NUR 242 Exam 1 Notes
Medical/Surgical Nursing Concepts
(Galen College of Nursing)
100% Guarantee Pass
CONTENTS
Professor Enide Mohomme
(Med surg Nur242) Nursing LPN to ADN
Anything Highlighted in Yellow = on test
Exam 1 includes
Unit 1 (Chapter 1, Ch 4, Ch 6, Ch 7, Ch 22, Ch 23,)
Unit2 (Ch 5, Ch 9, Ch36, Ch37)
Unit 3 (Ch 21, Ch 16, Ch 15, Ch 55)
,Notes for Medsurg test 1= WEEK 1
Chapter 1: Overview of Professional Nursing concepts for Medical Surgical nursing
-Attributes of patient centered care= respect of patient values , preferences and expressed needs; coordination and
integration of care, info, communication and education; physical comfort; emotional support and alleviation of fear and
anxiety; involvement of fam and friends; transition and continuity; access to care.
- complementary and alternative therapies= pet therapy, massage therapy, guided imagery, biofeedback, exercise and
fitness programs, Nutrional supplements, aromatherapy, health focused tv, music therapy, acupuncture, acupressure,
disease management program
- Patient centered care- integrative care model ( focus on diverse preferences and needs), Basic physical and comfort
needs met.
- Best care transition practices- educate and coach patients and their caregivers; use transition coaches, if available , to
improve care coordination and transition management; f/u with post drainage vistits or phone calls; improve
communication handoffs from hospitals to ambulatory care or home care settings, identify high risk patients for
readmission on basis of age ( older than 80 ) number of comorbidities (equal or less 3 ) number of RX ( equal or less
than 5) and difficulty performing at least 1 ADL; address patient caregiver needs to prevent caregiver role strain.
- Patient and staf f safety is the major priority for professional nurses.
- the best source of evidence is usually research
-Quality improvement- aka evidence-based practice and safety
-Joint commission requires that health care organizations create a culture of safety by following NPSG: safety
-vital role of nurse is an advocate to empower patients and families to have control over their health care and
function as safety partners Risk factors of immobility= caused by long periods of immobility
1. Activity intolerance, ineffective GI perfusion, ineffective renal perfusion, decreased cardiac output,
ineffective cerebral perfusion, ineffective tissue perfusion, disuse syndrome ( Nutritionist high protein (
albumin and pre albumin look at BMI
a. DVT decreased cardiac output, orthostatic hypotension, (encourage early ambulation, low dose 12
hours after surg, change position slowly
b. Constipation-, hydration, Colace, fiber, opioids ( other options NsaID))
c. Respiratory system- atelectasis, pneumonia,( incentive spirometer, HOB up, splint wound) coughing
deep breathing also
d. Nuero- depression, disorientation ( reorient, wake ,sleep cycle)
e. Urinary- urinary statis and retention ( UTI), renal calculi create schedule,
f. Skin- ( ulcers) perwick; high protein diet, turn every 2 hours
g. Musculoskeletal- ( contracture, foot drop, osteoporosis, fracture( up and moving , calcium
supplement) waffle mattress SCD, wedges, heel boots,
-Chapter 4= Common health problem of older adults
Common Health problems of older adults- decreased nutrition, hydration; decreased mobility; stress, loss coping,
accidents, polypharmacy, inadequate cognition, substance use
Older adult considerations-
Fastest growing subgroup is the OLD OLD sometimes referred to as advanced
older adult. Number of homless people older than 60 is growing
Heatlh protecting behaviors- yearly flu vaccine ( October- March annually), pneumococcal vaccine, shingles vaccines,
tetanus booster every 10 years, seatbelt, alcohol only in moderation, grab bars, smoke detectors, hazard free
environment, avoid OTC meds
Health enhancing behaviors- yearly physical exam, reduce fat in diet ( sautrated fat less htan 10%, no more than 30%
calories); increase daily intake of complex carbs and fiber, 5 or moe servings of fruit and veggies; 6 or more servings of
grain products); increase calcium 1000-1500mg daily take vit D as recommended; exercise regulary 3-5 times a week;
reminince use journaling
-diminished sense of taste= less ability to taste sweet and salt than bitter and sour
-Older adult Nutrional teaching- increase fiber and fluid intake, exercise regularyly avoid risk factors that contribut to
constipation. FIBER 35-50 grams, min 2 L of water a day, “colon cocktail mix of applesauce, prune juice, psyllium 1-2
tablesppons daily if not stool softner
, -TEACH OLDER ADULTS THAT FLUID RESTRICTIONS MAKE THEM LIKELY TO DEVELOP DEHYDRATION AND ELECTROLYTE
EMBALANCE ( sodium
and potassium) that can cause serious illness or death
-major advantages of maintaining appropriate levels of physical activity: decreased risk of falls, increased muscle
strenth and balance, increaed mobility, increased sleep, reduced or maintained weight, improved sense of well- being
and self esteem, decreased risk of constipation,improved longevity, reduced risk of diabetes , cornoary artey disease,
dementia
-Minimize effects of relocation stress in older adult= provide max oppurtunity for patient to assistn in decisions, carfully
explain procedures and routines, keepsake at bedside, reorient cleint to place and time, ask about expetations, ecourage
patient family to visit often, kestabilish trust with cleint, assess for patient usual lifestyle and daily activities= foods,
pereferreed time for bathing, avoid unnecceary food changes,
Risk factors for falls= Presbyopia, peripheral nerupathy, mutiple meds, bilateral
cataracts, hx of fallsZ Motor vechile crashes are a majorcause of accidnets and
death among the older adult population
Medical/Surgical Nursing Concepts
(Galen College of Nursing)
100% Guarantee Pass
CONTENTS
Professor Enide Mohomme
(Med surg Nur242) Nursing LPN to ADN
Anything Highlighted in Yellow = on test
Exam 1 includes
Unit 1 (Chapter 1, Ch 4, Ch 6, Ch 7, Ch 22, Ch 23,)
Unit2 (Ch 5, Ch 9, Ch36, Ch37)
Unit 3 (Ch 21, Ch 16, Ch 15, Ch 55)
,Notes for Medsurg test 1= WEEK 1
Chapter 1: Overview of Professional Nursing concepts for Medical Surgical nursing
-Attributes of patient centered care= respect of patient values , preferences and expressed needs; coordination and
integration of care, info, communication and education; physical comfort; emotional support and alleviation of fear and
anxiety; involvement of fam and friends; transition and continuity; access to care.
- complementary and alternative therapies= pet therapy, massage therapy, guided imagery, biofeedback, exercise and
fitness programs, Nutrional supplements, aromatherapy, health focused tv, music therapy, acupuncture, acupressure,
disease management program
- Patient centered care- integrative care model ( focus on diverse preferences and needs), Basic physical and comfort
needs met.
- Best care transition practices- educate and coach patients and their caregivers; use transition coaches, if available , to
improve care coordination and transition management; f/u with post drainage vistits or phone calls; improve
communication handoffs from hospitals to ambulatory care or home care settings, identify high risk patients for
readmission on basis of age ( older than 80 ) number of comorbidities (equal or less 3 ) number of RX ( equal or less
than 5) and difficulty performing at least 1 ADL; address patient caregiver needs to prevent caregiver role strain.
- Patient and staf f safety is the major priority for professional nurses.
- the best source of evidence is usually research
-Quality improvement- aka evidence-based practice and safety
-Joint commission requires that health care organizations create a culture of safety by following NPSG: safety
-vital role of nurse is an advocate to empower patients and families to have control over their health care and
function as safety partners Risk factors of immobility= caused by long periods of immobility
1. Activity intolerance, ineffective GI perfusion, ineffective renal perfusion, decreased cardiac output,
ineffective cerebral perfusion, ineffective tissue perfusion, disuse syndrome ( Nutritionist high protein (
albumin and pre albumin look at BMI
a. DVT decreased cardiac output, orthostatic hypotension, (encourage early ambulation, low dose 12
hours after surg, change position slowly
b. Constipation-, hydration, Colace, fiber, opioids ( other options NsaID))
c. Respiratory system- atelectasis, pneumonia,( incentive spirometer, HOB up, splint wound) coughing
deep breathing also
d. Nuero- depression, disorientation ( reorient, wake ,sleep cycle)
e. Urinary- urinary statis and retention ( UTI), renal calculi create schedule,
f. Skin- ( ulcers) perwick; high protein diet, turn every 2 hours
g. Musculoskeletal- ( contracture, foot drop, osteoporosis, fracture( up and moving , calcium
supplement) waffle mattress SCD, wedges, heel boots,
-Chapter 4= Common health problem of older adults
Common Health problems of older adults- decreased nutrition, hydration; decreased mobility; stress, loss coping,
accidents, polypharmacy, inadequate cognition, substance use
Older adult considerations-
Fastest growing subgroup is the OLD OLD sometimes referred to as advanced
older adult. Number of homless people older than 60 is growing
Heatlh protecting behaviors- yearly flu vaccine ( October- March annually), pneumococcal vaccine, shingles vaccines,
tetanus booster every 10 years, seatbelt, alcohol only in moderation, grab bars, smoke detectors, hazard free
environment, avoid OTC meds
Health enhancing behaviors- yearly physical exam, reduce fat in diet ( sautrated fat less htan 10%, no more than 30%
calories); increase daily intake of complex carbs and fiber, 5 or moe servings of fruit and veggies; 6 or more servings of
grain products); increase calcium 1000-1500mg daily take vit D as recommended; exercise regulary 3-5 times a week;
reminince use journaling
-diminished sense of taste= less ability to taste sweet and salt than bitter and sour
-Older adult Nutrional teaching- increase fiber and fluid intake, exercise regularyly avoid risk factors that contribut to
constipation. FIBER 35-50 grams, min 2 L of water a day, “colon cocktail mix of applesauce, prune juice, psyllium 1-2
tablesppons daily if not stool softner
, -TEACH OLDER ADULTS THAT FLUID RESTRICTIONS MAKE THEM LIKELY TO DEVELOP DEHYDRATION AND ELECTROLYTE
EMBALANCE ( sodium
and potassium) that can cause serious illness or death
-major advantages of maintaining appropriate levels of physical activity: decreased risk of falls, increased muscle
strenth and balance, increaed mobility, increased sleep, reduced or maintained weight, improved sense of well- being
and self esteem, decreased risk of constipation,improved longevity, reduced risk of diabetes , cornoary artey disease,
dementia
-Minimize effects of relocation stress in older adult= provide max oppurtunity for patient to assistn in decisions, carfully
explain procedures and routines, keepsake at bedside, reorient cleint to place and time, ask about expetations, ecourage
patient family to visit often, kestabilish trust with cleint, assess for patient usual lifestyle and daily activities= foods,
pereferreed time for bathing, avoid unnecceary food changes,
Risk factors for falls= Presbyopia, peripheral nerupathy, mutiple meds, bilateral
cataracts, hx of fallsZ Motor vechile crashes are a majorcause of accidnets and
death among the older adult population
