ATI RN Adult Medical Surgical 2023 Key Points
1. Seizure precautions: Ensure client has IV access for seizure medication administration.
2. Postoperative lab values: Report Hgb level of 8 g/dL to provider as an indicator of postoperative
hemorrhage or anemia.
3. ESWL procedure: Expect stone fragments in the urine after extracorporeal shock wave lithotripsy.
4. Airborne precautions: Initiate airborne precautions for a client with anorexia, low-grade fever, night
sweats, and productive cough, as these are manifestations of tuberculosis.
5. TPN administration: Administer dextrose 10% in water until new TPN bag arrives to avoid drop in blood
glucose level.
6. Levothyroxine interaction: Instruct client to avoid taking calcium within 4 hr of levothyroxine admin-
istration, as calcium can interfere with the effectiveness of the medication.
7. Mechanical ventilation anxiety: Instruct client to allow the machine to breathe for them to reduce
anxiety and restlessness associated with fighting the ventilator.
8. Adverse effect of enalapril: Identify orthostatic hypotension as an adverse effect of enalapril.
9. Delayed wound healing: Identify urine output of 25 mL/hr as a finding that contributes to delayed
wound healing.
10. Hypothyroidism and opioid analgesic: Instruct client to void every 4 hours to decrease the risk
of urinary retention, which is an adverse effect of opioid analgesics.
11. Portal hypertension: Obtain vital signs first when caring for a client who is vomiting blood mixed with
food after a meal, as this indicates a potential rupture of esophageal varices.
12. Gastrectomy postoperative instructions: Instruct client to avoid drinking fluids with meals,
eat several small meals per day, consume high-protein snacks, and avoid highly seasoned foods.
13. Cushing's triad: Identify bradycardia as a component of Cushing's triad in a client with increased intracra-
nial pressure from a traumatic brain injury.
14. Client coping with diabetes diagnosis: Recognize the client's change in behavior of inspecting
feet daily as an indication of successful coping with the diagnosis.
15. Inguinal hernia assessment: Palpate location C to verify the presence of an inguinal hernia.
16. Rattlesnake bite treatment: Expect a prescription for an opioid analgesic to promote comfort
following a rattlesnake bite.
17. Hemodialysis treatment: Perform a 12-lead ECG, place the client in Trendelenburg position, admin-
ister a 0.9% sodium chloride 200 mL IV bolus, apply oxygen at 2 L/min via nasal cannula, and notify the provider
immediately.
18. Client rights: Ensure a client signs informed consent before receiving a placebo during a research trial.
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1. Seizure precautions: Ensure client has IV access for seizure medication administration.
2. Postoperative lab values: Report Hgb level of 8 g/dL to provider as an indicator of postoperative
hemorrhage or anemia.
3. ESWL procedure: Expect stone fragments in the urine after extracorporeal shock wave lithotripsy.
4. Airborne precautions: Initiate airborne precautions for a client with anorexia, low-grade fever, night
sweats, and productive cough, as these are manifestations of tuberculosis.
5. TPN administration: Administer dextrose 10% in water until new TPN bag arrives to avoid drop in blood
glucose level.
6. Levothyroxine interaction: Instruct client to avoid taking calcium within 4 hr of levothyroxine admin-
istration, as calcium can interfere with the effectiveness of the medication.
7. Mechanical ventilation anxiety: Instruct client to allow the machine to breathe for them to reduce
anxiety and restlessness associated with fighting the ventilator.
8. Adverse effect of enalapril: Identify orthostatic hypotension as an adverse effect of enalapril.
9. Delayed wound healing: Identify urine output of 25 mL/hr as a finding that contributes to delayed
wound healing.
10. Hypothyroidism and opioid analgesic: Instruct client to void every 4 hours to decrease the risk
of urinary retention, which is an adverse effect of opioid analgesics.
11. Portal hypertension: Obtain vital signs first when caring for a client who is vomiting blood mixed with
food after a meal, as this indicates a potential rupture of esophageal varices.
12. Gastrectomy postoperative instructions: Instruct client to avoid drinking fluids with meals,
eat several small meals per day, consume high-protein snacks, and avoid highly seasoned foods.
13. Cushing's triad: Identify bradycardia as a component of Cushing's triad in a client with increased intracra-
nial pressure from a traumatic brain injury.
14. Client coping with diabetes diagnosis: Recognize the client's change in behavior of inspecting
feet daily as an indication of successful coping with the diagnosis.
15. Inguinal hernia assessment: Palpate location C to verify the presence of an inguinal hernia.
16. Rattlesnake bite treatment: Expect a prescription for an opioid analgesic to promote comfort
following a rattlesnake bite.
17. Hemodialysis treatment: Perform a 12-lead ECG, place the client in Trendelenburg position, admin-
ister a 0.9% sodium chloride 200 mL IV bolus, apply oxygen at 2 L/min via nasal cannula, and notify the provider
immediately.
18. Client rights: Ensure a client signs informed consent before receiving a placebo during a research trial.
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