Final Study Guide Med surg

NURS120- MED SURG FINAL STUDY GUIDE Diagnostic - determines origin and cause of disorder Curative - resolves health problem by repairing/removing cause Restorative - improves patients’ functional ability Palliative - relieves symptoms of disease process, but does not cure Cosmetic - alters/enhances personal appearance Informed consent - surgeon obtains signed consent Preoperative Fasting - NPO 8 hrs prior to surgery, decreases risk for aspiration Malignant Hyperthermia - may be genetic, increased metabolism, leads to acidosis, high temp, muscle rigidity, dysrhythmias (reversal: dantrolene) Endoscopy - tube through mouth to small intestine Normal finding- delayed swallow response Abnormal finding- blood sputum, hoarseness, inability to speak Colonoscopy - use go lightly (day before, encourage high fluid intake b/c will lose lots of fluids), tube in rectum to large intestine Malignant Hyperthermia in Acute phase* Abnormal finding- dark tarry (upper GI), bright red (lower GI) GERD Triggers- fatty foods, chocolate, peppermint, coffee, tea, milk, late/large meals S/S- pyrosis (heartburn), regurgitation Treatment- avoid aggravating factors, small frequent meals, last meal 3 hrs prior to bed, lose weight, drugs (H2 Antihistamine, PPI, Sucralfate) RN- lifestyle changes, elevate 30 degrees, not supine 2-3 hrs after meal, fluids Complication- Barrett’s esophagus, PNA, bronchitis, asthma (due to gastric secretions) IBD- lost of meds needed Crohns - any part of GI tract Risk factors- genetic, environmental (smog), immune system abnormalities S/S- fever, weight loss, malabsorption Treatment- bowel rest, drugs Comp- Fistulas, strictures, anal abscess, perforation UC - starts at rectum to colon S/S- rectal bleeding (pink/frothy), rectal pain (tenesmus) Treatment- Colectomy Comp- perforation PUD Risk factor- H.Pylori, NSAID use, high alcohol intake, smoking, stress, coffee S/S- burning/gaseous pain 1-5 hrs after meals, bleed, dehydration, feeling of fullness, NV Tests- Stool/Breath test Treatment- avoid spicy food, caffeine, pepper, broth, NG tube, rehydrate, bowel rest, drugs (H2 Antihistamine, PPI, ABX, Antacids) Complication- Hemorrhage, perforation (tight/rigidty), high HR, weak pulse, high RR Gastritis Risk factor- smoking, diet, NSAIDs, H.Pylori S/S- loss of IF, anorexia, anemia Closed reduction - nonsurgical, manual realignment of bone fragments to their anatomical position Open reduction - correction of bone alignment through surgical incision, screws/wires/pins/plates Traction - application of a pulling force to an injured/diseased body part Bucks Traction - 24-48 hrs before surgery to relieve painful muscle spasms, alignment of the bone assess skin/pressure points Q2-4hrs Skin Traction - removable, complication of weight falling & constant readjustment (do not touch) Skeletal Traction - holding different areas, tissue damage RICE - rest, ice, compress, elevate Hypoglycemia - sweat, pallor, hunger, shaky, tired, dizzy, palpitations,

NURS120- MED SURG FINAL STUDY GUIDE lack of coordination Treat- 15g carb, IV dextrose Hyperglycemia - dry mouth, thirst, weak, headache, blurred vision, frequent urination (3 P’s) Treat- insulin, fluids DKA - ketones, fruity breath, SOB, confusion, coma, abd pain Treat- insulin drip, 5% dextrose, fluids Hypovolemia - fluid volume deficit, decrease BP, decrease O2 Risk for Orthostatic Hypotension, increase sodium Nutrition for wound healing Vit C - collagen prod Vit A - epithelization Protein - synth of immune factors Carb - metabolic, energy Compartment Syndrome Early signs- pain unmanageable, Late-6 P’s (pain, pressure, paresthesia, pallor, paralysis, pulselessness) relieve source of pressure, cut cast/low weight Pulselessness/Paralysis- amputation may be needed! (fasciotomy- surgical decompression where it is left open for adequate soft tissue decompression) RN- do not elevate legs/apply cold, vasoconstriction occurs and worsens it! VTE - esp after hip fracture • Anticoagulant drugs given for 10-14 days (warfarin/heparin/aspirin/factor Xa inhibitor) • Wear compression gradient stockings, Intermittent pneumatic compression devices • Dorsiflex/plantar flex/ROM exercises on unaffected leg FES • Symptoms occur 24-48 hrs after injury, after S/S fluid+O2 admin • FE in lungs- hemorrhage, ARDs, chest pain, tachypnea, cyanosis, dyspnea, tachycardia, hypoxic S/S- sudden chest pain URGENT, petechiae RN- reposition patient as little as possible before fracture immobilization/stabilization TB Risk factors- poor, crowded cities, traveled countries • Airborne, granulomas (hallmark signs) S/S- crackles, rhonchi, night sweats, weight loss, bloody sputum Treatment- RIPE meds, meds are harsh to live (watch ALT/AST) RIF (urine orange), INH (tingling hands/feet), PYRAZINAMIDE (increase uric acid), ETHAMBUTOL (vision changes) • DOT therapy if patient does not adhere to med regime • Mantoux test (skin test), BCG vaccine always test positive PE • Blood clot, fat, air in lungs