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ATI Med surg retake studying (missed ones) (2), Summaries of Nursing

ATI Med surg retake studying (missed ones) (2)

Typology: Summaries

2023/2024

Available from 03/28/2024

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م 10:15 2024/ 3/ 27
ATI Med surg retake studying (missed ones)
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h"ps://quizlet.com/730060462/a9- -medical-surgical-rn proctored-2019-flash-cards/
h"ps://quizlet.com/582159240/medical-surgical-a9-proctored-exam- -flash-cards/2019
ATI Med surg retake studying:
- Postoperative Nursing Care: Priority Assessment Finding Following a Total
Laryngectomy (Active Learning Template - Therapeutic RM AMS RN Procedure, 11.0 Chp
96 Postoperative Care) Nursing
o Monitor irregular respirations, decreased saturation for choking, noisy, oxygen
values, and cyanosis
§ stridor
o Implement a head-tilt/chin- maneuver to the tongue forward and lift pull open
the airway
o Keep emergency equipment at the the (resuscitation bag, bedside in PACU
suction equipment, airways)
o Notify the anesthesiologist, elevate head contraindicated, of bed if not provide
humidified oxygen, and plan reintubation with endotracheal tubefor
§ Total laryngectomy: permanent tracheostomy
- HIV/AIDS: Teaching Home Care (RM AMS RN 11.0 Chp 86 HIV/AIDS,Active Learning
Template: System Disorder)
o Keep home environment clean and avoid being exposed to family and friends
who has colds or flu viruses
o Wash dishes in hot water using a dishwasher if available
o Avoid crowded areas or traveling to countries with poor sanitation
o Avoid raw foods (fruits, vegetables) and undercooked foods (meat, fish, eggs)
o Avoid cleaning pet litter boxes to reduce the risk of toxoplasmosis
§ And gardening
o Bathe using antimicrobial soap
Sx: persistent fever, swollen glands, diarrhea, weight loss and
fatigue
- Cancer Treatment Options: Nursing Care for a Client Who Is Receiving Internal Radiation
Therapy (RM AMS RN 11.0 Chp 91 Cancer Treatment Options,Active Learning Template:
Therapeutic Procedure)
o Put patient in private room, keep door closed as much as possible
o Place sign on door warning of the radiation source
o Wear a dosimeter film badge that records personal amount of radiation
exposure
§ Nurses and nursing staff
o Limit visitors to 30-min visits, and have visitors maintain a distance of 6 feet from
the source
o Individuals who are pregnant, trying to conceive or under the age of 16 should
not enter the clients room
o Wear a lead apron while providing care, keeping the front of the apron facing
the source of radiation
o Most linens and dressings are kept in the client’s room until the radiation source
is removed, to ensure it is not lost in the trash or laundry
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h"ps://quizlet.com/730060462/a9- rn-medical-sur gical-proctored- 2019 -flash-cards/ h"ps://quizlet.com/582159240/medical-surgical-a9-proctored-exam- 2019 -flash-cards/ ATI Med surg retake studying:

  • Postoperative Nursing Care: Priority Assessment Finding Following a Total Laryngectomy (Active Learning Template - Therapeutic Procedure, RM AMS RN11.0 Chp 96 Postoperative NursingCare) o Monitor for choking, noisy, irregular respirations, decreased oxygensaturation values, and cyanosis § stridor o Implement a head-tilt/chin- lift maneuver to pull the tongue forward andopen the airway o Keep emergency equipment at the bedside in the PACU(resuscitation bag, suction equipment, airways) o Notify the anesthesiologist, elevate head of bed if not contraindicated,provide humidified oxygen, and plan forreintubation with endotracheal tube § Total laryngectomy: permanent tracheostomy
  • HIV/AIDS: Teaching Home Care (RM AMS RN 11.0 Chp 86 HIV/AIDS,Active Learning Template: System Disorder) o Keep home environment clean and avoid being exposed to family and friends who has colds or flu viruses o Wash dishes in hot water using a dishwasher if available o Avoid crowded areas or traveling to countries with poor sanitation o Avoid raw foods (fruits, vegetables) and undercooked foods (meat, fish, eggs) o Avoid cleaning pet litter boxes to reduce the risk of toxoplasmosis § And gardening o Bathe using antimicrobial soap - Sx: persistent fever, swollen glands, diarrhea, weight loss and fatigue
  • Cancer Treatment Options: Nursing Care for a Client Who Is Receiving Internal Radiation Therapy (RM AMS RN 11.0 Chp 91 Cancer Treatment Options,Active Learning Template: Therapeutic Procedure) o Put patient in private room, keep door closed as much as possible o Place sign on door warning of the radiation source o Wear a dosimeter film badge that records personal amount of radiation exposure § Nurses and nursing staff o Limit visitors to 30-min visits, and have visitors maintain a distance of 6 feet from the source o Individuals who are pregnant, trying to conceive or under the age of 16 should not enter the clients room o Wear a lead apron while providing care, keeping the front of the apron facing the source of radiation o Most linens and dressings are kept in the client’s room until the radiation source is removed, to ensure it is not lost in the trash or laundry
  • Immunizations: Recommended Vaccinations for Older Adult Clients (RM AMS RN 11. Chp 85 Immunizations, Active Learning Template: Growth and Development) o MMR: people born before 1957 is considered immune to measles and mumps o Varicella: for adults who do not have evidence of a previous infection o Pneumococcal: for adults 65 and older who have not been immunized with PCV13 or PPSV23; don’t give at the same time (6-12 months apart) o Hep A: for high risk individuals o Hep B: high risk individuals o Flu: annually for all adults o Meningococcal conjugate polysaccharide vaccines (MPSV4): for adults older than 55 years § MCV4: under 56 years old o HPV: administered young o Zoster: age 50 and older
  • Pulmonary Embolism: Risk Factors for Deep-Vein Thrombosis (Active Learning Template
    • System Disorder, RM AMS RN 11.0 Chp 24 PulmonaryEmbolism) o Risk factors: long-term immobility, oral contraceptive use,pregnancy, tobacco use, hypercoagulability, obesity, surgery, central venouscatheters, heart failure or chronic atrial fib, autoimmune hemolytic anemia, long bone fx,cancer, trauma, septicemia, advanced age
  • Coping Mechanisms - (1) o Coping: Evaluating a Client's Adaptation to a Role Change (Active Learning Template - Basic Concept, RM Fund 10.0 Chp 33 Coping) § Alarm stage § Resistance stage § Exhaustion stage
  • Mental Health Concepts - (1) o Alzheimer's Disease: Assessing a Client's Abstract Thinking(Active Learning Template - System Disorder, RM AMS RN 11.0 Chp8 Alzheimer's Disease) § Mini-mental state examination,
  • Elimination - (1) o Disorders of the Eye: Priority ActionforEye Irrigation (Active Learning Template - Therapeutic Procedure, RM AMS RN 11.0 Chp 12 Disorders of theEye) § Determine mechanism of injury § Irrigate with 0.9% sodium chloride
  • Mobility/Immobility - (1) o Pressure Ulcers, Wounds, and WoundManagement: Implementing Preventive Strategies (Active Learning Template - Basic Concept, RM Fund 10.0 Chp 55 Pressure Injury, Wounds, and WoundManagement) § Prevention infection by using aseptic techniquewhen performing dressing changes § Monitor all clients regularly for skin-integrity status and for riskfactors that contribute to impaired skinintegrity § Use a riskassessment tool

§ Double check opioid doses with another nurse prior to admin

  • Parenteral/Intravenous Therapies - (1) o Dosage Calculation: Calculating Rate ofIV Solution (Active Learning Template - Basic Concept, RM Fund 10.0 Chp 48 Dosage Calculation)
  • Diagnostic Tests - (1) o Principles of Antimicrobial Therapy: Intervention forSuspected Septicemia (Active Learning Template - System Disorder) § Broad spectrum abx § After getting lab result back on what type of infection, change tospecific abx
  • Potential for Complications of Diagnostic Tests/Treatments/Procedures - (1) o Cancer Disorders: Monitoring a Client Who Has ChronicLymphocytic Leukemia (Active Learning Template - System Disorder, RM AMS RN11.0 Chp 92 Cancer Disorders) § Monitor for evidence ofinfection - Frequent hand hygiene - Private room - Only healthy visitors, or illvisitors have to wear a mask - Screen visitors - No fresh fruits orvegetables - Monitor WBC - Prevent transmission of bacteria and viruses, no live plantsor flowers in room § Monitor platelets/ prevent injury - Avoid IV sticks and venipunctures § Avoid trauma (electric shaver, softbristled toothbrush, avoid contact sports) § Consume energy - Rest, adequate nutrition, fluidintake - Adequate sleep - Assess clients energyresources/capability
  • System Specific Assessments - (2) o Cancer Disorders: Expected Findings of ColonCancer (Active Learning Template - System Disorder, RM AMS RN 11.0 Chp 92 CancerDisorders) § Changes in stool consistency orshape § Blood in stool § Cramps and/or gas § Palpable mass § Weight loss and fatigue § Vomiting § Abdominal fullness, distention orpain § Abnormal bowel sounds indicative ofobstruction § Rectal pain

§ Sensations of bowel fullnessafter defecation o Inflammatory Disorders: Assessing a Client WhoHas a Friction Rub (Active Learning Template - Nursing Skill, RM AMS RN 11.0 Chp 34 Inflammatory Disorders) § Heard at left lower sternalborder

  • Therapeutic Procedures - (1) o Invasive Cardiovascular Procedures: Teaching About Left-SidedCardiac Catheterization (Active Learning Template - Diagnostic Procedure,RM AMS RN 11.0 Chp 30 Invasive Cardiovascular Procedures) § Likely be awake for theprocedure but given medicine to helpthem relax § Recovery isfast § If groin is used - pt will need to lay flat for several hoursafter the procedure to avoid seriousbleeding § Monitor VSand assess site frequently § Elevate HOB to 30 degrees or lay flat after the procedure for 2-6hours depending on the providersorders § Increase fluids after to get all the contrast dye out ofthe system § Contrast dye- hot flashfeeling § Keep leg straight after procedure
  • Alterations in Body Systems - (3) o Asthma: Using a Peak FlowMeter (Active Learning Template - Diagnostic Procedure, RM NCC RN 11.0 Chp 18 Asthma) § Used to measure the amount of air that can be forcefull exhaled in 1 second - Hard fast blow § Each child needs to establish personalbest § Record highestreading after 3 attempts - No average § Keep taking medicine even when attempts are in the greenzone § Measure at the same time each day o Head Injury: Responding to Change in Level of Consciousness(Active Learning Template - System Disorder, RM AMS RN 11.0 Chp 14 Head Injury) § Loss of consciousness: length of time theclient is unconsciousis significant § Even if the LOC is decreased, explain to the client the actions being taken and why (hearing is the last sense affected by a head injury) o Renal Calculi: Dietary Recommendations for a Low-Purine Diet(Active Learning Template - System Disorder, RM AMS RN 11.0 Chp 61 Renal Calculi) § Decrease intake of purine sources: organ meats, poultry, fish, gravies,red wine, and sardine - Increased uricacid
  • Hemodynamics - (3) o Anemias: Manifestations of Anemia (Active Learning Template - SystemDisorder, RM AMS RN 11.0 Chp 41 Anemias)

§ DVT

  • Encourage ambulation following initiation ofanticoag therapy o Encourage dorsiflexion/plantar exercises of thefoot when in bed o Occasionally elevate the legs above the level ofthe heart while the client is in bed (avoid using a knee gatchor pillow under the knees)
  • Administer intermittent or continuous warm moist compressesas prescribed
  • Do not massage the affected limb
  • Thigh - high compression oranti- embolismstockings
  • Prepare the client for an inferior vena cava interruptionsurgery § Venous insufficiency
  • Avoid crossing legs or wearing constrictive clothing orstockings
  • Wear elastic compression stockings. Apply them after thelegs have been elevated and when swelling is at aminimum
  • Analyze Cues - (1) o Hypertension: Identifying a Prescription to Clarify With the Provider(Active Learning Template - System Disorder, RM AMS RN 11.0 Chp 36 Hypertension) § Common meds
  • Diuretics “hydrochlorothiazide, furosemide,spironolactone”
  • CCB “verapamil, amlodipine, diltiazem”
  • ACE inhibitors “pril”
  • ARBs “sartan”
  • Aldosterone-receptor antagonists “eplerenone,spironolactone”
  • Beta blockers (lowers BP and HR)“lol”
  • Evaluate Outcomes - (1) o Meningitis: Caring for a Client WhoHas Meningitis (Active Learning Template - System Disorder, RM AMS RN 11.0 Chp5 Meningitis) § Isolation/private room § Droplet precautions (PIMP) § Cooling blanket § Report to health department § Decrease environment stimuli (quiet, dim room)
  • Seizure precautions § HOB elevated 30 § Monitor for increased ICP
  • Avoid coughing and sneezing § Replace f/e Zarahs

Preoperative Nursing Care: Identifying Allergic Cross-Reactivity (RM AMS RN 11.0 Chp 95 Preoperative Nursing Care,Active Learning Template: Basic Concept)

  • Latex al lergy: bananas, avo cados, strawberries
  • Propofol allergy: eggs, soybean oil
  • Povidone-iodine allergy: shellfish Preoperative Nursing Care: Priority Action for a Client Who Has Alcohol Intoxication (RM AMS RN 11.0 Chp 95 Preoperative Nursing Care,Active Learning Template: System Disorder)
  • ABC’s
  • Airway patency, O Stroke: Caring for a Client Who Has Left - Sided Hemiplegia (RM AMS RN 11.0 Chp 15 Stroke,Active Learning Template: System Disorder)
  • Left: language
  • Aphasia
  • Slow cautious behavior
  • Perception is fine
  • Cant recognize familiar objects o Right: reckless, poor judgement, bad perception Benign Prostatic Hyperplas 11.0 Chp 66 Disorders of the Male Reproductive Syia, Erectile Dysfunction, (^) stem,Active Learning Template: Therapeutic Procedure)and Prostatitis: Complication of Continuous Bladder Irrigation Following Tra (RM AMS RN
  • If obstructed, turn off CBI and irrigate with 50 mL irrigation solution using a larg e piston syringe or per facility policy Medications Affecting Coagulation: Contraindications for Heparin (RM Pharm RN 8.0 Chp 25 Medications Affecting Coagulation, RM Pharm RN 8.0 Chp 25 Medications Affecting Coagulation v2,Active Learning Template: Medication)
  • Bleeding (uncontrollable)
  • Hypersensitivity
  • Recent major surgery
  • During lumbar puncture, regional anesthesia, or surgery that involves the brain, eyes, or spinal cord
  • Severe thrombocytopenia (increased bleeding risk)
  • Peptic ulcer disease
  • Hx of stroke
  • Recent trauma Electrocardiography and Dysrhythmia Monitoring: Identifying Atrial Flutter (RM AMS RN 11.0 Chp 28 Electrocardiography and Dysrhythmia Monitoring,Active Learning Template: Diagnostic Procedure)
  • Flutter: normal rhythm but fast
  • Sawtooth!!! (fluTTer à sawTooTh) Electrolyte Imbalances: Treatment for Hypokalemia (RM AMS RN 11.0 Chp 44 Electrolyte Imbalances,Active Learning Template: Therapeutic Procedure)
  • Encourage foods with high potassium (avocados, broccoli, dairy products, dried fruit, cantaloupe, bananas, juices)
  • Oral potassium medicaitons