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Med Surge 1 Exam Review

HEAL100 Health Care — exam and revision material · Other

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Health Care study guide material, 9 pages. Originally published on StudyMerit.

Pages
9
Academic year
2025/2026
Language
English

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Med Surg Exam 1 Review Preoperative Care Basic Concepts of Perioperative Care Risk factors for complications - Smoking - Alcohol - Heart disease - Respiratory disease - Kidney disease - Age - Malnutrition - Obesity - Previous reactions to anesthesia (malignant hypertension When does discharge planning begin? Beginning at admission, the provider will write in progress notes the expected date of discharge. Does the patient have family to help or should they go to rehab, home health Pre op instructions NPO status, consent, skin prep, bowel prep, what meds needed the morning of surgery – insulin, BP meds , med hx ( anesthesia reaction) Did the patient stop taking NSAIDS 2 weeks before surgery or stop anticoagulants Labs: - CBC - BMP - CMP - XRAY - EKG - Vitals CBC Hemoglobin (Hgb) : M: 14g/dL - 18g/dL F: 12g/dL - 16g/dL Hematocrit (Hct) : M: 42-52% F: 37-47% White Blood Cells (WBC) : 5,000 - 10,000 Red Blood Cells (RBC) : M: 4.7-6.1 mm F: 4.2-5.4mm Platelet count (PLT) : 150,000 - 400,000 mm (clotting)

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BMP Glucose (Glu) : 70-110mg/dL Calcium (Ca) : 9-10.5mg/dL Sodium (Na) : 135-145mEq/L Chloride (Cl) : 98-106mEq/L Potassium (K) : 3.5-5mEq/L Magnesium (Mg) : 1.5-2.5mEq/L Blood Urea Nitrogen (BUN) : 10-20mg/dL CMP Albumin: 3.5-5g/dl Teaching: - Early ambulation - Splinting - Incentive Spirometer use - Return demonstration - Risks : Wound dehiscence (obesity, increased drainage, separation of sutures, diabetes, steroids, ,malnutrition) , infection (proper dressing change,assess odor, drainage, fever, wbc) , hemorrhaging (hematoma, low BP, high HR - Hypovolemic shock) DVT (SCD - meds) Pneumonia( , Constipation, Fluid volume excess/deficit, Paralytic ileus (monitor bowel sounds, look for increased distention, NPO, might need NG tube) Consent MD explains procedure, nurse witness, 2 nurses witness to guide blind patient, if pt can’t write have them sign with x while 2 nurses witness, , speaks another language get interpreter, pt can always change their mind, PreOp Meds - Atropine - Anticholinergic ; dries up secretions - Midazolam - Anxiety (Versed) - PPI - Pantoprazole and omeprazole - reduce stomach acid (Pantoprazole - Protonix and omeprazole Prilosec) - Morphine - Pain - Antibiotics Don’t allow patient to get out of bed after these meds, safety to prevent falls

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List in order the assessments you would make as the PACU nurse. ABC - airway, breathing, circulation Pain Surgical area I/Os, drains LOC GI Pain Acute Vs. Chronic pain Vs Neuropathic ● Acute – sudden, if severe can see increased vs, restlessness. Nonopioids, opioids, PT/OT, massage, TENS unit, etc ● Chronic- long term, persistent. Body adapts so it doesn't see changes. Need a pain specialist, not Opioids, or adjuvant therapies ● Neuropathic – damage to PNS, CNS. Burning, tingling, shooting pain. Difficult to treat, Gabapentin and pregabalin are the first choice. Anticonvulsants, antidepressants (TCAs, SNRI) Best Pain Assessment - Self report - pain scale - Behavior cues - Grimacing - Vitals Patients who are at the highest risk for undertreated pain - Elderly - Non-verbal - Language barriers - Cognitively impaired - Drug abusers

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