Med-Surg Objectives
Describe the focus of medical-surgical nursing? - ANS-the adult patient with or at risk for a
health problem; the "backbone" or foundation of nursing practice
Define professional identity. - ANS-compromised of the compilation of the skills, values, and
expertise common to a group of individuals who are part of the same profession; encompasses
personal values, beliefs, and perceptions about work to be done
Discuss the attributes of a professional nurse. - ANS-autonomy, competence, knowledge,
profession hood, accountability, advocacy, collaborative practice, commitment
Review the definition of safety in the health care context. - ANS-the prevention of healthcare
errors and the elimination or mitigation of a patient injury caused by health care errors
List the levels of error in health care environments. - ANS-adverse event: unintended harm by
an act of commission or omission rather than as a result of disease process; near miss: error of
commission or omission that could have harmed a patient but harm did not occur as a result of
chance; sentinel event: unexpected occurrence involving death or serious injury
Define clinical judgment. - ANS-interpretations and inferences that influence actions in clinical
practice; process of forming an option or evaluation by discerning or comparing; capacity for
judging, discernment, or the exercise of this capacity; proposition stating something believed or
asserted, inference, interpretation and/or decision about the patient situation; interpretations of
conclusion about a patent's needs, concerns, or health problems, and/or the decision to take
action (or not), use of modify standard approaches, or improvise new ones as deemed
appropriate by the patient's response
Discuss the significance of clinical judgment in nursing practice. - ANS-in each clinical
encounter inside or outside the hospital, nurses assess patients or populations and their issued
that lead to clinical judgments which impact both safety and quality of care
Describe ways that students learn good clinical judgment. - ANS-taking advantage of a wide
range of clinical learning opportunities and working closely with experiences nurses; analyzing
situations in which appropriate nursing actions are not obvious or clear-cut; look for factors that
impact the judgments that are mad; knowledge or deep understanding; learning to recognize
patterns; apply concepts to nursing practice; reflections; narrative
Apply the principles of concept mapping to a case study about infection. - ANS-antibiotics need
to be taken in the full term even if the patient feels better, monitor vitals (especially temp),
educating the patient, adequate nutrition, hydration
,Describe preventative actions for alternatives in skin integrity. - ANS-primary: hygiene, nutrition,
sun exposure, burn prevention, dermal ulcer prevention, activity; secondary: screening;
collaborative: emollients, meds, chemo
Describe an interdisciplinary approach to wound management. - ANS-nutritional support
(protein, vitamin A, vitamin C are critical); pharmacotherapy (antibiotics, steroids, emollients,
chemo agents); phototherapy; surgical interventions (excisions, debridement, skin grafts);
wound care
Plan nursing care for a patient with an alteration in skin integrity. - ANS-adequate nutrition,
hydration, positing, turning Q2hours, making sure the skin is not too moist or too dry, meds
Discuss risk factors for infection. - ANS-population: infant, child, older adult, low socioeconomic
status; tissue trauma: friction, shearing, moisture pressure; exposure to irritants: radiation, temp
extremes, chemical or mechanical trauma, medical treatments; health conditions associated
with: poor peripheral perfusion, malnutrition or obesity, dehydration or edema, impaired mobility,
immunosuppression; chronic illness environmental conditions
Describe actions that may prevent infection. - ANS-infection control, vaccines, handwashing,
nutrition, fluids
Discuss nursing management of a person with an infection. - ANS-eradicate the infection,
prevent secondary infection, limit damage to the body, antimicrobials, nutrition, rest, fluids
Plan care for a patient with a communicable infection. - ANS-patients should be instructed to
take antibiotics exactly as prescribed and for the length of time prescribed; assess for s/s of
superinfection (fever, perineal itching, cough, lethargy, or any unusual discharge); adequate
nutrition, fluids
Describe antibiotics commonly used to treat infections. - ANS-sulfonamides, penicillins,
cephalosporins, tetracyclines, aminoglycosides, quinolones, macrolides
Discuss the significance of antibiotic resistance. - ANS-resistance occurs when pathogenic
organisms change in ways that decrease the ability of a drug to treat disease; antibiotics are
overprescribed, course of antibiotics are not completed by the patient
Describe the three phases of preoperative nursing. - ANS-preoperative (before), intraoperatice
(during), postoperative (after)
Discuss the nursing care and responsibilities in each of the three phases of perioperative
nursing (preoperative, intraoperative, and postoperative) - ANS-preoperative: teaching ensure
patient NPO at least 2hr before, ensure that identification, blood and allergy bands are correct,
legible, and secure, review lab results and notify physician prn, verify that the informed consent
, has been signed, weigh the patient and record height and weight, administer meds as
schedules, obtain and record vitals, help verify surgical site, provide ongoing support to patient
and family; intraoperative: circulating nurse (RN, coordinates activities, helps with positioning,
prep, ensure sterile technique, manages the count of sponges and instruments), scrub nurse
(may be OR tech, manages the sterile field, handles instruments and supplies), CRNA
(evaluates patient preoperatively, administers anesthesia, responsible for patient's wellbeing
including ventilation), anesthesiologist (may provide anesthesia or supervise the CRNA),
surgeon (performs the procedure, responsible for preop med hx, physical assessment, patient
safety, postop management), surgeon's assistant (RN or PA, holds retractors, assists with
homeostasis and suturing, may perform portions of procedure under supervision), RNFA
(handles tissue, uses instruments, provides exposure to surgical site, assists with homeostasis,
performs suturing); postoperative: protecting patient, preventing complications post surgical
procedure, general appearance and LOC, vitals, skin color and temp, pain/discomfort,
nausea/vomiting, dressing site and drainage, urinary output, strength and sensation of
extremities
Compare and contrast the definitions and characteristics of acute and chronic pain. -
ANS-acute: < 3 months, sudden, mild to severe, generally can identify a precipitating event,
decreases over time, pain control with eventual elimination; chronic: > 3 months, persistent, may
result from underlying medical conditions, gradual or sudden, mild to severe, period of
increasing and decreasing pain, predominantly behavioral manifestations, pain control is to
focus on enhancing function and quality of life
Describe the difference between nociceptive and neuropathic pain. - ANS-nociceptive: normal
functioning of physiologic systems that lead to perception of noxious stimuli (tissue injury) as
being painful, aching, cramping, throbbing, "normal" pain transmission; neuropathic: abnormal
processing of sensory input by nervous system as a result of damage to brain, spinal cord, and
peripheral nerves, burning, sharp, shooting
Discuss factors affecting individualized responses to pain. - ANS-population: older adult,
neonate, cancer patient, mental ill patient, critically ill patient; emotions
Describe components of a comprehensive pain assessment and the nursing care and
responsibilities of a patient in pain. - ANS-pain pattern, location, intensity, quality, associated
symptoms, management strategies, impact of pain, patient' beliefs, expectations, and goals
Explain pharmacological and non-pharmacological measures to treat pain. -
ANS-pharmacological: nonopioid, opioid, adjuvant; nonpharmacological: massage, positioning
and body alignment, splinting, thermal interventions (heat and cold), mind-body therapies
Describe principles of pain management specific to acute postoperative pain control. -
ANS-develop a written agreement or treatment plan that describes the pain management,
effective communication, institutionalizing pain education and management, follow the principles
of pain assessment, use a holistic approach, every patient deserves adequate pain
Describe the focus of medical-surgical nursing? - ANS-the adult patient with or at risk for a
health problem; the "backbone" or foundation of nursing practice
Define professional identity. - ANS-compromised of the compilation of the skills, values, and
expertise common to a group of individuals who are part of the same profession; encompasses
personal values, beliefs, and perceptions about work to be done
Discuss the attributes of a professional nurse. - ANS-autonomy, competence, knowledge,
profession hood, accountability, advocacy, collaborative practice, commitment
Review the definition of safety in the health care context. - ANS-the prevention of healthcare
errors and the elimination or mitigation of a patient injury caused by health care errors
List the levels of error in health care environments. - ANS-adverse event: unintended harm by
an act of commission or omission rather than as a result of disease process; near miss: error of
commission or omission that could have harmed a patient but harm did not occur as a result of
chance; sentinel event: unexpected occurrence involving death or serious injury
Define clinical judgment. - ANS-interpretations and inferences that influence actions in clinical
practice; process of forming an option or evaluation by discerning or comparing; capacity for
judging, discernment, or the exercise of this capacity; proposition stating something believed or
asserted, inference, interpretation and/or decision about the patient situation; interpretations of
conclusion about a patent's needs, concerns, or health problems, and/or the decision to take
action (or not), use of modify standard approaches, or improvise new ones as deemed
appropriate by the patient's response
Discuss the significance of clinical judgment in nursing practice. - ANS-in each clinical
encounter inside or outside the hospital, nurses assess patients or populations and their issued
that lead to clinical judgments which impact both safety and quality of care
Describe ways that students learn good clinical judgment. - ANS-taking advantage of a wide
range of clinical learning opportunities and working closely with experiences nurses; analyzing
situations in which appropriate nursing actions are not obvious or clear-cut; look for factors that
impact the judgments that are mad; knowledge or deep understanding; learning to recognize
patterns; apply concepts to nursing practice; reflections; narrative
Apply the principles of concept mapping to a case study about infection. - ANS-antibiotics need
to be taken in the full term even if the patient feels better, monitor vitals (especially temp),
educating the patient, adequate nutrition, hydration
,Describe preventative actions for alternatives in skin integrity. - ANS-primary: hygiene, nutrition,
sun exposure, burn prevention, dermal ulcer prevention, activity; secondary: screening;
collaborative: emollients, meds, chemo
Describe an interdisciplinary approach to wound management. - ANS-nutritional support
(protein, vitamin A, vitamin C are critical); pharmacotherapy (antibiotics, steroids, emollients,
chemo agents); phototherapy; surgical interventions (excisions, debridement, skin grafts);
wound care
Plan nursing care for a patient with an alteration in skin integrity. - ANS-adequate nutrition,
hydration, positing, turning Q2hours, making sure the skin is not too moist or too dry, meds
Discuss risk factors for infection. - ANS-population: infant, child, older adult, low socioeconomic
status; tissue trauma: friction, shearing, moisture pressure; exposure to irritants: radiation, temp
extremes, chemical or mechanical trauma, medical treatments; health conditions associated
with: poor peripheral perfusion, malnutrition or obesity, dehydration or edema, impaired mobility,
immunosuppression; chronic illness environmental conditions
Describe actions that may prevent infection. - ANS-infection control, vaccines, handwashing,
nutrition, fluids
Discuss nursing management of a person with an infection. - ANS-eradicate the infection,
prevent secondary infection, limit damage to the body, antimicrobials, nutrition, rest, fluids
Plan care for a patient with a communicable infection. - ANS-patients should be instructed to
take antibiotics exactly as prescribed and for the length of time prescribed; assess for s/s of
superinfection (fever, perineal itching, cough, lethargy, or any unusual discharge); adequate
nutrition, fluids
Describe antibiotics commonly used to treat infections. - ANS-sulfonamides, penicillins,
cephalosporins, tetracyclines, aminoglycosides, quinolones, macrolides
Discuss the significance of antibiotic resistance. - ANS-resistance occurs when pathogenic
organisms change in ways that decrease the ability of a drug to treat disease; antibiotics are
overprescribed, course of antibiotics are not completed by the patient
Describe the three phases of preoperative nursing. - ANS-preoperative (before), intraoperatice
(during), postoperative (after)
Discuss the nursing care and responsibilities in each of the three phases of perioperative
nursing (preoperative, intraoperative, and postoperative) - ANS-preoperative: teaching ensure
patient NPO at least 2hr before, ensure that identification, blood and allergy bands are correct,
legible, and secure, review lab results and notify physician prn, verify that the informed consent
, has been signed, weigh the patient and record height and weight, administer meds as
schedules, obtain and record vitals, help verify surgical site, provide ongoing support to patient
and family; intraoperative: circulating nurse (RN, coordinates activities, helps with positioning,
prep, ensure sterile technique, manages the count of sponges and instruments), scrub nurse
(may be OR tech, manages the sterile field, handles instruments and supplies), CRNA
(evaluates patient preoperatively, administers anesthesia, responsible for patient's wellbeing
including ventilation), anesthesiologist (may provide anesthesia or supervise the CRNA),
surgeon (performs the procedure, responsible for preop med hx, physical assessment, patient
safety, postop management), surgeon's assistant (RN or PA, holds retractors, assists with
homeostasis and suturing, may perform portions of procedure under supervision), RNFA
(handles tissue, uses instruments, provides exposure to surgical site, assists with homeostasis,
performs suturing); postoperative: protecting patient, preventing complications post surgical
procedure, general appearance and LOC, vitals, skin color and temp, pain/discomfort,
nausea/vomiting, dressing site and drainage, urinary output, strength and sensation of
extremities
Compare and contrast the definitions and characteristics of acute and chronic pain. -
ANS-acute: < 3 months, sudden, mild to severe, generally can identify a precipitating event,
decreases over time, pain control with eventual elimination; chronic: > 3 months, persistent, may
result from underlying medical conditions, gradual or sudden, mild to severe, period of
increasing and decreasing pain, predominantly behavioral manifestations, pain control is to
focus on enhancing function and quality of life
Describe the difference between nociceptive and neuropathic pain. - ANS-nociceptive: normal
functioning of physiologic systems that lead to perception of noxious stimuli (tissue injury) as
being painful, aching, cramping, throbbing, "normal" pain transmission; neuropathic: abnormal
processing of sensory input by nervous system as a result of damage to brain, spinal cord, and
peripheral nerves, burning, sharp, shooting
Discuss factors affecting individualized responses to pain. - ANS-population: older adult,
neonate, cancer patient, mental ill patient, critically ill patient; emotions
Describe components of a comprehensive pain assessment and the nursing care and
responsibilities of a patient in pain. - ANS-pain pattern, location, intensity, quality, associated
symptoms, management strategies, impact of pain, patient' beliefs, expectations, and goals
Explain pharmacological and non-pharmacological measures to treat pain. -
ANS-pharmacological: nonopioid, opioid, adjuvant; nonpharmacological: massage, positioning
and body alignment, splinting, thermal interventions (heat and cold), mind-body therapies
Describe principles of pain management specific to acute postoperative pain control. -
ANS-develop a written agreement or treatment plan that describes the pain management,
effective communication, institutionalizing pain education and management, follow the principles
of pain assessment, use a holistic approach, every patient deserves adequate pain
