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ATI RN Medical Surgical 2024/2025 (100% verified)
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ATI RN Medical Surgical 2024/2025 (100% verified)
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ATI RN Medical Surgical 2024Brachytherapy - ANSInternal radiation therapy implant
Vagina, abdomen or IV
Private room with sign on door
Wear dosimeter film badge
Visitors: 30 mins, 6ft from source
No pregnant or <16 yo visitors or staff
Lead container for spontaneous loss of item
Pt to maintain position to avoid dislodging item
Plan of care for pt with clostridium difficile - ANSContact precautions
Quad cane use with hemiplegia - ANSUse cane on unaffected side (bad side can't hold
cane!)
Advance cane 6-10"
Advance weak leg
Move strong leg past cane
Stairs: up with the good and down with the bad
Hypersensitivity to morphine - ANSNarcan as antagonist
If resp. <12/min, discontinue and admin Narcan
Do not use with other depressants
Older pts do not metabolize as well
Cardiac Catheterization (PICC line) - ANSProvider inserts, except PICC: trained RN
Verify with x-ray before use
Initial gauze dressing, then transparent w/in 24hr
Tape cath hub for stability
Remove dressing distal to proximal
Measure to note migration
Assess q8h
Clean port for 3 seconds and allow to dry
Flush with 10ml or smaller syringe
Flush before, between, and after meds
No BP on arm with PICC
Beta blockers - ANSFor patients with MI or unstable angina
Decrease cardiac output
Monitor BP and pulse
Fatigue, weakness, depression, sexual dysfunction
Do not suddenly d/c
Know signs of hypoglycemia besides tachycardia
, Evaluating client understanding of TPN - ANSAdmin. after 7% BW loss or 5+ days NPO
Monitor glucose q4-6h for 24 hours
At risk for hyperglycemia, may need extra insulin
Never stop abruptly
Admin. through PICC or central line
Dysrhythmias and Management - ANSSymptomatic bradycardia <60/min:
Atropine, isoproterenol
Pacemaker
A. fib, SVT, ventricular tachycardia with pulse:
Amiodarone, adenosine, verapamil
Synchronized cardioversion
Ventricular tachycardia w/o pulse, v. fib:
Amiodarone, lidocaine, epinephrine
Defibrillation
Lab values assoc. with hyperthyroidism - ANSDecreased serum TSH
Increased FTI and T3
Failure of expected rise in TSH with thyrotropin-releasing hormone stimulation test
Thyroid storm - ANSSudden surge of large amt of thyroid hormones into the bloodstream
Hyperthermia
Hypertension
Delirium
Vomiting and abdominal pain
Hyperglycemia
Tachydysrhythmias
Chest pain
Dyspnea
Diabetes mellitus foot care - ANSKeep foot dry and clean
Shoes at all times for protection
Test water temp with hands
Head injury - ANSRespiratory status
Assess changes in consciousness with GCS
Cranial nerve fx
Amnesia
Length of time of lost consciousness
Monitor for ICP:
-CSF leaking out ear or nose (halo sign)
-Headache
-Restlessness, irritability, decreasing consciousness
-Deteriorating motor fx
-Seizures
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