lOMoARcPSD|32226831
COMPLETE MED-SURG
BUNDLE
, lOMoARcPSD|32226831
TABLE OF CONTENTS
Nervous System Disorders 1
Respiratory System Disorders 17
Cardiovascular System Disorders 30
EKG Interpretation 42
Gastrointestinal System Disorders 52
Hepatic System Disorders 60
Renal-Urinary Disorders 63
Endocrine System Disorders 70
Integumentary System Disorders 82
Hematologic Disorders 89
Musculoskeletal System Disorders 93
Reproductive System Disorders 99
Immune System 101
Cancer 104
Shocks 110
Bed Positions 111
Acid-Base Balance 114
Lab Values 118
, lOMoARcPSD|32226831
Frontal Lobe Injured Brain Area Nursing Intervention
Parietal Lobe
Frontal Lobe Give simple instructions,
re-orientate as needed
Temporal Lobe Speak clearly due to
impaired hearing
Occipital Occipital Lobe Assist with ADL due to
Lobe visual disturbances.
Cerebellum Assist with walking
Brain Stem Monitor Vital Signs
Temporal Lobe
Cerebellum Parietal Lobe Provide simple, one-step
instructions
- Cerebrum
Consists in the Right and Left hemisphere. Each one receives sensory info from the opposite side of
the body.
- Cerebral Cortex
Outer grey matter
Frontal Lobe: Contains the motor cortex and Broca’s area (speech function)
Parietal Lobe: Contains the sensory cortex.
Occipital Lobe: Contains the visual cortex.
Temporal Lobe: Contains the auditory cortex and Wernicke’s area (comprehension of verbal/written
language).
- Basal Ganglia
Cell bodies in white matter that help cerebral cortex produce voluntary movements.
- Diencephalon
Thalamus: relays sensory impulses to the cortex. Provide a Pain gate. Part of Reticular activating
system.
Hypothalamus: Regulates responses of Sympathetic/Parasympathetic Nervous System. Regulates
Stress response, sleep, appetite, body temperature, fluid balance, and emotions. Responsible for
production of Hormones secreted by the Pituitary Gland and hypothalamus.
- Brainstem
Midbrain: Motor coordination. Visual reflex and auditory relay centers.
Pons: Respiratory center and regulates breathing.
Medulla Oblongata: Contains Afferent and efferent tracts, and cardiac, respiratory, vomiting, and
vasomotor center. Controls Heart Rate, respiration, blood vessel diameter, sneezing, swallowing,
vomiting and coughing.
- Cerebellum
Coordinates muscle movement, posture, equilibrium, and muscle tone.
NursingExamSuccess
, lOMoARcPSD|32226831
- Sympathetic (Adrenergic)
Fight or Flight. Originates at T1-L2 in the spinal cord.
Effects: Increase cardiac output, vasoconstriction (Increase BP), bronchodilation, pupil dilation,
Decrease secretions and peristalsis. Increase perspiration.
- Parasympathetic (Cholinergic)
Rest and Digest. Originates at S2-S4 in the spinal cord.
Effects: Decrease cardiac output, Vasodilation (Decrease BP), Bronchoconstriction, pupil constriction,
Increases Secretions and Peristalsis. Increase salivation, bladder contraction.
Computed Tomography (CT)
A brain scan that may or may not require injection of dye. Used to detect intracranial bleed, cerebral
edema, infarctions, hydrocephalus, cerebral atrophy, shifts of brain structures.
Pre-procedure: Assess for allergies to Iodine, contrast dyes, shellfish if using dye. Withhold metformin if
iodinated contrast dye used, risk of metformin-induced lactic acidosis.
Post-procedure: Fluids replacement, monitor for allergies to dye. Assess injection site for bleeding.
Magnetic Resonance Imaging (MRI)
Noninvasive procedure that identifies tissues, tumors, and vascular abnormalities. Provides more
detailed pictures than a CT.
Pre-procedure: Remove all metal objects from the client. Make sure patient doesn’t have metal
implants, pace-maker, implanted defibrillator, hip prosthesis, vascular clip. Also contraindicated in
pregnant women (Increases temperature of Amniotic fluid). Assess for claustrophobia.
Post-procedure: Patient resumes normal activities.
Cerebral Angiography
Injection of contrast usually through the femoral artery into the carotid artery to visualize cerebral
arteries, and assess for lesions.
Pre-procedure: Assess for allergies to Iodine and shellfish. Assess Renal Function. Withhold
anticoagulation meds. NPO 4-6 hours before procedure. Assess and mark distal pulses (to easily
recheck them post-op).
Post-procedure: Monitor for swelling of the neck and difficulty swallowing. Bed rest for 12hrs. Check
insertion site for bleeding. Keep extremity straight and check for blood flow distal to the puncture site
(pulses, capillary refill, temp, color). Increase fluid intake.
Electroencephalography (EEG)
Used to identify seizures, sleep disorders, and other conditions. Electrodes place on scalp to record
electrical activity in the brain.
Pre-procedure: Wash the patient’s hair. Withhold coffee, tea, caffeine beverages, antidepressants,
tranquilizers, and seizure meds 24-48hrs before test. No NPO needed, can have breakfast.
During-procedure: Hyperventilation or strobe lights may be used to increase seizure activity.
Post-procedure: Wash patient’s hair. Safety precautions if patient was sedated. NursingExamSuccess
COMPLETE MED-SURG
BUNDLE
, lOMoARcPSD|32226831
TABLE OF CONTENTS
Nervous System Disorders 1
Respiratory System Disorders 17
Cardiovascular System Disorders 30
EKG Interpretation 42
Gastrointestinal System Disorders 52
Hepatic System Disorders 60
Renal-Urinary Disorders 63
Endocrine System Disorders 70
Integumentary System Disorders 82
Hematologic Disorders 89
Musculoskeletal System Disorders 93
Reproductive System Disorders 99
Immune System 101
Cancer 104
Shocks 110
Bed Positions 111
Acid-Base Balance 114
Lab Values 118
, lOMoARcPSD|32226831
Frontal Lobe Injured Brain Area Nursing Intervention
Parietal Lobe
Frontal Lobe Give simple instructions,
re-orientate as needed
Temporal Lobe Speak clearly due to
impaired hearing
Occipital Occipital Lobe Assist with ADL due to
Lobe visual disturbances.
Cerebellum Assist with walking
Brain Stem Monitor Vital Signs
Temporal Lobe
Cerebellum Parietal Lobe Provide simple, one-step
instructions
- Cerebrum
Consists in the Right and Left hemisphere. Each one receives sensory info from the opposite side of
the body.
- Cerebral Cortex
Outer grey matter
Frontal Lobe: Contains the motor cortex and Broca’s area (speech function)
Parietal Lobe: Contains the sensory cortex.
Occipital Lobe: Contains the visual cortex.
Temporal Lobe: Contains the auditory cortex and Wernicke’s area (comprehension of verbal/written
language).
- Basal Ganglia
Cell bodies in white matter that help cerebral cortex produce voluntary movements.
- Diencephalon
Thalamus: relays sensory impulses to the cortex. Provide a Pain gate. Part of Reticular activating
system.
Hypothalamus: Regulates responses of Sympathetic/Parasympathetic Nervous System. Regulates
Stress response, sleep, appetite, body temperature, fluid balance, and emotions. Responsible for
production of Hormones secreted by the Pituitary Gland and hypothalamus.
- Brainstem
Midbrain: Motor coordination. Visual reflex and auditory relay centers.
Pons: Respiratory center and regulates breathing.
Medulla Oblongata: Contains Afferent and efferent tracts, and cardiac, respiratory, vomiting, and
vasomotor center. Controls Heart Rate, respiration, blood vessel diameter, sneezing, swallowing,
vomiting and coughing.
- Cerebellum
Coordinates muscle movement, posture, equilibrium, and muscle tone.
NursingExamSuccess
, lOMoARcPSD|32226831
- Sympathetic (Adrenergic)
Fight or Flight. Originates at T1-L2 in the spinal cord.
Effects: Increase cardiac output, vasoconstriction (Increase BP), bronchodilation, pupil dilation,
Decrease secretions and peristalsis. Increase perspiration.
- Parasympathetic (Cholinergic)
Rest and Digest. Originates at S2-S4 in the spinal cord.
Effects: Decrease cardiac output, Vasodilation (Decrease BP), Bronchoconstriction, pupil constriction,
Increases Secretions and Peristalsis. Increase salivation, bladder contraction.
Computed Tomography (CT)
A brain scan that may or may not require injection of dye. Used to detect intracranial bleed, cerebral
edema, infarctions, hydrocephalus, cerebral atrophy, shifts of brain structures.
Pre-procedure: Assess for allergies to Iodine, contrast dyes, shellfish if using dye. Withhold metformin if
iodinated contrast dye used, risk of metformin-induced lactic acidosis.
Post-procedure: Fluids replacement, monitor for allergies to dye. Assess injection site for bleeding.
Magnetic Resonance Imaging (MRI)
Noninvasive procedure that identifies tissues, tumors, and vascular abnormalities. Provides more
detailed pictures than a CT.
Pre-procedure: Remove all metal objects from the client. Make sure patient doesn’t have metal
implants, pace-maker, implanted defibrillator, hip prosthesis, vascular clip. Also contraindicated in
pregnant women (Increases temperature of Amniotic fluid). Assess for claustrophobia.
Post-procedure: Patient resumes normal activities.
Cerebral Angiography
Injection of contrast usually through the femoral artery into the carotid artery to visualize cerebral
arteries, and assess for lesions.
Pre-procedure: Assess for allergies to Iodine and shellfish. Assess Renal Function. Withhold
anticoagulation meds. NPO 4-6 hours before procedure. Assess and mark distal pulses (to easily
recheck them post-op).
Post-procedure: Monitor for swelling of the neck and difficulty swallowing. Bed rest for 12hrs. Check
insertion site for bleeding. Keep extremity straight and check for blood flow distal to the puncture site
(pulses, capillary refill, temp, color). Increase fluid intake.
Electroencephalography (EEG)
Used to identify seizures, sleep disorders, and other conditions. Electrodes place on scalp to record
electrical activity in the brain.
Pre-procedure: Wash the patient’s hair. Withhold coffee, tea, caffeine beverages, antidepressants,
tranquilizers, and seizure meds 24-48hrs before test. No NPO needed, can have breakfast.
During-procedure: Hyperventilation or strobe lights may be used to increase seizure activity.
Post-procedure: Wash patient’s hair. Safety precautions if patient was sedated. NursingExamSuccess
