Medical Surgical Nursing Mastery 1 Review

Flashcards covering Medical Surgical Nursing objectives including laboratory values, perioperative care, medications, skin disorders, orthopedics, and gastrointestinal/cardiovascular systems.

Normal RBC Range

$4.2-6.2$; low levels result in signs of hypoxia such as SOB, altered mental status, cold, and pale skin.

Normal HCT Range

$37-54\%$; low levels contribute to signs of hypoxia.

Normal Hgb Range

$12-18$; low levels contribute to signs of hypoxia.

Normal PLT Range

$150-400$ thousand; if low, the patient is a priority due to risk of bleeding.

Hyponatremia

Electrolyte imbalance characterized by N/V, altered mental status, and seizures.

Hypernatremia

Electrolyte imbalance characterized by signs of dehydration.

Hypokalemia/Hyperkalemia

Electrolyte imbalance of potassium that results in heart arrhythmia; priority if multiple electrolytes are altered.

Hypocalcemia

Electrolyte imbalance characterized by muscle twitching/tetany and Chvostek's sign.

Informed Consent

The nursing process of ensuring the person is capable and the document is signed; the nurse does not provide the teaching but confirms it is done.

Spinal Headache Interventions

Positioning in low fowlers and increasing fluids.

PACU Assessment Priority

Airway (positioning), Breathing (rate and depth), and Circulation (VS); follow the ABCs.

Midazolam

A benzodiazepine ($-LAMS/-PAMS$) that will depress respirations.

Fentanyl

An opioid that decreases respirations; can be reversed with Naloxone.

Naloxone

An opioid antagonist used to reverse any opiate.

Atelectasis

A respiratory complication prevented by DB+C and Incentive Spirometry; symptoms include SOB, low $O_2$ Sat, and coughing.

Venous Stasis/DVT

Prevention includes SCDs, leg exercises, ambulation, and fluids; symptoms include pain, redness, and edema on one back of leg.

Dehiscence and Evisceration

Skin complications with risk factors like obesity, diabetes, age, and abdominal incisions; priority intervention is wet saline soaked gauze.

Ileus

Gastrointestinal complication characterized by a lack of peristalsis (no bowel sounds); prevention involves ambulation.

Acetaminophen

A nonopioid analgesic with a daily limit of $4\,g$ ($4000\,mg$); important to check for it in other medications.

Ibuprofen

An NSAID that causes dyspepsia (GI upset) and should be taken with food.

Electronic Infusion Device Rate

$$\frac{\text{Total \# of mL}}{\text{Total number of hours}} = \text{mL per hour}$$

Gravity Infusion Rate

$$\frac{mL}{hr} \times \frac{1\,hr}{60\,minutes} \times \frac{gtt}{1\,ml} = \text{gtt per minute}$$

Infiltration

IV complication characterized by skin that is cold, pale, wet, and swollen.

Phlebitis

IV complication characterized by skin that is hot, red, and painful, following the veins.

3rd Degree Burn

A burn characterized as pale, dry, and painless.

Herpes Zoster (Shingles)

Emerges under stress or illness in people who have had chicken pox; follows a nerve tract with red/hot/itchy vesicles.

Melanoma ABCDE

Assessment for malignant skin lesions: Asymmetrical, Border, Color, Diameter, Elevated.

Cellulitis

Symptoms include redness, heat, swelling, fever, pain, and purulent drainage; treated with antibiotics and topical washes.

7 P's (Ortho)

Assessment for traction or casts: polar, pallor, puffiness, pulselessness, paraesthesia, paralysis, pain.

Fat Emboli

Risk for anyone with broken bones; symptoms include severe SOB, tachypnea, tachycardia, low BP, and petechiae.

Methotrexate

Chemotherapy drug used for Rheumatoid arthritis; suppresses bone marrow resulting in decreased WBC, RBC, and PLT.

Alendronate

A bisphosphonate that must be taken first thing in the morning with a full glass of water and requires the patient to sit up after.

Rheumatoid Arthritis

Disorder featuring fever, body aches, malaise, morning stiffness, and joint deformity.

Osteoarthritis

Wear and tear disorder associated with age featuring Heberden's nodules and pain at the start of ambulation.

Hip Arthroplasty Precautions

Do not cross the body's midline and do not bend more than $90$ degrees.

Stool for Occult Blood

Test requiring two samples from different parts of the stool; patient must avoid red meat and iron supplements.

GERD Dietary Teaching

Small frequent meals; avoid acidic, spicy, greasy foods, and alcohol; sit up after eating and avoid meals before bed.

H2 Receptor Antagonists / Proton Pump Inhibitors

Includes Cimetidine and Omeprazole; take at least $30$ minutes before eating, by themselves, and not with antacids.

Crohn's and Ulcerative Colitis Priorities

Increase fluids and monitor potassium levels (to prevent arrhythmias).

Small Bowel Obstruction

Symptoms include pain, distention, and N/V with fecal contents; treated with NG tube decompression.

NG Tube Nursing Priority

Check patency, irrigate with $30\,ml$ saline, maintain HOB above $30$ degrees, and verify initial placement with X-ray.

Hepatitis A

Foodborne hepatitis caused by uncooked or unwashed foods.

Cirrhosis

Characterized by ascites, bruising, spider angioma, high ammonia, and low albumin; requires low sodium diet and fluid restriction.

Pancreatitits Priority

Keep patient NPO and provide oral care.

Furosemide

Diuretic resulting in increased urination and decreased weight/edema; side effects include dehydration and potassium loss.

Atenolol

Medication that decreases BP and pulse; side effects include BP below $90/60$ and pulse below $60$.

EKG Waves

P wave (atrial depolarization), QRS wave (ventricular depolarization), T wave (ventricular repolarization).

Myocardial Infarction Labs

CK and troponin levels will elevate.

Peripheral Arterial Disease (PAD)

Characterized by pale, cold, shiny hairless skin, pain, paraesthesia, and intermittent claudication.

Digoxin Hold Parameters

Hold if digoxin level is above $2$ or if the apical pulse is below $60$.