Summary Medical-Surgical Nursing Complete Study Notes: Foundations, Cardiovascular, Respiratory & GI Disorders (Chapters 1–5)

Medical-Surgical Nursing:
Complete Notes for
Students
Chapter 1: Foundations of Medical-
Surgical Nursing

1.1: Introduction to Medical-Surgical Nursing


I. Definition

Medical-Surgical Nursing is a specialty focused on adult patients with acute or chronic
health conditions across a wide range of settings. It emphasizes evidence-based practice,
clinical reasoning, and patient-centered care.



II. Roles of the Medical-Surgical Nurse

 Caregiver – Provides direct nursing care
 Educator – Teaches patients and families
 Advocate – Promotes patient rights and safety
 Collaborator – Works with healthcare team
 Leader/Manager – Delegates tasks, prioritizes care
 Researcher – Implements evidence-based interventions



III. Core Competencies

 Clinical judgment

,  Patient safety and quality care
 Cultural competence
 Communication and documentation
 Technological literacy (e.g., EMRs, monitoring systems)




1.2: Health and Illness Concepts


I. Health

A dynamic state of physical, mental, and social well-being.

II. Illness

A personal experience of diminished functioning or well-being.

III. Health Continuum

Health exists on a spectrum:

Wellness ←———————→ Illness
Optimal health to chronic illness


IV. Factors Influencing Health

 Genetics
 Environment
 Lifestyle (diet, activity, smoking)
 Socioeconomic status
 Access to care
 Cultural beliefs




1.3: The Nursing Process in Med-Surg Care


I. Steps of the Nursing Process

, Step Description
Assessment Collect data (subjective + objective)
Diagnosis Analyze data to determine nursing diagnoses
Planning Set SMART goals and prioritize interventions
Implementation Carry out interventions safely and effectively
Evaluation Assess outcomes and revise care plan if needed


II. Prioritization Frameworks

 Maslow’s Hierarchy of Needs
1. Physiological (airway, breathing, circulation)
2. Safety
3. Love/Belonging
4. Esteem
5. Self-actualization
 ABCs – Airway, Breathing, Circulation
 Acute vs. Chronic – Address acute before chronic issues
 Actual vs. Potential – Actual problems take precedence
 Systemic vs. Local – Systemic issues are more urgent




1.4: Patient Safety and Quality Care


I. National Patient Safety Goals (Joint Commission)

 Identify patients correctly (2 identifiers)
 Improve communication among caregivers
 Use medications safely
 Prevent infection
 Identify safety risks (e.g., suicide risk)
 Prevent surgical mistakes (correct patient/site)



II. Fall Prevention Strategies

 Bed in low position
 Call light within reach
 Hourly rounding
 Use of assistive devices

,  Non-slip footwear



III. Medication Safety

 Use 5 Rights: right patient, drug, dose, route, time
 Double-check high-alert medications (e.g., insulin, heparin)
 Use barcode scanning and electronic MAR




1.5: Cultural Competence in Nursing Care


I. Importance

Respecting cultural beliefs improves trust, adherence, and outcomes.



II. Key Concepts

 Cultural awareness – Self-reflection on own biases
 Cultural knowledge – Understanding patient backgrounds
 Cultural skills – Conducting culturally respectful assessments
 Cultural desire – Genuine interest in diverse perspectives



III. Spirituality and Beliefs

 Ask about religious practices, dietary needs, or prayer preferences
 Collaborate with chaplains or spiritual leaders if needed




✅ Chapter 1 Summary: Key Takeaways
 Med-surg nurses must be competent, adaptable, and safety-focused.
 The nursing process is foundational for all care decisions.
 Use prioritization frameworks to manage complex patient needs.
 Cultural competence and effective communication enhance care.

,  Patient safety is non-negotiable and deeply tied to quality outcomes.




Chapter 2: Fluid, Electrolyte, and Acid-
Base Balance
This chapter is foundational for understanding how the body maintains homeostasis and
how nurses manage imbalances that commonly arise in hospitalized patients.




Section 2.1: Fluid Balance and Homeostasis


I. Body Fluid Compartments

Compartment Description
Intracellular (ICF) Fluid inside cells (~70% of body fluid)
Extracellular (ECF) Outside cells; includes:
- Intravascular Plasma (fluid in blood vessels)
- Interstitial Between cells
- Transcellular CSF, synovial fluid, peritoneal, pleural, etc.


II. Functions of Body Fluids

 Transport nutrients, oxygen, and waste
 Regulate body temperature
 Lubricate joints and membranes
 Medium for cellular metabolism



III. Fluid Movement

 Diffusion – Passive movement from high to low concentration
 Osmosis – Water moves from low solute → high solute concentration
 Filtration – Fluid pushed by hydrostatic pressure (e.g., capillaries)
 Active Transport – Requires energy (e.g., sodium-potassium pump)

, IV. Hormonal Regulation

Hormone Function
ADH Retains water in kidneys (posterior pituitary)
Retains sodium & water, excretes potassium (adrenal
Aldosterone
cortex)
Excretes sodium & water; reduces blood
ANP/BNP
volume/pressure
Renin-Angiotensin System
Raises BP via vasoconstriction & fluid retention
(RAAS)



Section 2.2: Fluid Volume Imbalances


I. Fluid Volume Deficit (Dehydration/Hypovolemia)

Causes:

 Vomiting, diarrhea, bleeding, diuretics, third spacing (burns, ascites)

Signs & Symptoms:

 Dry mucous membranes
 Decreased skin turgor
 Hypotension, tachycardia
 Oliguria (low urine output)
 Confusion, weakness
 ↑ Hct, BUN, urine specific gravity

Nursing Interventions:

 Monitor I&O, daily weights
 Encourage oral fluids or IV fluids (NS, LR)
 Monitor vitals and LOC
 Fall precautions



II. Fluid Volume Excess (Hypervolemia)