ATI Med-Surg Remediation ALL ANSWERS 100% FALL-2021/2022 SOLUTION EDITION GUARANTEED GRADE A+

1. Safety and Infection Control a. Standard Precautions/Transmission-Based Precautions/Surgical Asepsis i. Tuberculosis: Priority Intervention (Active Learning Template – System Disorder, RM AMS RN 10.0 Chp 23) 1. Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. TB is transmitted through aerosolization (airborne route). Once inside the lung, the body encases the T bacillus with collagen and other cells. This can appear as a Chon tubercle on a chest x-ray. Only a small percentage of people infected with TB develop an active form of the infection. The TB bacillus can lie dormant for many years before producing the disease. 2. Health Promotion and Maintenance a. Health Promotion/Disease Prevention i. Diabetes Mellitus Management: Recognizing Manifestations (Active Learning Template – System Disorder, RM AMS RN 10.0 Chp 82) 1. Diabetes mellitus is a metabolic disorder resulting from either an inadequate production of insulin (type 1) or an inability of the body’s cells to respond to insulin that is present (type 2) 3. Basic Care and Comfort a. Non-pharmacological Comfort Interventions i. Rheumatoid Arthritis: Pain Management Strategies (Active Learning Template – System Disorder, RM AMS RN 10.0 Chp 88) 1. Rheumatoid arthritis (RA) is a chronic, progressive inflammatory disease that can affect tissues and organs but principally attacks the joints, producing an inflammatory synovitis. It involves joints bilaterally and symmetrically, and typically affects several joints at one time. b. Nutrition and Oral Hydration i. Fluid Imbalances: Hypertonic Dehydration (Active Learning Template – System Disorder, RM AMS RN 10.0 Chp 43) 1. The body maintains homeostasis when the characteristics of body fluid remain in balance: volume, concentration (osmolality), composition (electrolyte concentration), and acidity (pH). In the healthy adult client, 55% to 60% of body weight is comprised of body fluid. This decreases to about 50% to 55% in a healthy older adult client. 4. Pharmacological and Parenteral Therapies a. Adverse Effects/Contraindications/Side Effects/Interactions i. Vitamins, Minerals, and Supplements: Adverse Effects of Magnesium Sulfate (Active Learning Template – Medication, RM Pharm RN 7.0 Chp 30) 1. Vitamins and minerals have important roles in the body, including the production of red blood cells, building bones, making hormones, regulating body fluid volume, and supporting nerve cell function. Vitamin and mineral deficiencies can increase the risk for health problems, such as anemias, heart disease, cancers, and osteoporosis. Supplements of vitamins and minerals can help prevent multiple health conditions. ii. Head Injury: Adverse Effects of an Osmotic Diuretic (Active Learning Template – Medication, RM AMS RN 10.0 Chp 14) 1. Head injuries are classified as open or closed. In an open head injury, the integrity of the skull is compromised by either a penetrating object or blunt trauma that causes acceleration of the head and then deceleration or hits a stationary object. Head injuries are also classified as mild, moderate, or severe, depending upon Glasgow Coma Scale ratings and the length of time the client was unconscious. iii. Hypertension: Recognizing Adverse Effects of Propranolol (Active Learning Template – Medication, RM AMS RN 10.0 Chp 36) 1. For an adult client, hypertension occurs when systolic blood pressure is at or greater than 140 mm Hg or diastolic blood pressure is at or greater than 90 mm Hg for two or more assessments of blood pressure. For clients older than 60 years, blood pressure should be less than 150/90. iv. Pain Management: Assessing a Client Who is Receiving Morphine (Active Learning Template – Medication, RM AMS RN 10.0 Chp 4) 1. Effective pain management includes the use of pharmacological and nonpharmacological pain management therapies. Clients have a right to adequate assessment and management of pain. Nurses are accountable for the assessment of pain. Professional organizations and The Joint Commission have mandates requiring pain assessment and management. The nurse’s role is that of an advocate, member of the health care team, and educator for effective pain management. v. HIV/AIDS: Adverse Effects of Amphotericin B (Active Learning Template – Medication, RM AMS RN 10.0 Chp 86) 1. Human immunodeficiency virus (HIV) is a retrovirus that is transmitted through blood and body fluids. HIV targets CD4+ lymphocytes also 2. knowns as T-cells or T-lymphocytes. T-cells work in concert with B- lymphocytes. Both are part of a specific acquired immunity. HIV integrates its RNA into host cell DNA through reverse transcriptase, 3. reshaping the host’s immune system. vi. Integumentary Diagnostic Procedures: Contraindication for Allergy Skin Testing (Active Learning Template – Diagnostic Procedure, RM AMS RN 10.0 Chp 73) 1. Integumentary diagnostic procedures involve identification of pathogenic micro-organisms. The most accurate and definitive way to identify micro-organisms and cell characteristics is by examining blood, body fluids, and tissues samples under a microscope. Skin lesions or changes in the skin can need confirmation by microscope to determine if the cause is viral, fungal, or bacterial. b. Blood and Blood Products i. Blood and Blood Product Transfusions: Transfusion Reactions (Active Learning Template – Nursing Skill, RM AMS RN 10.0 Chp 4) 1. Clients can receive transfusions of whole blood or components of whole blood for replacement due to blood loss or blood disease. Blood components include packed RBCs, fresh frozen plasma, albumin, clotting factors, cryoprecipitate, and platelets. c. Expected Actions/Outcomes i. Heart Failure and Pulmonary Edema: Assessing for Digoxin Toxicity (Active Learning Template – Medication, RM AMS RN 10.0 Chp 32) 1. Heart failure occurs when the heart muscle is unable to pump effectively, resulting in inadequate cardiac output, myocardial hypertrophy, and pulmonary/systemic congestion. The heart is unable to maintain adequate circulation to meet tissue needs. ii. Hematologic Diagnostic Procedures: Efficacy of Warfarin Therapy (Active Learning Template – Medication, RM AMS RN 10.0 Chp 39) 1. Hematologic assessment and diagnostic procedures evaluate blood function by testing indicators such as erythrocytes (RBCs), leukocytes (WBCs), platelets, and coagulation times. By testing the blood, diagnosis of a disease and efficacy of treatment can be determined. d. Medication Administration i. Angina and Myocardial infarction: Teaching About Sublingual Nitroglycerin (Active Learning Template – Medication, RM AMS RN 10.0 Chp 31) 1. The continuum from angina to myocardial infarction (MI) is acute coronary syndrome. Symptoms of acute coronary syndrome are due to an imbalance between myocardial oxygen supply and demand. Angina pectoris is a warning sign of an impending acute MI. ii. Endocrine Disorders: Interaction with Levothyroxine (Active Learning Template – Medication, RM Pharm RN 7.0 Chp 40) 1. The endocrine system is made up of glands that secrete hormones, which act on specific receptor sites. Hormones target receptor sites to 2. regulate response to stress, growth, metabolism, and homeostasis. An endocrine disorder usually involves the oversecretion or undersecretion of hormones, or an altered response by the target area or receptor. iii. Cancer Treatment Options: Teaching About Epoetin Alfa (Active Learning Template – Medication, RM AMS RN 10.0 Chp 91) 1. Cancer treatment is based on the cell of origin of the cancer. When metastasis occurs, treatment is still based on the primary tumor origin even though the malignancy is located elsewhere in the body. Many cancers are curable when diagnosed early. iv. Safe Medication Administration and Error Reduction: Intramuscular Injection (Active Learning Template – Nursing Skill, RM Pharm RN 7.0 Chp 2) 1. The providers who may legally write prescriptions in the United States include physicians, advanced practice nurses, dentists, and physician assistants. These providers are responsible for obtaining clients’ medical history, performing a physical examination, diagnosing, prescribing medications, monitoring response to therapy, and modifying prescriptions as necessary. e. Parenteral/Intravenous Therapies i. Cardiovascular Diagnostic and Therapeutic Procedures: Caring for a Peripherally Inserted Central Catheter (Active Learning Template – Therapeutic Procedure, RM AMS RN 10.0 Chp 27) 1. Cardiovascular diagnostic procedures evaluate the functioning of the heart by monitoring for enzymes in the blood; using ultrasound to visualize the heart; determining the heart’s response to exercise; and using catheters to determine blood volume, perfusion, fluid status, how the heart is pumping, and degree of artery blockage. f. Total Parenteral Nutrition (TPN) i. Gastrointestinal Therapeutic Procedures: Glucose Monitoring for a Client Receiving Total Parenteral Nutrition (Active Learning Template – Basic Concept, RM AMS RN 10.0 Chp 47) 1. Gastrointestinal therapeutic procedures are performed for maintenance of nutritional intake, and treatment of gastrointestinal obstructions, obesity, and other disorders. Gastrointestinal therapeutic procedures nurses should be knowledgeable about include enteral feedings, total parenteral nutrition (TPN), paracentesis, nasogastric decompression, bariatric surgeries and ostomies. 5. Reduction of Risk Potential a. Laboratory Values i. Pancreatitis: Expected Laboratory Findings (Active Learning Template – System Disorder, RM AMS RN 10.0 Chp 54) 1. Pancreatitis is an autodigestion of the pancreas by pancreatic digestive enzymes that activate prematurely before reaching the intestines. The mechanism of action is unclear. Inflammation of the pancreatic tissue causes duct obstruction, which can lead to increased pressure and duct rupture, causing the release of pancreatic enzymes into the pancreatic tissue. Pancreatitis can result in pancreatic inflammation, necrosis, and hemorrhage. Classis presentation of an acute attack includes severe, constant, knifelike pain.