Medical surgical ATI proctored exam review 2022
What would you do for wound Evisceration ( removal of internal organs) , Emergency management? - Saline ... [Show More] cover wound
What would you do for an ASTHMA emergency management of a bee sting allergies? - Epi Pen
Seizures and Epilepsy: Seizure precautions - During a seizure:
1) Position client on the floor
2)Provide a patent airway
3) Turn client to side
4) Loosen restrictive clothing
Cancer treatment options: Protective Isolation
- If WBC drops below 1,000, place the client in a private room and initiate neutropenic precautions.
- Have client remain in his room unless he needs to leave for a diagnostic procedure, in that case transport patient and place a mask on him.
- Protect from possible sources of infection (plants, change water in equipment daily)
- Have client, staff and visitors perform frequent hand hygiene, restrict ill visitors
- Avoid invasive procedures (rectal temps, injections)
- Administer (neupogen, neulasta) to stimulate WBC production
Infection control: Appropriate room assignment - Standard Precautions:
1. applies to all patients
2. Hand washing
a. alcohol based preferred unless hands visually soiled ( then soap and water )
3. Gloves - when touching anything that has the potential to contaminate.
4. Masks, eye protection & face shields when care may cause splashing or spraying of body fluids
1. private room or with someone with same illness
1. private room
2. masks or respiratory protection devices
a. use an N95 respirator for tuberculosis
3. Negative pressure airflow
4. full face protection if splashing or spraying is possible
1. private room or room with same illness
2. gloves & gowns
3. disposal of infections dressing materials into a single, nonporous bag without touching the outside of the bag
TB: Priority action for a client in the emergency department -
-Wear an N95 or HEPA respirator
-Place client in negative airflow room and implement airborne precautions
-use barrier protection when the risk of hand or clothing contamination exists
Immunizations: Recommended vaccinations for older adult clients - Adults age 50 or older:
- Pneumococcal Vaccine (PPSV)
- Influenza vaccine
- Herpes Zoster Vaccine
- Hepatitis A
- Hepatitis B
- Meningococcal Vaccine
Pulmonary Embolism: Risk factors for DVT - - Long term immobility
- Oral contraceptives
- Tobacco use
- Heart failure or chronic A-Fib
- Autoimmune hemolytic anemia (sickle cell)
- Long bone fractures
- Advanced age
Disorders of the male reproductive system: Complications of continuous irrigation following Trans-urethral Resection - - Urethral trauma
- Urinary retention
Non-modifiable risk factors ( Page 3 ATI ) - 1) Age
4) Developmental level
Modifiable risk factors ( Page 3 ATI ) - 1) Smoking
3) Health education and awareness
5) Sex practices
Emergency nursing - Triage - BASED ON ACUITY
1) Emergent- Life threatening situation going on.
2) Urgent - Need to be treated soon but not life threatening.
3) Non urgent- The patient can wait for an extended period of time , without big issues.
Mass casualty event - Class 1 - RED TAG - Immediate threat to life
1) Breathing issues
2) Chest pain
3) Heart attack coming on
4) Airway problem
Class II - YELLOW TAG - Major injuries that require immediate treatment but not life threatening.
1) Major fracture
Class III - GREEN TAG - Minor injury that does not require immediate attention.
Class IV - BLACK TAG - Expected to die
1) Penetrating head wound
Triage priority setting - 1) Red tag
2) Yellow Tag
3) Green tag
4) Black tag
Priorities: general rule -
A - Airway - Secure the airway by head tilt , chin lift maneuver unless a fracture in cervical spinal. Brain injury or death in 3 - 5 minutes if airway not patent.
B- Breathing - Auscultation of breath sounds, Chest expansion and respiratory effort, Rate and depth of respiration's, Look for chest trauma, Determine tracheal position, Check for jugular vein distension.
C- Circulation - Heart rate, BP, Peripheral pulses, Cap refill.
D - Disability - Clients level of consciousness with:
1) Glasgow coma scale
a) <<< 8 Comatose state
b) 3 Client totally unresponsive
c) 15 A client within normal limits.
E- Exposure - Hypothermia - Patient in cold icy water:
1) Remove wet clothing
2) Provide blankets
3) Increase the temperature of the room
4) Warm IV fluid going into the patient
IF patient has had accidental or purposeful poisoning:
1) Activated charcoal
2) Gastric lavage
3) Whole bowel irrigation
*** DO NOT INDUCE VOMITING OR SYRUP OF IPECAC
Call rapid response team when client is rapidly declining.
Cardiac Emergencies - If V fib or ventricular tachycardia you would initiate:
1) Basic life support ( BLS) and CPR
2) Establish IV access
3) Epinephrine is used to get the heart up and moving.
Alpha 1 receptors - Activation Causes the skin , mucus membranes and veins to vasoconstrict.
2) Superficial bleeding
3) In general help raise blood pressure by constricting the veins.
Epinephrine:Triggers the Alpha 1 receptors
Causing vasoconstriction and increase blood pressure.
Epinephrine side effects - Increases blood pressure
1) Hypertensive crisis
Dopamine side effects - 1) Dysrhythmia
Dobutamine side effects - Increased heart rate
Beta 1 receptors - Help stimulate the heart
Beta I - You have 1 heart
Stimulate the heart and increase the heart rate
Used for treating:
1) AV block
2) Cardiac arrest
Epinephrine:Triggers the Beta 1 receptors
Cause increase heart rate
Beta II receptors - Help stimulate the heart and lungs
Beta II You have 2 Lungs
1) Bronchodilation in the lungs
2) Causes uterine smooth muscle to relax
3) Asthma situation
Epinephrine:Triggers the Beta II receptors
Cause bronchodilation and treat Asthma
Dopamine - Causes renal blood vessels to dilate. [Show Less]