9/11/24, 9:29 AM Med Surg Study Bundle - Notes
Med-Surg Study Guide
Table of Contents
Burns 2 Hematologic Disorders 87
Cancer 8 Musculoskeletal 89
Cardiac 12 Musculoskeletal System 89
Cardiac Basics 12 Fracture 92
Heart Failure 14 Osteoarthritis 95
Coronary Artery Disease 16 Rheumatoid Arthritis 97
Angina Pectoris 18 Osteoporosis 100
Myocardial Infarction 20 Gout 103
Electrolyte Imbalances 22 Neurology 105
Sodium 22 Brain Anatomy and Physiology 105
Potassium 23 Stroke 108
Calcium 24 Seizure 114
Magnesium 25 Increased Intracranial Pressure 118
Phosphorus 26 Multiple Sclerosis 123
Chloride 27 Parkinson's Disease 126
Relationships 28 Myasthenia Gravis 130
Endocrine 29 Guillain-Barre Syndrome 133
Endocrine System 29 Renal 136
Thyroid Gland and Disorders 32 Kidneys, Nephrons and RAAS 136
Hyper- and Hypoparathyroidism 37 Chronic Kidney Disease 139
Adrenal Glands and Disorders 40 Acute Kidney Injury 141
DI vs SIADH 45 Renal Calculi 143
Diabetes Mellitus 48 Urinary Tract Infections 146
Gastrointestinal 58 Glomerulonephritis 149
The Digestive System 58 Nephrotic Syndrome 151
Gastroesophageal Reflux Disease 61 Dialysis 152
Peptic Ulcer Disease 62 Diuretics 154
Inflammatory Bowel Disease 63 Respiratory Disorders 159
Diverticulosis and -itis 67 Lung Anatomy and Physiology 159
Celiac Disease 69 Pneumonia 160
Hepatitis 71 COPD 161
Cirrhosis 77 Asthma 162
Pancreatitis 80 ARDS 163
Cholecystitis 83 Pleural Effusion 164
Appendicitis 85 Shock 165
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,9/11/24, 9:29 AM Med Surg Study Bundle - Notes
BURNS
Damage to the skin's integrity by some kind of energy source
Types of Burns
Thermal - Most common - caused by flame, flash, scald or contact with hot
objects (liquid, steam, fire); e.g. from cooking, burning leaves, smoking
Chemical - caused by contact with acids, alkali or organic compounds - no heat
needed
acids (e.g. hydrochloric, oxalic, hydrofluoric)
alkali (e.g. cement, oven/drain cleaners, heavy industrial cleaners); harder
to treat because adheres to tissue
organic compounds (e.g. phenols and petroleum products)
Electrical - caused by intense heat generated from an electric current that
passes through the body and damages tissue
hard to determine extent of damage because most of damage is below the
skin - 'iceberg effect'
Cold - caused by cold exposure to skin; frostbite
Radiation - caused by sun or cancer treatment
Friction - caused by abrasion to skin
road rash (car accident)
rope burn
Superficial partial Epidermis
thickness (1st degree)
Sweat
Deep partial gland Dermis
thickness Hair
(2nd degree) Follicle
Fat
Full
thickness
(3rd & 4th Muscle
degree)
Bone
Skin Structure and Degree of Burn
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,9/11/24, 9:29 AM Med Surg Study Bundle - Notes
Burn Severity Depends on:
Depth of Burn Location of Burn
Extent of Burn Patient risk factors
Calculated in % of TBSA If they experienced an inhalation
Use Rule of 9s (see next page) injury or not
Depth of Burn
st Degree rd Degree
Superficial partial thickness Full thickness
Epidermis only All layers are damaged
Least severe Not painful due to damage to nerves
Heals in 7 days Skin will NOT heal - needs skin
Erythema grafting
Blanching on pressure Will take months to heal
Pain/mild swelling Dry, leathery hard skin (eschar)
Skin pink/red May be black, yellow, red, waxy
Warm to touch white
No blisters Eschar - dead tissue - dangerous if
Usually no scarring around torso or extremity; will need
to be removed via escharotomy
th Degree
nd Degree
Deep full thickness
Deep partial thickness
All layers destroyed and extends to
Epidermis and dermis
muscles, bone, ligaments
Very painful
NO pain sensation
Blisters
Black, charred with eschar
Redness that blanches
Months to heal
Swelling (mild - moderate)
Will need skin grafts
Shiny red/pink and moist
If severe, may need skin In Full Thickness, watch for acute
grafting tubular necrosis (ATN), due to the
release of myoglobin and hemoglobin
that block kidney tubules.
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, 9/11/24, 9:29 AM Med Surg Study Bundle - Notes
Extent of Burn
To determine the extent of burn, calculate the TBSA burned using the Rule
of Nines and then use the Parkland Formula to calculate the fluids needed
Rule of Nines
Purpose:
4.5%
To calculate the total body surface area burned 4.5%
(TBSA%) for 2nd, 3rd and 4th degree burns
To determine the amount of fluid therapy needed 18%
18% 4.5%
using the Parkland Formula 4.5% Front 4.5%
Back
4.5%
To determine if the patient meets criteria for
burn unit
1%
Add the percent of each body 9% 9% 9% 9%
Use for 2nd part burned.
degree burns This number equals the
or greater TBSA%.
Parkland Formula
Purpose: To calculate the total volume
4 mL X TBSA (%) X Body weight (kg) =
of fluids (mL) that a patient needs
total mL of fluid (lactated Ringer's) needed
24 hours after experiencing a burn.
Make sure TBSA is NOT a decimal!
Give first half of Give second half of
For instance, if a patient has a TBSA% =
the solution in the solution over the
45%, use 45 in the equation, NOT .45
the first 8 hours next 16 hours
Location of Burn - potential problems
Respiratory - face, mouth, neck, trunk (due to edema or eschar)
Disability - Eyes, hands, feet, joints (due to damage to nerves)
Infection - Perineum (due to infection from urine/feces) and ears, nose (thin skin)
Trouble Healing - Ears, nose (due to thin skin and poor blood supply)
Compartment syndrome - Full thickness circumferential burns
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Med-Surg Study Guide
Table of Contents
Burns 2 Hematologic Disorders 87
Cancer 8 Musculoskeletal 89
Cardiac 12 Musculoskeletal System 89
Cardiac Basics 12 Fracture 92
Heart Failure 14 Osteoarthritis 95
Coronary Artery Disease 16 Rheumatoid Arthritis 97
Angina Pectoris 18 Osteoporosis 100
Myocardial Infarction 20 Gout 103
Electrolyte Imbalances 22 Neurology 105
Sodium 22 Brain Anatomy and Physiology 105
Potassium 23 Stroke 108
Calcium 24 Seizure 114
Magnesium 25 Increased Intracranial Pressure 118
Phosphorus 26 Multiple Sclerosis 123
Chloride 27 Parkinson's Disease 126
Relationships 28 Myasthenia Gravis 130
Endocrine 29 Guillain-Barre Syndrome 133
Endocrine System 29 Renal 136
Thyroid Gland and Disorders 32 Kidneys, Nephrons and RAAS 136
Hyper- and Hypoparathyroidism 37 Chronic Kidney Disease 139
Adrenal Glands and Disorders 40 Acute Kidney Injury 141
DI vs SIADH 45 Renal Calculi 143
Diabetes Mellitus 48 Urinary Tract Infections 146
Gastrointestinal 58 Glomerulonephritis 149
The Digestive System 58 Nephrotic Syndrome 151
Gastroesophageal Reflux Disease 61 Dialysis 152
Peptic Ulcer Disease 62 Diuretics 154
Inflammatory Bowel Disease 63 Respiratory Disorders 159
Diverticulosis and -itis 67 Lung Anatomy and Physiology 159
Celiac Disease 69 Pneumonia 160
Hepatitis 71 COPD 161
Cirrhosis 77 Asthma 162
Pancreatitis 80 ARDS 163
Cholecystitis 83 Pleural Effusion 164
Appendicitis 85 Shock 165
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,9/11/24, 9:29 AM Med Surg Study Bundle - Notes
BURNS
Damage to the skin's integrity by some kind of energy source
Types of Burns
Thermal - Most common - caused by flame, flash, scald or contact with hot
objects (liquid, steam, fire); e.g. from cooking, burning leaves, smoking
Chemical - caused by contact with acids, alkali or organic compounds - no heat
needed
acids (e.g. hydrochloric, oxalic, hydrofluoric)
alkali (e.g. cement, oven/drain cleaners, heavy industrial cleaners); harder
to treat because adheres to tissue
organic compounds (e.g. phenols and petroleum products)
Electrical - caused by intense heat generated from an electric current that
passes through the body and damages tissue
hard to determine extent of damage because most of damage is below the
skin - 'iceberg effect'
Cold - caused by cold exposure to skin; frostbite
Radiation - caused by sun or cancer treatment
Friction - caused by abrasion to skin
road rash (car accident)
rope burn
Superficial partial Epidermis
thickness (1st degree)
Sweat
Deep partial gland Dermis
thickness Hair
(2nd degree) Follicle
Fat
Full
thickness
(3rd & 4th Muscle
degree)
Bone
Skin Structure and Degree of Burn
about:blank 2/167
,9/11/24, 9:29 AM Med Surg Study Bundle - Notes
Burn Severity Depends on:
Depth of Burn Location of Burn
Extent of Burn Patient risk factors
Calculated in % of TBSA If they experienced an inhalation
Use Rule of 9s (see next page) injury or not
Depth of Burn
st Degree rd Degree
Superficial partial thickness Full thickness
Epidermis only All layers are damaged
Least severe Not painful due to damage to nerves
Heals in 7 days Skin will NOT heal - needs skin
Erythema grafting
Blanching on pressure Will take months to heal
Pain/mild swelling Dry, leathery hard skin (eschar)
Skin pink/red May be black, yellow, red, waxy
Warm to touch white
No blisters Eschar - dead tissue - dangerous if
Usually no scarring around torso or extremity; will need
to be removed via escharotomy
th Degree
nd Degree
Deep full thickness
Deep partial thickness
All layers destroyed and extends to
Epidermis and dermis
muscles, bone, ligaments
Very painful
NO pain sensation
Blisters
Black, charred with eschar
Redness that blanches
Months to heal
Swelling (mild - moderate)
Will need skin grafts
Shiny red/pink and moist
If severe, may need skin In Full Thickness, watch for acute
grafting tubular necrosis (ATN), due to the
release of myoglobin and hemoglobin
that block kidney tubules.
about:blank 3/167
, 9/11/24, 9:29 AM Med Surg Study Bundle - Notes
Extent of Burn
To determine the extent of burn, calculate the TBSA burned using the Rule
of Nines and then use the Parkland Formula to calculate the fluids needed
Rule of Nines
Purpose:
4.5%
To calculate the total body surface area burned 4.5%
(TBSA%) for 2nd, 3rd and 4th degree burns
To determine the amount of fluid therapy needed 18%
18% 4.5%
using the Parkland Formula 4.5% Front 4.5%
Back
4.5%
To determine if the patient meets criteria for
burn unit
1%
Add the percent of each body 9% 9% 9% 9%
Use for 2nd part burned.
degree burns This number equals the
or greater TBSA%.
Parkland Formula
Purpose: To calculate the total volume
4 mL X TBSA (%) X Body weight (kg) =
of fluids (mL) that a patient needs
total mL of fluid (lactated Ringer's) needed
24 hours after experiencing a burn.
Make sure TBSA is NOT a decimal!
Give first half of Give second half of
For instance, if a patient has a TBSA% =
the solution in the solution over the
45%, use 45 in the equation, NOT .45
the first 8 hours next 16 hours
Location of Burn - potential problems
Respiratory - face, mouth, neck, trunk (due to edema or eschar)
Disability - Eyes, hands, feet, joints (due to damage to nerves)
Infection - Perineum (due to infection from urine/feces) and ears, nose (thin skin)
Trouble Healing - Ears, nose (due to thin skin and poor blood supply)
Compartment syndrome - Full thickness circumferential burns
about:blank 4/167
