Med-Surg Study Guide 2020
QUIZ 1 – 25 questions.
Traumatic Brain Injury – Glasgow Coma scale
o Moderate: 9-12
o Greater than 13: There’s a minor head injury
o Severe head injury: 8 and below
Glasgow coma scale
o Priority assessment: LOC, PERRLA (tells us the level of brain injury)
If BP decreases on someone who has a brain injury
o There will be an increased intracranial pressure.
Stroke
o Right side of the brain controls: the left side of the brain.
Injury: may not recognize obvious objects or faces, may have spacial
unawareness – don’t know the distances
Seizure disorder
o Do not use the tongue depressor
o Do guide them down on the floor, safety is an issue
PT has severe head injury, projectile vomiting, bp is high, HR high, temp high, what type
of CNS injury is it?
o Hemorrhagic stroke, sudden instant increase in vital signs meaning there was a
vessel that ruptured.
A thrombus may cause an slow incremental increase.
Embolic stroke is when someone has a DVT, massaging the lower legs
can cause it to travel. Slow increase.
Increased Intracranial Pressure
o Restlessness is the first subtle sign
o To drowsiness, to loss of consciousness.
Dilantin (Fentanyl)
o Teaching: Avoid grapefruit juice, no alcohol – high risk for seizures because it
alters levels in the blood
S/S of Parkinson’s disease
o Tremors
o Mask-like face
o Shuffling movement (bradykinsis)
Epilepsy
o Same precautions with seizure disorders
o Fall precaution, environment safety, do not restrain them
Cirrhosis of the liver with ascites because they retain fluids
o Nursing intervention:
fluid restriction,
they are on diuretic,
diet: low in sodium because sodium retains water.
, Crhon’s disease:
o Where can it occur? Any place along the GI tract.
o Many areas along the GI tract.
o Foods allowed: low-fat, low fiber, low-lactose
No milk
No buttered bread
Moderate amount of fat, glucose, and fiber is good.
Ulcer diverticulitis: can be on one spot on the GI tract.
End stage liver disease
o Clinical manifestations: Jaundice
o Brain: encephalopathy, swelling of brain
o Lab: high ammonia levels
o Teaching: no alcohol, Protein increase ammonia levels when protein is broken
down – they need to be on low-protein diet.
Inflammatory bowel disease:
o Diet: do not give milk or dairy based products, because it causes increase pain and
increase episodes of
o Give them soy-based products.
Pancreatitis
o What can cause pancreatitis: gallstones, alcohol,
o What questions to ask related to history?
Cirrhosis of the liver
o Part of assessment:
v/s
mental assessment,
weigh daily
measure the abdominal girth
Cholecystitis
o Inflammation of the gall bladder
o Diet: low-fat
o Lab values: CBC, liver function test (ALT/AST), fluid and electrolyte, complete
metabolic panel, ammonia levels
Cbc with dif – NO because
Lactulose is often used to pull the ammonia out – s/s massive diarrhea.
Similarities of Crohn’s disease and diverticulitis.
o Give them: corticosteroids, anti-inflammatory
Aneurism precautions
o Before and after surgery, make sure they are not moving around too much, no
sudden movement, where to place this patient on the unit? –low stress/low stimuli
environment. They’re most likely on the ICU where they’re monitored closely but
do not put them by the nursing station.
o What level height? 15-30 degrees.
45 degrees will increase intracranial pressure.
o They are on complete bed rest.
QUIZ 1 – 25 questions.
Traumatic Brain Injury – Glasgow Coma scale
o Moderate: 9-12
o Greater than 13: There’s a minor head injury
o Severe head injury: 8 and below
Glasgow coma scale
o Priority assessment: LOC, PERRLA (tells us the level of brain injury)
If BP decreases on someone who has a brain injury
o There will be an increased intracranial pressure.
Stroke
o Right side of the brain controls: the left side of the brain.
Injury: may not recognize obvious objects or faces, may have spacial
unawareness – don’t know the distances
Seizure disorder
o Do not use the tongue depressor
o Do guide them down on the floor, safety is an issue
PT has severe head injury, projectile vomiting, bp is high, HR high, temp high, what type
of CNS injury is it?
o Hemorrhagic stroke, sudden instant increase in vital signs meaning there was a
vessel that ruptured.
A thrombus may cause an slow incremental increase.
Embolic stroke is when someone has a DVT, massaging the lower legs
can cause it to travel. Slow increase.
Increased Intracranial Pressure
o Restlessness is the first subtle sign
o To drowsiness, to loss of consciousness.
Dilantin (Fentanyl)
o Teaching: Avoid grapefruit juice, no alcohol – high risk for seizures because it
alters levels in the blood
S/S of Parkinson’s disease
o Tremors
o Mask-like face
o Shuffling movement (bradykinsis)
Epilepsy
o Same precautions with seizure disorders
o Fall precaution, environment safety, do not restrain them
Cirrhosis of the liver with ascites because they retain fluids
o Nursing intervention:
fluid restriction,
they are on diuretic,
diet: low in sodium because sodium retains water.
, Crhon’s disease:
o Where can it occur? Any place along the GI tract.
o Many areas along the GI tract.
o Foods allowed: low-fat, low fiber, low-lactose
No milk
No buttered bread
Moderate amount of fat, glucose, and fiber is good.
Ulcer diverticulitis: can be on one spot on the GI tract.
End stage liver disease
o Clinical manifestations: Jaundice
o Brain: encephalopathy, swelling of brain
o Lab: high ammonia levels
o Teaching: no alcohol, Protein increase ammonia levels when protein is broken
down – they need to be on low-protein diet.
Inflammatory bowel disease:
o Diet: do not give milk or dairy based products, because it causes increase pain and
increase episodes of
o Give them soy-based products.
Pancreatitis
o What can cause pancreatitis: gallstones, alcohol,
o What questions to ask related to history?
Cirrhosis of the liver
o Part of assessment:
v/s
mental assessment,
weigh daily
measure the abdominal girth
Cholecystitis
o Inflammation of the gall bladder
o Diet: low-fat
o Lab values: CBC, liver function test (ALT/AST), fluid and electrolyte, complete
metabolic panel, ammonia levels
Cbc with dif – NO because
Lactulose is often used to pull the ammonia out – s/s massive diarrhea.
Similarities of Crohn’s disease and diverticulitis.
o Give them: corticosteroids, anti-inflammatory
Aneurism precautions
o Before and after surgery, make sure they are not moving around too much, no
sudden movement, where to place this patient on the unit? –low stress/low stimuli
environment. They’re most likely on the ICU where they’re monitored closely but
do not put them by the nursing station.
o What level height? 15-30 degrees.
45 degrees will increase intracranial pressure.
o They are on complete bed rest.
