Med Surg HESI Study Guide 2025–2026 |
Comprehensive Nursing Review with
Pneumonia, COPD, Asthma, Prevention, and
Pharmacology Notes.
Communication Strategies
-assess the client for hearing deficits
-determine whether the client understands questions
-take the time to ask yes/no questions if the client is having difficulty communicating
-observe the client's nonverbal communication cues
-provide continuity of care by assigning the same nurse
-encourage presence of family members to reassure the client
Primary Prevention
-intended to reduce health risks and increase healthy behaviors
-immunizations
-teaching nutrition classes
-requiring smoke free zones
Secondary Prevention
-intended to detect disease through screening and treat the disease as early as possible
-colonoscopy
-mammograms
Tertiary Prevention
-intended to prevent disability and complications and to provide for a peaceful death
-rehabilitation
Pneumonia
-inflammation of the lower respiratory
tract
-affects people of all ages especially those 65 or older and infants under 2
-may be community acquired, hospital associated, ventilator associated, or health care
associated
,Causes
-aspiration
-inhalation
-hematogenous spread
High Risk Groups
-debilitated by accumulated lung secretions (COPD, asthma, sickle cell)
-smokers
-immobile
-immunosuppressed
-depressed gag or cough reflex
-sedated
-experiencing neuromuscular disorders
-nasogastric/orogastric intubation
-hospitalized pt
-altered LOC
-brain injury
-alcoholics
-anesthetized individuals
-drug overdose
-stroke victims
Pneumonia Nursing Assessment
-tachypnea
-shallow respirations
-use of accessory muscles
-abrupt onset fever with shaking and chills (not relieved in OA)
-productive cough with pleuritic pain
-rapid bounding pulse
-pain and dullness to percussion over the affected lung area
-crackles
-egophy: letter E sounds like A when heard via stethoscope
-tactile fremitus: chest vibrations when the client says 99
-chest x ray indications infiltration with consolidation or pleural effusion
-elevated WBC
-hypoxemia
-drop in O2: should be >90, ideally >95
OA
-confusion
,-lethargy/malaise
-anorexia
-rapid RR
-tachycardia
Fever
-increases metabolism and the demand for oxygen
-can cause dehydration because of excessive fluid loss due to diaphoresis
Pneumonia Nursing Interventions
-assess sputum for volume, color, consistency, clarity, and odor
-deep breathing q2hrs with incentive spirometry
-use humidity to loosen secretions (may be oxygenated)
-suction airway if necessary
-chest physiotherapy
-provide fluids 3L/day
-assess lung sounds before and after coughing
-assess rate, depth, and pattern of respirations, normal (16-20)
-assess for accessory muscle use
-monitor ABG's Po2 >80 Pco2 <45
-monitor O2, ideally >95
-assess skin color, nail beds, mucous membranes
-assess mental status, restlessness, irritability
-administer humidified O2
-monitor temp regularly
-provide adequate rest throughout the day
-administer antibiotics as prescribed
-teach about risk factors and preventive measures
-encourage pneumonia and flu vaccinations, protection occurs 2-3 weeks after vaccine is given
-promote rest and conserve energy
Penicillins
-penicillin G
-penicillin V
-antiinfective
-used primarily for gram positive infections
Adverse Reactions
-allergic reactions
, -anaphylaxis
-phlebitis at IV site
-diarrhea
-GI distress
-superinfection
Nursing Implications
-use caution in client allergic to cephalosoprins
-monitor for allergic reactions
-observe pts for at least 30 minutes after parenteral administration
-oral penicillin G should be taken on an empty stomach
-alters contraceptive effectiveness
-decreases renal excretion thereby resulting in an increased blood level of the drug
Semisynthetic
-oxacillin sodium
-naficillin sodium
-cloxacillin sodium
-dicloxacillin sodium
-antiinfective
-use primarily for gram positive infections
Adverse Reactions
-allergic reactions
-anaphylaxis
-superinfection
-GI distress
-phlebitis at IV site
Nursing Implications
-cannot be used in clients allergic to penicillin
-caution in clients allergic to penicillin
-monitor for superinfection (sore mouth, vaginal discharge, diarrhea, cough)
-alters contraceptive effectiveness
-decreases renal excretion, increases blood level of drug
-observe for at least 30 minutes after parenteral administration
-use with caution in clients allergic to cephalosporins
Antipseudomonal Penicillins
-ampicillin
-ticarcillin
Comprehensive Nursing Review with
Pneumonia, COPD, Asthma, Prevention, and
Pharmacology Notes.
Communication Strategies
-assess the client for hearing deficits
-determine whether the client understands questions
-take the time to ask yes/no questions if the client is having difficulty communicating
-observe the client's nonverbal communication cues
-provide continuity of care by assigning the same nurse
-encourage presence of family members to reassure the client
Primary Prevention
-intended to reduce health risks and increase healthy behaviors
-immunizations
-teaching nutrition classes
-requiring smoke free zones
Secondary Prevention
-intended to detect disease through screening and treat the disease as early as possible
-colonoscopy
-mammograms
Tertiary Prevention
-intended to prevent disability and complications and to provide for a peaceful death
-rehabilitation
Pneumonia
-inflammation of the lower respiratory
tract
-affects people of all ages especially those 65 or older and infants under 2
-may be community acquired, hospital associated, ventilator associated, or health care
associated
,Causes
-aspiration
-inhalation
-hematogenous spread
High Risk Groups
-debilitated by accumulated lung secretions (COPD, asthma, sickle cell)
-smokers
-immobile
-immunosuppressed
-depressed gag or cough reflex
-sedated
-experiencing neuromuscular disorders
-nasogastric/orogastric intubation
-hospitalized pt
-altered LOC
-brain injury
-alcoholics
-anesthetized individuals
-drug overdose
-stroke victims
Pneumonia Nursing Assessment
-tachypnea
-shallow respirations
-use of accessory muscles
-abrupt onset fever with shaking and chills (not relieved in OA)
-productive cough with pleuritic pain
-rapid bounding pulse
-pain and dullness to percussion over the affected lung area
-crackles
-egophy: letter E sounds like A when heard via stethoscope
-tactile fremitus: chest vibrations when the client says 99
-chest x ray indications infiltration with consolidation or pleural effusion
-elevated WBC
-hypoxemia
-drop in O2: should be >90, ideally >95
OA
-confusion
,-lethargy/malaise
-anorexia
-rapid RR
-tachycardia
Fever
-increases metabolism and the demand for oxygen
-can cause dehydration because of excessive fluid loss due to diaphoresis
Pneumonia Nursing Interventions
-assess sputum for volume, color, consistency, clarity, and odor
-deep breathing q2hrs with incentive spirometry
-use humidity to loosen secretions (may be oxygenated)
-suction airway if necessary
-chest physiotherapy
-provide fluids 3L/day
-assess lung sounds before and after coughing
-assess rate, depth, and pattern of respirations, normal (16-20)
-assess for accessory muscle use
-monitor ABG's Po2 >80 Pco2 <45
-monitor O2, ideally >95
-assess skin color, nail beds, mucous membranes
-assess mental status, restlessness, irritability
-administer humidified O2
-monitor temp regularly
-provide adequate rest throughout the day
-administer antibiotics as prescribed
-teach about risk factors and preventive measures
-encourage pneumonia and flu vaccinations, protection occurs 2-3 weeks after vaccine is given
-promote rest and conserve energy
Penicillins
-penicillin G
-penicillin V
-antiinfective
-used primarily for gram positive infections
Adverse Reactions
-allergic reactions
, -anaphylaxis
-phlebitis at IV site
-diarrhea
-GI distress
-superinfection
Nursing Implications
-use caution in client allergic to cephalosoprins
-monitor for allergic reactions
-observe pts for at least 30 minutes after parenteral administration
-oral penicillin G should be taken on an empty stomach
-alters contraceptive effectiveness
-decreases renal excretion thereby resulting in an increased blood level of the drug
Semisynthetic
-oxacillin sodium
-naficillin sodium
-cloxacillin sodium
-dicloxacillin sodium
-antiinfective
-use primarily for gram positive infections
Adverse Reactions
-allergic reactions
-anaphylaxis
-superinfection
-GI distress
-phlebitis at IV site
Nursing Implications
-cannot be used in clients allergic to penicillin
-caution in clients allergic to penicillin
-monitor for superinfection (sore mouth, vaginal discharge, diarrhea, cough)
-alters contraceptive effectiveness
-decreases renal excretion, increases blood level of drug
-observe for at least 30 minutes after parenteral administration
-use with caution in clients allergic to cephalosporins
Antipseudomonal Penicillins
-ampicillin
-ticarcillin
