Med-surge, ICU, L&D

Adult Med-Surg Topics

1. Heart Failure (HF)

  • Pathology: Impaired cardiac output due to systolic/diastolic dysfunction. Leads to fluid overload and decreased perfusion.

  • Pharmacology: ACE inhibitors (e.g., Lisinopril), Beta-blockers (e.g., Metoprolol), Diuretics (e.g., Furosemide), Digoxin.

  • Nursing Considerations: Monitor daily weights, fluid intake, lung sounds, and electrolytes (potassium with diuretics).

2. Chronic Kidney Disease (CKD)

  • Pathology: Progressive loss of kidney function resulting in waste accumulation, fluid overload, and electrolyte imbalances.

  • Pharmacology: Erythropoietin-stimulating agents (e.g., Epoetin alfa), Phosphate binders, Antihypertensives.

  • Nursing Considerations: Monitor BUN/creatinine, fluid restrictions, dialysis education, and dietary management (low sodium, potassium, and protein).

3. COPD (Chronic Obstructive Pulmonary Disease)

  • Pathology: Chronic inflammation causing airflow limitation due to bronchitis and/or emphysema.

  • Pharmacology: Bronchodilators (e.g., Albuterol), Corticosteroids (e.g., Prednisone), Anticholinergics (e.g., Tiotropium).

  • Nursing Considerations: Promote smoking cessation, monitor oxygen levels (avoid high O2 in chronic CO2 retainers), and encourage pursed-lip breathing.

ICU Topics

4. Sepsis and Septic Shock

  • Pathology: Systemic inflammatory response to infection leading to tissue hypoperfusion and organ dysfunction.

  • Pharmacology: Broad-spectrum antibiotics (e.g., Vancomycin + Piperacillin-tazobactam), Vasopressors (e.g., Norepinephrine), IV fluids.

  • Nursing Considerations: Monitor for signs of organ failure, measure lactate levels, and initiate early goal-directed therapy.

5. ARDS (Acute Respiratory Distress Syndrome)

  • Pathology: Acute lung injury causing non-cardiogenic pulmonary edema and severe hypoxemia.

  • Pharmacology: Sedatives (e.g., Propofol), Paralytics (e.g., Vecuronium), Vasopressors, Steroids.

  • Nursing Considerations: Mechanical ventilation with low tidal volumes, prone positioning, and strict fluid management.

6. Acute Kidney Injury (AKI)

  • Pathology: Sudden decline in kidney function, often due to hypoperfusion, nephrotoxins, or obstruction.

  • Pharmacology: Diuretics (e.g., Furosemide), Electrolyte replacement, Vasopressors in prerenal causes.

  • Nursing Considerations: Monitor urine output, fluid balance, and nephrotoxic medications (e.g., NSAIDs, contrast agents).

Labor & Delivery Topics

7. Preeclampsia

  • Pathology: Pregnancy-induced hypertension with proteinuria, leading to potential multi-organ damage.

  • Pharmacology: Antihypertensives (e.g., Labetalol, Hydralazine), Magnesium sulfate for seizure prevention.

  • Nursing Considerations: Monitor blood pressure, deep tendon reflexes, and signs of magnesium toxicity.

8. Postpartum Hemorrhage (PPH)

  • Pathology: Excessive bleeding (>500 mL vaginal delivery, >1000 mL C-section) due to uterine atony, retained placenta, or trauma.

  • Pharmacology: Oxytocin, Methylergonovine, Misoprostol.

  • Nursing Considerations: Fundal massage, assess for clots, monitor vital signs, and prepare for possible blood transfusion.

9. Preterm Labor

  • Pathology: Labor occurring before 37 weeks' gestation, often due to infection, uterine overdistension, or placental issues.

  • Pharmacology: Tocolytics (e.g., Terbutaline, Nifedipine), Corticosteroids (e.g., Betamethasone) for fetal lung maturation.

  • Nursing Considerations: Monitor contractions, cervical dilation, and fetal heart rate. Educate on bed rest and hydration.