ARELLANO UNIVERSITY

COLLEGE OF NURSING

CAPP 1 / COURSE AUDIT 1 / CAA 1

MEDICAL SURGICAL NURSING 1

DLP

NAME: CHARISSA DE LEON Branch: LEGARDA

INSTRUCTIONS. Answer the following questions. Write your answers neatly and
clearly with complete citation of reference used including the page number

1. Julienne , a 25 y/o bank teller was rushed to the hospital due to ruptured appendix
and has undergone appendectomy. Upon her stay in the hospital, she suffered one of
the postoperative complication known as Atelectasis, which refers to the closure of the
collapse of the alveoli.

a. List 3 possible causes of atelectasis in the postoperative patient. (3 pts)

• Generalized anesthesia
• pleural effusion
• Obsturction due to increased mucus production

b. Name 3 manifestations of atelectasis (3pts)

• Difficulty of breathing
• Rapid and shallow breathing
• Wheezing

c. Identify 3 nursing measures that can prevent atelectasis (3pts)

• Educate patient on the use of incentive spirometer and its importance
• Educate patient on proper coughing and deep-breathing exercises and
encourage her to do it every 1-2 hours
• Ensure proper positioning of the patient and assist her in ambulation

2.Mang Jose 80 y/o is to be discharged from the hospital. He is just recovering from
pulmonary edema secondary to congestive heart failure.
a. What is pulmonary edema, its most cause and its classic symptom? (3pts)
Pulmonary edema is a condition characterized by excessive fluid accumulation in
the lungs caused by the extravasation of fluid from pulmonary vasculature into
the interstitium and alveoli of the lungs. Its classic symptoms include: dyspnea,
pink frothy sputum, wheezing, cold clammy skin, palpitations and anxiety

b. Why is frequent rest necessary for his condition? 1pts

In this condition, Physical activity can make pulmonary edema worse. Metabolic
wastes removal is slowed down due to pulmonary congestion. This then leads to
decreased cardiac output making the patient feel restless or unexplainably tired,
thus requiring frequent rest periods

c. He is prescribed 0.25 mg of digoxin once a day. What is the action of Digoxin

and what is the initial sign for digitalis toxicity? (3pts)
 • It works by affecting certain minerals (sodium and potassium) inside
heart cells. This reduces strain on the heart and helps it maintain a normal,
steady, and strong heartbeat.
• the initial sign for digitalis toxicity are confusion, loss of appetite,
nausea, vomiting, diarrhea, or vision problems

d. What is the key diagnostic indicator of heart failure? (1pts)

BNP (B-type natriuretic peptide)

3. Explain the 4 stages of anesthesia. (8pts)

STAGES NAME (1pt each) CLINICAL MANIFESTATION ( 1pt each)
STAGE I - Anesthetic administration to loss of
Onset consciousness
- Drowsiness/diziness and auditory and visual
hallucination
- Sedation, partial loss of reaction to external
stimuli
STAGE II - Loss of consciouness to loss of eyelid reflexion  
Excitement - Increase in autonomic activity
- Irregular breathing
- Uncoordinated movement

STAGES III - Loss of eyelid reflex to loss of most reflexes and

Surgical depression of vital function
anesthesia - Unconsciousness, relaxation of muscles, 
diminished gag and blink reflexes
- Total loss of equilibrium
STAGES IV - Depression of vital function to respiratory and
Danger circulatory failure
- Client is not breathing, heart beat may or may
not present