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Med surge study guide

Page 177 table 12-8 and 12-9
Pg 169

When a patient comes into the hospital with a high BAC level what would you be
watching for? Does not matter the BAC, if they been drinking for a long time and they
come in what would you look for? She is going to give a BAC, so look over the little box;
look at the BAC levels and see how they are responding to it. Symptoms for each level.
Withdrawal symptoms

Pg 187 perioperative care
Respiratory and bleeding- these are risks for any operative procedures when alcohol is
involved. These are the main two you would be looking for. What kind of risks does
someone intoxicated bring with them to surgery?

Know that Narcan reverses a narcotic

Chapter 10 Pain
Pg 138

Don’t give Demerol to a patient for chronic pain because it may cause neurotoxicity.
Look at what drugs you would not give for chronic pain vs. acute pain. Darvon is only as
effective as 600 mg of Aspirin and not given for chronic pain due to toxic levels
produced.

Pg 170
What age group would you focus on as a nurse for prevention teaching on tobacco if the
majority starts around ages 18-25?
You would start teaching at high school or before the age of 18.

Pg 134
How does chronic pain affect someone?
It interferes with ADL’s.

Pg 168
What do you think is a sign of Heroin abuse?
Track marks
Tobacco use- their hair and clothes smell
Marijuana-
Cocaine- nasal sores, septal necrosis or perforations, chronic sinusitis, cardiac
dysrhythmias, myocardial ischemia and infarction

an irreversible form of amnesia characterized by loss of short- term memory and an inability to learn. 175 What is the most important intervention for a nurse to watch for with someone on methamphetamines? Crystal meth They could have possible MI’s or cardiac problems. Look at physical complications in box 12-9. Treatment is administering thiamine. put on O2 first. how are they going to get home…? If they have sleep apnea. Teaching the patient to reduce fear and anxiety Pg 347 Complementary and Alternative therapies Blue table Some cause increase bleeding with anticoagulants. One complication of chronic alcohol abuse is Wernicke’s encephalopathy. These things cause patients to recover slower from surgery *If a patient does not understand the procedures. Pg 352 Same day surgeries. Table 18-7. Hold it and call the doctor so he can come back in and reteach the patient. *What do you want to teach pt having abdominal surgery? Deep breath and cough . and a decreased LOC. an inflammatory. but they are having SOB and maybe heart palpitations. you’re not going to send them home. look at questions you would ask preoperatively to the patient for teaching. Pg 175 table 12-7 Know your priorities!! What comes first? If they are having short of breath. hemorrhagic.what is a concern for the patient? Transportation. It’s caused by a thiamine deficiency resulting from poor diet and alcohol induced suppression of thiamine absorption. Make sure you know your priorities. It’s not listed on the chart. you’re going to put on oxygen before anything. If left untreated it may lead to Korsakoff’s psychosis. some prolong anesthetic effects. Alcohol-induced CNS depression leads to respiratory and circulatory failure manifested by depressed respirations. They may not need to be intibated. degenerative condition of the brain. maybe tables 18-3 and 18-5. hypotension.hook them up to EKG and watch for ST depression on monitors Pg 177 complications Acute alcohol toxicity may occur with binge drinking or the use of alcohol with other CNS depressants. but breathing comes first.Pg 169. hypothermia. do not make them sign the consent form. Give them the thiamine first over giving them ativan to calm them down because calming them down is not going to help much or work.

constipation is the most common one and they should be started on a gentle stimulant laxative. What are you going to say when someone has a lot of stressors in their life and they tell you they can’t take it anymore? Ask them. increased muscle tension. You take the vital signs when they arrive.is an opiate • They cause more agitation.reduces the full feeling Pg 138 Talwin. The acute stress response is a state of physiologic and psychological arousal characterized by increased sympathetic nervous system activity that leads to increased heart and respiratory rate.a condition described as food forming into a ball that clings to the stomach or intestines. can you tell me about your life? Get them to talk about it to get them some relief. make sure you take vital signs before they leave to make sure that their BP and HR was just increased due to the major stress they just experiences. Empaco is treated by folk remedies such as strong massage over the stomach. diabetics will stress in the hospital and will have higher blood pressures. What happens to blood sugars when you’re stressed? They increase. Pg 138 Side effects of opioids. increased brain activity and decreased skin temperature. increased BP.cultural stress from relocating to new place and tuberculosis (TB). give them Reglan.Pg 37 Culture What do you do when you don’t have an interpreter and need to communicate with the patient? Use gestures or hand signals Pg 35 Empaco.most common problem . If someone comes in the ER that has just been raped. use of medications. They may control their sugars with diet and exercise and they come into hospital and they need insulin they freak out. If someone is nauseated from them. Asians have the highest rate of TB Pg 114 summary of stress response The fight-or-flight response is a very important adaptive mechanism of the body to acute stress. “what treatments help you with the pain?” Pg 34 Immigrants and Immigration Problems. causing pain and cramping. Your patient has Empaco and they explain what it is what are you going to do? As them. you may see the above signs and symptoms. or gently pinching and rubbing the spine.

the operative procedure and location. If a patient states to you that they have had Rheumatic fever at sometime in their life and are going to have surgery. They could have bacterial endocarditis from this.parameters . Why do they have all those pieces of tapes in the OR? To reduce the transmission of infection Pg 364 admitting the patient. What kinds of questions will they ask you before you have anesthesia? Allergies – make sure you find out family history if anyone in family have had problems with anesthesia. you better be checking their blood glucose before they go to surgery. first paragraph They have to be able to state their name. These are compared with patients ID band and charts. doctor’s name. They need to have prophylactic antibiotics. this is a major problem. what do they target? Pg 378 PACU What is the first thing the PACU nurse checks for when a patient comes from another floor to the PACU? Airway and pulse ox Pg 386 nursing assessment. Pg 369 IV barbiturates What drugs are used in conscious sedation? Versed Pg 370 neuromuscular blocking agents What do they do.Give Tylenol before you give something stronger like morphine Anyone who is going to surgery. When you get the labs back take them to OR immediately.

Pg 389 What is post-op hypothermia? Who is at risk for it? Long surgeries most at risk A patient goes from the PACU to the med surge floor.4 (pg 390 table 20-6) Make sure you secure IV lines when a patient is waking up from anesthesia. workbooks and CD questions Cardiac. Distention for retention If you suspect any bleeding after surgery. neuro. if nothing by then palpate the abdomen for distention.study NCLEX books. what do you do? Take VS for Hypovolemic shock Know signs and symptoms of DVT’s What are signs of Atelectasis? Temperature of 100. the first action the nurse does is ABC’s Patients are at risk for DVT’s after surgery due to immobilization Pg 392 Most patients urinate with in 6-8 hours after surgery. For final. GI and this study guide for final .