Nursing Interventions and Considerations for Various Medical Conditions

QUESTION

Medical surgical nursing II midterm study guide 1. What nursing Interventions to perform for patients with respiratory arrest ? 2. What nursing Interventions to perform for patients with Intervention for heart failure ? 3. ABG levels how to determine acidosis/alkalosis: 4. Respiratory terms definition like (3 or 4): cheynes stroke, 5. Cheynes stroke: mixture of very deep shallow and episode of apnea. 6. ABG apnea : respiratory acidosis 7. S/S of hypoxia, assessment, how you can determine: 8. Pneumonia: how will there secretions be ? thick, what to do ? increase fluids, give albuterol to thinning secretion , increase fluids 9. ABG question 10. Respiration conditions: Increase fluid and position pt on high fowlers position 11. If you have accumulated secretions what would you do ? vibration, giving massage to remove secretions 12. Patients with COPD what kind of diet will they take ? more fluid, stay hydrated, no caffeine, 13. Cataract: avoid bending from waist, color perception decrease, blurry vision 14. Cataract surgery: intracapsular cataract extraction (ICCE) 15. Cataract is done with surgery and still complaining of pain, what do you do ? always to report it, because patient should not have severe pain 16. Cataract: what to avoid to prevent pressure ? avoid constipation (first give soft stools, fluid, fiber, abulation), no coughing, no bending at waist 17. Cover eye with patch to avoid further injury 18. Should a patient change dressing if the patient is discharged ? yes patient can change dressing when getting discharge, but not the first dressing 19. Should patients wear dark glasses while going outside? Yes to protect eye from sun 20. Eye surgery improvement in 2 weeks, and fully recover in 3 months 21. What Position should you put your patient who has cataract surgery ? on non-affected/ uneffective side 22. Tonometry is the procedure eye care professionals perform to determine the intraocular pressure (IOP), what’s normal IOP ? 10- 21 23. BP 122/82 – pre- hypertension If between →120-130, 80-89 24. If your patient is in Hypovolemia what kind of eye solution should you provide ? 0.9 saline and Ringer’s lactated (Ringer’s is an isotonic crystalloid solution with lactate added to correct possible metabolic acidosis in the patient) 25. Teaching and education for Hypertension (modifier) ? diet, less sodium, caffeine, smoking, exercise 26. Risk factors of hypertension ? 27. Signs and symptoms of hypovolemic shock ? heart rate: high, bp: low, oliguria, hypertension, tachycardia 28. (4 q’s on hypovolemic shock) 29. Anaphylaxis shock first treatment ? epinephrine 30. Signs and symptoms of HIV and AIDS ? oral thrush and candidates 31. If a patient has a blood transfusion reaction what to do ? stop IV transfusion and 32. Sign and symptoms of blood transfusion reaction ? lower back pain 33. Know all HIV tests ?Tests for HIV and AIDS ? CD4, ELISA, western blocker for confirmation. Viral load to check blood levels 34. Education teaching about infection ? hand washing, use bleach solution for sponges 35. Complications of AIDS ? sarcoma – Kaposi 36. Education for HIV transmission ? 37. If a patient is on treatment and you wanna check for viral load blood levels are increasing or decreasing ? quantity RNA 38. Infection control for HIV ? standard, use one pair of gloves 39. Anemias: ( B12, pernicious anemia- missing that factor, cannot absorb b12, so you perform the first schilling test to determine whether the body absorbs vitamin B12 normally. If Patient is not having intrinsic factor you will give first b12 injection first month (4x) and second month (1x) a month 40. How to assess your patient for dehydration ? turgor skin, check mucus membranes, oliguria, hypotension 41. What’s normal specific gravity ? 1.005 to 1.030 42. Normal urinary output: body weight x 0.5   43. Plan of care for dehydration ? hydrate, IV drip, Hydration should be caffeine free 44. Cystitis – inflammation of bladder, expected findings: tenderness on their suprapubic area, 45. Pylorinifradies – inflammation of renal pelvis, expected findings: tenderness at flank, pain at flank 46. Patients who have Nephritis or disease disorder put on low sodium(salt) diet, low protein diet, but carbs can lean still need energy from somewhere 47. Which test will you perform if your patient has globolephines ? GFR, BUNS, CREATINE 48. Your globolephines start with ? sore throat → give antibiotics 49. For globolephines hematuria is expected 50. Priority of globolephines ? blood pressure specially if more than 160 51. IVP (intravenous pillar gram) – give them in contrast iodine, check for allergies, sea food, iodine, always ask patient if they are in Metamorphine because it has interaction/adverse effect with IVP 52. Urilitilises – stone in ureters, educate patient to take at least 3 Lor 2500 to 4000 ml of water 53. oliguria is low urine output 54. anuria means no urine output 55. Polyuria means excessive urine production 56. Normal Urine output 57. Peritoneal dialysis solution: glucose solution 58. Complications of Peritoneal dialysis ? lead to sepsis,and symptoms: riding abdomen, board line abdomen, tenderness, nausea, vomiting 59. draining out the fluid it should be clear, if cloudy or pus is infection and needs to be reported 60. Hemodialisis : check if patient is good for hemodialysis, don’t do it if patients potassium is low (hypokalemia) don’t do it of patient is metabolic alkalosis, only do it if medications are not responding 61. Polynesian IV bags should be up and drainage bags down. 62. If you are assessing patient who has AV graft (arteriovenous) auscultating you will hear whooshing or brutal sound, palpating you will hear thrill or vibration 63. CABD (continuous ambulatory peritoneal dialysis) – means 24 hour for 7 days 64. Can you do renal transplantation on a patient who is an IV drug abuser ? NO 65. ECG – check heart rhythms or check heart valves 66. Stress test – monitor heart while walking or running 67. Coronary Angiography- always want to educate patients to keep their legs straight, supine position, bed rest after procedure because by that you are actually preventing bleeding since you’re using femoral. If used, the left or right leg should be straight for at least 4 hrs. 68. MI test – troponin <-(prioritize), myoglobin, creatine, 69. In MI there will be 100% blockage 70. If something is wrong with the heart and you already gave medications, treatment and patient is still no compensating you have to go with pacemaker, always go with temporary pacemaker and than with permanent pacemaker 71. Cardioversen and your defibrillator if no pulse 72. Anticoagulant – thin blood, prevent blood clots, no to patients with bleeding teeth 73. CABG (coronary artery bypass grafting) – education and intervention: take deep breathing exercises 74. Cardiac procedure education: restriction of activities and exercise for a few days, no lift more than 5 lb or 2.5 lb 75. Dysrhythmias – risk factors: smoking, drinking, high cholesterol diet, opioid abuse 76. Peripheral bypass graft surgery: education and assess (bleeding): 77. Capillary refill: 3 sec is normal 78. Angioplasty from femoral artery- if bleeding report because its a large artery and patient can die in few seconds 79. Peripheral bypass graft surgery if intermittent claudication (numbness or burning ) always report like 80. Know MI which one is stable, unstable, non-stable 81. Function of Aspirin – blood thinner, help in preventing blood clotting 82. Metoprolol – beta blocker dont give if heartbeat is under 60 83. Lifestyle changes if have MI : diet, avoid smoking, avoid alcohol 84. Position if patient is having shortness of breath : high fowler’s position 85. Digoxin : heart rate and bp watch for bradycardia 86. Potassium: check potassium levels so patient doesn’t have dysrhythmias (report has leg cramping, muscle cramps, bradycardia← hypokalemia 87. Pulmonary edema manifestations/ signs and symptoms: patient will productive cough, sputum, urine output will decrease 88. Ventricular assist devices: if patient has heart failure or MI we use devices to help patient if your heart is not responding and your heart is also not responding to medication so we have to put you in this assisting device 89. Potassium rich diet : banana, potatoes, beans, avocado 90. If patient has Compression socks what do we educate about them: no wrinkles and its compressing and on proper timing before they get up apply in morning and remove at night 91. Peripheral artery disease :signs: pallor, What nursing education: lift legs on pillow to elevate legs 92. Clopidogrel -blood thinner for heart, dont use with other stuff like garlic, ginger, gango, ganset , feverfew, perform pt and INR for platelet levels 93. DVT : drugs: Anticoagulants, such as heparin(short acting), warfarin(long term) , dabigatran, apixaban, and rivaroxaban, are medications that thin the blood and help to dissolve blood clots. 94. AAA (abdominal aortic aneurysm) : priority: surgery, maintain hydrate, prescribe IV

ANSWER

Nursing Interventions and Considerations for Various Medical Conditions

Introduction

Nursing care plays a pivotal role in managing a wide array of medical conditions, from respiratory issues and cardiovascular diseases to renal disorders and surgical interventions. This essay aims to discuss nursing interventions, patient education, and key considerations for diverse medical conditions, highlighting the importance of evidence-based practice and patient-centered care.

Respiratory and Cardiovascular Conditions

Respiratory Arrest Nursing Interventions

Ensure patent airway by positioning the patient for optimal ventilation.
Administer oxygen therapy as prescribed to improve oxygenation.
Initiate cardiopulmonary resuscitation (CPR) if necessary.
Monitor vital signs and oxygen saturation levels continuously.
Administer emergency medications as ordered, such as epinephrine.

Heart Failure Nursing Interventions

Monitor fluid intake and output to manage fluid balance.
Administer diuretics and other medications as prescribed to alleviate symptoms.
Educate patients on sodium and fluid restriction to prevent fluid overload.
Assess for signs of worsening heart failure, such as dyspnea and edema.
Collaborate with the healthcare team to manage and adjust treatment plans.

Acid-Base Balance and Urinary Conditions

Determining Acidosis/Alkalosis with ABG Levels

Evaluate pH, pCO2, and bicarbonate levels to diagnose respiratory acidosis/alkalosis and metabolic acidosis/alkalosis.
Respiratory acidosis: low pH, high pCO2.
Metabolic acidosis: low pH, low bicarbonate.
Respiratory alkalosis: high pH, low pCO2.
Metabolic alkalosis: high pH, high bicarbonate.

Urinary Conditions and Assessment

Monitor specific gravity of urine (normal range: 1.005 – 1.030) to assess hydration status.
Observe for signs of dehydration, such as dry mucous membranes and oliguria.
Educate patients on maintaining adequate fluid intake and managing urinary output.

Post-Surgical Considerations and Cardiac Disorders

Postoperative Dressing Changes

Ensure sterile technique during dressing changes to prevent infection.
Instruct patients to follow dressing change guidelines after discharge.
Monitor incision sites for signs of infection, such as redness or increased drainage.

Cardiac Procedures and Education

Educate patients about coronary angiography, emphasizing bed rest after the procedure to prevent bleeding.
Instruct patients on post-MI lifestyle changes, including a heart-healthy diet, smoking cessation, and exercise.
Provide education on the proper use of anticoagulants and potential interactions.

Peripheral Artery Disease (PAD) and Thromboembolic Disorders

Peripheral Artery Disease Interventions

Elevate legs to reduce pain and enhance blood flow.
Administer antiplatelet medications, such as clopidogrel, to prevent clot formation.
Educate patients on the importance of avoiding tight clothing and promoting circulation.

Deep Vein Thrombosis (DVT) Management

Administer anticoagulant medications to prevent clot formation and growth.
Encourage early ambulation and leg exercises to promote circulation.
Monitor for signs of bleeding, and educate patients about potential side effects of anticoagulants.

Conclusion

Nursing interventions for various medical conditions require a comprehensive understanding of the underlying pathophysiology and evidence-based practices. By offering patient-centered care, educating patients about self-care strategies, and collaborating with the healthcare team, nurses play a pivotal role in improving patient outcomes and promoting overall well-being.