ATI medsurg nursing *best review*

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ATI medsurg nursing ATI MEDSURG FOCUSED REVEIWED. Heart failure patient teaching: Maintain exercise and remain active Low sodium and fluid restriction Promote smoking cessation (Consult wit... h provider before starting exercise and regarding diet) Kidney disease nutrition Low sodium diet Adjust protein intake according to protein loss in the urine over 24hrs Eat biological high value protein (i.e. meat, fish, poultry, and diary) Provide frequent feeding related to loss in appetite. Administering blood products for the adult patient: Assess vital signs regularly Monitor for increase in pulse, BP, respirations: may indicate fluid overload or transfusion reaction. Pt. with cardiac or renal dysfunction is at increase risk for heart failure and fluid overload when receiving a transfusion Understanding of digoxin administration This medication increases contractility of the heart and improve cardiac output Count apical pulse for one minute before administering medications. Hold medication for irregular pulse Do not take medication if pulse is greater than 100 or less than 60bpm Take medication same time each day Do not take digoxin with antacids (take two hours apart) Report sign of toxicity (fatigue, muscle weakness, confusion and loss of appetite) Check digoxin and potassium level regularly Referred pain: Visceral type pain AKA Pain in the internal organ (stomach/ intestine) Can cause referred pain in other body location not associated with the stimulus. Client receiving enoxaparin (anticoagulant) Prevent clot from getting bigger Check for contraindication (active bleeding, peptic ulcer disease, history of stroke and recent trauma) Monitor bleeding time and CBC Monitor for thrombocytopenia, anemia and hemorrhage Endotracheal tube Reposition oral endotracheal tube Q24hrs Assess for skin breakdown Older adult have fragile skin and are more prone to skin and mucous breakdown. Older adult also have decreased oral secretion Perform frequent gentle skin and oral care. Chest tube Keep all tubing straight and coiled loosely Do not let tubing lie below the top of the of the drainage system Prevent client from lying on the tubing Position client on unaffected side as this prevent the tube from getting kink Ensure all connection is tights. (Tape to prevent kink) Milk tubing: increases amount of negative pressure to the pleural space Only empty drainage bottle when overflowing Never clamp tubing without Dr’s order Refill water chamber if fluid is low and ensure chamber is below the chest. Encourage ambulation, deep breathing and coughing every 2hrs At the end of shift document amount of fluid Administer pain medication one and half hour before removing tube Kidney transplant postoperative Continually monitor vitals Administers fluid Cough turn and deep breathing Attach catheter to bedside drainage and provide daily cath. Care Remove catheter once risk for urine retention is over. Reinsert if unable to void. D/C IV fluid once bowel function returns Weigh patient daily Administer immunosuppressive medication (teach patient about increase risk of infection during immunosuppressant therapy) Notify surgeon of sign of organ rejection Monitor for depression, paranoia and psychosis Continue dialysis until kidney function is satisfactory Ensure follow up appointments and counselling ………………………………………………………………continued……………………………………………………… [Show More]

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