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HESI MED SURG

#1

QuestionAnswer
Post op vital sign- drug use Opioid use for pain management puts the patient at an increased risk of respiratory complications such as atelectasis (alveolar collapse, and incomplete expansion of the lungs)
Post op priority Priority is respiratory function, followed by Cardiovascular, skin color, LOC, ability to respond to commands.
Post op vital signs- reason Observed at least every 15 minutes
Post Op Pain Opioids can be administered with those that score a sedation score of 1 or 2. However, beginning over level 3 the recommendations is the nurse should provide nonopioid interventions to treat pain. In other words, the patient can be sleepy, but should be easy to arouse
Malignant Hyperthermia MEDICAL EMERGENCY. It is a hypermetabolic state. Known to be inherited (ask about family history in preop). Symptoms include extreme muscle rigidity, temp over 104, increased lactic acid, metabolic acidosis, cardiac dysrhythmias, and cyanosis.
Malignant Hyperthermia Treatment Cooling blankets, IV fluids, 100% oxygen. Dantrolene (muscle relaxant)
Pain Outcome Planning Realistic pain goals should be encouraged, rather than the total elimination of pain
Community Acquired Pneumonia (CAP) Occurs in the community or up to 48 hours after hospitalization. Empiric therapy should be started ASAP. Most common symptoms include cough, fever, shaking, dyspnea, tachypnea, pleuritic chest pain, green, yellow, or rust-colored sputum.
Ventilator Associated Pneumonia (VAP) Pneumonia that is acquired while on a ventilator. Nurses should remove secretions as needed.
Aspiration Pneumonia Secretions enter the lower airway, inflammatory response is triggered, and primary bacterial infection is the most common.
Nursing Interventions/Patient Teaching in Pneumonia Utilize breathing techniques such as pursed lip and diaphragmatic breathing to lower oxygen consumption during activity. Remove suctions as needed. Encourage 2-3 L of fluids per day to loosen secretions. Provide high humidity facemask to liquify secretions and relieve tracheobronchial irritations
COPD- oxygen level At least 90%
HF & COPD Often co-exist together
COPD & infections- 1st sign Fever, changes in sputum color, character, consistency, or amount.
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