Medical-Surgical Nursing: Core Concepts

• Medical-surgical nursing is a specialty focused on the care of adult patients with a wide variety of medical conditions and those recovering from surgery.
• It requires a broad understanding of anatomy, physiology, and pharmacology.
• Medical-surgical nurses must possess strong assessment, critical thinking, and clinical skills.

Core Concepts

• Holistic care addresses the physical, psychological, emotional, and spiritual needs of the patient.
• Patient-centered care focuses on the individual needs and preferences of each patient.
• Evidence-based practice involves using research findings to guide clinical decision-making.
• Quality improvement aims to enhance the safety and effectiveness of patient care.
• Collaboration involves working effectively with other healthcare professionals to achieve optimal patient outcomes.

Key Terminology

• Assessment: The systematic collection of data about a patient's health status.
• Diagnosis: Identification of a disease or condition based on assessment findings.
• Intervention: An action taken to improve, maintain, or restore a patient's health.
• Evaluation: Assessment of the effectiveness of interventions.
• Acute: A condition or illness that is severe and sudden in onset.
• Chronic: A condition or illness that develops slowly and lasts for a long time.
• Exacerbation: A worsening of symptoms or severity of a disease.
• Remission: A period when symptoms of a disease are reduced or absent.
• Palliation: Relieving or alleviating pain or symptoms without curing the underlying disease.
• Prognosis: The likely course and outcome of a disease.
• Comorbidity: The presence of two or more diseases or conditions in a patient.
• Nosocomial infection: An infection acquired in a hospital.
• Iatrogenic: Relating to illness caused by medical examination or treatment.
• Idiopathic: Relating to a disease or condition with no known cause.

Common Medical Conditions

• Cardiovascular diseases: Including hypertension, heart failure, coronary artery disease, and arrhythmias.
• Respiratory diseases: Including chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and respiratory failure.
• Endocrine disorders: Including diabetes mellitus, thyroid disorders, and adrenal insufficiency.
• Gastrointestinal disorders: Including peptic ulcer disease, inflammatory bowel disease, and cirrhosis.
• Neurological disorders: Including stroke, multiple sclerosis, Parkinson's disease, and Alzheimer's disease.
• Renal disorders: Including acute kidney injury, chronic kidney disease, and glomerulonephritis.
• Musculoskeletal disorders: Including osteoarthritis, rheumatoid arthritis, and osteoporosis.

Preoperative Nursing Care

• Preoperative assessment includes a thorough medical history, physical examination, and review of medications.
• Patient education is provided regarding the surgical procedure, expected outcomes, and postoperative care.
• Informed consent is obtained to ensure the patient understands the risks and benefits of the surgery.
• Preoperative preparation includes ensuring the patient is NPO (nothing by mouth) for a specified period.
• Psychological support is provided to reduce anxiety and promote a sense of well-being.

Postoperative Nursing Care

• Monitoring vital signs and assessing for complications such as bleeding, infection, and respiratory distress.
• Pain management involves administering analgesics as ordered and using non-pharmacological techniques.
• Wound care includes assessing the incision site, changing dressings, and monitoring for signs of infection.
• Respiratory care includes encouraging coughing and deep breathing to prevent pneumonia.
• Cardiovascular care involves monitoring fluid balance and preventing deep vein thrombosis (DVT).
• Gastrointestinal care includes monitoring bowel sounds and preventing constipation.
• Early ambulation is encouraged to promote circulation and prevent complications.
• Patient education is provided regarding medication management, activity restrictions, and follow-up appointments.

Medication Administration

• Understanding drug classifications, mechanisms of action, side effects, and contraindications.
• Calculating dosages accurately and administering medications using the correct route and technique.
• Monitoring patients for adverse drug reactions and drug interactions.
• Educating patients about their medications, including dosage, timing, and potential side effects.
• Adhering to medication safety protocols to prevent medication errors.

Infection Control

• Practicing hand hygiene consistently to prevent the spread of microorganisms.
• Using personal protective equipment (PPE) such as gloves, masks, and gowns when indicated.
• Following isolation precautions for patients with infectious diseases.
• Implementing measures to prevent healthcare-associated infections (HAIs).
• Educating patients and families about infection prevention strategies.

Wound Management

• Assessing wounds for signs of infection, such as redness, swelling, and drainage.
• Cleansing wounds with appropriate solutions and techniques.
• Applying dressings and bandages to protect wounds and promote healing.
• Monitoring wound healing and documenting progress.
• Educating patients and families about wound care at home.

Pain Management

• Assessing pain using standardized pain scales and techniques.
• Administering analgesics as ordered and monitoring for effectiveness.
• Using non-pharmacological pain management techniques such as heat, cold, massage, and relaxation.
• Educating patients about pain management options and strategies.
• Addressing the psychological and emotional aspects of pain.

Fluid and Electrolyte Balance

• Monitoring fluid intake and output to assess fluid balance.
• Assessing for signs and symptoms of fluid overload and dehydration.
• Monitoring electrolyte levels and administering electrolyte replacements as ordered.
• Educating patients about fluid and electrolyte balance and dietary modifications.

Respiratory Care

• Assessing respiratory status, including breath sounds, respiratory rate, and oxygen saturation.
• Administering oxygen therapy as ordered and monitoring for effectiveness.
• Encouraging coughing and deep breathing to prevent pneumonia.
• Providing suctioning to clear airway secretions.
• Educating patients about respiratory care techniques and strategies.

Ethical Considerations

• Autonomy: Respecting the patient's right to make their own decisions.
• Beneficence: Acting in the patient's best interest.
• Non-maleficence: Avoiding harm to the patient.
• Justice: Treating all patients fairly and equitably.
• Veracity: Being honest and truthful with the patient.
• Fidelity: Maintaining confidentiality and keeping promises to the patient.