Summary NURS 3205 - MedSurg Final Exam Study Guide.

NURS 3205 - MedSurg Final Exam Study Guide • . Blood/Blood Products (2) • Types of blood products and why they are given • Administration and monitoring of blood products • Transfusion reactions – clinical manifestations; nursing interventions HIV/AIDS (2) • Complications/problems associated with HIV; nursing care • Modes of transmission • Progression from HIV to AIDS • Diagnostics Diabetes (5) • Differences between type 1 and type 2 • Labs • Diet and exercise • Patient education; sick days • Oral hypoglycemic agents • Insulins – onset, peaks, durations • Complications • Hypo vs. hyperglycemia Fracture/amputation/SCI/LBP (3) • Types of fractures (open, closed etc.) • Neurovascular assessment • Immobilization, traction, and reduction • Complications (infection, compartment syndrome, DVT/PE, & fat embolism) • Management of amputation • Management of spinal cord injury and low back pain Pneumonia (2) • Etiology/Risk factors/clinical manifestations • Diagnostics and treatments • Complications Asthma/COPD (4) • Patient teaching for patient with asthma; medications; use of inhalers • Chronic bronchitis, emphysema – clinical manifestations • Treatment and nursing care for acute exacerbations and chronic condition TB (2) • Diagnosis, Treatment; medications • Complication from meds • Patient education Coronary Artery Disease (2) • Types of angina • Pt care, prioritization for CAD and MI • Risk factors, labs, and medications • Atherosclerosis Heart Failure (5) • Assessments, clinical manifestations associated with heart failure (right vs. left) • Treatment (Nutrition, drug therapy) • Complications • Diagnostics PVD (2) • Difference between arterial and venous disorders • Raynaud’s & Buerger’s • Anticoagulant therapy • Post op care post vascular surgery; complications post- surgery; patient teaching • DVT & PE Hepatitis (2) • Hepatitis A, B, C, D, E – risk factors; clinical manifestations; treatment, modes of transmission Hypertension (2) • Primary vs. Secondary • Clinical manifestations and complications • Lifestyle modification Hematologic Problems (2) • Clinical manifestations of anemia & labs • Etiology and nursing management (i.e. Sickle cell) Chronic kidney disease (5) • Clinical manifestations associated with CKD • Peritoneal dialysis and hemodialysis treatments and complications • Diet and labs • CKD Complications Urinary Problems (3) • Distinguish between BPH and Prostate cancer • Surgery – post TURP care • Urinary diversions for bladder cancer • UTI (patho, clinical manifestations etc) GI Alterations (5) • Difference between Crohns, Diverticular disease, and Ulcerative Colitis • Dietary consideration and teaching for lower GI conditions (appendicitis, peritonitis, ulcerative colitis, crohns disease, diverticulitis etc.); and clinical manifestations • Colostomy care • Post op care; teaching • Labs, meds • Post-surgical care • GERD risk factors/complications/clinical manifestations, PUD • Cholecystitis and obesity treatment • Colorectal CA assessment & nursing management Cancer (2) • Know common presenting signs and symptoms • Blood values and labs • Diagnostic test • Nursing care of problems that occur during chemotherapy and radiation treatment. (i.e. myelosuppression) • Palliative Care • Be sure to know the individual cancer types we discussed. Low Back Pain Risk Factors: ● Smoking ● Stress ● Poor posture ● Lack of muscle tone ● Excess weight ● Heavy lifting, vibration, extended periods of sitting Related to: ● Closely related to opioid addiction; addicts ○ Don’t have to have opioid for effective pain relief ○ Avenue for opioid addiction ● Related to muscular, disks, osteoporotic changes, ● Radiculopathy - hernia pushes on nerve ● spinal stenosis: narrowing of spinal cord Assessment : ● Assess movement, sensory ● L4, L5, L6 - sensory in legs ● Bladder/bowel function = important question to ask ● If spine unstable: do spinal fusion = fusion of levels of the spine. Maintains space = spaces between vertebrae don’t push on each other; maintains alignment. Gets bone from iliac crest (top of pelvis), shave a chunk off and puts it on spine; ○ Super painful ○ See 1-2 inch incision on buttock ○ Pain in hip ○ Unstable spine ○ Treat like a spinal cord injury: log roll, brace, can’t sit up, changes in neurological assessment ○ Bowel incontinence: normal first few hours post op, assess neurological sensation in legs/toes (do this first) ○ Recovery = may see effects for rest of life ○ May take weeks/months/year to fully recover ○ Spinal surgery: ortho and neuro specialists perform this Interventions/Patient Teaching ● Proper body alignment and posture; keep spine align; use lifting mechanisms instead; use back braces ● R.I.C.E. ○ Rest, Ice, Compress, Elevate ○ Stop doing stuff that hurts it ○ Heat doesn’t help ○ Elevate back - get swelling off ● Maintain body weight ● Sleep in side lying position with knees and hips bent; use pillow in between knees for support (When disks sits on nerve, overtime nerve becomes ischemic: get disk off nerve; primarily discectomy or percutaneous skin procedures; decrease pressure off disk) Spinal Cord Injury Greatest risk: young adult men ages 16-30 yrs Common causes : ● Trauma: car accidents, falls, violence, sport injuries ○ Primary injury: bone displacement, interruption of blood supply, or traction from pulling on the cord ■ Blunt: car accidents ■ Penetrating: gunshot, stabbing ○ Secondary injury: progressive damage ■ cancerous/benign tumo r Types : ● tetraplegia/quadriplegia: paralysis (loss of sensation) of all four extremities; have muscle atrophy, lose muscle mass, elasticity of joints ● Paraplegia: paralysis of legs; caused by damage to thoracic, lumbar, or sacral spinal cord ● Complete cord involvement: total loss of sensory and motor function below level of injury; most serious but rare ● Incomplete cord involvement: partial transection; mixed loss of voluntary motor activity and sensation and leaves some tracts intact Early assessment findings: ● Respiratory :