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Medical Surgical ATI Review Flashcards Quizlet
Nursing Nclex review (Nur003)
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Medical Surgical ATI Review
Science/Medicine/Surgery
Terms in this set (695)
Prophylactic DVT Care
-Assess and compare peripheral pulses -Caused by dehydreation, obesity, trauma, malignacy, Hx of thrombosis, hormones, and use of indwelling cath -Nursing actions: prevention, avaoid dangling pt for long periods, anticoagulants, provide adequate hydration
Cardiac cath postoperative care
-Apply an initial dressing of gauze and replace with transparent dressing w/i 24 hr -x ray to ensure placement -assess q8hr
- Use 10mL or < syringe to flush -Clean port for 3 seconds and allow to dry -flush before, between, and after meds
- no BP on arm with PICC
Study sets, textbooks, questions
Medical Surgical ATI Review
Ventricular fibrillation
-can cause cardiogenic shock -Dx- ECG, Ech, CT, Cardiac cath, chest x ray -Tx- Cardiac cath, Anticoagulants, defib shock to fix rythem
Assessing arterial line
-check placement -keep pressure -flush before between and after meds -watch for clotting
Eval. pt understanding of digoxin administration
-Hold if apical HR is <60bpm per min -Watch for N&V -Monitor ECG, BP -Take same time each day -take 2 hr before or after antacids
- If you miss dose take it as soon as you remember
Expected findings following administering Narcan
-Increase Resp. -Pain returns -increase HR -increase BP
Allergic blood transfusion reactions
Mild- Itching, urticaria, flushing- Administer benadryl Anaphylactic- wheezing, dyspnea, chest tightness, cyanosis, hypotension -maintain airway, admin. 02, IV fluids, antihistamines, corticosteroids, and vasopressors
Medical Surgical ATI Review
Acute and Chronic kidney: Med Adverse effects
-Avoid antimicrobial, NSAIDs, ACE inhibitors, IV contrast dye -Monitor Digoxin lvl & administer post dialysis -kayexalate to increase elemination of serum potassium -epogen, procrit, to increase RBS stimulation -Iron supplement -Lasix -Amphojel- taken to stop phsophate absorption -take 2 hr before or after digoxin
Preventing complications following a transurethral resection of the prostate
-Urine should be light pink. If red increase irrigation -If cath becomes obstructed turn of CBL and irrigate with 50mL -Record amt. of irrigation and sub. from total to get true output -Instruct pt not to urinate around cath-it will cause bladder spasem -Monitor vitals and bleeding
Teaching colostomy care
Cause odor-fish, eggs, asparagus, garlic, beans, greeen leafy veggie cause gas- green leafy veggies, beer, pop, dairy, corn -Avoid incresed fiber for 2 months post op, drink lots H2O and watch for obstruction when adding fiber
- proper appliance fit and maintenance prevent odor -refer to counseling if needed
Medical Surgical ATI Review
Head injury: Monitor. for CSF leakage
-CSF leakage from ears or nose -"halo" sign- yellow stain surrounded by blood on a paper towel, fluid tests positive for glucose -report to dr.
Resp. manage. & Mechanical ventilation: Need for suctioning
Suction secretions to maintain airway and tube patency
Monitoring initial does of lisinopril (Zestril)
-may make pt feel dizzy -Monitor BP, HR, and keep on falls precautions -Remind pt top ask for assistance to get up and to move slowly
Self-administering enoxaparin (lovenox)
-Injection given in R or L abdomen -Take only as directed -may inhibit blood clotting
Safer sex practices
-Abstienence is best -Use condoms -Get tested regularly
Complications following extubation
-RR > 30/min or <8/min -BP or HR changes >20% baseline -SaO2 <90% -Dysrhythmias, increased ST segment -Sig. decrease in tidal volume -Labored resp. and increased use of accessory muscles -Restlessness, anxiety, decreased LOC -Monitor for resp. destress or airway obstruction such as ineffective cough, dyspnea, and stridor Medical Surgical ATI Review
Peptic ulcer Disease:
Comlications
-Heartburn, bloating, N&V -Pain, bloddy emisis or stools -weight loss, med. side effects -Perforation/hemorrhage-pain, rigid abd, rebound tenderness -pernicious anemia dumping syndrom
Burns: Prioritizing emergency interventions
-Airway -fluid and electrolyte -thermoregulation -infection
Cardio Dx: Accessing implanted port
-x ray to confirn placement -document cath placement @ beg. and end of shift (and any time py is moved) -check readings for hemodynamic cath -use 0% sodium chloride of flushing no heparin -Avoid air embolisim -risk for pneumothorax -Risk for dysrhythmias with insertion/movement of line
Dietary restricions for Renal Calculi
-Limit food high in animal protine -reduce calcium intake
Evaluating therapeutic response to blood transfusion
Monitor Vitals I&O and Labs
Evaluating epoetin alfa (Epogen) effectiveness
Monitor hematocrit lab values
Medical Surgical ATI Review
Calculating protein intake 0.8-1/kg
Adverse effects of Garlic therapy
-Effect blood clotting
Laryngeal Cancer and Body Image Disturbance
-Consult speech language path. for clients who have difficulty speaking -Provide comfort to pt who have permenant loss of voice or disfigurment -Refer to counseling servcies as needed
Complications of hemodialysis
-Clotting/Infection of access site -Disequilibrium syndrome -use slow exchange rate
- Administer anticonvulsant/barbituates if needed -Hypotensoin -IV fluids -Decreased HOB -Anemia -Monitor labs and provide blood products as needed -Infectious Diseases
Clinical manifestations of thoracic outlet syndrome
-Neck, shoulder, and arm pain, numbness -Impaired circulation and flushed sensations to the extremities -Symptoms are reproduced when arm is positioned above the shoulder or extended
Medical Surgical ATI Review
Verifying tip placement of PICC line
x ray verification prior to use Use 10mL or < syringe Tape cath hub to minimize manipulation Remove dressing from distal to proximal note length to help detect cath. migration
Plan of care for pt who has diabetes insipidus
-monitor Vitals and labs -weigh daily -IV therapy -Fall precautions -Add bulk foods and fruit juices -Assess skin turgor and mucous membranes -provide skin and mouth care -encourage pt to drink in response to thirst
Quad cane use with hemiplegia
-Use cane on uneffected side -Advance cane at same time as affected limb -Stairs- -Up with the good and down with the bad
Hemoglobin Female 12- Male 14-
Hematocrit Female 35- Male 42-
RBC 4-5 million
Erythrocyte sedimentation rate
Male up to 15 mm
Medical Surgical ATI Review
Medical Surgical ATI Review - Platelets 150,000-400, - Albumin 3- - Total protine 6-8. - Total Lipids 400- - Triglycerides 40-
- Total cholesterol 130- - CK-MB 50- - Troponin >0.
- Alkaline Phosphate 30- - Bilirubin < - Amonia 15- - Serum Amylase 56- - Serum Lipase 0-
Sodium 135-
ph (Blood) 7-7.
PaO2 80-
PaCO2 35-
HCO3 22-
Lactate 3-
Glucose 70-
Creatinine 0-1.
BUN 7-
PT 10-
INR 1-
aPTT 30-45 seconds
WBC 5,000-10,
Planning care for a pt undergoing Brachytherapy
If it falls out put in lead lined container and return to radiology
Medical Surgical ATI Review
Precautions for pt who is immunocopromised
-Avoid crowds -Take Temp daily -Avoid food that could contain bacteria -Avoid yard work -Avoid FLuids that have set out -Was dishes in hot soapy water -Wash toothbrush in dish washer or with bleach -Do not share toiletry
Seizures and Epilepsy: Recognizing at risk pt
-Genetic predisposition -Acute febrile state -Head trauma -Cerebral edema -Abrupt cessation of antiepileptic drugs -Infection -Metabolic disorder -Brain tumor -Hypoxia -Acute drug & alcohol withdrawl -Fluid and electrolyte imbalances
Choosing appropriate ) equipment
Nasal Canula Partial rebreather nonrebreather Aerosol mask T piece
Assessment of a pt who has a cervical injury
C4 or above poses risk for impaired spontaneous ventilation because of the involvement of the phrenic nerve
Medical Surgical ATI Review
Acute kidney injury & Chronic kidney disease: Recognizing priority lab valuse
Seerum creatinine gradual increases 1-2mL/dL q 24-48 hr or 1-6 in ine week BUN increased to 80-100 w/i week Urine specific gravity >1-1.
Priority analysis of an ECG strip
MI (chest pain and ST depression or elevation)
Monitoring a pt @ risk for pulmonary embolisim
-Caused by dysrythmia -dyspnea, chest pain, air hunger, decreased o
Interpreting montoux skin test
Red spot- no reaction Raised red bump- reaction 48-72 hours after injection
Recognizing risk factors for atelectasis
Snoring, Stridor Monitor Blood o2 lvl
Cancer screening:Assessing the need for intervention
CEA
PSA
AFP
Diabetes Mellitus: Glycosylated HGB Test (HgbA1c)
4-6% normal target <7% Indicates Blood sugar for last 120 days
Hyperthyroidisim: monitoring lab results
-Serum THS test- decreased -FTI and T3 increased -Thyroid-releasing hormone- failure of expected rise
Medical Surgical ATI Review
Arthoplasty: Post op care following a knee arthoplasty
Prevent complication- DVT, anemia, -Older adults @ higher risk CPM Prevent pressure ulcers
Inflammatory bowel disease: Interpreting lab results
HGB & HCT decreased ESR Increased WBC increased Platelet count increased Serum albumin decreased K, Mg, C decreased
Post op expected findings following coronary artery bypass graft
Splint incision with deep breathing and coughing Consult resp. services Continually monitor HR and rythem Hypertension and Hypotension Chest tube dreain >150mL/hr could mean hemorrage control plan Monitor fluid and electrolyte
Pulmonary embolism: Interventions
Administer O2 therapy nitiate and maintain IV therapy Provide emotional support Monitor changes in LOC and mental status
Heart failure and pulmonary edema: prioritizing interventions
Class I: Pt exhibits no symptoms with activity Class II: Pt has symptoms with ordinary exertion Class III: Pt displays symptoms with minimal exertion Class IV: Pt symptoms @ rest
Medical Surgical ATI Review
Manifestations of left-sided heart failure
-Dyspnea -Orthopena -Nocturnal dyspnea -Fatige -Displaced apical pulse (hypertrophy) _heart Gallop -Pulmonary congestion -Frothy sputum -Altered Mental status -manifestations of organ failure
TB: Client teaching regarding medication therapy
Must take for 6-12 months No alcohol, may interfere with BC, report yellowing skin, drink lots of water, notify provider with vision or hearing changes
Disorders of the eye Analyzing findings
-Monitor for IOP -monitor for decreased vision and light sensitivity -Assess pt for aching or discomfort around the eye -Tx severe plain and nausea with analgesics and antiemetics
Tx hypomagnesemia
-DC mag-lloosing meds (loop diuretics) -Administer oral or IV mag sulf Im can cause pain and tissue damage, oral can cause diarrhea and increase mag depletion -Incourage food high in mag: dairy, dark green leafy veggies
Administering Insulin check glucose before meds if take insulin must eat after
Medical Surgical ATI Review
Health screening
-Physical assessment -Evaluating health perceptions -Identifying risks to health/wellness -identify access to healthcare -Identify obsticals to compliance and adhearance -Belief in prescribed therapy -Availibility of support system -financial restricitions
Post op care: using an incentive spirometer
Clear lung bases bilaterally
Signs and symptoms of aortic disection
- Sudden onset of "tearing" "ripping" and "stabbing" abd or back pain -Hypovolemic shock -Diaphoresis, N&V, faintness, apprehension
- decreased or absent peripheral pulses -Neuro deficits -hypotension and tachycardia -Thoracic aortic aneusysim -Severe back pain -Hoarsness, cough, SOB, difficulty swallowing -Decreased urinary output
using Continuious passive motion device
-promote motion in the knee and prevent scar tissue -Full extention to perscribed amt of flexion -Placed and initiated right after surgery -stopped for meals
Menstrual disorders and menopause: Adverse effects of medication
Menopausal Hormone Therapy
- increased risk for blood clots
- long term use increases cancer risk Medical Surgical ATI Review
Medical Surgical ATI Review Flashcards Quizlet
Course: Nursing Nclex review (Nur003)
University: Chicago School of Professional Psychology
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