HESI MED SURG STUDY GUIDE

Fentanyl Citrate (Duragesic) - IM - 7-15 min onset; IV - onset within 5 min; intradermal - within 12 hour
onset; intrabuccal - 5 to 15 min onset; intrathecal has an immediate onset; synthetic narcotic, MSO4-like;
acts quicker with a less duration

Narcotic analgesics - Preferred for pain relief because they bind to the various opiate receptor sites in the
CNS

Death - Death is the last developmental task for an individual; completes the life cycle

Grief - Process an individual goes through to deal with loss

Denial - Coping style used to protect self/ego; noncompliance, refusal to seek treatment, ignoring
symptoms; changing the subject when speaking about the illness; "not me, this must be a mistake"

Anger - Often directing it at family or health care team members; "why me? Its not fair"

Bargaining - Making a deal with God to prolong life; usually not sharing this with anyone

Depression - Results from the losses experienced because of health status and hospitalization; anticipating
the loss of life

Acceptance - Accepting the inevitable; beginning to separate emotionally

Shock, disbelief, rejection, or denial - Anger, crying, conflicting emotions, anger toward the deceased,
guilt, preoccupation with loss

Resolution - Process taking up to 1+ years, renewed interest in activities

Complicated grief - Unresolved grief, physical symptoms similar to those of the deceased, clinical
depression, social isolation, failure to acknowledge loss

Pneumonia - Inflammation of the lower respiratory tract; caused by infectious agents that reach the lungs
through aspiration, inhalation, hematogenous spread

High risk groups for pneumonia - Debilitated by accumulated lung secretions; cigarette smokers;
immobile; immunosuppressed; experiencing a depressed gag reflex; sedated; experiencing neuromuscular
disorders

Nursing assessment for pneumonia - Tachypnea; abrupt onset of fever with shaking and chills; productive
cough with pleuritic pain; rapid, bounding pulse; pain and dullness to percussion over the affected lung
area; bronchial breath sounds, crackles; infiltrates with consolidation or pleural effusion; elevated WBC;
ABG indication of hypoxemia.

Pneumonia in the elderly - Confusion, lethargy, anorexia, rapid RR

Fever - Can cause dehydration because of excessive fluid loss due to diaphoresis. Also increases
metabolism and the demand for oxygen