Medical-Surgical Nursing: High-Yield Study Notes, Key Concepts & Exam Review Guide
Introduction
Medical-Surgical Nursing is a core area of nursing education focused on the care of adult
patients experiencing acute and chronic medical or surgical conditions. Effective preparation
requires understanding not only disease processes, but also assessment findings, nursing
priorities, interventions, complications, patient education, and clinical safety.
These notes provide a concise revision resource covering high-yield concepts commonly
encountered in medical-surgical nursing courses and examinations.
1. Nursing Assessment and Clinical Priorities
A systematic patient assessment helps nurses identify actual and potential problems and
determine appropriate interventions.
Primary Assessment
The ABCDE approach is useful when assessing an acutely ill patient:
A – Airway: Assess whether the airway is open and protected.
B – Breathing: Assess respiratory rate, depth, effort, oxygen saturation, and breath
sounds.
C – Circulation: Assess pulse, blood pressure, skin perfusion, bleeding, and cardiac
status.
D – Disability: Assess level of consciousness, pupils, and neurological status.
E – Exposure: Examine the patient systematically while maintaining privacy and
preventing heat loss.
Nursing Priorities
When several problems are present, prioritize:
1. Airway and breathing problems
2. Circulation and severe bleeding
3. Acute neurological deterioration
4. Severe pain or other urgent symptoms
5. Infection and other complications
6. Psychosocial and educational needs
The nurse should reassess the patient after interventions to determine whether the desired
outcome has been achieved.
,2. Fluid and Electrolyte Balance
Fluid and electrolyte disturbances can rapidly become life-threatening.
Dehydration / Fluid Volume Deficit
Common causes include vomiting, diarrhea, excessive sweating, hemorrhage, fever, burns, and
inadequate fluid intake.
Possible findings
Increased thirst
Dry mucous membranes
Decreased urine output
Tachycardia
Hypotension
Weakness
Poor skin turgor
Nursing Management
Monitor vital signs.
Monitor intake and output.
Assess urine characteristics.
Monitor laboratory results.
Administer prescribed fluids.
Identify and treat the underlying cause.
Monitor for signs of worsening hypovolemia.
Fluid Volume Excess
Possible causes include heart failure, renal impairment, excessive sodium or fluid intake, and
certain endocrine disorders.
Possible findings
Peripheral edema
Weight gain
Elevated blood pressure
Pulmonary crackles
, Shortness of breath
Jugular venous distention
Nursing Management
Monitor daily weight.
Assess edema and lung sounds.
Monitor intake and output.
Follow prescribed fluid or sodium restrictions.
Administer prescribed diuretics.
Monitor electrolytes and renal function.
Exam tip: A sudden increase in body weight is often a useful indicator of fluid retention.
3. Potassium Imbalances
Hypokalemia
Hypokalemia refers to an abnormally low serum potassium concentration.
Possible causes include prolonged vomiting or diarrhea, certain diuretics, and inadequate
potassium intake.
Possible manifestations
Muscle weakness
Fatigue
Muscle cramps
Constipation
Cardiac dysrhythmias
Abnormal ECG findings
Nursing considerations
Monitor serum potassium.
Assess cardiac rhythm when clinically indicated.
Identify medications that may contribute to potassium loss.
Administer potassium replacement as prescribed.
Never administer concentrated intravenous potassium by rapid IV push.
Introduction
Medical-Surgical Nursing is a core area of nursing education focused on the care of adult
patients experiencing acute and chronic medical or surgical conditions. Effective preparation
requires understanding not only disease processes, but also assessment findings, nursing
priorities, interventions, complications, patient education, and clinical safety.
These notes provide a concise revision resource covering high-yield concepts commonly
encountered in medical-surgical nursing courses and examinations.
1. Nursing Assessment and Clinical Priorities
A systematic patient assessment helps nurses identify actual and potential problems and
determine appropriate interventions.
Primary Assessment
The ABCDE approach is useful when assessing an acutely ill patient:
A – Airway: Assess whether the airway is open and protected.
B – Breathing: Assess respiratory rate, depth, effort, oxygen saturation, and breath
sounds.
C – Circulation: Assess pulse, blood pressure, skin perfusion, bleeding, and cardiac
status.
D – Disability: Assess level of consciousness, pupils, and neurological status.
E – Exposure: Examine the patient systematically while maintaining privacy and
preventing heat loss.
Nursing Priorities
When several problems are present, prioritize:
1. Airway and breathing problems
2. Circulation and severe bleeding
3. Acute neurological deterioration
4. Severe pain or other urgent symptoms
5. Infection and other complications
6. Psychosocial and educational needs
The nurse should reassess the patient after interventions to determine whether the desired
outcome has been achieved.
,2. Fluid and Electrolyte Balance
Fluid and electrolyte disturbances can rapidly become life-threatening.
Dehydration / Fluid Volume Deficit
Common causes include vomiting, diarrhea, excessive sweating, hemorrhage, fever, burns, and
inadequate fluid intake.
Possible findings
Increased thirst
Dry mucous membranes
Decreased urine output
Tachycardia
Hypotension
Weakness
Poor skin turgor
Nursing Management
Monitor vital signs.
Monitor intake and output.
Assess urine characteristics.
Monitor laboratory results.
Administer prescribed fluids.
Identify and treat the underlying cause.
Monitor for signs of worsening hypovolemia.
Fluid Volume Excess
Possible causes include heart failure, renal impairment, excessive sodium or fluid intake, and
certain endocrine disorders.
Possible findings
Peripheral edema
Weight gain
Elevated blood pressure
Pulmonary crackles
, Shortness of breath
Jugular venous distention
Nursing Management
Monitor daily weight.
Assess edema and lung sounds.
Monitor intake and output.
Follow prescribed fluid or sodium restrictions.
Administer prescribed diuretics.
Monitor electrolytes and renal function.
Exam tip: A sudden increase in body weight is often a useful indicator of fluid retention.
3. Potassium Imbalances
Hypokalemia
Hypokalemia refers to an abnormally low serum potassium concentration.
Possible causes include prolonged vomiting or diarrhea, certain diuretics, and inadequate
potassium intake.
Possible manifestations
Muscle weakness
Fatigue
Muscle cramps
Constipation
Cardiac dysrhythmias
Abnormal ECG findings
Nursing considerations
Monitor serum potassium.
Assess cardiac rhythm when clinically indicated.
Identify medications that may contribute to potassium loss.
Administer potassium replacement as prescribed.
Never administer concentrated intravenous potassium by rapid IV push.
