Medical-Surgical Nursing Foundations Quiz

Medical-Surgical Nursing Foundations

• This unit covers Emergency Department (ED) and Trauma Nursing, Fluids, Electrolytes, Acid-Base Imbalances, Immunity, Hematology, and Oncology.

Preparatory Module Goals

• Develop clinical judgment, critical thinking, clinical reasoning, and systems thinking.
• Recognize, Respond, and Report on patient conditions.
  • Safe delegation doesn't include assessments or education
  • Failure to Rescue involves failing to recognize and respond appropriately to patient condition changes.
  • Rapid Response Teams (RRT) handle sudden changes in patient condition.
  • Code Teams manage cardiopulmonary arrest.

ED Nursing

• Social determinants of health and vulnerable populations.
• Safety and violence within the ED.
• Priorities of care (X, A, B, C, D, E).
• Triage.
• Mechanism of injury.
• Complications of trauma.

Fluid and Electrolyte Balance

• Homeostasis.
• Ions move via diffusion and active transport.
• Water moves via osmosis and filtration.

Fluid Volume Imbalances

• Fluid Overload: Weight gain, pitting edema, hypertension, tachycardia with bounding pulses, jugular vein distension, crackles in lungs, dyspnea, orthopnea, bulging fontanels, periorbital edema.
• Fluid Deficit: Weight loss, dry cracked mucosa, tenting of the skin, hypotension, tachycardia with thready pulses, flat neck veins, oliguria, hemoconcentration, sunken fontanels, sunken eyes.

Fluid Balance Strategies

• Rehydration: Oral solutions, salts and water, not concentrated glucose, IV solutions (20 ml/kg bolus), goal PO: 64 ounces, Output: 720 ml clear urine.
• Diuresis: Safe removal of water, electrolyte balance, limit oral salt intake, oral fluid restrictions if CHF or hemodialysis.

Electrolyte Imbalances

• Sodium (natremia): Seizures, confusion, risk for injury.
• Potassium (kalemia): Cardiac dysrhythmias, muscle weakness, GI changes.
• Calcium (calcemia): Neuromuscular changes, cardiac dysrhythmias.
• Magnesium (magnesemia): Mimics other problems, neuromuscular changes, seizures, respiratory depression, cardiac dysrhythmias.

Acid-Base Balance

• This section discusses acid-base balance.

Immunity

• Topics on Hypersensitivity reactions, Immune conditions, and Covid-19 are discussed here.

Hypersensitivity Reactions

• Type I: Histamine and inflammatory response (Allergy, Rhinitis, Asthma, Anaphylaxis).
• Type II: Cellular response to foreign proteins (Hemolysis, Transfusion reactions, graft rejection).
• Type III: Immune reaction (Lupus, Serum sickness).
• Type IV: Inflammatory response (Contact dermatitis, RA, MS).

Immune Conditions

• Lupus, Lyme disease, HIV.

Hematolog

• Core concepts include hematopoiesis, low blood counts (anemia, leukopenia, thrombocytopenia), and high blood counts (polycythemia, leukocytosis).

Medications to Manage Hematologic Conditions

• Iron: Microcytic anemia.
• B12/Pernicious Anemia
• Folate: Macrocytic anemia.
• Erythropoietin alfa (Epogen): Increase reticulocytes (become erythrocytes), use cautiously in hypertension.
• Filgrastim (Neupogen): Increases neutrophils, avoid within 24 hours of chemotherapy or infection.
• Clotting Factors (DDAVP, TXA): Hemophilia and others.

Blood and Blood Product Transfusions

• This is about transfusion procedures and related questions.
• Questions like 'Why? What? Who? Where?, When? How?', and "Watch out!" are mentioned for this aspect.

Oncology

• Oncology discusses benign versus malignant cells, prevention, diagnosis, management, and emergencies.