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ATI Adult Medical Surgical Nursing 2024/2025 graded A+ by experts
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ATI Adult Medical Surgical Nursing 2024/2025 graded A+ by experts

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  • March 7, 2024
  • 129
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

Subjects

  • ati adult medical surgical
  • aseptic technique ansmeans clean technique han
  • 13 body weight ansis extracellular 1 kg 22 l
  • high hematocrit 45 bun 20 tenting of skin

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  • ATI ADULT MEDICAL SURGICAL
  • ATI ADULT MEDICAL SURGICAL

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ATI Adult Medical Surgical Nursing

aseptic technique - ANSmeans clean technique
-hand hygiene, sterile gloves not used

bacterial meningitis - ANSis an emergency and IV antibitoics are needed ASAP

stress fracture - ANSa small crack in the bone that often develops from chronic, excessive
impact

adults body fluids - ANS50-60% of total body weight is water

infants body fluids - ANS15-80% of total body wt is water

2/3 body weight - ANSis intracellular

1/3 body weight - ANSis extracellular

1 kg (2.2 lb) of body weight - ANSis approximately 1 L of fluid

older adults - ANShave less body water and decreased thirst sensation

fluid volume deficit factors - ANSexcess GI and/or renal loss
diaphoresis
fever
long term NPO
hemorrhage
burns

fluid volume deficit manifestations - ANSweight loss, dry mucus membranes, increased HR
and RR, thready pulse, capillary refill less than 3 seconds, weakness, fatigue, orthostatic
hypotension, poor skin turgor
-urine output less than 25 mL/hr
-high hematocrit (>45%)
-BUN >20
-tenting of skin

fluid volume deficit LATE signs - ANSoliguria, decreased CVP, flattened neck veins

hypertonic dehydration - ANSless sodium than water is lost
-sodium >145
-spec graph >1.03

high urine specific gravity - ANSbody is dehydrated and conserving water
-concentrated urine

,mild to moderate dehydration - ANSdry skin and increased thirst

severe dehydration - ANSpulse >100
cold extremities

central venous pressure - ANSvenous blood pressure within the right atrium that influences
the pressure in the large peripheral veins

normal output - ANS0.5 mL/kg/hr

no more than 2000mL/day

isotonic IVF - ANStreatment of vascular system fluid deficit
-concentration = to plasma
-prevent fluid shift between compartments

isotonic solutions - ANSnormal saline
lactated ringer's
5% dextrose in water

hypotonic IVF - ANStreatment of intracellular dehydration
-lower osmolality than the ECF
-shift fluid from ECF to ICF

hypotonic solutions - ANS0.45% NS
2.5% dextrose in 0.45% saline

small numbers --> big cells

hypertonic IVF - ANSused only when serum osmolality is critically low
-osmolality higher than the ECF
-shift fluid from ICF to ECF

hypertonic solutions - ANS10% Dextrose in Water, 5% Dextrose in 0.45% Saline, 5%
Dextrose in 0.9% Saline

-big numbers --> shink cells

fluid volume excess - ANSFluid intake or fluid retention that EXCEEDS the fluid needs of the
body

fluid volume excess factors - ANSkidney failure (late phase), heart failure, cirrhosis,
hypertonic fluids, burns, excessive water intake, long term *corticosteroid therapy*

fluid volume excess manifestations - ANS• Pitting edema, sacral edema.
• Dyspnea, crackles, possible pulmonary edema.
• Bounding pulse, weight gain.

,• Lethargy, dizziness, headache, confusion, weakness
• Increased CVP, jugular vein distention.
• Increased blood pressure, *tachycardia*, tachypenia

-decrease spec graph
-BUN <7
-Decreased hemoglobin and hematocrit

urine specific gravity - ANS1.010-1.030

pitting edema scale - ANS1+ (minimal) to 4+ (severe)

fluid volume excess NI - ANS*first evaluate electrolytes*
measure abdominal girth
daily weights
strict I/O
maintain skin integrity
use semi-Fowler's position; reposition q 2hr

Major intracellular electrolytes - ANSpotassium, phosphate, magnesium

major extracellular electrolytes - ANSSodium, Chloride, Calcium, and Bicarbonate.

hypokalemia risk factors - ANSadverse effects: *corticosteroids*, diuretics (thiazide), laxative
abuse, terbutaline
body fluid loss: vomiting, diarrhea, wound drainage, NG suction
excessive diaphoresis, kidney disease, alkalosis
bulimia

hypokalemia symptoms - ANSmuscle weakness, cramps, *ileus*, hyporeflexia,
*parasthesias (numbness/tinging)*, flaccid paralysis, constipation, *flat/inverted T waves*,
dysrhythmias, fatigue

shallow respirations, orthostatic hypotension

hypokalemia interventions - ANSmonitor cardiovascular, respiratory, neuromuscular,
gastrointestinal, and *renal status*, and place on a cardiac monitor
monitor electrolytes values
administer potassium supplements *(not on empty stomach)* --> may need to be
discontinued if client complains of abdominal pain, distention, nausea, vomiting, diarrhea, or
gastrointestional bleeding; IV bolus must be diluted
Liquid potassium chloride has an unpleasant taste and should be taken with juice or another
liquid
*--do not administer K if patient is not peeing*

KCl administrationn - ANSmust not exceed 10 mEq per hr

, hyperkalemia risk factors - ANSdecreased potassium excretion due to renal failure,
hypoaldosteronism, potassium-conserving diuretics or ACE inhibitors; high potassium intake
due to excessive use of potassium containing salt substitutes, excessive or rapid IV
potassium infusion, *potassium shift out of the tissue cells into the plasma due to burns*,
infections, or acidosis *(DKA specifically)*

hyperkalemia manifestations - ANS* PEAKED T WAVES and WIDENED QRS *
- Ventricular dysrhythmias
- muscle twitching & paresthesia - numbness/tingling (EARLY)
- Ascending muscle weakness (LATE)
- Increased bowel motility - diarrhea
- bradycardia and hypotension

hyperkalemia interventions - ANSmonitor ECG, bowel sounds
initiate dialysis
meds: Kayexalate, *50% glucose* with *insulin*, calcium gluconate, bicarbonate, loop
diuretics, lactulose
sodium polystyrene or tap water enema

hyponatremia risk factors - ANSGI loss; NG tube with suctioning
SIADH
Adrenal insufficiency
Diuretics - *mannitol*
Water intoxication
Decreased intake/NPO - *mechanical vent*
Excessive diaphoresis
Burns
Meds: diuretics, anti-convulsants, SSRIs, lithium

hyponatremia manifestation - ANSweakness, lethargy, confusion, seizures
headache, anorexia, N/V, muscle cramps, twitching, hypotension, tachycardia, wt gain,
edema

hyponatremia interventions - ANSsodium replacement
restrict oral intake
daily weight
I&O

*risk with hypertonic solutions - used for cerebral edema*

hypernatremia risk factors - ANSGI loss, dehydration
hyperaldosteronism
hypertonic tube feedings
diabetes insipidus
kidney failure
burns
heatstroke
corticosteroids

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