Med-Surg Final Exam Master Review Guide

Comprehensive vocabulary flashcards covering Respiratory, Cardiac, Gastrointestinal, Endocrine, and Neurological systems based on Med-Surg Final Exam review materials.

Atelectasis

Partial or complete collapse of alveoli (lung tissue), commonly seen post-op due to shallow breathing and immobility.

Pneumonia

Infection causing inflammation of the alveoli, where alveoli fill with fluid or pus, often presenting with fever, tachycardia, and leukocytosis.

Incentive Spirometry Frequency

Should be used $q1h$ while the patient is awake.

Elderly Pneumonia Presentation

May present with confusion and agitation rather than classic fever or cough.

COPD (Chronic Obstructive Pulmonary Disease)

Characterized by air trapping and $CO_2$ retention, leaving the patient in a constant state of Respiratory Acidosis.

Hypoxic Drive

A condition in COPD patients where low $O_2$ levels trigger breathing; therefore, high levels of supplemental oxygen should be avoided.

Venturi mask

The most precise and accurate $O_2$ delivery device, typically used for low levels ($24-28\%$) in COPD patients.

Pursed-lip breathing

A technique that helps expel trapped $CO_2$ and keeps airways open longer.

Asthma

Reversible airway obstruction due to bronchospasm, mucus, and inflammation, characterized by wheezing and accessory muscle use.

Asthma Medication Order

Always use a Bronchodilator (rescue inhaler) FIRST, then a Steroid inhaler SECOND.

Asthma Contraindication

Beta-blockers are contraindicated because they can cause bronchospasm.

Pneumothorax

Air in the pleural space causing lung collapse; may show tracheal deviation away from the affected side in tension cases.

Hemothorax

Blood in the pleural space causing lung collapse and signs of blood loss like hypotension and tachycardia.

SubQ emphysema

Air trapped under the skin that feels like 'Rice Krispies' or crepitus; a complication of pneumothorax.

Water Seal Chamber: Tidaling

The rising on inspiration and falling on expiration of fluid levels, indicating the chest tube is patent.

Water Seal Chamber: Continuous Bubbling

An indication of an air leak in the chest tube system.

Pleural Effusion

Abnormal accumulation of fluid in the pleural space between the lung and chest wall.

Transudative Effusion

Low protein fluid leaks due to pressure changes, most commonly caused by Heart failure, cirrhosis, or nephrotic syndrome.

Exudative Effusion

High protein fluid leaks due to inflammation or infection, such as pneumonia, malignancy, or PE.

Thoracentesis Position

Sitting upright, leaning forward on an overbed table to widen intercostal spaces.

Thoracentesis Complication

Pneumothorax is the most common complication; monitor for respiratory distress and obtain a post-procedure X-ray.

Pulmonary Edema

Fluid inside the alveoli, often from left heart failure, characterized by pink frothy sputum.

Normal ABG Reference Values

pH: $7.35–7.45$, $CO_2$: $35–45\,mmHg$, $HCO_3$: $22–26\,mEq/L$, $O_2$ Sat: $95–100\%$.

ROME Mnemonic

Respiratory Opposite (pH and $CO_2$ move in opposite directions), Metabolic Equal (pH and $HCO_3$ move in same direction).

Bronchoscopy Post-op Priority

Assess for the gag reflex before allowing food or drink (PO).

Pulmonary Embolism (PE)

A blood clot lodging in pulmonary vasculature (often from DVT or A-Fib) causing sudden onset dyspnea and decreased $O_2$ saturation.

Troponin

The hallmark cardiac marker for Myocardial Infarction; rises in $3-6\,h$ and peaks at $24\,h$. Normal value is $< 0.04\,ng/mL$.

STEMI

ST Elevation on an EKG, indicating active heart muscle damage or infarction.

MONA Protocol Reality

Stands for Morphine, Oxygen, Nitroglycerin, Aspirin; however, Nitroglycerin is usually given before Morphine.

Stable Angina

Predictable chest pain occurring with exertion and relieved by rest or one nitroglycerin tablet.

Unstable Angina

Unpredictable chest pain occurring at rest; it is an emergency and higher risk for pre-infarction.

Right-Sided Heart Failure

Blood backs up into systemic circulation, causing Jugular Vein Distension (JVD), peripheral edema, and hepatomegaly.

Left-Sided Heart Failure

Blood backs up into pulmonary circulation, causing crackles in lungs, dyspnea, pink frothy sputum, and orthopnea.

BNP (B-type Natriuretic Peptide)

The hallmark lab for Heart Failure indicated by fluid overload; normal is $< 100\,pg/mL$.

Hypertension (HTN) Crisis

Systolic $> 210$ or Diastolic $> 101$; treated with nitroprusside to lower BP by $25\%$ in the first hour.

Intermittent Claudication

Pain with walking that is the hallmark sign of Peripheral Arterial Disease (PAD).

A-Fib (Atrial Fibrillation)

Irregularly irregular rhythm with no P-waves; creates a high risk for clots and stroke.

Atropine

The first-line drug for symptomatic bradycardia (HR $< 60\,bpm$).

Asystole Intervention

Requires CPR and Epinephrine; Defibrillation is not used because there is no electrical rhythm to shock.

V-Tach / V-Fib Intervention

Defibrillate immediately if pulseless.

Beck's Triad

Hypotension, Muffled Heart Sounds, and JVD; indicates Cardiac Tamponade, a risk after CABG.

Allen's Test

Performed before placing an arterial line to check collateral circulation to the hand.

Valvular Stenosis

The valve is stiff or narrowed and will not open fully, decreasing forward flow and perfusion.

Valvular Regurgitation

The valve is leaky and will not close fully, causing backflow of blood.

Pericarditis Hallmark

A friction rub heard on auscultation; pain is often relieved by leaning forward.

Hyperkalemia Tx Protocol

1. Calcium Gluconate (cardioprotective), 2. Insulin + Dextrose $50\%$ (drives K+ into cells), 3. Kayexalate (removes K+).

Hyponatremia

Sodium $< 135\,mEq/L$, leading to decreased LOC, confusion, and potential seizures; treated with fluid restriction.

Hypocalcemia Signs

Chvostek sign (facial twitch with cheek tap) and Trousseau sign (hand spasm with BP cuff), indicating tetany risk.

Gastric Ulcers

Pain occurs with eating due to acid stimulation; patients often avoid food and experience weight loss.

Duodenal Ulcers

Pain is relieved by eating; burning sensations often occur $2-3$ hours after meals or at night.

Upper vs. Lower GI Bleed

Melena (dark, tarry stool) indicates Upper GI bleed; Hematochezia (bright red blood) indicates Lower GI bleed.

Diverticulitis Signature

Left lower quadrant pain, decreased bowel sounds, and elevated WBC.

Crohn's Disease

Inflammatory bowel disease affecting the full thickness of the wall from mouth to anus with 'skip lesions'.

Ulcerative Colitis (UC)

Affects only the large intestine and the mucosal layer, showing continuous lesions from the rectum upward.

Hepatic Encephalopathy

High ammonia levels due to liver failure causing confusion; treated with Lactulose to expel ammonia via diarrhea.

Hepatitis A (HAV)

Transmitted via the fecal-oral route, often through contaminated food or water.

HgA1C Goal

Reflects average blood sugar over $2-3$ months; the goal is $< 7.0\%$.

DKA and HHS Treatment Rule

Always administer IV isotonic fluids FIRST, then IV insulin SECOND.

Diabetes Insipidus (DI)

A lack of ADH causing excessive dilute urination, hypernatremia, and low urine specific gravity.

SIADH

Excess ADH causing fluid retention, oliguria, hyponatremia, and high urine specific gravity.

Thyroid Storm

Emergency hyperthyroidism marked by fever $> 104^{\circ}F$, severe tachycardia, and extreme agitation.

Addison's Disease

Adrenal insufficiency causing decreased cortisol, hypotension, hypoglycemia, hyperkalemia, and bronze skin.

Cushing's Syndrome

Excess cortisol causing hypertension, hyperglycemia, moon face, buffalo hump, and central obesity.

Cushing's Triad

A late sign of increased ICP consisting of Bradycardia, Bradypnea, and Widened Pulse Pressure (HTN).

Ischemic Stroke Priority

Always perform a non-contrast CT scan FIRST to rule out hemorrhage before giving tPA.

Epidural Hematoma

An arterial bleed between the skull and dura mater, often involving the middle meningeal artery, characterized by a classic 'lucid interval'.

Bacterial Meningitis CSF

Cloudy CSF with low glucose and highly elevated WBC count; requires IV antibiotics and droplet precautions.

Glasgow Coma Scale (GCS) Score of 8

A score of $8$ or less indicates the patient is comatose and requires airway protection/intubation.

Parkinson's Disease

Dopamine depletion in basal ganglia causing pill-rolling tremors, shuffling gait, mask-like face, and high fall risk.

Delirium

Acute, sudden onset confusion that is reversible once the cause (like a UTI in the elderly) is treated.