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Supplemental BULLETS Med-Surg Nursing

Supplemental BULLETS Med-Surg Nursing

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Published by rayneamg
Nursing Review Bullets
Nursing Review Bullets

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Published by: rayneamg on Jul 29, 2009
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05/11/2014

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Supplemental BULLETSSupplemental BULLETS
MEDICAL – SURGICALMEDICAL – SURGICAL NURSING NURSING
CAUSE OF FEVER IN A PATIENT WHO HAS HAD SURGERY WITHIN THE PAST 48 HOURS – CAUSE OF FEVER IN A PATIENT WHO HAS HAD SURGERY WITHIN THE PAST 48 HOURS –  ATELECTASISATELECTASIS
WHAT IS THE CAUSE OF FEVER IN A PATIENT WHO IS 5-6 DAYS POST OPERATIVE?- WOUNDWHAT IS THE CAUSE OF FEVER IN A PATIENT WHO IS 5-6 DAYS POST OPERATIVE?- WOUND INFECTIONINFECTION
COMMON ELECTROLYTE DISTURBANCE IN PATIENTS WITH ACUTE PANCREATITIS – COMMON ELECTROLYTE DISTURBANCE IN PATIENTS WITH ACUTE PANCREATITIS –  HYPOCALCEMIA AND HYPOMAGNESEMIAHYPOCALCEMIA AND HYPOMAGNESEMIA
GREY-TURNERS SIGN: FLANK ECCHYMOSIS INDICATIVE OF PANCREATIC DISEASEGREY-TURNERS SIGN: FLANK ECCHYMOSIS INDICATIVE OF PANCREATIC DISEASE
CULLEN SIGN:PERIUMBILICAL ECCHYMOSIS INDICATIVE OF PANCREATIC DISEASECULLEN SIGN:PERIUMBILICAL ECCHYMOSIS INDICATIVE OF PANCREATIC DISEASE
BODY SURFACE AREA/RULE OF NINES %-FACE 9, ARMS 9 EACH,BODY SURFACE AREA/RULE OF NINES %-FACE 9, ARMS 9 EACH,FRONT 18%, BACK 18%, LEGS 18% EACHFRONT 18%, BACK 18%, LEGS 18% EACH
PREVENTIVE MEASURES-TREATMENT OF HEMORRHOIDS- HIGH FIBER DIET, SITZ BATHPREVENTIVE MEASURES-TREATMENT OF HEMORRHOIDS- HIGH FIBER DIET, SITZ BATH AND GOOD HYGIENEAND GOOD HYGIENE
SPINAL SHOCK-SUDDEN AREFLEXIA, HYPOTENSION WITH PARADOXICAL BRADYCARDIASPINAL SHOCK-SUDDEN AREFLEXIA, HYPOTENSION WITH PARADOXICAL BRADYCARDIA
Life threatening injury associated with pelvic fractures – severe hemorrhageLife threatening injury associated with pelvic fractures – severe hemorrhage (retroperitoneal)(retroperitoneal)
Compartment Syndrome- increased pressure within closed tissue spaces, whichCompartment Syndrome- increased pressure within closed tissue spaces, which compromises blood flow to muscle and nerve tissue. Contributing causes include externalcompromises blood flow to muscle and nerve tissue. Contributing causes include external compression(by burn eschar,circumferential casts,dressings or pneumatic pressurecompression(by burn eschar,circumferential casts,dressings or pneumatic pressure garments ) and volume increase within the compartment(due to hemorrhage into thegarments ) and volume increase within the compartment(due to hemorrhage into the compartment, IV infiltration , or edema with post-ischemic swelling that is secondary tocompartment, IV infiltration , or edema with post-ischemic swelling that is secondary to injury)injury)
Early signs and symptoms of compartment syndrome-tenderness and pain out of Early signs and symptoms of compartment syndrome-tenderness and pain out of   proportion to the injury, pain that accompanies active and passive motion and paresthesia. proportion to the injury, pain that accompanies active and passive motion and paresthesia.
Late signs of compartment syndrome- compartment is tense, indurated andLate signs of compartment syndrome- compartment is tense, indurated and erythematous, there is pallor and pulselessness and capillary refill is slow.erythematous, there is pallor and pulselessness and capillary refill is slow.
Acute tinnitus toxicity to-aspirinAcute tinnitus toxicity to-aspirin
Unilateral tinnitus- trauma, Otitis and MenieresUnilateral tinnitus- trauma, Otitis and Menieres
Valsalva maneuvers holding the breath, stimulation of the gagValsalva maneuvers holding the breath, stimulation of the gag reflex,ipecac,squating,pressure on the eyeball or immersing face inreflex,ipecac,squating,pressure on the eyeball or immersing face in iceice
 
Adverse effects of lidocaine- drowsiness, nausea,Adverse effects of lidocaine- drowsiness, nausea, vertigo,confusion, ataxia, tinnitus, muscle twitchingvertigo,confusion, ataxia, tinnitus, muscle twitching
Sudden non-traumatic cardiac arrest-ventricular fibrillation(80-90%). EarlySudden non-traumatic cardiac arrest-ventricular fibrillation(80-90%). Early defibrillation is the keydefibrillation is the key
CPR, one rescuer- 2 breaths , 15 compressionsCPR, one rescuer- 2 breaths , 15 compressions
CPR, two rescuers- 1 breath 5 compressionsCPR, two rescuers- 1 breath 5 compressions
Which hypertensive medications should not be given to diabetics? – Which hypertensive medications should not be given to diabetics? –  diuretics and B-blockers which increase insulin resistance-ACE drug of diuretics and B-blockers which increase insulin resistance-ACE drug of  choice for these patientschoice for these patients
Choking but able to speak- encourage to breathe deeply-don’t interruptChoking but able to speak- encourage to breathe deeply-don’t interrupt spontaneous breathing but if with severe respiratory difficulty withspontaneous breathing but if with severe respiratory difficulty with weakening cough and inability to talk – Heimlich Maneuver weakening cough and inability to talk – Heimlich Maneuver 
Obese and pregnant chest thrust above navelObese and pregnant chest thrust above navel
Most common postoperative resp. complication-atelectasisMost common postoperative resp. complication-atelectasis
COPD –high FiO2 – suppression of the hypoxic ventilatory driveCOPD –high FiO2 – suppression of the hypoxic ventilatory drive
Common presentation of cyctic fibrosis in newborns – GI ObstructionCommon presentation of cyctic fibrosis in newborns – GI Obstruction
Chronic hoarseness more than 4-6 weeks – laryngeal carcinomaChronic hoarseness more than 4-6 weeks – laryngeal carcinoma
Major cause of pulmonary embolism – DVTMajor cause of pulmonary embolism – DVT
Elect. Imbalance in cirrhosis- hypo NA, hypoK,hypoMgElect. Imbalance in cirrhosis- hypo NA, hypoK,hypoMg
Colon Ca screening; annual digital exam –over 40 ; occult blood –annualColon Ca screening; annual digital exam –over 40 ; occult blood –annual over 50 ; sigmoidoscopy – Q3-5 years – 50y.o.over 50 ; sigmoidoscopy – Q3-5 years – 50y.o.
Common cause of bacterial diarrhea – E. ColiCommon cause of bacterial diarrhea – E. Coli
Diarrhea due to toxin – within 12 hoursDiarrhea due to toxin – within 12 hours
Travellers diarrhea – 3-7 days after travelTravellers diarrhea – 3-7 days after travel
Chronic diarrhea – above 200g lbm/day for 3 wks.Chronic diarrhea – above 200g lbm/day for 3 wks.
Crampy abdl. Pain,mucus filled stool..relief after defecation – IrritableCrampy abdl. Pain,mucus filled stool..relief after defecation – Irritable Bowel SyndromeBowel Syndrome
Obese – 20% above the weight recommended for heightObese – 20% above the weight recommended for height
Hyperglycemia leads to hyponatremiaHyperglycemia leads to hyponatremia
Hyponatermia- NAV , lethargy , seizures and comaHyponatermia- NAV , lethargy , seizures and coma
Hyper natremia – confusion, muscle irritability resp. paralysis , seizuresHyper natremia – confusion, muscle irritability resp. paralysis , seizures and comaand coma
 
Hypokalemia- flattened T waves , depressed ST segments, prominent PHypokalemia- flattened T waves , depressed ST segments, prominent P waveswaves
Hyperkalemia – tall/peaked T-waves, diminished P – wavesHyperkalemia – tall/peaked T-waves, diminished P – waves
Hyperkalemia – acidosisHyperkalemia – acidosis
Hypocalcemia – alkalosisHypocalcemia – alkalosis
Hyperkalemia – common cause – CRFHyperkalemia – common cause – CRF
Hypercalcemia – common cause – malignancy, hyperparathyroidism andHypercalcemia – common cause – malignancy, hyperparathyroidism and thiazidesthiazides
S and Sx of hypercalcemia: stones,bones abd.groans and psychic overtonesS and Sx of hypercalcemia: stones,bones abd.groans and psychic overtones (calculi,osteolysis, PUD and pancreatitis and psych. D.O.)(calculi,osteolysis, PUD and pancreatitis and psych. D.O.)
Hypercalcemia – interfere with ADH – DHN – 5 – 10 L for 24 hours of Hypercalcemia – interfere with ADH – DHN – 5 – 10 L for 24 hours of   NSS. NSS.
Adrenal Insufficiency-fatigue,weakness,weight loss,hyperpigmentation,Adrenal Insufficiency-fatigue,weakness,weight loss,hyperpigmentation,  NAVDA, orthostatic hypotension NAVDA, orthostatic hypotension
Adrenal insufficiency – hyperK, hypoNa and hypoglycemiaAdrenal insufficiency – hyperK, hypoNa and hypoglycemia
Myxedema coma- hypothermia and comaMyxedema coma- hypothermia and coma
ALS- progressive loss of the anterior motor neurons.no sensoryALS- progressive loss of the anterior motor neurons.no sensory abnormalities just muscular atrophy and gradual weaknessabnormalities just muscular atrophy and gradual weakness
GCS – eye opening, verbal ability and motor activityGCS – eye opening, verbal ability and motor activity
Korsakoff’s Psychosis- inability to process new information-toKorsakoff’s Psychosis- inability to process new information-to form new memories-reversible condition sec. to chronicform new memories-reversible condition sec. to chronic alcoholism-induced by thiamine def.alcoholism-induced by thiamine def.
Werniche,s encephalopathy – irrev. Brain tissues break Werniche,s encephalopathy – irrev. Brain tissues break  down,inflame and bleed. Dec. muscle coordination,opthalmoplegiadown,inflame and bleed. Dec. muscle coordination,opthalmoplegia and confusion.induce by thiam.def.and confusion.induce by thiam.def.
MG- exogenous anticholinesterase-relieve SxMG- exogenous anticholinesterase-relieve Sx
Resting tremor- parkinsonsResting tremor- parkinsons
APAP(acetaminophen poisoning – liver damageAPAP(acetaminophen poisoning – liver damage
Most common oppurtunistic infection in AIDS-PCP-non-Most common oppurtunistic infection in AIDS-PCP-non- productive cough and dyspnea productive cough and dyspnea
Common food allergies-milk,eggs and nutsCommon food allergies-milk,eggs and nuts
Drug allergies-PenicillinsDrug allergies-Penicillins

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