MNS 5430 MED-SURG PRACTICE EXAM CONCEPTS |STUDYGUIDE 2021.

MNS 5430 MED-SURG PRACTICE EXAM CONCEPTS |STUDYGUIDE 2021.Med-Surg Practice Exam Concepts o Crutches ▪ Place body weight on crutches ▪ Advance unaffected leg onto the stair ▪ Shift weight from crutches to unaffected leg ▪ Bring crutches and affected leg up to the stair o Closed-suction drain nursing interventions ▪ Negative-pressure device ▪ Doesn’t require wall suction ▪ *Compress the drain reservoir after emptying (creates negative pressure) ▪ Do not need to put below bed (doesn’t use gravity) o External fixation device ▪ Surgeon applies the external fixation device directly to the client’s bone to form a rigid structure around the affected extremity • Casts, boots, or splints are applied directly to the leg for internal fixation ▪ Client should wear external fixation device continuously for a period of 4-6 weeks • Nurse should teach the client to perform care of the wound and pin sites at home ▪ Use crutches with rubber tips • Prevents the client from slipping and decreases fall risks ▪ Only the provider should adjust the client’s external fixation device in order to maintain bone alignment o Long-term mechanical ventilation complications ▪ Decreased cardiac output and hypotension, related to positive pressure from mechanical ventilation inhibiting blood return to the heart ▪ Fluid retention related to decreased cardiac output ▪ Stress ulcers, related to elevated levels of HCl in the stomach • Increase risk for systemic infection and require pharmacological treatment ▪ Hyponatremia, secondary to fluid retention o Postoperative nursing interventions following mastectomy ▪ Instruct client that the drain will remain in place for 1-3 weeks after surgery and will be removed when there is 25 mL of output or less in a 24-hour period ▪ Instruct client to start exercising the arm on side of surgery 24 hours after surgery ▪ Elevate arm on surgical side on a pillow to promote lymphatic fluid return ▪ Nurse should elevate the head of the client’s bed to at least 30 degrees to promote drainage from the surgical site and facilitate breathing o Patient teaching for active tuberculosis ▪ Sputum specimens are necessary every 2-4 weeks until there are three negative cultures • After 3 negative cultures, the client is no longer considered infectious ▪ Client’s infection is usually no longer contagious after taking TB medications for 2-3 weeks ▪ Family members do not need to follow airborne precautions because they have already been exposed to TB