Med/Surg 3 Tips for Final Exam (PDF)

Med/Surg 3 Focus on the following: Neurology a\. Ischemic stroke risk factors, patho clinical manifestations, diagnostics/stroke care protocol b\. treatments: antiplatelets, coumadin ([spinach for food])& food teaching, Lovenox, heparin -pt teaching ([Protamine sulfate antidote]), side effects g...

Med/Surg 3 Focus on the following: Neurology a\. Ischemic stroke risk factors, patho clinical manifestations, diagnostics/stroke care protocol b\. treatments: antiplatelets, coumadin ([spinach for food])& food teaching, Lovenox, heparin -pt teaching ([Protamine sulfate antidote]), side effects general c\. nursing care of stroke d\. Lumbar puncture care- pre & post procedure\ monitor for leakage, headache e\. Guillain Barre syndrome\ immune system attacks PNS. Monitor airway breathing, paralysis, numbness of peripherals and skeletal muscles. Ascending paralysis f\. Bacterial meningitis -- how to DX &Treatment\ Dx with LP, treat with prophylactic abx even before results if shown viral. IV abx for specific culture of bacteria. Seizure precautions a. Multiple Sclerosis; [Definition]: Multiple sclerosis (MS) is a chronic, progressive, irreversible, autoimmune neurologic disorder with an unknown etiology\ damages brain and spinal cord of CNS. S/S: descending paralysis. b. ALS also called Lou Gehrig's disease (amyotrophic lateral sclerosis) goals of care\ manage respiratory status as condition develops, manage pain and maintain range of motion with exercises, rehab. c. Parkinson's disease -- Levodopa carbidopa- action/side effects\ drug to slow down the progression of the disease, increasing the amount of dopamine in the brain. Side effects of bad nightmares/ visual hallucinations, [dyskinesia], [orthostatic hypotension]. d. Encephalitis -- nursing assessment\ Monitor ICP, monitor for neurological changes and assessment. Renal a\. labs, creatinine clearance & GFR 90-120, BUN 8-24 c\. Acute Renal Failure causes/ S& S, treatments\ Pre, intra, and post renal failure causes\ S/S: oliguria phase (low urine output), then diuresis phase monitor fluid and electrolyte levels. d\. Chronic renal failure\ irreversible, slow onset, 1: diminished renal reserve gfr above 90, 2 gfr is 60, 3 gfr is 40. e\. Diet choices\ low in protein and electrolytes. Calcium and phosphorus supplement. f\. Hemodialysis- fistula site assessment: [assess thrill and bruit for patency].\ tele monitoring, g\. glomerulonephritis Oncology a\. Cancer screening -- Colonoscopy, Pap smear and mammogram for women\ [Biopsy for tumors to find out whether benign or malignant.] b\. chemotherapy & radiation side effects\ General side effects of chemo and radiation: fatigue, maintain activity but ensure adequate rest and periods. Excoriation. c\. Nursing care of cancer patients/ pt teaching\ small frequent meals, stool softeners, antiemetics, avoid sun exposure, avoid exposure to large crowds, very immunosuppressed, avoid raw foods. Immunity/HIV (review the questions that the class worked on) a\. ART (antiretroviral therapy); effectiveness (which one is safe for pregnancy)\ cannot miss doses- if missed dose, take dose asap and start schedule from there, start ASAP\ Side effects: take antacids 2 hours before or after to avoid interactions with other medications\ N/V, report severe muscle pain/aches b\. Infection: pneumonia\ [Notify provider immediately for s/s of new infection, with AIDS extremely immunocompromised] c\. Infection/ transmission\ [transmitted through blood, body fluids, sharing needle] d\. Testing e\. Priority setting for care. f\. psych/social g\. Antiretroviral meds h\. Rapid antibody test i\. AIDS symptoms and care -- **[CD4 Cells lymphocytes below 200 becomes aids]**. j\. Post exposure prophylaxis Cardiac: R vs. L heart failure Heart Failure nursing interventions\ monitor I/Os, elevate head of bed, O2 saturation, Heart failure treatment/ meds/ actions\ diuresis with furosemide monitor K+ and other electrolytes sodium, BP, ease cardiac workload.\ \ Digoxin helps with heart contraction and reduces the heart rate. (measure apical pulse for 60 seconds, do not administer if HR \