lOMoAR cPSD| 56342273
MED SURG II - EXAM 2 STUDY GUIDE |COMPLETE AND DETAILED QUESTIONS AND ANSWERS| REAL
EXAM QNA | 2025 LATEST UPDATED 100% RATED CORRECT | 100% VERFIED | ALREADY GRADED
A+|GUARANTEED TO PASS!!
Respiratory
• A patient with synchronous primary cancers of the larynx and floor of the mouth treated by laryngectomy,
excision of the floor of the mouth, and skin grafting.
• Will be sitting up in high fowlers, will not be putting people flat
• Fracture of the nose o Displacement of the bone or cartilage can cause airway obstruction or cosmetic
deformity because the nasal passage clean things out in the air that are potential sources of infection
o Concerned about CSF leakage
May indicate a skull fracture
Leakage may not be clear because of the fracture, will have to test for glucose and paper test
will determine
There may be a halo of fluid and blood indicating the CSF o Simple fracture
, lOMoAR cPSD| 56342273
No blood or fluid
If there is blood/CSF then its more
serious fracture o Interventions
Assessment
• Document a nasal problem
• Document nasal hx
• Crepitus
• Bruising
• Pain
Closed reduction
• Snapping it back into place
Rhinoplasty
• Immediate post operative o Splint
o Moustache drip pad, change as needed o
Monitor for drainage o Observe for edema and
bleeding o Will take about 6 months to a year to
heal o Check VS q4
o May order ice and quaze for swelling o
Monitor for bleeding
Watch for increased amount of swallowing o Might be
some brusing- most likely for several weeks
Education o Edema can last for weeks o Final results may
take 6-12 months
o Position in a Semi-fowlers
o Humidified air because the nasal packing in
the nose o Move slowly
o Check the gag reflex before eating
o Drink 2500cc of fluid per day if not contraindicated
o Will need to mouth breath o Will have packing in both of the nostrils
o Splint needs to stay on to keep things into alignment Naso-septoplasty
• Epistaxis o Nosebleed is a common problem
o Cauterization of affected cappilaries may be needed
Nose will be packed o Posterior nasal bleeding is an emergency
, lOMoAR cPSD| 56342273
Because it is too far back in the nose, can be hard to manage o Assess for respiratory distress, tolerance of
packing or tubes o Humidification, O2, bedrest, antibiotics, pain medications (if needed) o Causes Trauma
High BP (if diagnosed, need to know about the meds taking)
Tumor
Chronic cocaine use
Leukemia
Low humidity
Picking the nose
Nasal tracheal suctioning
o Problem
Can’t reach the area easily and can lose a lot of blood easily
• Cancer of the nose and sinuses o Tumors are
rare, can be benign or malignant
o Seen with exposure to dust from wood, textlies, leather, as well as flour, nickel, chromium mustard gas, radium (work place
exposure) o Slow onset, manifestations resemble sinusitis
Will continually be diagnoses with sinusitis
Persistent drainage, bloody discharge and pain o Community care/preventions
What should be taught to whom?
• People who are exposed to the things listed
above
o Sinusitis:
Drainage
Bloody discharge
Pain in the nose area
If symptoms don’t go away need to address them
Can scan the sinus and look up the nose o Local lymph enlargement often occurs on side with tumor mass is
located o Surgical removal is main treatment
May be combined with radiation
also can be combined with chemo or even both o Post surgery usually body image issues
Also airway, bleeding, wound care, trach care surgery dependent
• Facial Trauma o Priority action is airway assessment
o And airway support
o Could be difficult to intubate a patient with facial trauma o
Manifestations
, lOMoAR cPSD| 56342273
Stridor
• Upper airway blocking
• Assess for distress
SOB and dyspnea
Anxiety and restlessness
Hypoxia and hypercapnia
• High CO2 and low O2
• Will show s/s of restlessness and anxiety
Cyanosis, LOC- will not be the 1st thing you see
Check the trauma, eye movement, and if the eye is being compromised
Likely not able to intubate, will need airway support
Eye movement will be a problem and teeth depending on what the issue is
Bruising behind the mastoid, can indicate brain and skull trauma o Interventions
Airway assessment is PRIORITY
Anticipate need for emergency intubated because of the airway blockage
• Tracheotomy
• Cricothyroidotomy
Fixed occlusion
• If had a major fracture of the face will need this
• It is the wiring of the jaw shut and wires all the way across
• Will need wire cutters at the bedside to reduce aspiration, emesis and chocking Will be wired shut about 6-
10 weeks Will need to assess for nutrition.
MED SURG II - EXAM 2 STUDY GUIDE |COMPLETE AND DETAILED QUESTIONS AND ANSWERS| REAL
EXAM QNA | 2025 LATEST UPDATED 100% RATED CORRECT | 100% VERFIED | ALREADY GRADED
A+|GUARANTEED TO PASS!!
Respiratory
• A patient with synchronous primary cancers of the larynx and floor of the mouth treated by laryngectomy,
excision of the floor of the mouth, and skin grafting.
• Will be sitting up in high fowlers, will not be putting people flat
• Fracture of the nose o Displacement of the bone or cartilage can cause airway obstruction or cosmetic
deformity because the nasal passage clean things out in the air that are potential sources of infection
o Concerned about CSF leakage
May indicate a skull fracture
Leakage may not be clear because of the fracture, will have to test for glucose and paper test
will determine
There may be a halo of fluid and blood indicating the CSF o Simple fracture
, lOMoAR cPSD| 56342273
No blood or fluid
If there is blood/CSF then its more
serious fracture o Interventions
Assessment
• Document a nasal problem
• Document nasal hx
• Crepitus
• Bruising
• Pain
Closed reduction
• Snapping it back into place
Rhinoplasty
• Immediate post operative o Splint
o Moustache drip pad, change as needed o
Monitor for drainage o Observe for edema and
bleeding o Will take about 6 months to a year to
heal o Check VS q4
o May order ice and quaze for swelling o
Monitor for bleeding
Watch for increased amount of swallowing o Might be
some brusing- most likely for several weeks
Education o Edema can last for weeks o Final results may
take 6-12 months
o Position in a Semi-fowlers
o Humidified air because the nasal packing in
the nose o Move slowly
o Check the gag reflex before eating
o Drink 2500cc of fluid per day if not contraindicated
o Will need to mouth breath o Will have packing in both of the nostrils
o Splint needs to stay on to keep things into alignment Naso-septoplasty
• Epistaxis o Nosebleed is a common problem
o Cauterization of affected cappilaries may be needed
Nose will be packed o Posterior nasal bleeding is an emergency
, lOMoAR cPSD| 56342273
Because it is too far back in the nose, can be hard to manage o Assess for respiratory distress, tolerance of
packing or tubes o Humidification, O2, bedrest, antibiotics, pain medications (if needed) o Causes Trauma
High BP (if diagnosed, need to know about the meds taking)
Tumor
Chronic cocaine use
Leukemia
Low humidity
Picking the nose
Nasal tracheal suctioning
o Problem
Can’t reach the area easily and can lose a lot of blood easily
• Cancer of the nose and sinuses o Tumors are
rare, can be benign or malignant
o Seen with exposure to dust from wood, textlies, leather, as well as flour, nickel, chromium mustard gas, radium (work place
exposure) o Slow onset, manifestations resemble sinusitis
Will continually be diagnoses with sinusitis
Persistent drainage, bloody discharge and pain o Community care/preventions
What should be taught to whom?
• People who are exposed to the things listed
above
o Sinusitis:
Drainage
Bloody discharge
Pain in the nose area
If symptoms don’t go away need to address them
Can scan the sinus and look up the nose o Local lymph enlargement often occurs on side with tumor mass is
located o Surgical removal is main treatment
May be combined with radiation
also can be combined with chemo or even both o Post surgery usually body image issues
Also airway, bleeding, wound care, trach care surgery dependent
• Facial Trauma o Priority action is airway assessment
o And airway support
o Could be difficult to intubate a patient with facial trauma o
Manifestations
, lOMoAR cPSD| 56342273
Stridor
• Upper airway blocking
• Assess for distress
SOB and dyspnea
Anxiety and restlessness
Hypoxia and hypercapnia
• High CO2 and low O2
• Will show s/s of restlessness and anxiety
Cyanosis, LOC- will not be the 1st thing you see
Check the trauma, eye movement, and if the eye is being compromised
Likely not able to intubate, will need airway support
Eye movement will be a problem and teeth depending on what the issue is
Bruising behind the mastoid, can indicate brain and skull trauma o Interventions
Airway assessment is PRIORITY
Anticipate need for emergency intubated because of the airway blockage
• Tracheotomy
• Cricothyroidotomy
Fixed occlusion
• If had a major fracture of the face will need this
• It is the wiring of the jaw shut and wires all the way across
• Will need wire cutters at the bedside to reduce aspiration, emesis and chocking Will be wired shut about 6-
10 weeks Will need to assess for nutrition.
