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MEDICAL SURGICAL NURSING NOTES PDF

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Medical-surgical nursing is a complex and varied field with many You'll need to take some notes so that you can accurately remem-. This is the best collection of lecture notes for Medical Surgical nursing. It composes of everything you will be needing in a lecture. 63 Nursing Management: Musculoskeletal Trauma and Orthopedic Surgery, .. spontaneous abortion at the ambulatory care center, the nurse notes that the.


Medical Surgical Nursing Notes Pdf

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Diagnostic Procedures 1. CT Scan — reveals brain lesions 2. EEG — reveals hyper activity of electrical brain waves D. Nursing Management 1. Maintain patent airway and promote safety before seizure activity a. Administer medications as ordered a. Anti convulsants Dilantin, Phenytoin b. Provide comfortable and warm environment 7. Provide dietary intake that is low in calories 6. Signs and Symptoms Early Signs 1.

Decrease in all vital signs — hypotension. Cold intolerance 5. Provide meticulous skin care 8. Constipation Late Signs 1. Serum Cholesterol is increased 3. Levothyroxine b. Loss of appetite but with weight gain which promotes lipolysis leading to atherosclerosis and MI 3.

Maintain side rails 7. Administer medications as ordered Anti Thyroid Agent a. Thyroid Scan. Provide bilateral eye patch to prevent drying of the eyes. All vital signs are increased 6. Increase appetite hyperphagia but there is weight loss 2. Diarrhea 5. Excessive iodine intake 3.

CNS involvement a. Insomnia e. Serum T3 and T4 is increased 2. Autoimmune — it involves release of long acting thyroid stimulator causing exopthalmus protrusion of eyeballs enopthalmus late sign of dehydration among infants 2. Provide dietary intake that is increased in calories. Goiter 8. Restlessness c. Exopthalmus 9. Tremors d. Provide meticulous skin care 5. Amenorrhea C. Heat intolerance 4. Moist skin 3. Hallucinations 7. Prophythioracill PTU b. Irritability and agitation b.

Monitor strictly vital signs and intake and output 2. Related to hyperplasia increase size B. Comfortable and cold environment 6. Hormonal replacement therapy for lifetime 6. Atrophy of parathyroid gland due to: Anti Pyretics b. Following subtotal thyroidectomy 2. Beta-blockers o monitor strictly vital signs. Signs of bleeding feeling of fullness at incisional site Nursing Management o Check the soiled dressings at the back or nape area.

X-ray of long bones reveals a decrease in bone density 4. Administer medications as ordered such as: Acute tetany a. Chronic tetany a. Serum Phosphate is decreased normal value: CT Scan — reveals degeneration of basal ganglia D.

Serum Calcium is decreased normal value: Serum Calcium is increased 2. Morphine Sulfate Demerol 5. Prevent complications seizure and arrhythmia Hormonal replacement therapy for lifetime Prevent complications 8. Assist in surgical procedure known as parathyroidectomy Serum Phosphate is decreased 3. Force fluids to prevent kidney stones 2. Agitation and memory impairment C. Avoid precipitating stimulus such as glaring lights and noise 3.

Strain all the urine using gauze pad for stone analysis 3. Osteomalacia B. Encourage client to breathe using paper bag to produce mild respiratory acidosis result. Hyperplasia of parathyroid gland 2. Hormonal replacement therapy for lifetime 9. X-ray of long bones reveals bone demineralization D. Importance of follow up care. Constipation Side Effect: Diarrhea 2. Encourage increase intake of foods rich in calcium a. Ricketts b.

Provide warm sitz bath 4. Institute seizure and safety precaution 5. Kidney stones a. Provide acid ash in the diet to acidify urine and prevent bacterial growth 7.

Encourage increase intake of foods rich in phosphate but decrease in calcium 6. Maintain side rails 9. Over compensation of parathyroid gland due to vitamin D deficiency a.

Prepare trache set at bedside for presence of laryngo spasm 7. Bone pain especially at back bone fracture 2. Related to atrophy of adrenal glands 2.

Sex 3. Sugar 2. Decrease tolerance to stress 3. Zona Glumerulosa. Fungal infections B. Zona Fasciculata. Adrenal Cortex — outermost b. Zona Reticularis. Serum Sodium is decrease normal value: Force fluids 4. Mineralocorticoids Flourocortisone 5. Assist in mechanical ventilation. Administer medications as ordered Corticosteroids a. Serum Potassium is increased normal value: Decrease libido 6. Monitor side effects a.

Hydrocortisone Cortison Nursing Management when giving steroids 1. Provide client health teaching and discharge planning a. Loss of pubic and axillary hair 7. FBS is decreased normal value: Taper dose withdraw gradually from drug 3.

Administer isotonic fluid solution as ordered 3. Dexamethasone Decadrone b. Prednisone c. Plasma Cortisol is decreased 3. Provide meticulous skin care 7.

Textbook of Medical-Surgical Nursing

Provide dietary intake. Bronze like skin pigmentation C. Increase masculinity among females B. Plasma Cortisol is increased 3.

Measure abdominal girth daily and notify physician 4. Easy bruising 8. Acne and striae 7. Predisposing Factors 1 Related to hyperplasia of adrenal gland 2. Weigh patient daily and assess for pitting edema 3.

Table of Contents

Mixed gland exocrine and endocrine. Hypernatremia a. Consist of acinar cells which secretes pancreatic juices that aids in digestion thus it is an exocrine gland. Serum Sodium is increased 4. Located behind the stomach. Increase susceptibility to infections 3. Spinarolactone — potassium sparring diuretics 7.

Has alpha cells that secretes glucagons function: Beta cells secretes insulin function: Assist in surgical procedure bilateral adrenoraphy 9. FBS is increased 2.

Medical & Surgical Nursing (Notes)

Hirsutism 6. Serum Potassium is decreased C. Consist of islets of langerhans. Restrict sodium intake 5. Hormonal replacement for lifetime U wave upon ECG T wave hyperkalemia 5. Prevent complications DM 8. Hypokalemia a. Polyphagia 5. Drugs a. Polyphagia 3. Osmolar 3. Related to viruses receptor binding sites 3. Incidence Rate A. Glucosuria 4. Insulin therapy 1. Adult onset. Diabetes Mellitus 3. Glucosuria 6. Incidence Rate.. Blurring of vision 8.

MedSurg Notes: Nurse's Clinical Pocket Guide

Polyuria 3. Steroids 4. Weight gain 7. Diabetic Ketoacidosis 1. Ketotic 5. Diet 3. Related to carbon tetrachloride toxicity C. Brittle disease. Maturity onset type. Polydypsia 4. Delta cells secretes somatostatin function: Exercise 3. Predisposing Factors B.

Treatment D. Complications 1. Complication E. Obese over 40 years old A. Obesity — because obese persons lack insulin 2. Juvenile onset type. Increase susceptibility to infection 9.

Polyuria 1. Hyper 2. Oral Hypoglycemic agents 2. Weight loss 5. Lasix b. Signs and Symptoms C. Usually asymptomatic 2. Polydypsia 2. Diet 2. Non 4. Exercise E. Hereditary total destruction of pancreatic cells 1. Carbohydrates Glucose Glycogen 2. Protein Amino Acids Nitrogen 3. Creatinine normal value: Acetone breath odor 9.

Hct normal value: Polyphagia 4. Glucosuria 5. Seizure activity 4.

1st Edition

Infection B. Polydypsia 3. Sodium Bicarbonate to counteract acidosis c.

Decrease LOC — diabetic coma B. BUN normal value: Administer 0. Headache and dizziness 2. Hyperglycemia 2. Non ketotic: Stress — number one precipitating factor 3.

Restlessness 3. Rapid Acting Insulin clear. When mixing 2 types of insulin aspirate first the clear insulin before cloudy to prevent contaminating the clear insulin and promote proper calibration. Insulin therapy regular acting insulin peak action of 2 — 4 hours.

Nursing Management for Insulin Injections 1. Lipodystrophy c. Tolbutamide Orinase c. Artificially Compound Insulin B. Sources of Insulin 1. Stimulates the pancreas to secrete insulin A.

Derived from beef and pork 2. Allergic reactions b.

Classsification 1. Long Acting Insulin cloudy. Tolamazide Tolinase 2.

Peak action is 2 — 4 hours 2. Avoid shaking insulin vial vigorously instead gently roll vial between palm to prevent formation of bubbles 4. Place in refrigerator once opened 3. Animal sources. Regular acting insulin IV only.

Peak action is 8 — 16 hours 3. Second Generation Sulfonylureas a. Use gauge 25 — 26 needle 5. Most accessible route is abdomen 9. Rarely used because it can cause severe allergic reaction.

Frequently used type because it has less antigenicity property thus less allergic reaction 3. Administer at room temperature to prevent development of lipodystrophy atrophy. Rotate insulin injection sites to prevent development of lipodystrophy 8. First Generation Sulfonylureas a. Monitor for signs of local complications such as a. Peak action is 16 — 24 hours C. Intermediate Acting Insulin cloudy. No need to aspirate upon injection 7. Human Sources. Ultra Lente. Administer insulin either 45o — 90o depending on amount of clients tissue deposit 6.

Glipzide Glucotrol b. Chlorpropamide Diabenase b. Diabeta Micronase. Types of Insulin 1. Provide nutritional intake of diabetic diet that includes: Gangrene formation e. Renal failure c. CVA b. Atherosclerosis HPN. Instruct the client to avoid taking alcohol because it can lead to severe hypoglycemia reaction or Disulfiram Antabuse toxicity symptoms B. Blood II. Monitor for peak action of insulin and OHA and notify physician 2.

Spleen 4. Lymph Nodes formed in liver 6. Monitor for signs of hypoglycemia and hyperglycemia. Arteries 1. Random Blood Sugar is increased 3. Instruct client to exercise best after meals when blood glucose is rising 7. Administer insulin and OHA therapy as ordered 3. Oral glucose tolerance test is increased — most sensitive test 4.

Nursing Management when giving OHA 1. Bone Marrow. Instruct the client to take it with meals to lessen GIT irritation and prevent hypoglycemia 2. Blood Forming Organs 1.

Monitor signs for complications a. Alpha Glycosylated Hemoglobin is increased C. Blood Vessels III. Institute foot care management a. Instruct client to have an annual eye and kidney exam FBS is increased 3 consecutive times with signs or polyuria.

Veins 3. Shock due to dehydration. HPN and DM major cause of renal failure d. Beta globulins — iron and copper. Alpha globulins. Normal life span of RBC is 80 — days and is killed in red pulp of spleen 2.

Albumin 2. Polymorphonuclear Eosinophils. Lymphocytes B-cell T-cell Natural killer cell. Polymorpho Neutrophils. Non Granulocytes 1. Globulins 3. Largest and numerous plasma CHON. Polymorphonuclear Basophils. Gamma globulins a. Granulocytes 1. Brittleness of hair and spoon shape nails koilonychias.

Palpitations 7. Related to malabsorption syndrome c. Common among tropical zones 3. Dyspnea 6. Pallor and cold sensitivity 5. Pneumocystis Carinii Pneumonia 3. Inadequate intake of iron due to a. Incidence Rate 1. Related to improper cooking of foods C.

Heavy menstruation b. High cereal intake with low animal protein digestion d. Normal life span of platelet is 9 — 12 days Signs of Platelet Dysfunction 1. Promotes hemostasis prevention of blood loss. Chronic blood loss due to trauma a. Weakness and fatigue initial signs 3. Headache and dizziness 4. Common among women 15 — 35 years old 4. Subtotal gastrectomy 4.

Related to poor nutrition B. Echhymosis 3. Normal value: Chronic diarrhea b. A chronic microcytic anemia resulting from inadequate absorption of iron leading to hypoxemic tissue injury A. Consist of immature or baby platelets or megakaryocytes which is the target of dengue virus. Petechiae 2. Common among developed countries 2.

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Organ meat b. Iron is decreased 5. Dried fruits f. Legumes g. Atropic Glossitis inflammation of tongue. Ferrous Gluconate. Instruct the client to avoid taking tea and coffee because it contains tannates which impairs iron absorption 5. Abdominal pain d. Egg yolk c. Hgb is decreased 3. Fever and chills e. Iron Dextran IM. RBC is decreased 2.

Enforce CBR so as not to over tire client 3. Melena 5. Sorbitex IM Nursing Management when giving parenteral iron preparations 1. Instruct client to take foods rich in iron a. Dysphagia 9. Pain at injection site b.

Monitor and inform client of side effects a. Reticulocyte is decreased 6. Nausea and vomiting c. Ferrous Sulfate b. Raisin d. Lymphadenopathy d. Instruct client to take with meals to lessen GIT irritation 2.

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A value cohort is a group of people who experienced an out-of-the-ordinary event that shaped their values. Schedule V drugs, such as cough syrups that contain codeine , have the lowest abuse potential of the controlled substances. TYPES 1. Signs of bleeding feeling of fullness at incisional site Nursing Management o Check the soiled dressings at the back or nape area.

Tonic contractions - direct symmetrical extension of extremities Clonic contractions - contraction of extremities d. Enforce CBR 2. Instruct client to take in the morning to prevent insomnia 2. Dysphagia 9.

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