Nursing Study Guide: ATI MedSurg Focused Review, Exams of Biology

Download Nursing Study Guide: ATI MedSurg Focused Review and more Exams Biology in PDF only on Docsity! BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score . CHAPT E R 4 Pain Management: Use of Nonpharmacolo gi c Methods of Pain Relief (RN QSEN - Patient- centered Care, Active Learning Template - Basic Concept, RM AMS RN 10.0 Chp 4) 1. relaxation 2. distraction 3. cutaneous stimulation (ie acupressure, massage, thermal therapy, contralat stimulation) 4. guided imagery 5. hypnosis 6. biofeedback 7. music therapy 8. exercise NSAIDS have analgesic, anti-inflammatory, antiplatelet, & antipyretic effects. - Be aware of Hepatotoxic effects of Acetiminophen. Pt w/ a healthy liver should take no more than 4g/day. - prevent GI upset in pt by admin the Rx w/ food or antacids. - Monitor pt for bleeding w/ long term NSAID use. - Monitor pt for "Salicylism" (tinnitus, vertigo, decreased hearing acuity). More notes on management of pain https://skillsmodules.atitesting.com/ SkillsModulesConten t/pain-management/ap7.html CHAPT E R 16 Spinal Cord Injury: Care of -Application of Immobilization Devices & Traction - *Pts who have cervical fractures may be placed in a halo fixation BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score a Client who has a Halo Device (RN QSEN - Safety , Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 16) device or cervical tongs. Purpose is to provide traction &/or immobilize the spinal column. - NURSING ACTIONS - *maintain body alignment & ensure cervical tong weights hang freely. *Monitor skin integrity by providing pin care & assessing the skin under the halo fixation vest as appropriate. - PT EDUCATION - *if the pt goes home w/ a Halo fixation device on, provide instruction on pin & vest care. *Teach the pt signs of infection & skin breakdown. BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score 28) CHAPT ER 36 Hypertension: Evaluating a Client Who Takes Lisinopril (RN QSEN - Safety , Active Learning Template - Medication, RM AMS RN 10.0 Chp 36) Beta blockers Metroprolol and atenolol. For patients with unstable angina or myocardial infarction. Decreases cardiac output and blocks the release of renin, subsequently decreasing vasoconstriction in the peripheral vasculature Side effects of beta blockers Fatigue, weakness, depression, sexual dysfunction. Stopping abruptly can cause rebound hypertension. Can mask hypoglycemia Adverse effect of Lisinopril is persistent dry cough. BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score CHAPT E R 40 Blood and Blood Product Transfusions: Treatment for Circulatory Overload (Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 40) For blood transfusion on the elderly, use no larger than a 19- gauge needle is used Assess kidney function, fluid status, and circulation prior to blood product administration. Older adult patient are at an increased risk for fluid overload Use blood products that are less than 1 week old. Assess vital signs every 15 min throughout the transfusion for fluid overload Administer the blood transfusion over 2 to 4 hr for older adult clients. Without giving other IV fluid to prevent fluid overload Risk for HF and fluid overload 1.Stop transfusion immediately if reaction is suspected 2. Start infusion of NS with separate line 3. Save and send bag and lines of blood to testing lab 4. Maintain patent airway,administer oxygen 5. Give antibiotic and administer vasopressors (dopamine) 1. Monitor daily weights, I and O, edema- may be indication of worsening condition. 2. Monitor for cardiac output, blood pressure, and ejection fraction. 3. Hemodynamic monitoring using arterial line can tell us more about patient's condition. 4. Harder for heart failure patient to receive transfusions- worsening condition is manifested as dyspnea, chest tightness, tachycardia, tachypnea, headache, hypertension, jugular vein distention, peripheral edema, orthopnea, anxiety and crackles in the bases of the lungs 5. nursing interventions are to give O2, monitor VS, BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score slow infusion, give diuretics and contact provider. BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score use gentle friction do not use cotton balls or other products that shed fibers document the location and type of wound and incision, the status of the wound, type of dressing and materials, client teaching, and how the client handled the procedure CHAPT E R 70 Osteoporosis: Teaching Self- Administration of Alendronate (RN QSEN - Safety , Active Learning Template - Medication, RM AMS RN 10.0 Chp 70) • Take with 8oz water in the early morning before eating • Remain upright for 30 min after taking oral medication • Report early signs of indigestion, chest pain, difficulty swallowing, or bloody emesis. • Clients using IV preparations should have dental examinations and preventative treatment prior to starting therapy. Alendronate is an oral bisphosphonate used to treat postmenopausal osteoporosis, male osteoporosis, glucocorticoidinduced osteoporosis, and Paget’s disease of the bone. Although generally safe, esophagitis and esophageal ulceration are the most serious adverse effects. To minimize the risk of esophagitis and ulceration, the client should be instructed to remain upright (sitting or standing) for a minimum of 30 minutes (up to 1 hour) after administration. Other rare adverse effects are musculoskeletal pain, ocular inflammation, atypical femur fractures, and osteonecrosis of the jaw. CHAPT E R 71 Musculoskeletal Trauma: Maintaining Proper Traction (Active Learning Template - Maintain body alignment and realign if the client seems uncomfortable or reports pain. Ensure that weights hang freely and are not resting on the floor. BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score Therapeutic Procedure, RM AMS RN 10.0 Chp 71) CHAPT E R 85 `BBBBBBBBB BBB` For adults 65 years and older who have not been immunized with PCV13 or PPSV23, administer PCV13 first and then give PPSV23 in 6 to 12 months; do not administer both during the same visit. For adults who received a dose of PPSV23 at age 65 or older, an additional dose is not indicated. MPSV4 is preferred for adults who are 56 years of age or older, require a single dose, and have nothad MenACWY previously Zoster vaccine: Recommended as a one-time dose for all adults older than 60 years BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score CHAPT E R 93 Pain Management • Manage acute severe pain with short term (24 to 48 hr) around the clock administration of opioids rather than following a PRN schedule • The parenteral route is best for immediate, short-term relief of acute pain. The oral route is better for chronic, non- fluctuating pain. • Combinations such as hydrocodone and acetaminophen for breakthrough pain. for Clients Who Have Cancer: Managing Breakthrough Pain (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 93) CHAPTER 78 Hyperthyroidism: Assessing a Client for Chvostek's Sign Following a Thyroidectomy (Active Learning Template - Nursing Skill, RM AMS RN 10.0 Chp 78) BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score Acid-Base Imbalances: Identifying Clients at Risk for Imbalances (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 45) CHAPTER 14 Head Injury: Monitoring Neurological Status (RN QSEN - Patient-centered Care, Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 14) CHAPTER 80 Cushing's Disease/Syndrome: Priority Actions (RN QSEN - Safety , Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 80) https://quizlet.com/50582148/mod-2-cushings-diseasesyndrome-ati-flash-cards/ CHAPTER 75 Burns: Assessment Findings of Early Phase of Injury (RN QSEN - Safety , Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 75) Inhalation damage findings include: • Singed nasal hair, eyebrows, and eyelashes; sooty sputum; hoarseness; wheezing; edema of the nasal septum; and smoky smelling breath. Carbon monoxide inhalation (from burns in an enclosed area) findings include: • Headache, weakness, dizziness, confusion, erythema (pink or cherry red skin) and upper airway edema BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score Hypovolemic shock • Hypotension and tachycardia. Burns: Priority Action During Resuscitation Phase (RN QSEN - Safety, Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 75) Emergent (Resuscitative Phase): • Begins with the injury and continues for 24 to 48 hr. • Priorities include securing the airway, supporting circulation and organ perfusion by fluid replacement, managing pain, preventing infection through wound care, maintaining body temperature, and providing emotional support. CHAPTER 47 Gastrointestinal Therapeutic Procedures: Appropriate Actions for an Abdominal Paracentesis (RN QSEN - Safety , Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 47) BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score • Goal: Relieve abdominal ascites pressure • Performed by inserting a needle or trocar through the abdominal wall into the peritoneal cavity Preprocedure • Consent sign • Have patient void prior • High fowler position, sit upright, edge of bed with feet support, • Restore fluids before or after • Assess lab (amylase, BUN, creatinine, albumin, protein, glucose) Intraprocedure • 4-6L drain from cavity. Monitor drainage. CHAPTER 45 Sensory Perception: Performing Ear Irrigation (Active Learning Template - Nursing Skill, RM FUND 9.0 Ch 45) Use a commercial ceruminolytic (ear drops that soften cerumen) for impactions and follow with warm water irrigation. CHAPTER 15 Stroke: Planning to Administer Thrombolytic Therapy (Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 15) Medication: • Give within 4-5hr of initial symptoms. Catheter – directed thrombolytic therapy must be administered within 6 hr of the onset of symptoms • Contraindication Hemorrhagic BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score - Nursing Skill, RM AMS RN 10.0 Chp 60) CHAPTER 5 Meningitis: Planning Interventions for Care (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 5) • Isolate the client in a private room as soon as meningitis is suspected (droplet precaution). • Continue droplet precautions till antibiotics have been administered for 24 hrs and secretions are no longer infectious. • Clients who have bacterial meningitis might need to remain on droplet precautions continuously. • Implement fever reduction measures such as a cooling blanket. • Decrease environmental stimuli (quiet). • Minimize exposure to bright light. • Head of bed 30 degrees. • Avoid coughing and sneezing. BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score • Seizure precautions • Older adults at increased risk for pneumonia. CHAPTER 23 Tuberculosis: Discharge Teaching About Tuberculosis (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 23) • Educate the client and family to continue medication therapy for its full duration of 6 to 12 months, even up to 2 years for multidrug resistant TB. • Instruct the client to continue with follow up care for 1 full year. • Instruct the client that sputum samples are needed every 2 to 4 weeks to monitor therapy effectiveness. • Advise clients who have active TB to wear a mask when in public places or in contact with crowds. CHAPTER 43 Fluid Imbalances: Clinical Manifestations of Dehydration (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 43 Chapter 59 Polycystic Kidney Disease, Acute Kidney Injury, and Chronic Kidney Disease: Findings to Report (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 59 CHAPTER 28 Electrocardiography and Dysrhythmia Monitoring: Priority Action for Sinus Bradycardia (Active BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score Learning Template - System Disorder, RM AMS RN 10.0 Chp 28) • Atropine or Isoproterenol. Implantation of pacemaker CHAPTER 29 Pacemakers: Evaluating Client Understanding of Discharge Teaching (Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 29) • Carry a pacemaker identification card at all times • Prevent wire dislodgement (wear sling when out of bed. Do not raise arm above shoulder for 1 to 2 weeks). • Take pulse daily at the same time. Notify the provider if heart rate is less than the pacemaker rate BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score • Administer IV fluids. • Monitor I & O • Monitor vital signs and SaO2. CHAPTER 78 Hyperthyroidism: Client Teaching About Thyroid Storm (RN QSEN - Patient-centered Care, Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 78) □Thyroid storm/crisis results from a sudden surge of large amounts of thyroid hormones intothe bloodstream, causing an even greater increase in body metabolism. This is a medical emergency with a high mortality rate. □Precipitating factors include infection, trauma, emotional stress, diabetic ketoacidosis, and digitalis toxicity, all of which increase demands on body metabolism. It also can occur following a surgical procedure or a thyroidectomy as a result of manipulation of the gland during surgery. □Findings are hyperthermia, hypertension, delirium, vomiting, abdominal pain, hyperglycemia, and tachydysrhythmias. Additional findings include chest pain, dyspnea, and palpitations. □Nursing Actions ■ Maintain a patent airway. ■ Provide continuous cardiac monitoring for dysrhythmias. ■ Administer acetaminophen to decrease the client's temperature. ☐ Caution - Salicylate antipyretics are contraindicated because they release thyroxine from protein-binding sites and increase free thyroxine levels. ■ Provide cool sponge baths, or apply ice packs to decrease fever. If fever continues, obtain aprescription for a cooling blanket for hyperthermia. ■ Administer thionamides - methimazole or propylthiouracil (PTU) - to prevent further synthesisand release of thyroid hormones. ■ Administer propranolol to block sympathetic nervous system effects. BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score ■ Administer glucocorticoids to treat shock. ■ Administer IV fluids to provide adequate hydration and prevent vascular collapse. Fluid volume deficit may occur because of increased fluid excretion by the kidneys or excessivediaphoresis. Monitor intake and output hourly to prevent fluid overload or inadequate replacement. ■ Administer sodium iodide as prescribed, 1 hr after administering PTU. ☐ Caution - If given before PTU, sodium iodide can exacerbate manifestations in susceptible clients. ■ Administer small doses of insulin as prescribed to control hyperglycemia, which can occurbecause of the hypermetabolic state. ■ Administer supplemental O2 to meet increased oxygen demands. □Client Education ■ Provide the client and family support and information about the client's condition and all procedures. Advise the client to notify the provider of fever, increased restlessness, palpitations, and chest pain. CHAPTER 71 1. Identify three causes for hypokalemia vomiting diarrhea failure to replace potassium losses kidney disease medication (Example is diuretics like lasix) 2. List three symptoms of hypokalemia muscle weakness fatigue decreased GI motility constipation muscle cramps arrhythmias, List three nursing implications Monitor ECG Administer K+ (I WILL NEVER give K+ IV bolus; I MUST dilute). Teach dietary sources of K+ BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score Musculoskeletal Trauma: Assessing for Compartment Syndrome (RN QSEN - Safety , Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 71) CHAPTER 7 Parkinson¶s Disease: Teaching About Pathophysiology (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 7) • Parkinson’s Disease is a progressively debilitating disease that grossly affects motor function. BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score appear blue or purple in darker skin tones. 3. STAGE II: This stage of pressure ulcer is characterized by shallow open ulcer with a red pink wound bed. It can also present as an intact or open/ruptured serum-filled blister. At this stage, there is a partial- thickness loss of dermis and the ulcer can appear as shiny or dry shallow slough. The ulcer at this stage may become infected, possibly with pain and scant drainage. 4. STAGE III: At this stage, the subcutaneous fat may be open, but the bone, tendon, or muscle are not exposed. This stage presents with a full- thickness tissue loss. This stage of pressure ulcer can look shallow in areas where there is no subcutaneous fat like the ear and nose. It’s depth usually depends on the anatomical location. Slough may be present but will not obscure the depth of tissue loss. The areas that are rich in subcutaneous tissue experience a deep and big damage to the subcutaneous tissue. Drainage and infection of the wound can occur at this stage. 5. STAGE IV: Unlike in stage III, bone, muscle, and tendon are exposed with full thickness tissue loss and tissue necrosis. This stage makes Osteomyelitis possible because the ulcer extends into the muscle and other supporting structures like tendon and fascia. There may be slough, eschar, tunneling, undermining, and infection. BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score 6. UNSTAGEABLE: At this stage, the base of the ulcer is obscured by slough (can be yellow, tan, grey, green, or brown) and eschar (can be tan, brown, or black). The stage of the ulcer cannot be determined until the slough and eschar is removed to reveal the base of the wound. NURSING ACTIONS: List four nursing interventions to help prevent pressure ulcers. • Reposition clients every 2 hours while in bed and every 1 hour while sitting on a chair. This will help to relieve pressure on the bony prominences where pressure ulcer mostly occur. • Use pressure-relieving devices and implement pressure reduction surfaces like air mattress, foam mattress. • Keep clients clean, dry, well-nourished, and hydrated. • If possible, encourage ambulation and mobility of clients. TREATMENT OPTIONS: List two treatment options for pressure ulcers BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score • Cleaning and dressing the wound as prescribed • Adequate nutrition can encourage wound healing. • Administer prescribed analgesics to relieve pain, antimicrobials, and antibiotics to prevent infection. • Surgical intervention and wound vac. RISK POTENTIAL: Discuss two indicators that increase a client’s risk for pressure ulcer • Limited mobility which can lead to poor blood flow and circulation thereby causing bedsores. • Incontinence which can lead to skin damage and may encourage pressure ulcer to develop. • Poor nutritional status: Patients with poor nutritional status have a higher chance of developing pressure ulcer • Pain can limit a client’s ability to reposition himself. A nurse is caring for a client who is receiving a blood transfusion. What nursing actions should the nurse anticipate if a transfusion reaction is suspected? • STOP THE INFUSION and maintain intravenous (IV) access by infusing normal saline solution through new tubing at a slow rate. BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score • What are the similarities? Most reactions result in changes in vital signs, fever, chills, back/abdominal pain, and headache. • For each type of blood reaction, name a medication that can be administered and explain why that medication would be given. This question has been answered above. POTENTIAL COMPLICATIONS: Describe one nursing actions for each type of reaction : BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score The first and priority nursing action for any kind of blood transfusion reaction is to STOP THE INFUSION. OUTCOMES: How do we identify improvement following blood administration? What blood type is considered the universal donor and why? people with type O blood are known as “universal donors” because anyone can receive type O red blood cells What blood type is considered the universal recipient and why? People with type AB blood are known as “universal recipients” because type AB individuals can receive red blood cells of any ABO type. Are the answers to these questions the same for all blood products? Give an example of any differences if there are any. The only difference I know is that for plasma blood product, AB plasma donors can give to all blood types. BIOL 334 ATI MEDSURG FOCUSED REVIEW CORRECT STUDY GUIDE (100% VERIFIED). Download to score 1. Identify and discuss three risk factors that can result in heart failure. • Hypertension • Obesity • Coronary artery disease • Diabetes • smoking 2. Identify and discuss three types of medications that you might anticipate being prescribed for a client with heart failure. Discuss why these meds would be used. • Diuretics like Furosemide (Lasix) and chlorothiazide : These help to get rid of extra fluid and relieves symptoms like swelling on the leg. • Beta Blockers like metoprolol and carvedilol : These medications slow the heart rate. It can help the heart fill with blood more completely and also lowers the blood pressure.