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Med surg MT review - Summary Brunner and Suddarth's Textbook of Medical-Surgical Nursing

Chapter 1 1. Conduct a cultural assessment prior to initiating health teaching (patient driven) 2. Education- teach patient about modifiable and non-modifiable risk factors; Chapter 12 1. Pai n is whatever the patient says it is. The single most reliable indicator of pain is the patients (self-report) and intensity. Self -report – the ability of an individual to give a report – in this case pain – especially intensity; the most essential component of pain assessment 14. Mild to moderate pain = aspirin or acetaminophen 15. Moderate pain = non-steroidal anti-inflammatory drugs 16. severe pain = morphine, opioids Adjuvant analgesic agent- a drug that has a primary indication other than pain, (anticonvulsant, antidepressant) Neuropathic pain – (pathophysiologic) pain sustained by injury or dysfunction of the peripheral central nervous system. Different from nociceptive pain 30. FLACC / PAINAD / CPOT – used for nonverbal or patients who are unable to otherwise express pain. FLACC – used for young children, scores are assigned after assessing; facial expression, leg movement, activity, crying and consolability 10. Chvostek sign: a contraction of the facial muscle elicited in response to light tap over the facial nerve in front of the ear. 11. Trousseau sign – carpopedal spasm induced by inflating a bp cuff above systolic BP Magnesium 1. Normal value = 1.5-2.5 2. Magnesium has an inverse relation with calcium (low magnesium stimulates parathyroid hormone secretion) takes calcium from bones. 8. IV potassium must be given via Infusion pump. Sodium Normal values 135-145 1. water follows salt so an increase in sodium typically results in (edema) and in crease in blood pressure. 4. The higher the concentration of enteral feeding the greater the need for water (if its to thick it can cause dumping syndrome) and puts the patient at a greater risk for dehydration. 5. The elderly have a decrease in total body water which puts them at an increased risk for fluid volume deficit (renal function declines) 26. An air embolism is treated by placing the client onto their left side in Trendelenburg (apex of the heart.) This allows the embolism to travel toward the feet and dissipate. 27. If infiltration is of concern, tie tourniquet proximal to the IV site and check the flow to confirm. Chapter 17 1. Corticosteroids and alcohol may increase the risk for infection (postoperatively) 2. Ambulatory surgery – outpatient, same-day or short stay surgery. Does not require an over night hospital stay. Chapter 18 1. Anesthesia – a state of narcosis or sever central nervous system depression produced by pharmacologic agents 2. circulating nurse – a RN who coordinates and documents patient care in the operating room. Chapter 19 1. Dehiscence – partial or complete separation of wound edges 2. evisceration – protrusion of organs through the surgical incision. Chapter 20 1. Apnea – temporary cessation of breathing, 2. cilia- short hairs that provide constant movement to propel mucus and foreign substances away from the lung toward the larynx, 12. Order of perfusion in the body = 1. Heart, 2. Brain, 3. Lungs, 4. Systemic 13. Surfactant (secretions on/in the lungs needed for expansion) This prevents the lungs from atelectasis. Chapter 21 1. BiPAP – noninvasive spontaneous breath mode of mechanical ventilation. It allows separate control of inspiratory and expiratory pressures; given via a mask. 2. CPAP – Positive pressure applied throughout the respiratory cycle to a spontaneously breathing patient. Promotes alveolar and airway stability; given via endotracheal or tracheostomy tube or mask. Chapter 47 Abscess- localized collection of purulent drainage (stays in one area) Colostomy – surgical opening into the colon Constipation – few than three bowel movements a week, or difficulty passing stool Chapter 49 1. Ascites – an accumulation of fluid in the abdominal cavity 2. Asterixis – involuntary flapping movement of the hands. (this is usually caused by a build up if ammonia in the bloodstream) • Inability to reproduce a simple figure in two or three dimensions is referred to as constructional apraxia 24. The patient receiving lactulose is monitored closely for the development of watery diarrhea stools, because they indicated a medication over dose. Serum ammonia levels are closely monitored as well. Chapter 50 1. Amylase – Pancreatic enzyme; aids in the digestion of carbohydrates 2. Lipase – pancreatic enzyme; aids in the digestion of fats 3. Trypsin – pancreatic enzyme; aids in the digestion of protein. 4. Cholecystectomy – the surgical removal of the gallbladder.

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