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ATI MED SURG FORM A EXAM REVIEW 2019
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ATI MED SURG FORM A EXAM REVIEW 2019 / ATI MED SURG FORM A EXAM REVIEW 2019
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ATI MED SURG FORM AEXAM REVIEW 2019
Basic Care and Comfort (5)
Prostate Surgeries: Intervention for Complication of Continuous Bladder Irrigation-
The irrigation should be a pink or lighter. If it is bright red (arterial) bleeding clots are
observed and the nurse should increase the CBI rate. If the catheter becomes
obstructed (bladder spasms, reduced irrigation outflow) the nurse should turn off the
CBI and irrigate with 50ml of solution and contact the primary care provider if the
clot is not dislodged.
Q: If a pt is in complaining of pain and there is no irrigation fluid coming out of the
catheter what the priority nursing action be?
I put the answer on the first test as being to reduce the flow rate and the
second test as administer an antispasmodic med and got it wrong both times….so
by process of elimination I think the answer is to irrigate the catheter with saline
solution (if the catheter is clotted)
Q: If the pt has had their prostate removed and the irrigating 3 way catheter
shows bright red clotted blood being released from the end what should you do?
To increase the flow rate (this bleeding is an expected outcome)
Immobilizing Interventions: Assessing for Complications- Acute compartment
syndrome is a buildup of pressure within muscle that can cause circulatory
obstructions that can cause ischemia or necrosis. Initial alterations are paresthesias,
pallow, and diminshed pulses and the primary care provider should be notified.
Interventions include relieving the pressure by loosening constricting dressings.
Another complication is Osteomyelitis which is inflammation within the bone
secondary to penetration of organisms. Characterisitcs are bone pain that worsens
with movement. Initial symptoms are erythema, edema and fever.
Q: what assessment finding would be a cause for concern in an immobile pt?
Diminished pulses in the feet, redness and edema in the legs (understand
symptoms)
Pressure Ulcers: Appropriate Interventions for for a Stage III Ulcer- It is a deep crater
and may have a foul smelling drainage, also yellow slough or necrotic tissue in
wound bed. Clean and debride: wet to dry dressing, surgical interventions and
proteolytic enzymes. Provide nutritional supplements, administer analgesics and
administer antimicrobials (topical or systemic).
Q: how would you care for a pt with a stage III pressure ulcer?
Apply proteolytic enzymes
Q: which of the following would be an appropriate nursing intervention for a stage II
pressure ulcer in the heals?
Increase IV fluids (pg 1049)
Cholescystitis: Dietary Teaching to Prevent Acute Episodes- low fat diet (reduced
dairy, avoid fried foods, chocolate and nuts). Promote weight reduction. Fat-soluble
vitamins and bile salts can be prescribed to enhance absorption and aid in
digesiton. Avoid gas forming foods (beans, cabbage, cauliflower and broccoli). Small
more frequent meals are tolerated better.
Q: what foods would you teach a pt suffering from cholescystitis to eliminate from
,their diet at home?
Fried eggs
Fluid Imbalances: Assessment Findings- Hypovolemia: increased Hgb and Hct.
Dehydration can be increased. Dehydration can also cause increased protein, blood
urea nitrogen (BUN), electrolytes and glucose. Urine specific gravity is increased with
dehydration. Serum sodium is
, increased with dehyrdation. Vital signs: hyperthermia, tachycardia, thready pulse,
hypotension, orthostatic hypotension, decreased central venous pressure.
Neuromuscular: dizziness, syncope, confusion, weakness and fatigue. GI: thirst,
nause/vomiting, anorexia. Renal: oliguria. Other signs: diminished capillary refill,
cool clammy skin, diaphoresis, sunken eyeballs, flattened neck veins.
Q: what assessment finding would lead you to believe a pt suffers from
Hypovolemia? Increased blood osmolarity
Pharmacological and Parenteral Therapies (16)
Cancer: Side Effects of Chemotherapy- Most significant adverse effect is
immunosuppression (bone marrow suppression). Nausea, vomiting, alopceia,
mucositis are common side effects. Oral inflammation and inflammation of the
mucous membrane.
Q: What would you expect from a client receiving chemotherapy?
Decreased WBC
Hypertension: Client Teaching Regarding ACE Inhibitors- Teach to change positions
slowly because of orthostatic hypotension. Monitor signs for heart failure such as
edema. Also report a cough. Hypotension is a common side effect.
Q: Which of the following would lead you to believe that a client understands his
teachings about using his ACE inhibitors?
I put that they should use salt substitutes and I got it wrong, my guess is the
answer is to decrease K and Na intake.
Pain Management: Client Teaching Regarding Opioid Use- Client is the only person
who should push the PCA for administration of opioids. An occlusive sterile dressing
should be maintained over the catheter site for an epidural analgesic. Oral route is
the preferred route for opioid administration.
Q: what would you include in your education of a client receiving
opioids? Increase you fiber intake (because of the
constipation it causes)
Pain Management: Recognizing Adverse Effects- Constipation: preventative
measures- monitor BM's, fiber intake, excercise, stool softeners, stimulant laxatives
and enemas. Urinary retention: monitor intake and output, assess for distention,
and catheterize. Nause/vomiting: administer antiemetics such as compazine, reglan,
zorfran. lie still and or move slwoly during first hours after initiation. Sedation:
monitor LOC and take safety precautions. Respiratory depression: monitor
respiratory rate prior to and following administration. Initial treatment is a
reducation in opioid dose. If necessary slowly administer diluted naloxone to
reverse opioid effects. Pruritus: can be treated with a small dose of naloxone
(narcan).
Q: what nursing interventions would you implement to address adverse effects of
opiods?
Laxatives and enemas
Blood Transfusions: Managing Reaction- Acute hemolytic reaction is immediate and
includes chills, fever, lower back pain, tachycardia, flushing, hypotension, chest
tightening, tachypnea, nausea, anxiety. Febrile reaction is 30 min to 60 min and
include chills, fever, flushing, headache and anxiety and should use a white blood
cell filter administer antipyretics. Mild allergic reaction is during or up to 24 hours
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