MedSurg FINAL REVIEW UPDATED 2023
• Math on final- 3 questions
o Heparin
▪ Weight based
▪ 1200units/hour
▪ 25,000 units/500 mL
▪ Want mL/hour
▪ 500 mL X. 1200 units = 24mL/hr
▪ 25,000units X 1 mL
o Drips/min
o mL/hour
• Nursing process
o A-assessment
▪ Risk factors
▪ History
▪ Gather data
o D- diagnosis
▪ Helps with prioritization (maslow)
▪ ID strengths and weaknesses
▪ PED statements using NANDA
o P- planning
▪ What patient WILL do
▪ SMART (specific, measurable, attainable, realistic, timeframe)
o I- Interventions
▪ What will you do as a nurse
o E- evaluation
▪ Assessing for complications and to be sure that what you’re doing
is preventing complications.
• QSEN Competencies (6)
o 1. Quality Improvement
o 2. Teamwork and collaboration
o 3. Informatics
o 4. Patient-centered Care
o 5. Safety
o 6. Evidence-based practice
o Safety- SBAR: a means of communication that minimizes risk of harm to patients
• Health promotion
o Teaching (teach-back)
o Learning readiness, teachable moments
• Health prevention
o Primary, secondary, tertiary (Know examples of each)
, MedSurg FINAL REVIEW UPDATED 2023
• Precautions, asepsis, pressure injuries, general precautions
o Contact precautions
o Medical asepsis is clean technique
o Surgical asepsis is sterile technique
o Hand hygiene (five moments)
▪ Before touching patient, before clean procedure, after bodily fluid
exposure risk, after touching a patient, after touching
surroundings
o Healthcare associated infections are preventable
▪ PPE and transmission-based precautions
▪ MRSA, VRE, C. diff require contact isolation and full PPE
▪ Contact precautions (MRSA, VRE, Cdiff) private room, gloves, and gown
▪ Droplet precautions (adenovirus, influenza, bacterial meningitis)
private room, gloves, gown, mask, surgical mask on patient
▪ Airborne precautions (TB, varicella) door closed, respirator on when
in room
o Pressure injuries (friction and shear, external pressure, big emphasis on
turning the patient, thorough admission assessment)
▪ BRADEN stage to determine risk for pressure injury
▪ Stage 1: intact skin, non-blanchable redness, localized over bony
prominence
▪ Stage 2: partial thickness loss of dermis, shallow open ulcer,
red/pink wound bed, shiny/dry
▪ Stage 3: full-thickness loss, subcutaneous fat may be visible, but
tendon/bone/muscle not exposed, may see undermining or
tunneling
▪ Stage 4: full-thickness tissue loss with exposed
bone/tendon/muscle, often included tunneling and undermining
▪ Unstageable: full thickness tissue loss, unable to visualize d/t slough
or eschar, eschar on heels should NOT be removed
o Drains
▪ 80-120cc/day, serosanguinous, puss, suction working, small clots OK
o Overall skin care and assessing skin
▪ Dehiscence is intentionally closed wounds that open d/t pressure
or positioning
▪ Evisceration is separation of muscle
▪ Cover with sterile saline dressing and notify provider
• Safety
o Fall precautions
o ABC IN and OUT PS
▪ Are they breathing?
▪ Everything going in (IV, what’s running)
▪ What’s coming out of them
▪ P- pain
• Math on final- 3 questions
o Heparin
▪ Weight based
▪ 1200units/hour
▪ 25,000 units/500 mL
▪ Want mL/hour
▪ 500 mL X. 1200 units = 24mL/hr
▪ 25,000units X 1 mL
o Drips/min
o mL/hour
• Nursing process
o A-assessment
▪ Risk factors
▪ History
▪ Gather data
o D- diagnosis
▪ Helps with prioritization (maslow)
▪ ID strengths and weaknesses
▪ PED statements using NANDA
o P- planning
▪ What patient WILL do
▪ SMART (specific, measurable, attainable, realistic, timeframe)
o I- Interventions
▪ What will you do as a nurse
o E- evaluation
▪ Assessing for complications and to be sure that what you’re doing
is preventing complications.
• QSEN Competencies (6)
o 1. Quality Improvement
o 2. Teamwork and collaboration
o 3. Informatics
o 4. Patient-centered Care
o 5. Safety
o 6. Evidence-based practice
o Safety- SBAR: a means of communication that minimizes risk of harm to patients
• Health promotion
o Teaching (teach-back)
o Learning readiness, teachable moments
• Health prevention
o Primary, secondary, tertiary (Know examples of each)
, MedSurg FINAL REVIEW UPDATED 2023
• Precautions, asepsis, pressure injuries, general precautions
o Contact precautions
o Medical asepsis is clean technique
o Surgical asepsis is sterile technique
o Hand hygiene (five moments)
▪ Before touching patient, before clean procedure, after bodily fluid
exposure risk, after touching a patient, after touching
surroundings
o Healthcare associated infections are preventable
▪ PPE and transmission-based precautions
▪ MRSA, VRE, C. diff require contact isolation and full PPE
▪ Contact precautions (MRSA, VRE, Cdiff) private room, gloves, and gown
▪ Droplet precautions (adenovirus, influenza, bacterial meningitis)
private room, gloves, gown, mask, surgical mask on patient
▪ Airborne precautions (TB, varicella) door closed, respirator on when
in room
o Pressure injuries (friction and shear, external pressure, big emphasis on
turning the patient, thorough admission assessment)
▪ BRADEN stage to determine risk for pressure injury
▪ Stage 1: intact skin, non-blanchable redness, localized over bony
prominence
▪ Stage 2: partial thickness loss of dermis, shallow open ulcer,
red/pink wound bed, shiny/dry
▪ Stage 3: full-thickness loss, subcutaneous fat may be visible, but
tendon/bone/muscle not exposed, may see undermining or
tunneling
▪ Stage 4: full-thickness tissue loss with exposed
bone/tendon/muscle, often included tunneling and undermining
▪ Unstageable: full thickness tissue loss, unable to visualize d/t slough
or eschar, eschar on heels should NOT be removed
o Drains
▪ 80-120cc/day, serosanguinous, puss, suction working, small clots OK
o Overall skin care and assessing skin
▪ Dehiscence is intentionally closed wounds that open d/t pressure
or positioning
▪ Evisceration is separation of muscle
▪ Cover with sterile saline dressing and notify provider
• Safety
o Fall precautions
o ABC IN and OUT PS
▪ Are they breathing?
▪ Everything going in (IV, what’s running)
▪ What’s coming out of them
▪ P- pain
