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 MarijuanaCocaine- nasal sores, septal necrosis or perforations, chronic sinusitis, cardiac dysrhythmias, myocardial ischemia and infarction

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

What happens to blood sugars when you’re stressed? They increase. Pg 138 Side effects of opioids.cultural stress from relocating to new place and tuberculosis (TB). causing pain and cramping. you may see the above signs and symptoms. Your patient has Empaco and they explain what it is what are you going to do? As them.most common problem .reduces the full feeling Pg 138 Talwin. increased brain activity and decreased skin temperature. increased muscle tension. 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.a condition described as food forming into a ball that clings to the stomach or intestines. Empaco is treated by folk remedies such as strong massage over the stomach. “what treatments help you with the pain?” Pg 34 Immigrants and Immigration Problems. You take the vital signs when they arrive. 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. If someone comes in the ER that has just been raped.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. 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. If someone is nauseated from them. increased BP. diabetics will stress in the hospital and will have higher blood pressures. or gently pinching and rubbing the spine.constipation is the most common one and they should be started on a gentle stimulant an opiate • They cause more agitation. can you tell me about your life? Get them to talk about it to get them some relief. 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. give them Reglan. use of medications. They may control their sugars with diet and exercise and they come into hospital and they need insulin they freak out.

the operative procedure and location. you better be checking their blood glucose before they go to surgery. doctor’s name. They need to have prophylactic antibiotics. When you get the labs back take them to OR immediately. 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. These are compared with patients ID band and charts. 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.Give Tylenol before you give something stronger like morphine Anyone who is going to surgery. They could have bacterial endocarditis from this. Why do they have all those pieces of tapes in the OR? To reduce the transmission of infection Pg 364 admitting the patient. Pg 369 IV barbiturates What drugs are used in conscious sedation? Versed Pg 370 neuromuscular blocking agents What do they do.parameters . If a patient states to you that they have had Rheumatic fever at sometime in their life and are going to have surgery. first paragraph They have to be able to state their name.

neuro.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. For final. 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. what do you do? Take VS for Hypovolemic shock Know signs and symptoms of DVT’s What are signs of Atelectasis? Temperature of 100. Distention for retention If you suspect any bleeding after surgery.4 (pg 390 table 20-6) Make sure you secure IV lines when a patient is waking up from anesthesia. GI and this study guide for final . workbooks and CD questions NCLEX books. if nothing by then palpate the abdomen for distention.

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