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NURC 1021 Med Surg ATI Final Review
- Institution
- Eastern Florida State College
Med Surg ATI Final Review for NURC 1021. *Essential and Valuable Study Material!! *For effective Exam Preparation!!
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Med Surg ATIA patient either a Halo: Further teaching
What statement by the client indicates further teaching?
I can drive once I am not taking analgesics.
Put a small pillow under the patients head
Baths instead of showers
Avoid fiber foods
Medication: Bumetanide (Bumex) Heart failure
What does it treat? A rapid acting diuretic to reduce preload and promote fluid excretion.
Medication: Metoprolol
What would you do before administration? Check heart rate
Beta-adrenergic blockers (beta-blockers)
Medications such as carvedilol (Coreg) and metoprolol (Lopressor) may be used to improve
the condition of the client who has sustained increased levels of sympathetic stimulation and
catecholamines. This would include clients who have chronic heart failure.
Nursing considerations
Monitor BP, pulse, activity tolerance and orthopnea.
Check orthostatic blood pressure readings.
Client Education
Instruct the client to weigh daily.
Advise the client to regularly check BP.
Tell the client to follow the provider’s instructions on increasing medication dosage.
Peak Flow meter: Order in which you would do it?
Peak Flow meter: Order in which you would do it? Page 179 peds book
Ensure marker is at zero
, Have the child stand up straight
Close lips tightly around mouth piece (ensure tongue is not occluding)
Blow out hard and as quick as possible
Read the number on the meter
Repeat two more times (wait at least 30 seconds between attempts)
Record highest number
Chart
What priority finding would a nurse notify the physician postop parathyroidectomy?
Hemorrhage page 873
Semi-Fowlers
Check surgical dressing and back of neck for excessive bleeding.
Be aware that respiratory distress can occur from compression of trachea due to
hemorrhage (have tracheostomy tray, O2, suction at bedside
The thyroidectomy patient faces three life-threatening postoperative complications:
hemorrhage, tetany, and thyroid crisis.
Hoarseness
Signs of Tetany
Signs of Thyroid Storm-caused by increased release of the hormone d/t manipulation
o
Stridor?????????? Most likely not the complication-This if edema occurs
Medications: Calcium gluconate and calcium chloride
Calcium supplement is used for emergency treatment of hypocalcemia due to damage of
the parathyroid glands.
Nursing Considerations
Keep emergency equipment near the bedside.
Monitor the client for evidence of hypocalcemia, such as tingling, muscle twitching, and
numbness of mouth or distal extremities.
Client Education
Advise the client to notify the nurse of any muscle twitching or tingling sensation of the
mouth or distal extremities
Abg’s questions. No compensation??????????????
What to expect with an orchiectomy?
Choices hormonal based?
, o Reduce testosterone or androgen
o Osteoporosis
o Gynecomastia
o Fertility is affected (sterility)
o Loss of sexual interest
o Erection problems
o Hot flashes
o Weight gain
o Loss of muscle mass
Can get hormonal injections/medications postop
Page 1063
Leuprolide acetate (Lupron) – gonadotropin-releasing hormone (GnRH)
Used in advanced prostate cancer to produce chemical castration.
Client Education
Warn the client that hot flashes are an adverse effect.
Tell the client that impotence and decreased libido may also be adverse effects.
Inform the client that he should be monitored for osteoporosis, which can occur due to
testosterone suppression.
Flutamide (Eulexin) – androgen receptor blocker
Used in conjunction with a GnRH.
Client Education
Alert the client that gynecomastia is an adverse effect.
Inform the client that liver function tests should be periodically monitored
Medication: Furosemide Why would you give it? Heart failure and pulmonary edema/Fluid
retention And what labs??????????????
Page 365
Diuretics: Diuretics are used to decrease preload.
Loop diuretics, such as furosemide (Lasix), bumetanide (Bumex)
Thiazide diuretics, such as hydrochlorothiazide (Hydrodiuril)
Potassium-sparing diuretics, such as spironolactone (Aldactone)
Nursing Considerations
Administer furosemide IV no faster than 20 mg/min.
Teach client to ingest foods that are high in potassium
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