SIMPLIFIED STUDY GUIDE: NR 341 Week 7 Exam Three Study Guide (Chapters 19, 20, 6, 17, 13,, Exercises of Nursing

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SIMPLIFIED STUDY GUIDE: NR 341 Week 7 Exam Three Study Guide (Chapters 19, 20, 6, 17, 13, 21, 18) Chapter 19 Trauma and Surgical Management • Introduction • Trauma demographics • Systems approach to trauma care o Trauma system ▪ Levels of trauma care ▪ Trauma continuum ▪ Injury prevention ▪ Trauma team concept ▪ Prehospital care and transport ▪ Trauma triage ▪ Disaster and mass casualty management • Mechanism of injury o Blunt trauma o Penetrating trauma o Blast injuries • Emergency care phase o Initial patient assessment o Primary and secondary survey • Resuscitation phase o Establishing airway patency o Maintaining effect breathing o Maintaining circulation o Diagnostic testing o Adequacy of resuscitation o Fluid resuscitation o Assessment of neurological disabilities o Exposure and environmental considerations • Assessment and management of specific organ injuries o Thoracic injuries ▪ Injury above the glottis ▪ Injury below the glottis • Burn classification and severity o Depth of injury o Extent of injury • Physiological response to burn injury o Cardiovascular response o Host defense mechanisms o Pulmonary response o Renal response o Gastrointestinal response o Metabolic response • Phases of burn assessment and collaborative interventions o Resuscitative phase: prehospital ▪ Primary survey • Stopping the burning process • Airway (with cervical spine precautions)breathing • Circulation ▪ Secondary survey o Resuscitative phase: emergency department and critical care burn center ▪ Transfer to a burn center ▪ Primary survey • Airway • Breathing • Circulation o Fluid resuscitation o End point monitoring o Peripheral circulation ▪ Secondary survey • Cardiovascular system • Neurological status • Renal status • Gastrointestinal system • Integumentary system • Blood and electrolytes o Acute care phase: critical care burn center ▪ Respiratory system ▪ Cardiovascular system ▪ Neurological status ▪ Renal status ▪ Gastrointestinal system ▪ Integumentary system ▪ Blood and electrolytes • Special considerations and areas of concern o Burns of the face o Burns of the ears o Burns of the eyes • Practice guidelines o Enteral nutrition o Parenteral nutrition o Drug-nutrient interactions • Monitoring nutritional status and complications of nutritional support o Monitoring and evaluating the nutrition care plan Chapter 17 Gastrointestinal Alterations • Introduction • Review of anatomy and physiology o Gastrointestinal tract ▪ Gut wall • Mucosa o Gastric mucosal barrier • Submucosa ▪ Oropharyngeal cavity • Mouth • Salivary glands • Pharynx ▪ Esophagus ▪ Stomach ▪ Small intestine ▪ Large intestine o Accessory organs ▪ Pancreas ▪ Liver • Vascular functions o Blood storage o Blood filtration • Secretory functions o Bile production o Bilirubin metabolism • Metabolic functions o Carbohydrate metabolism o Fat metabolism o Protein metabolism o Production and removal of blood clotting factors o Detoxification o Storage, synthesis, and transport of vitamins and minerals ▪ Gallbladder o Neural innervation of the gastrointestinal system o Hormonal control of the gastrointestinal system o Blood supply of the gastrointestinal system o Geriatric considerations • General assessment of the gastrointestinal system o History o Inspection ▪ Skin color and texture ▪ Transjugular intrahepatic portosystemic shunt ▪ Esophagogastric tamponade ▪ Surgical interventions o Patient outcomes • Acute pancreatitis o Pathophysiology o Assessment ▪ History and physical examination ▪ Diagnostic tests ▪ Predicting the severity of acute pancreatitis o Nursing diagnoses o Medical and nursing interventions ▪ Fluid replacement ▪ New modalities ▪ Electrolyte replacement ▪ Nutrition support ▪ Comfort management ▪ Pharmacological intervention ▪ Treatment of systemic complications ▪ Surgical therapy o Patient outcomes • Hepatic failure o Pathophysiology ▪ Hepatitis • Assessment • Nursing diagnoses • Medical and nursing interventions ▪ Cirrhosis ▪ Fatty liver o Assessment of hepatic failure ▪ Presenting clinical signs • Portal hypertension • Impaired metabolic processes • Impaired bile formation and flow o Nursing diagnoses o Medical and nursing interventions ▪ Diagnostic tests ▪ Supportive therapy ▪ Support for the failing liver ▪ Treatment of complications • Ascites • Portal systemic encephalopathy • Hepatorenal syndrome • Hepatopulmonary syndrome o Patient outcomes • Bariatric surgery Chapter 13: Nervous System Alterations • Introduction o Assessment ▪ Monitoring Techniques • Intracranial Pressure Monitoring • Cerebral Oxygenation Monitoring o Diagnostic Testing o Nursing Diagnoses o Management ▪ Medical and Nursing Interventions (Nonsurgical) • Nursing Actions to Manage Intracranial Pressure • Medical Management • Adequate Oxygenation • Management of Carbon Dioxide • Diuretics • Optimal Fluid Administration • Blood Pressure Management • Reducing Metabolic Demands o Temperature Control o Sedation o Seizure prophylaxis o Neuromuscular Blockade and Barbiturate Therapy ▪ Surgical Interventions ▪ Psychosocial Support • Traumatic Brain Injury (TBI) o Pathophysiology ▪ Scalp Lacerations ▪ Skull Fractures • Linear Skull Fracture • Depressed Skull Fracture • Comminuted Skull Fracture ▪ Brain injury • Primary Brain Injury • Concussion • Contusion • Diffuse Axonal injury • Penetrating Injury • Hematoma o Epidural Hematoma o Subdural Hematoma o Intracerebral Hematoma • Secondary Brain Injury o Assessment ▪ Nursing Diagnoses o Management ▪ Medical (Nonsurgical) Interventions ▪ Surgical Interventions • Acute Stroke o Pathophysiology ▪ Ischemic Stroke ▪ Pathophysiology ▪ Assessment ▪ Diagnostics Tests ▪ Management • Nursing Diagnoses • Nursing and Medical Management • Spinal Cord Injury o Pathophysiology o Assessment ▪ Airway and Respiratory Assessment ▪ Neurological Assessment ▪ Bowel and Bladder Function ▪ Skin Assessment ▪ Psychological Assessment o Diagnostic Studies o Management ▪ Nursing Interventions ▪ Nursing and Medical Interventions ▪ Surgical Intervention Chapter 21 Solid Organ Transplantation • Introduction o Organ donation o Donor management ▪ Organ recovery o selection of candidates for transplantation o posttransplant management ▪ infection ▪ recipient-derived infections ▪ viral infections ▪ malignancies • transplant immunology: immunosuppression and rejection o immunosuppression o rejection • lung transplantation o indications o candidate criteria o donor criteria o postoperative management ▪ complications ▪ rejection • kidney transplantation o indications o candidate criteria o donor criteria o postoperative management ▪ complications ▪ rejection • heart transplantation • Laboratory evaluation ▪ Nursing and medical interventions • Respiratory support • Fluid replacement • Insulin therapy • Electrolyte management • Treatment of acidosis • Patient and family education ▪ Patient outcomes o Hypoglycemia ▪ Pathophysiology ▪ Etiology ▪ Assessment • Clinical presentation • Laboratory evaluation ▪ Nursing diagnoses ▪ Nursing and medical interventions ▪ Patient outcomes • Acute and relative adrenal insufficiency o Etiology o Review of physiology o Pathophysiology o Assessment ▪ Clinical presentation • Cardiovascular system • Neurological system • Gastrointestinal system • Genitourinary system ▪ Laboratory evaluation o Nursing diagnoses o Nursing and medical interventions ▪ Fluid and electrolyte replacement ▪ Hormone replacement ▪ Patient and family education • Thyroid gland in critical care o Review of physiology o Effects of aging o Thyroid function in the critically ill • Thyroid crisis o Etiology o Thyrotoxic crisis (thyroid story) ▪ Pathophysiology ▪ Assessment • Clinical presentation o Thermoregulation disturbances o Neurological disturbances o Cardiovascular disturbances o Pulmonary disturbances ▪ Pathophysiology ▪ Assessment • Clinical presentation • Laboratory evaluation ▪ Nursing diagnoses ▪ Nursing and medical interventions • Volume replacement • Hormone replacement • Nephrogenic diabetes insipidus • Patient and family education ▪ Patient outcomes o Syndrome of inappropriate antidiuretic hormone ▪ Etiology ▪ Pathophysiology ▪ Assessment • Clinical presentation o Central nervous system o Gastrointestinal system o Cardiovascular system o Pulmonary system • Laboratory evaluation ▪ Nursing diagnoses ▪ Nursing and medical interventions • Fluid balance • Nursing • Patient and family education ▪ Patient outcomes o Cerebral salt wasting ▪ Etiology ▪ Pathophysiology ▪ Assessment ▪ Clinical presentation • Laboratory evaluation ▪ Nursing diagnoses ▪ Nursing and medical interventions ▪ Patient outcomes