lOMoARcPSD|69074652
NSG 4100 Med Surg ATI Exam Study Guide
Med-S rg E am Concep
o C che
Place bod eigh on cr che
Ad ance naffec ed leg on o he air
Shif eigh from cr che o naffec ed leg
Bring cr che and affec ed leg p o he air
o Clo ed- c ion d ain n ing in e en ion
Nega i e-pre re de ice
Doe n req ire all c ion
*Compre he drain re er oir af er emp ing (crea e nega i e pre re)
Do no need o p belo bed (doe n e gra i )
o E e nal fi a ion de ice
S rgeon applie he e ernal fi a ion de ice direc l o he clien bone o form a
rigid r c re aro nd he affec ed e remi
Ca , boo , or plin are applied direc l o he leg for in ernal fi a ion
Clien ho ld ear e ernal fi a ion de ice con in o l for a period of 4-6 eek
N r e ho ld each he clien o perform care of he o nd and pin i e a
home
U e cr che i h r bber ip
Pre en he clien from lipping and decrea e fall ri k
Onl he pro ider ho ld adj he clien e ernal fi a ion de ice in order o
main ain bone alignmen
o Long- e m mechanical en ila ion com lica ion
Decrea ed cardiac o p and h po en ion, rela ed o po i i e pre re from
mechanical en ila ion inhibi ing blood re rn o he hear
Fl id re en ion rela ed o decrea ed cardiac o p
S re lcer , rela ed o ele a ed le el of HCl in he omach
Increa e ri k for emic infec ion and req ire pharmacological rea men
H pona remia, econdar o fl id re en ion
o Po o e a i e n ing in e en ion follo ing ma ec om
In r c clien ha he drain ill remain in place for 1-3 eek af er rger and ill
be remo ed hen here i 25 mL of o p or le in a 24-ho r period
In r c clien o ar e erci ing he arm on ide of rger 24 ho r af er rger
Ele a e arm on rgical ide on a pillo o promo e l mpha ic fl id re rn
N r e ho ld ele a e he head of he clien bed o a lea 30 degree o promo e
drainage from he rgical i e and facili a e brea hing
o Pa ien eaching fo ac i e be c lo i
Sp m pecimen are nece ar e er 2-4 eek n il here are hree nega i e
c l re
Af er 3 nega i e c l re , he clien i no longer con idered infec io
Clien infec ion i all no longer con agio af er aking TB medica ion for 2-3
eek
Famil member do no need o follo airborne preca ion beca e he ha e
alread been e po ed o TB
, lOMoARcPSD|69074652
A follo - p e al a ion of he clien TB ho ld be performed ing a che -ra
beca e he TB kin e i no longer con idered acc ra e af er a per on ha e ed
po i i e
o N ing in e en ion follo ing o al hi a h o la
A i clien o main ain leg in abd c ion
Clien ho ld no fle hip grea er han 90 degree o pre en hip di loca ion
N r e ho ld place a pillo be een clien leg o pre en hip di loca ion
N r e ho ld no keep clien hip in ernall ro a ed, a hi can lead o hip
di loca ion
o Pa ien eaching on kidne o gan dona ion
Clien ho i recipien of organ dona ion ill req ire lifelong imm no ppre i e
herap o pro ec again ran plan rejec ion
A heal h donor ho ha one kidne can manage he bod rinar e cre ion
req iremen
Clien nonf nc ioning kidne remain in he bod n il ran plan rger , nle
he clien ha chronic kidne infec ion or pain
A clien ho recei e a kidne from li e donor ha a lo er ra e of ran plan rejec ion
Clien ho recei e a kidne from a li e donor ha a lo er ra e of ran plan
rejec ion beca e he donor i of en more medicall compa ible han a donor
ho i decea ed
o Pa ien eaching abo e en ion of a he o cle o i
Smoking ce a ion
Main ain an appropria e eigh
Ea a lo -fa die
o MRSA eca ion fo heal h ca e ofe ional
Clien ho ld ear an i ola ion go n and a h hand before being ran por ed from
he room o pre en pread of micro-organi m
N r e ho ld ba he clien ing arm a er and a chlorhe idine ol ion o pre en
he pread of micro-organi m
U e dedica ed a e men eq ipmen hen a e ing he clien and lea e in room o
pre en cro -con amina ion i h o her clien
Mode of ran mi ion = con ac
o Ne h o om e ec ed finding
Red- inged rine d ring he fir 12-24 ho r
Normal BUN
Increa ed rine o p (no if pro ider for decrea ed UO)
NOTIFY PROVIDER FOR BACK PAIN
Can indica e he be i di lodged or clogged
o N ing in e en ion fo d h hmia
Defibrilla ion for en ric lar ach cardia or en ric lar fibrilla ion
Cardio er ion for all o her d rh hmia
CPR for a clien ho i p l ele or no brea hing
Lidocaine IV bol for a clien ho ha en ric lar d rh hmia
o Sei e eca ion
Clien ho ld limi in ake of alcohol or caffeine, minimi e re , fe er, and fa ig e o
pre en riggering a ei re
, lOMoARcPSD|69074652
N r e ho ld keep 2-3 ide rail p o pre en fall
Keep clien bed in lo e po i ion o pre en fall
En re clien ha pa en IV acce in he e en ha he clien req ire medica ion o
op ei re ac i i
o N ing in e en ion fo blood an f ion
Priori = check for he pe and n mber of ni of blood o admini er
Ob ain ba eline i al ign for compari on
De cribe blood ran f ion o promo e clien nder anding
En re clien ha a large-bore IV acce o pre en hemol i d ring ran f ion
o Pa ien eaching fo in lin li o
Rapid-ac ing in lin ha he clien can e in conj nc ion i h in ermedia e or long-
ac ing in lin
Clien ho ld injec he medica ion bc aneo l in o he abdomen, pper high, or
arm
N r e ho ld in r c clien ha in lin li pro i rapid-ac ing and he clien ho ld
admini er immedia el before ea ing or immedia el af er ea ing
In r c he clien o con in e aking in lin li pro a pre cribed d ring ime of
illne , and no if pro ider of he illne
o Pa ien eaching fo me fo min
Decrea e he amo n of gl co e prod ced in he li er and increa e i e en i i i
o in lin
Clien ho ld ake me formin i h or immedia el follo ing meal o impro e
ab orp ion and o minimi e GI di re
Clien picall lo e eigh hen beginning me formin d e o N/V
Ad er e effec = ra h
o E i ce a ion n ing in e en ion
Priori = call for help
Co er he o nd i h erile, aline-moi ened dre ing o pro ec organ
Moni or clien i al ign o moni or for complica ion
Place clien in pine po i ion o promo e blood flo o organ
o Blood an f ion com lica ion in e en ion
Bac erial ran f ion reac ion = an ibio ic
Manife a ion : h po en ion, ach cardia, hock
Febrile ran f ion reac ion = an ip re ic, ace aminophen
Manife a ion : ach cardia, fe er, h po en ion, chill
Circ la or o erload from ran f ion: loop-di re ic, f ro emide
Manife a ion : d pnea, h po en ion, h per en ion, di ended neck ein
Allergic ran f ion reac ion: an ihi amine, diphenh dramine
Manife a ion : r icarial, i ching, fl hing, broncho pa m , anaph la i
o Cen al eno ca he e n ing in e en ion
Place clien in Trendelenb rg po i ion i h a rolled o el be een clien ho lder
blade
Po i ion facili a e he in er ion of he ca he er b dila ing blood e el of he
clien neck and ho lder
Goe in o bcla ian ein
, lOMoARcPSD|69074652
o Ho mone e lacemen he a ad e e effec
Urgen effec (con ac pro ider)
Calf pain (indica e DVT)
N mbne of he arm (indica e po ible CVA)
In en e headache (indica e po ible CVA)
Non rgen effec (manife a ion of menopa e)
Nigh ea
Vaginal dr ne
o Tho acen e i n ing in e en ion
Af er horacen e i , clien ho ld deep brea he o re-e pand l ng
Place clien in prigh po i ion i h arm re ing on an o erhead able o iden he
in erco al pace and pread rib for be in er ion
N r e ho ld a i a clien ho canno i p in o a ide-l ing po i ion i h
he affec ed ide p
Clien ho ld recei e local ane he ic for he proced re and ill no req ire NPO
a af er midnigh
In r c clien o re me ac i i i hin 1 ho r follo ing proced re
o A e ial line n ing in e en ion
U ed o ob ain ar erial blood ga e and moni or hemod namic pre re
Mo appropria e po i ion of a clien hile recording al e ob ained from an ar erial
line i pine i h he head of he bed ele a ed p o 60 degree
N r e ho ld place a pre re bag aro nd he fl h ol ion of 0.9% odi m chloride
beca e he pre re from an ar er i grea er han ha of he line
o Pa ien eaching of he a in
In r c he clien o repor an bleeding or br i ing o pro ider
In r c he clien o a oid flo ing
In r c clien o appl firm pre re o injec ion i e 1-2 min e b o a oid
ma aging
In r c he clien o e an elec ric ra or hen ha ing o red ce he ri k of c o
he kin
o Pa ien eaching fo e e o om
D ring proced re, clien bladder i remo ed and he re er are bro gh o he kin
rface of he abdomen o form a oma from hich rine ill flo in o o om bag
Clien ill no ha e rge o oid
Drink 2-3 L of fl id per da o red ce m c forma ion and main ain h dra ion
Clien ho ld c he opening of he kin barrier 1/8-inch ider han he oma o
minimi e irri a ion of he kin from e po re o rine
Clien ho ld a oid ing moi ri ing oap o clean he kin aro nd he oma
beca e i ill pre en he po ch from adhering o he kin
o COPD e ec ed finding
Increa e in PaCO2, beca e COPD re ain PaCO2 d e o he eakening and he
collap e of he al eolar ac , hich decrea e he area in l ng for ga e change and
ca e he PaCO2 o increa e abo e he e pec ed reference range
pH belo e pec ed range
Increa ed HCO3 le el
Lo o gen le el
NSG 4100 Med Surg ATI Exam Study Guide
Med-S rg E am Concep
o C che
Place bod eigh on cr che
Ad ance naffec ed leg on o he air
Shif eigh from cr che o naffec ed leg
Bring cr che and affec ed leg p o he air
o Clo ed- c ion d ain n ing in e en ion
Nega i e-pre re de ice
Doe n req ire all c ion
*Compre he drain re er oir af er emp ing (crea e nega i e pre re)
Do no need o p belo bed (doe n e gra i )
o E e nal fi a ion de ice
S rgeon applie he e ernal fi a ion de ice direc l o he clien bone o form a
rigid r c re aro nd he affec ed e remi
Ca , boo , or plin are applied direc l o he leg for in ernal fi a ion
Clien ho ld ear e ernal fi a ion de ice con in o l for a period of 4-6 eek
N r e ho ld each he clien o perform care of he o nd and pin i e a
home
U e cr che i h r bber ip
Pre en he clien from lipping and decrea e fall ri k
Onl he pro ider ho ld adj he clien e ernal fi a ion de ice in order o
main ain bone alignmen
o Long- e m mechanical en ila ion com lica ion
Decrea ed cardiac o p and h po en ion, rela ed o po i i e pre re from
mechanical en ila ion inhibi ing blood re rn o he hear
Fl id re en ion rela ed o decrea ed cardiac o p
S re lcer , rela ed o ele a ed le el of HCl in he omach
Increa e ri k for emic infec ion and req ire pharmacological rea men
H pona remia, econdar o fl id re en ion
o Po o e a i e n ing in e en ion follo ing ma ec om
In r c clien ha he drain ill remain in place for 1-3 eek af er rger and ill
be remo ed hen here i 25 mL of o p or le in a 24-ho r period
In r c clien o ar e erci ing he arm on ide of rger 24 ho r af er rger
Ele a e arm on rgical ide on a pillo o promo e l mpha ic fl id re rn
N r e ho ld ele a e he head of he clien bed o a lea 30 degree o promo e
drainage from he rgical i e and facili a e brea hing
o Pa ien eaching fo ac i e be c lo i
Sp m pecimen are nece ar e er 2-4 eek n il here are hree nega i e
c l re
Af er 3 nega i e c l re , he clien i no longer con idered infec io
Clien infec ion i all no longer con agio af er aking TB medica ion for 2-3
eek
Famil member do no need o follo airborne preca ion beca e he ha e
alread been e po ed o TB
, lOMoARcPSD|69074652
A follo - p e al a ion of he clien TB ho ld be performed ing a che -ra
beca e he TB kin e i no longer con idered acc ra e af er a per on ha e ed
po i i e
o N ing in e en ion follo ing o al hi a h o la
A i clien o main ain leg in abd c ion
Clien ho ld no fle hip grea er han 90 degree o pre en hip di loca ion
N r e ho ld place a pillo be een clien leg o pre en hip di loca ion
N r e ho ld no keep clien hip in ernall ro a ed, a hi can lead o hip
di loca ion
o Pa ien eaching on kidne o gan dona ion
Clien ho i recipien of organ dona ion ill req ire lifelong imm no ppre i e
herap o pro ec again ran plan rejec ion
A heal h donor ho ha one kidne can manage he bod rinar e cre ion
req iremen
Clien nonf nc ioning kidne remain in he bod n il ran plan rger , nle
he clien ha chronic kidne infec ion or pain
A clien ho recei e a kidne from li e donor ha a lo er ra e of ran plan rejec ion
Clien ho recei e a kidne from a li e donor ha a lo er ra e of ran plan
rejec ion beca e he donor i of en more medicall compa ible han a donor
ho i decea ed
o Pa ien eaching abo e en ion of a he o cle o i
Smoking ce a ion
Main ain an appropria e eigh
Ea a lo -fa die
o MRSA eca ion fo heal h ca e ofe ional
Clien ho ld ear an i ola ion go n and a h hand before being ran por ed from
he room o pre en pread of micro-organi m
N r e ho ld ba he clien ing arm a er and a chlorhe idine ol ion o pre en
he pread of micro-organi m
U e dedica ed a e men eq ipmen hen a e ing he clien and lea e in room o
pre en cro -con amina ion i h o her clien
Mode of ran mi ion = con ac
o Ne h o om e ec ed finding
Red- inged rine d ring he fir 12-24 ho r
Normal BUN
Increa ed rine o p (no if pro ider for decrea ed UO)
NOTIFY PROVIDER FOR BACK PAIN
Can indica e he be i di lodged or clogged
o N ing in e en ion fo d h hmia
Defibrilla ion for en ric lar ach cardia or en ric lar fibrilla ion
Cardio er ion for all o her d rh hmia
CPR for a clien ho i p l ele or no brea hing
Lidocaine IV bol for a clien ho ha en ric lar d rh hmia
o Sei e eca ion
Clien ho ld limi in ake of alcohol or caffeine, minimi e re , fe er, and fa ig e o
pre en riggering a ei re
, lOMoARcPSD|69074652
N r e ho ld keep 2-3 ide rail p o pre en fall
Keep clien bed in lo e po i ion o pre en fall
En re clien ha pa en IV acce in he e en ha he clien req ire medica ion o
op ei re ac i i
o N ing in e en ion fo blood an f ion
Priori = check for he pe and n mber of ni of blood o admini er
Ob ain ba eline i al ign for compari on
De cribe blood ran f ion o promo e clien nder anding
En re clien ha a large-bore IV acce o pre en hemol i d ring ran f ion
o Pa ien eaching fo in lin li o
Rapid-ac ing in lin ha he clien can e in conj nc ion i h in ermedia e or long-
ac ing in lin
Clien ho ld injec he medica ion bc aneo l in o he abdomen, pper high, or
arm
N r e ho ld in r c clien ha in lin li pro i rapid-ac ing and he clien ho ld
admini er immedia el before ea ing or immedia el af er ea ing
In r c he clien o con in e aking in lin li pro a pre cribed d ring ime of
illne , and no if pro ider of he illne
o Pa ien eaching fo me fo min
Decrea e he amo n of gl co e prod ced in he li er and increa e i e en i i i
o in lin
Clien ho ld ake me formin i h or immedia el follo ing meal o impro e
ab orp ion and o minimi e GI di re
Clien picall lo e eigh hen beginning me formin d e o N/V
Ad er e effec = ra h
o E i ce a ion n ing in e en ion
Priori = call for help
Co er he o nd i h erile, aline-moi ened dre ing o pro ec organ
Moni or clien i al ign o moni or for complica ion
Place clien in pine po i ion o promo e blood flo o organ
o Blood an f ion com lica ion in e en ion
Bac erial ran f ion reac ion = an ibio ic
Manife a ion : h po en ion, ach cardia, hock
Febrile ran f ion reac ion = an ip re ic, ace aminophen
Manife a ion : ach cardia, fe er, h po en ion, chill
Circ la or o erload from ran f ion: loop-di re ic, f ro emide
Manife a ion : d pnea, h po en ion, h per en ion, di ended neck ein
Allergic ran f ion reac ion: an ihi amine, diphenh dramine
Manife a ion : r icarial, i ching, fl hing, broncho pa m , anaph la i
o Cen al eno ca he e n ing in e en ion
Place clien in Trendelenb rg po i ion i h a rolled o el be een clien ho lder
blade
Po i ion facili a e he in er ion of he ca he er b dila ing blood e el of he
clien neck and ho lder
Goe in o bcla ian ein
, lOMoARcPSD|69074652
o Ho mone e lacemen he a ad e e effec
Urgen effec (con ac pro ider)
Calf pain (indica e DVT)
N mbne of he arm (indica e po ible CVA)
In en e headache (indica e po ible CVA)
Non rgen effec (manife a ion of menopa e)
Nigh ea
Vaginal dr ne
o Tho acen e i n ing in e en ion
Af er horacen e i , clien ho ld deep brea he o re-e pand l ng
Place clien in prigh po i ion i h arm re ing on an o erhead able o iden he
in erco al pace and pread rib for be in er ion
N r e ho ld a i a clien ho canno i p in o a ide-l ing po i ion i h
he affec ed ide p
Clien ho ld recei e local ane he ic for he proced re and ill no req ire NPO
a af er midnigh
In r c clien o re me ac i i i hin 1 ho r follo ing proced re
o A e ial line n ing in e en ion
U ed o ob ain ar erial blood ga e and moni or hemod namic pre re
Mo appropria e po i ion of a clien hile recording al e ob ained from an ar erial
line i pine i h he head of he bed ele a ed p o 60 degree
N r e ho ld place a pre re bag aro nd he fl h ol ion of 0.9% odi m chloride
beca e he pre re from an ar er i grea er han ha of he line
o Pa ien eaching of he a in
In r c he clien o repor an bleeding or br i ing o pro ider
In r c he clien o a oid flo ing
In r c clien o appl firm pre re o injec ion i e 1-2 min e b o a oid
ma aging
In r c he clien o e an elec ric ra or hen ha ing o red ce he ri k of c o
he kin
o Pa ien eaching fo e e o om
D ring proced re, clien bladder i remo ed and he re er are bro gh o he kin
rface of he abdomen o form a oma from hich rine ill flo in o o om bag
Clien ill no ha e rge o oid
Drink 2-3 L of fl id per da o red ce m c forma ion and main ain h dra ion
Clien ho ld c he opening of he kin barrier 1/8-inch ider han he oma o
minimi e irri a ion of he kin from e po re o rine
Clien ho ld a oid ing moi ri ing oap o clean he kin aro nd he oma
beca e i ill pre en he po ch from adhering o he kin
o COPD e ec ed finding
Increa e in PaCO2, beca e COPD re ain PaCO2 d e o he eakening and he
collap e of he al eolar ac , hich decrea e he area in l ng for ga e change and
ca e he PaCO2 o increa e abo e he e pec ed reference range
pH belo e pec ed range
Increa ed HCO3 le el
Lo o gen le el
