ATI Med Surg
Study Guide
GRADUATEnurse
, lOMoARcPSD|18324521
MEDSURG ATI
Chapter 2: Emergency Nursing Principles and Management
Class 4: Black tag: Penetrating head wound
Airway – head lift chin lift unless SCI
Breathing
Circulation
Disability- LOC by Glasgow coma scale A&O
Exposure- EX. Hypothermia à increase temp of room, warm iv fluids, a warm blanket,
heat lamps
Poisoning
1. Activated charcoal
2. Gastric Lavage
3. Hold bowel irrigation
Cardiac emergencies:
Pulseless V-Tach & V-Fib
à CPR, IV access, epinephrine
Amiordiane, lidocaine, magnesium, vasopressor
Alpha 1: Vasoconstriction
à helps with congestion, bleeding, increases BP
Beta 1: Stimulate the heart
à increases HR, TREATS AV BLOCK AND CARDIAC ARREST
Beta 2: Heart/lungs
à Bronchodilatorà Asthma
Dopamineà Renal blood vessels to dilate
Epinephrine(INCREASES HR, INCREASES BP, BRONCHODILATION): Alpha 1, beta 1& 2
Alpha Vasoconstrictor increase BP
Beta 1 Increase HR
Beta 2 Bronchodilator
SE: HYPERTENSION and lead to Dysrhythmias and angina
Dopamine : USED FOR HF & SHOCK
Beta 1: IncreaseàHR
high doses alpha and beta 1: increases HR and Increase BP
SE: Dysrhythmias and angina
1
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Dobutamine USED FOR HF
Beta 1: increases HR
Chapter 3: Neurologic Diagnostic Procedures
Cerebral angiography: Visualizes brain vessels in the brain inserted through the
neck/groin
• Uses contrast dye check allergies(shellfish/iodine)
• No pregnant (toxic)
• Check renal functions (BUN(10-20), creatinine(0.6-1.2)
à check ability to excrete
dye
• ANTICOAGULANT RISK OF BLEEDING
• Monitor for bleeding/distal pulses
• 4-6 hr NPO before procedure
CT SCAN: contrast dye
EEG: used to detect seizures, sleep disorders, behavioral issues
• wash hair
• sleep deprived
• expose the patient to bright lights and hyperventilate
• 1 hr procedure
• NO FASTING
Glass cow coma scale: LOC
1-15
Less thanà
8 coma & severe head injury
Eye opening 1-4
4-open spontaneously
3- open w/ voice
2-open to pain
1-no eye opening
Verbal 1-5
5-coherent/oriented
4-incoherent/disoriented
3-slurred speech
2- Sounds no word
1- No vocalization
Motor 1-6
6-Follow commands
5-local reaction to pain
2
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4-general withdraw from pain
3: decorticate
2: decerebrate (worst)
1: No motor response
ICP: score of 8 and below
ICP Monitoringà high risk for infection, which can lead to meningitis
1. Intraventricular catheter
2. Subarachnoid screw/bolt
3. Epidural/subdural sensor
Treat pain *
S/S: Irritability
Severe headache
Decrease LOC
Unresponsive pupil
Alterations in breathing (apnea, Cheyne’s stoke, abnormal posturing, hyperventilation)
Normal ICP 5-15
Lumbar Puncture: used to withdraw CSF test for like meningitis, MS, syphilis
• Empty bladder prior
• Side-lying with knees to abdomen/chest
• Local anesthesia
• Monitor puncture site
à SUPINE POSITION FOR SEVERAL HOURS
If clotting does not occur to seal the puncture site, CSF can leak, increased
headache and increased risk for infection
à can be sealed with an epidural blood
patch
MRI’s: Sometimes uses contrast
Remove jewelry
Check for claustrophobicà sedation can be used
Implants w/metals: Pacemaker, orthopedic joint, article heart valves, aneurysm
clips
Earplugs à loud procedure
Parents can be in the room
PET scans: nuclear medicine checks for tumor activity
X-ray: diagnosing neurological issues
Fractures, curvatures, SCI can damage the nerves system
Chapter 4: Pain management
1. Acute pain: protective, temporary, resolves w/ tissue healing
3
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Study Guide
GRADUATEnurse
, lOMoARcPSD|18324521
MEDSURG ATI
Chapter 2: Emergency Nursing Principles and Management
Class 4: Black tag: Penetrating head wound
Airway – head lift chin lift unless SCI
Breathing
Circulation
Disability- LOC by Glasgow coma scale A&O
Exposure- EX. Hypothermia à increase temp of room, warm iv fluids, a warm blanket,
heat lamps
Poisoning
1. Activated charcoal
2. Gastric Lavage
3. Hold bowel irrigation
Cardiac emergencies:
Pulseless V-Tach & V-Fib
à CPR, IV access, epinephrine
Amiordiane, lidocaine, magnesium, vasopressor
Alpha 1: Vasoconstriction
à helps with congestion, bleeding, increases BP
Beta 1: Stimulate the heart
à increases HR, TREATS AV BLOCK AND CARDIAC ARREST
Beta 2: Heart/lungs
à Bronchodilatorà Asthma
Dopamineà Renal blood vessels to dilate
Epinephrine(INCREASES HR, INCREASES BP, BRONCHODILATION): Alpha 1, beta 1& 2
Alpha Vasoconstrictor increase BP
Beta 1 Increase HR
Beta 2 Bronchodilator
SE: HYPERTENSION and lead to Dysrhythmias and angina
Dopamine : USED FOR HF & SHOCK
Beta 1: IncreaseàHR
high doses alpha and beta 1: increases HR and Increase BP
SE: Dysrhythmias and angina
1
Downloaded by antony wamunyu ()
, lOMoARcPSD|18324521
Dobutamine USED FOR HF
Beta 1: increases HR
Chapter 3: Neurologic Diagnostic Procedures
Cerebral angiography: Visualizes brain vessels in the brain inserted through the
neck/groin
• Uses contrast dye check allergies(shellfish/iodine)
• No pregnant (toxic)
• Check renal functions (BUN(10-20), creatinine(0.6-1.2)
à check ability to excrete
dye
• ANTICOAGULANT RISK OF BLEEDING
• Monitor for bleeding/distal pulses
• 4-6 hr NPO before procedure
CT SCAN: contrast dye
EEG: used to detect seizures, sleep disorders, behavioral issues
• wash hair
• sleep deprived
• expose the patient to bright lights and hyperventilate
• 1 hr procedure
• NO FASTING
Glass cow coma scale: LOC
1-15
Less thanà
8 coma & severe head injury
Eye opening 1-4
4-open spontaneously
3- open w/ voice
2-open to pain
1-no eye opening
Verbal 1-5
5-coherent/oriented
4-incoherent/disoriented
3-slurred speech
2- Sounds no word
1- No vocalization
Motor 1-6
6-Follow commands
5-local reaction to pain
2
Downloaded by antony wamunyu ()
, lOMoARcPSD|18324521
4-general withdraw from pain
3: decorticate
2: decerebrate (worst)
1: No motor response
ICP: score of 8 and below
ICP Monitoringà high risk for infection, which can lead to meningitis
1. Intraventricular catheter
2. Subarachnoid screw/bolt
3. Epidural/subdural sensor
Treat pain *
S/S: Irritability
Severe headache
Decrease LOC
Unresponsive pupil
Alterations in breathing (apnea, Cheyne’s stoke, abnormal posturing, hyperventilation)
Normal ICP 5-15
Lumbar Puncture: used to withdraw CSF test for like meningitis, MS, syphilis
• Empty bladder prior
• Side-lying with knees to abdomen/chest
• Local anesthesia
• Monitor puncture site
à SUPINE POSITION FOR SEVERAL HOURS
If clotting does not occur to seal the puncture site, CSF can leak, increased
headache and increased risk for infection
à can be sealed with an epidural blood
patch
MRI’s: Sometimes uses contrast
Remove jewelry
Check for claustrophobicà sedation can be used
Implants w/metals: Pacemaker, orthopedic joint, article heart valves, aneurysm
clips
Earplugs à loud procedure
Parents can be in the room
PET scans: nuclear medicine checks for tumor activity
X-ray: diagnosing neurological issues
Fractures, curvatures, SCI can damage the nerves system
Chapter 4: Pain management
1. Acute pain: protective, temporary, resolves w/ tissue healing
3
Downloaded by antony wamunyu ()
