ATI FOCUS REVIEW REMEDIATED MEDSURG
1. Head Injury: Making Room Assignments for a Group of Clients (RM AMS RN 10.0 Chp 14,
Active Learning Template - Basic Concept, RN QSEN - Safety)
A. Close monitoring of the client’s vital signs and neurological status will allow early
reporting of changes in the GCS score, an increase in the blood pressure, and an
alteration in respiratory pattern and effort.
B. Care should include professionals from other disciplines as indicated. This may
include physical, occupational, recreational, and/or speech therapists due to
neurological deficits that may occur secondary to the area of the brain damaged.
C. Social services should be contacted to provide links to social service agencies and
schools.
2. Middle and Inner Ear Disorders: Actions to Take for Hearing Loss (RM AMS RN 10.0 Chp
13, RN QSEN - Patient centered Care, Active Learning Template - Basic Concept)
A. Monitor the client’s functional ability and balance. Take fall risk precautions as
necessary.
B. Evaluate the client’s home situation. Collaborate with home health to assess
home safety and falls risks, as needed.
C. Encourage client who has balance or functional limitations to rise slowly and use
assistance and assistive devices as needed.
3. Cancer Treatment Options: Caring for a Client Receiving Radiation (Active Learning
Template - System Disorder, RM AMS RN 10.0 Chp 91)
A. Do not use same toilet as others for 2 weeks, sit down to urinate, and flush toilet
three times.
B. Take a laxative 2 to 3 days after treatment to help rid the body of stool
contaminated with radiation.
C. Wear clothing that is washable, wash clothing separate from clothing of others, and
run the washing machine for a full cycle after washing contaminated clothing.
4. Dosage Calculation: Determining IV Fluid Intake (Active Learning Template - Basic
Concept, RN QSEN - Safety , RM FUND 9.0 Ch 48)
A. Using Ratio and Proportion
B. Using Dimensional Analysis
C. Desired Over Have
5. Heart Failure and Pulmonary Edema: Identifying Digoxin Toxicity (RN QSEN - Safety , RM
AMS RN 10.0 Chp 32
, A. Report signs of toxicity, including fatigue, muscle weakness, confusion, and loss
of appetite.
B. Count pulse for 1 min before taking the medication. If the pulse rate is irregular
or the pulse rate is outside of the limitations set by the provider (usually less
than 60/min or greater than 100/min), instruct the client to hold the dose and
contact the provider.
C. Take the digoxin dose at the same time each day.
6. Active Pulmonary Embolism: Planning Care for a Client Who Is Receiving Enoxaparin (RM
AMS RN 10.0 Chp 24, RN QSEN - Safety , Active Learning Template - Medication)
A. Assess for contraindications (active bleeding, peptic ulcer disease, history of
stroke, recent trauma).
B. Monitor bleeding times. Prothrombin time (PT) & international normalized ration
(INR), partial thromboplastin time, & complete blood count.
C. Monitor for side effects of anticoagulants (anemia, thrombocytopenia,
hemorrhage).
7. Rheumatoid Arthritis: Reviewing Laboratory Values (RM AMS RN 10.0 Chp 88, Active
Learning Template - Medication)
A. Erythrocyte sedimentation rate (ESR) and high-sensitivity
B. C-reactive protein may be increased slightly related to secondary synovitis.
C. Osteoarthritis without synovitis is not an inflammatory disorder.
8. Medications Affecting Blood Pressure: Administering Valsartan for Heart Failure (RM
Pharm RN 7.0 Chp 20, Active Learning Template - Medication)
A. Do not take this medicine in larger or smaller amounts or for longer than
recommended.
B. You may take valsartan with or without food.
C. Take the medicine at the same time each day
9. Angina and Myocardial Infarction: Reinforcing Teaching About Nitroglycerin (RM AMS
RN 10.0 Chp 31, Active Learning Template - Medication)
A. The client can take up to two more doses of nitroglycerin at 5-min intervals.
B. Remind the client that a headache is a common side effect of this medication.
C. Encourage the client to sit and lie down slowly.
1. Head Injury: Making Room Assignments for a Group of Clients (RM AMS RN 10.0 Chp 14,
Active Learning Template - Basic Concept, RN QSEN - Safety)
A. Close monitoring of the client’s vital signs and neurological status will allow early
reporting of changes in the GCS score, an increase in the blood pressure, and an
alteration in respiratory pattern and effort.
B. Care should include professionals from other disciplines as indicated. This may
include physical, occupational, recreational, and/or speech therapists due to
neurological deficits that may occur secondary to the area of the brain damaged.
C. Social services should be contacted to provide links to social service agencies and
schools.
2. Middle and Inner Ear Disorders: Actions to Take for Hearing Loss (RM AMS RN 10.0 Chp
13, RN QSEN - Patient centered Care, Active Learning Template - Basic Concept)
A. Monitor the client’s functional ability and balance. Take fall risk precautions as
necessary.
B. Evaluate the client’s home situation. Collaborate with home health to assess
home safety and falls risks, as needed.
C. Encourage client who has balance or functional limitations to rise slowly and use
assistance and assistive devices as needed.
3. Cancer Treatment Options: Caring for a Client Receiving Radiation (Active Learning
Template - System Disorder, RM AMS RN 10.0 Chp 91)
A. Do not use same toilet as others for 2 weeks, sit down to urinate, and flush toilet
three times.
B. Take a laxative 2 to 3 days after treatment to help rid the body of stool
contaminated with radiation.
C. Wear clothing that is washable, wash clothing separate from clothing of others, and
run the washing machine for a full cycle after washing contaminated clothing.
4. Dosage Calculation: Determining IV Fluid Intake (Active Learning Template - Basic
Concept, RN QSEN - Safety , RM FUND 9.0 Ch 48)
A. Using Ratio and Proportion
B. Using Dimensional Analysis
C. Desired Over Have
5. Heart Failure and Pulmonary Edema: Identifying Digoxin Toxicity (RN QSEN - Safety , RM
AMS RN 10.0 Chp 32
, A. Report signs of toxicity, including fatigue, muscle weakness, confusion, and loss
of appetite.
B. Count pulse for 1 min before taking the medication. If the pulse rate is irregular
or the pulse rate is outside of the limitations set by the provider (usually less
than 60/min or greater than 100/min), instruct the client to hold the dose and
contact the provider.
C. Take the digoxin dose at the same time each day.
6. Active Pulmonary Embolism: Planning Care for a Client Who Is Receiving Enoxaparin (RM
AMS RN 10.0 Chp 24, RN QSEN - Safety , Active Learning Template - Medication)
A. Assess for contraindications (active bleeding, peptic ulcer disease, history of
stroke, recent trauma).
B. Monitor bleeding times. Prothrombin time (PT) & international normalized ration
(INR), partial thromboplastin time, & complete blood count.
C. Monitor for side effects of anticoagulants (anemia, thrombocytopenia,
hemorrhage).
7. Rheumatoid Arthritis: Reviewing Laboratory Values (RM AMS RN 10.0 Chp 88, Active
Learning Template - Medication)
A. Erythrocyte sedimentation rate (ESR) and high-sensitivity
B. C-reactive protein may be increased slightly related to secondary synovitis.
C. Osteoarthritis without synovitis is not an inflammatory disorder.
8. Medications Affecting Blood Pressure: Administering Valsartan for Heart Failure (RM
Pharm RN 7.0 Chp 20, Active Learning Template - Medication)
A. Do not take this medicine in larger or smaller amounts or for longer than
recommended.
B. You may take valsartan with or without food.
C. Take the medicine at the same time each day
9. Angina and Myocardial Infarction: Reinforcing Teaching About Nitroglycerin (RM AMS
RN 10.0 Chp 31, Active Learning Template - Medication)
A. The client can take up to two more doses of nitroglycerin at 5-min intervals.
B. Remind the client that a headache is a common side effect of this medication.
C. Encourage the client to sit and lie down slowly.
