparoscopy. Ferritin is decreased E. Thyroid Scan. Mitral Stenosis Nursing Management. Sex 3. Institute stress management techniques. Regular acting insulin IV only.
Signs of bleeding feeling of fullness at incisional site Nursing Management o Check the soiled dressings at the back or nape area. X-ray of long bones reveals a decrease in bone density 4. Administer medications as ordered such as: Acute tetany a. Chronic tetany a. Serum Phosphate is decreased normal value: CT Scan — reveals degeneration of basal ganglia D.
Serum Calcium is decreased normal value: Serum Calcium is increased 2. Morphine Sulfate Demerol 5. Prevent complications seizure and arrhythmia Hormonal replacement therapy for lifetime Prevent complications 8.
Assist in surgical procedure known as parathyroidectomy Serum Phosphate is decreased 3. Force fluids to prevent kidney stones 2. Agitation and memory impairment C. Avoid precipitating stimulus such as glaring lights and noise 3.
Strain all the urine using gauze pad for stone analysis 3. Osteomalacia B. Encourage client to breathe using paper bag to produce mild respiratory acidosis result. Hyperplasia of parathyroid gland 2.
Hormonal replacement therapy for lifetime 9. X-ray of long bones reveals bone demineralization D. Importance of follow up care. Constipation Side Effect: Diarrhea 2. Encourage increase intake of foods rich in calcium a. Ricketts b. Provide warm sitz bath 4. Institute seizure and safety precaution 5. Kidney stones a. Provide acid ash in the diet to acidify urine and prevent bacterial growth 7. Encourage increase intake of foods rich in phosphate but decrease in calcium 6. Maintain side rails 9.
Over compensation of parathyroid gland due to vitamin D deficiency a. Prepare trache set at bedside for presence of laryngo spasm 7. Bone pain especially at back bone fracture 2. Related to atrophy of adrenal glands 2.
Sex 3. Sugar 2. Decrease tolerance to stress 3. Zona Glumerulosa. Fungal infections B. Zona Fasciculata. Adrenal Cortex — outermost b. Zona Reticularis. Serum Sodium is decrease normal value: Force fluids 4. Mineralocorticoids Flourocortisone 5.
Assist in mechanical ventilation. Administer medications as ordered Corticosteroids a. Serum Potassium is increased normal value: Decrease libido 6. Monitor side effects a. Hydrocortisone Cortison Nursing Management when giving steroids 1. Provide client health teaching and discharge planning a. Loss of pubic and axillary hair 7. FBS is decreased normal value: Taper dose withdraw gradually from drug 3.
Administer isotonic fluid solution as ordered 3. Dexamethasone Decadrone b. Prednisone c. Plasma Cortisol is decreased 3. Provide meticulous skin care 7. Provide dietary intake. Bronze like skin pigmentation C. Increase masculinity among females B. Plasma Cortisol is increased 3. Measure abdominal girth daily and notify physician 4.
Easy bruising 8. Acne and striae 7. Predisposing Factors 1 Related to hyperplasia of adrenal gland 2. Weigh patient daily and assess for pitting edema 3. Mixed gland exocrine and endocrine. Hypernatremia a.
Consist of acinar cells which secretes pancreatic juices that aids in digestion thus it is an exocrine gland. Serum Sodium is increased 4. Located behind the stomach. Increase susceptibility to infections 3. Spinarolactone — potassium sparring diuretics 7. Has alpha cells that secretes glucagons function: Beta cells secretes insulin function: Assist in surgical procedure bilateral adrenoraphy 9.
FBS is increased 2. Hirsutism 6. Serum Potassium is decreased C. Consist of islets of langerhans. Restrict sodium intake 5. Hormonal replacement for lifetime U wave upon ECG T wave hyperkalemia 5. Prevent complications DM 8. Hypokalemia a. Polyphagia 5. Drugs a. Polyphagia 3.
Osmolar 3. Related to viruses receptor binding sites 3. Incidence Rate A. Glucosuria 4. Insulin therapy 1. Adult onset. Diabetes Mellitus 3. Glucosuria 6. Incidence Rate.. Blurring of vision 8. Polyuria 3. Steroids 4. Weight gain 7. Diabetic Ketoacidosis 1. Ketotic 5. Diet 3. Related to carbon tetrachloride toxicity C. Brittle disease. Maturity onset type. Polydypsia 4. Delta cells secretes somatostatin function: Exercise 3.
Predisposing Factors B. Treatment D. Complications 1. Complication E. Obese over 40 years old A. Obesity — because obese persons lack insulin 2. Juvenile onset type. Increase susceptibility to infection 9.
Polyuria 1. Hyper 2. Oral Hypoglycemic agents 2. Weight loss 5. Lasix b. Signs and Symptoms C.
Usually asymptomatic 2. Polydypsia 2. Diet 2. Non 4. Exercise E. Hereditary total destruction of pancreatic cells 1. Carbohydrates Glucose Glycogen 2. Protein Amino Acids Nitrogen 3. Creatinine normal value: Acetone breath odor 9. Hct normal value: Polyphagia 4.
Glucosuria 5. Seizure activity 4. Infection B. Polydypsia 3. Sodium Bicarbonate to counteract acidosis c. Decrease LOC — diabetic coma B. BUN normal value: Administer 0. Headache and dizziness 2.
Hyperglycemia 2. Non ketotic: Stress — number one precipitating factor 3. Restlessness 3. Rapid Acting Insulin clear. When mixing 2 types of insulin aspirate first the clear insulin before cloudy to prevent contaminating the clear insulin and promote proper calibration. Insulin therapy regular acting insulin peak action of 2 — 4 hours. Nursing Management for Insulin Injections 1. Lipodystrophy c.
Tolbutamide Orinase c. Artificially Compound Insulin B. Sources of Insulin 1. Stimulates the pancreas to secrete insulin A. Derived from beef and pork 2. Allergic reactions b. Classsification 1. Long Acting Insulin cloudy.
Tolamazide Tolinase 2. Peak action is 2 — 4 hours 2. Avoid shaking insulin vial vigorously instead gently roll vial between palm to prevent formation of bubbles 4. Place in refrigerator once opened 3.
Animal sources. Regular acting insulin IV only. Peak action is 8 — 16 hours 3. Second Generation Sulfonylureas a. Use gauge 25 — 26 needle 5. Most accessible route is abdomen 9. Rarely used because it can cause severe allergic reaction. Frequently used type because it has less antigenicity property thus less allergic reaction 3. Administer at room temperature to prevent development of lipodystrophy atrophy. Rotate insulin injection sites to prevent development of lipodystrophy 8.
First Generation Sulfonylureas a. Monitor for signs of local complications such as a. Peak action is 16 — 24 hours C. Intermediate Acting Insulin cloudy. No need to aspirate upon injection 7. Human Sources. Ultra Lente. Administer insulin either 45o — 90o depending on amount of clients tissue deposit 6. Glipzide Glucotrol b. Chlorpropamide Diabenase b. Diabeta Micronase. Types of Insulin 1. Provide nutritional intake of diabetic diet that includes: Gangrene formation e. Renal failure c.
CVA b. Atherosclerosis HPN. Instruct the client to avoid taking alcohol because it can lead to severe hypoglycemia reaction or Disulfiram Antabuse toxicity symptoms B.
Blood II. Monitor for peak action of insulin and OHA and notify physician 2. Spleen 4. Lymph Nodes formed in liver 6. Monitor for signs of hypoglycemia and hyperglycemia. Arteries 1.
Random Blood Sugar is increased 3. Instruct client to exercise best after meals when blood glucose is rising 7. Administer insulin and OHA therapy as ordered 3. Oral glucose tolerance test is increased — most sensitive test 4. Nursing Management when giving OHA 1. Bone Marrow. Instruct the client to take it with meals to lessen GIT irritation and prevent hypoglycemia 2. Blood Forming Organs 1. Monitor signs for complications a. Alpha Glycosylated Hemoglobin is increased C.
Blood Vessels III. Institute foot care management a. Instruct client to have an annual eye and kidney exam FBS is increased 3 consecutive times with signs or polyuria. Veins 3. Shock due to dehydration. HPN and DM major cause of renal failure d. Beta globulins — iron and copper. Alpha globulins.
Normal life span of RBC is 80 — days and is killed in red pulp of spleen 2. Albumin 2. Polymorphonuclear Eosinophils. Lymphocytes B-cell T-cell Natural killer cell. Polymorpho Neutrophils. Non Granulocytes 1. Globulins 3. Largest and numerous plasma CHON. Polymorphonuclear Basophils.
Gamma globulins a. Granulocytes 1. Brittleness of hair and spoon shape nails koilonychias. Palpitations 7. Related to malabsorption syndrome c. Common among tropical zones 3. Dyspnea 6. Pallor and cold sensitivity 5. Pneumocystis Carinii Pneumonia 3. Inadequate intake of iron due to a. Incidence Rate 1. Related to improper cooking of foods C.
Heavy menstruation b. High cereal intake with low animal protein digestion d. Normal life span of platelet is 9 — 12 days Signs of Platelet Dysfunction 1. Promotes hemostasis prevention of blood loss. Chronic blood loss due to trauma a. Weakness and fatigue initial signs 3. Headache and dizziness 4. Common among women 15 — 35 years old 4.
Subtotal gastrectomy 4. Related to poor nutrition B. Echhymosis 3. Normal value: Chronic diarrhea b. A chronic microcytic anemia resulting from inadequate absorption of iron leading to hypoxemic tissue injury A.
Consist of immature or baby platelets or megakaryocytes which is the target of dengue virus.
Petechiae 2. Common among developed countries 2. Organ meat b. Iron is decreased 5. Dried fruits f. Legumes g. Atropic Glossitis inflammation of tongue. Ferrous Gluconate. Instruct the client to avoid taking tea and coffee because it contains tannates which impairs iron absorption 5. Abdominal pain d.
Egg yolk c. Hgb is decreased 3. Fever and chills e. Iron Dextran IM. RBC is decreased 2. Enforce CBR so as not to over tire client 3. Melena 5. Sorbitex IM Nursing Management when giving parenteral iron preparations 1.
Instruct client to take foods rich in iron a. Dysphagia 9. Pain at injection site b. Monitor and inform client of side effects a. Reticulocyte is decreased 6. Nausea and vomiting c. Ferrous Sulfate b. Raisin d. Lymphadenopathy d. Instruct client to take with meals to lessen GIT irritation 2.
Ferritin is decreased E. When diluting it in liquid iron preparations administer with straw to prevent staining of teeth Medications administered via straw. Nitrofurantoin Macrodentin 3. Anorexia b. Skin rashes. Administer with Vitamin C or orange juice for absorption 4. Sweet potatoes e. Localized abscess c. Avoid massaging the injection site instead encourage to ambulate to facilitate absorption 3. PICA abnormal appetite or craving for non edible foods D. Administer Z tract technique to prevent discomfort.
Administer medications as ordered Oral Iron Preparations a. Ferrous Fumarate c. Monitor for signs of bleeding of all hema test including urinw. Nuts 4. Hct is deceased 4.
Provide a dietary intake that is high in carbohydrates. Chronic anemia characterized by a deficiency of intrinsic factor leading to hypochlorhydria decrease hydrochloric acid secretion A.
Dyspnea and palpitations as part of compensation 5. Enforce CBR 2. Hereditary factors 3. Subtotal gastrectomy 2. Never given orally because there is possibility of developing tolerance. Instruct client to avoid irritating mouth washes instead use soft bristled toothbrush. No side effects 3. Site of injection for Vitamin B12 is dorsogluteal and ventrogluteal.
GIT changes that includes a. Autoimmune 5. CNS changes a. Headache and dizziness 3. Administer Vitamin B12 injections at monthly intervals for lifetime as ordered. Inflammatory disorders of the ileum 4. Pallor and cold sensitivity 4.
Ecchymosis c. Institute BT as ordered 3. Avoid IM. Thrombocytopenia a. Institute reverse isolation 6. Oozing of blood from venipunctured sites C. Removal of underlying cause 2. Monitor for signs of infection a. Vincristine Plant Alkaloid c. Chemicals Benzine and its derivatives 2. Petechiae multiple petechiae is called purpura b.
Immunologic injury 4. Dyspnea and palpitations 2. Drugs Broad Spectrum Antibiotics a. Leukopenia a. Methotrexate Alkylating Agent b.
Enforce CBR 5. Administer oxygen inhalation 4. Pallor and cold sensitivity d. Increase susceptibility to infection 3. Weakness and fatigue b.
Headache and dizziness c. Chloramphenicol Sulfonamides Chemotherapeutic Agents a. Instruct client to use electric razor when shaving. CBC reveals pancytopenia 2. Anemia a. Corticosteroids — caused by immunologic injury b. Force fluids 5. Ecchymosis 3. Pregnancy B. Monitor NGT output 9.
Massive burns 3. Neoplasia new growth of tissue 7. Prevent complication a. Provide heparin lock 7. Related to rapid blood transfusion 2.
Massive trauma 4. Petechiae widespread and systemic eye. Hemoptysis 6. Oliguria late sign C. Anuria — late sign. Anaphylaxis 5. Monitor for signs of bleeding of all hema test including stool and GIT 2. CBC reveals decreased platelets 2.
ABG analysis reveals metabolic acidosis 4. Stool occult blood positive 3. Opthamoscopic exam reveals sub retinal hemorrhages D.
Septecemia 6. Oozing of blood from punctured sites 4. Hypovolemic shock b. Vitamin K b. Institute NGT decompression by performing gastric lavage by using ice or cold saline solution of — ml 8. Aseptically assemble all materials needed for BT a. Replace circulating blood volume 2. Gauge 18 — 19 needle c. Filter set b. Expiration of packed RBC is 3 — 6 days. Proper typing and cross matching a.
Monitor strictly vital signs before. Expiration of platelet is 3 — 5 days 2. Expiration date d. Prevent infection in there is a decrease in WBC 4. Warming is only done during emergency situation and if you have the warming device. Thrombocytopenia g. Type O — universal donor b. Pyrogenic reaction d. Air embolism f. Check the blood unit for bubbles cloudiness. Blood typing and cross matching c.
Cytrate intoxication h. Hyperkalemia caused by expired blood. Allergic reaction c. Proper refrigeration. Isotonic solution 0. Prevent bleeding if there is platelet deficiency Principles of blood transfusion 1. Instruct another RN to re check the following a. Never warm blood as it may destroy vital factors in blood.
Increase the oxygen carrying capacity of blood 3. Type AB — universal recipient c. Emergency rapid BT is given after 30 minutes and let natural room temperature warm the blood. Serial number 5. Client name b. Circulatory overload e. Hemolytic reaction b. Flush with plain NSS 4. Stop BT 2. Send the blood unit to blood bank for re examination 6.
Headache 3. Flushed skin 6. Fever and chills 2. Dyspnea 3.
Obtain urine and blood sample and send to laboratory for re examination 7. Send the blood unit to blood bank for re examination. Skin rashes 5. Dyspnea Nursing Management 1. Broncial wheezing 4. Urticaria 6.
Tachycardia 4. Administer isotonic fluid solution to prevent shock and acute tubular necrosis 5. Notify physician 3. Antipyretic b.
Signs and Symptoms of Hemolytic reaction 1. Anti Histamine Benadryl. Palpitations 5. Laryngospasm and Broncospasm Nursing Management 1. Diaphoresis 6. Fever 2. Antibiotic 5. Atrioventricular Valves — guards opening between a. Visceral — inner layer. Common among MI. Epicardium — outer layer 2. In order to propel blood to the systemic circulation. Lower Chamber contracting or pumping a.
Layers of Heart 1. Parietal — outer layer b. Muscular pumping organ of the body. Myocarditis can lead to cardiogenic shock and rheumatic heart disease B. Endocardium — inner layer. To promote unidimensional flow or prevent backflow 1.
Right atrium has decreased pressure which is 60 — 80 mmHg C. Located on the left mediastinum. Weighs approximately — grams. In between is the pericardial fluid which is 10 — 20 cc. Atria 2. Upper Chamber connecting or receiving a. Exertional discomfort Nursing Management 1. Myocardium — middle layer 3. Chambers of the Heart 1. Orthopnea 2.
Prevent pericardial friction rub. Cardiac tamponade A. Left ventricle has increased pressure which is — mmHg. Resemble like a close fist. Covered by a serous membrane called the pericardium 2 layers of pericardium a. Monitor vital signs and intake and output 8.
Semi — lunar Valves. Initiates electrical impulse of 60 — bpm 2. Coronary Arteries. Delay of electrical impulse for about. Left Main Coronary Artery.
S4 — atrial gallop usually seen in Myocardial Infarction and Hypertension D. Right Main Bundle of His. Located at the inter atrial septum. S3 — ventricular gallop usually seen in Left Congestive Heart Failure 2.
Located at the junction of superior vena cava and right atrium. Purkinje Fibers.
Located at the interventricular septum 4. Cardiac Conduction System 1. P WAVE atrial depolarization contraction. Right Main Coronary Artery 2. Left Main Bundle of His. Bundle of His. Acts as primary pacemaker of the heart. Arises from base of the aorta Types of Coronary Arteries 1. Supplies the myocardium E. Peak T wave — Hyperkalemia 3. Increase survival rate. Myocardial Injury. Revascularize myocardium 2. Atherosclerosis 2. Sex — male 2. Hyperlipidemia 6.
ST segment elevation — Myocardial Infarction 5. To prevent angina 3. Race — black 3. Diabetes Mellitus 8. Obesity 5. Diet — increased saturated fats Duaphoresis C. T wave inversion — Myocardial Infarction 6. Chest pain 2. ST segment depression — Angina Pectoris 4. Myocardial Ischemia — Angina Pectoris 3. Type A personality B. Done to single occluded vessels. Nming is expanding to include health maintenance and strategies for self-care.
This edition has been expanded to give a balanced presentation of the growing numbers of diagnostic and trwtment modalities and nursing options. It provides principles of medical and surgical nursing to help the student understand physiological and psychological effects of disease on the whole person.
The patient education sections have also been expanded. Included in this book are an appendix and many helpful diagrams and charts. It would be a good resource book for nurses. This study guide was developed as a tool to help students focus on content areas considered essential for understanding the concepts, techniques, and disease processes in the textbook.
Practical application is tested by exercises for developing nursing care plans and patient teaching guides. Answers are keyed by page number to the text for easy reference.
It is a useful adjunct to the text. Quality control circles are a participatory management technique in which eight to 10 employees from one work area meet regularly to define, analyze, and solve workrelated problems.
Circles use techniques such as brainstorming, cause-effect diagrams, and charts to develop solutions. Benefits of a quality control circle are better rapport and communication among the staff and with other departments, and more trust in the nursing administration.
Employees who are involved in a circle usually offer more creative and in-depth solutions. To begin a quality control circle, the head nurse or supervisor of the work area acts as the leader and obtains the support of the nursing administration. The leader should receive proper training in quality control circle techniques, according to the report.
According to the report, a person from outside the work unit is needed to o k r v c the grsup prscess,assist the leader in teaching concepts, and serve as a resource and support person for the leader and the circle.
The leader should be flexible and allow the staff to define and solve problems; the circle process should not be rushed. Your name.