NSG 233 MED SURG 2 EXAM 1 DETAILED
PREPARATION PACK 2026
◉ PTSD- rape and stabbing. Answer: Keep patient comfortable
Offer therapeutic communication -listen
Avoid triggers
**ask if patient plans to harm self-
◉ Chest-Blunt trauma complications **. Answer: Flail chest:
paradoxical chest movement, hypoxemia, resp acidosis
Pulmonary contusion: abnormal accumulation of fluid,
- lung sounds, cough, frank blood, mucus, chest pain, atelectasis, -BP,
resp acidosis
Monitor: fluid intake, fluid replacement and pain
Managment: airway, O2, treat pain, bronchoscopy
Meds: morphine
Medical Management• ABC-oxygen, possible endotracheal
intubation, ventilatory support• Replace fluid volume• Restore
negative intrapleural pressure if needed• Needle decompression•
Chest tube if needed• Hemothorax• Pneumothorax• Hemo-
pneumothorax
◉ Crush injuries and trauma. Answer: Hypovolemic shock
,Spinal Cord Injury
Fractures
Acute Kidney Injury
Priority: ABC's
SATA: Rhabdomyolysis: Triad: muscle cramps, muscle weakness,
dark urine
Labs: CK levels, serum lactic acid levels
Compartment syndrome: elevate extremity, fasciotomy.
proper alignment of extremities, check peripheral pulses
Meds: pain, cephalosporins, penicillin
◉ Creatine Kinase (CK). Answer: Depend on age
30-200 men
30-170 women
◉ dissecting abdominal aneurysm. Answer: medical emergency
-chest or back pain is cardinal sign;
-hypotension;
-tachycardia
Weak pulses
treat with surgery stents
History: high blood pressure
, can cause cardiac tamponade/shock
◉ dissection aneurysm. Answer: hemorrhage into the vessel wall
with longitudinal tearing of the vessel wall to forma a blood-filled
channel
Clinical manifestations: sudden onset of excruciating pain, described
as TEARING or RIPPING
◉ PVC (Premature Ventricular Contraction). Answer: Irregular
rhythm. No Pwave. Wide,bizarre QRS.
Common and harmless
palpations, chest pain, SOB
not frequent- no treatment needed
frequent- medication is needed- amiodarone
◉ Hemorrhage -shock. Answer: Stop bleeding- pressure
Identify and treat the cause
-BP, +HR, cool clam skin, -H/H(Hgb -7 =Heaven),
Early: restless. Late: metabolic acidosis
◉ Shock- fluid**. Answer: two large-gauge IV
LR or NS
PREPARATION PACK 2026
◉ PTSD- rape and stabbing. Answer: Keep patient comfortable
Offer therapeutic communication -listen
Avoid triggers
**ask if patient plans to harm self-
◉ Chest-Blunt trauma complications **. Answer: Flail chest:
paradoxical chest movement, hypoxemia, resp acidosis
Pulmonary contusion: abnormal accumulation of fluid,
- lung sounds, cough, frank blood, mucus, chest pain, atelectasis, -BP,
resp acidosis
Monitor: fluid intake, fluid replacement and pain
Managment: airway, O2, treat pain, bronchoscopy
Meds: morphine
Medical Management• ABC-oxygen, possible endotracheal
intubation, ventilatory support• Replace fluid volume• Restore
negative intrapleural pressure if needed• Needle decompression•
Chest tube if needed• Hemothorax• Pneumothorax• Hemo-
pneumothorax
◉ Crush injuries and trauma. Answer: Hypovolemic shock
,Spinal Cord Injury
Fractures
Acute Kidney Injury
Priority: ABC's
SATA: Rhabdomyolysis: Triad: muscle cramps, muscle weakness,
dark urine
Labs: CK levels, serum lactic acid levels
Compartment syndrome: elevate extremity, fasciotomy.
proper alignment of extremities, check peripheral pulses
Meds: pain, cephalosporins, penicillin
◉ Creatine Kinase (CK). Answer: Depend on age
30-200 men
30-170 women
◉ dissecting abdominal aneurysm. Answer: medical emergency
-chest or back pain is cardinal sign;
-hypotension;
-tachycardia
Weak pulses
treat with surgery stents
History: high blood pressure
, can cause cardiac tamponade/shock
◉ dissection aneurysm. Answer: hemorrhage into the vessel wall
with longitudinal tearing of the vessel wall to forma a blood-filled
channel
Clinical manifestations: sudden onset of excruciating pain, described
as TEARING or RIPPING
◉ PVC (Premature Ventricular Contraction). Answer: Irregular
rhythm. No Pwave. Wide,bizarre QRS.
Common and harmless
palpations, chest pain, SOB
not frequent- no treatment needed
frequent- medication is needed- amiodarone
◉ Hemorrhage -shock. Answer: Stop bleeding- pressure
Identify and treat the cause
-BP, +HR, cool clam skin, -H/H(Hgb -7 =Heaven),
Early: restless. Late: metabolic acidosis
◉ Shock- fluid**. Answer: two large-gauge IV
LR or NS
