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ATI Med Surg CMS Study Guide Latest Update % Complete Guide
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lOMoARcPSD|25922779 ATI Med Surg CMS Study Guide Latest Update 2023 -2024 100% Complete G uide ATI Med Surg CMS Study Guide Ch. 1 Health, Wellness, and Illness Health & Wellness - Modifiable (can be changed) v. Nonmodifiable ( cannot be changed) - Aspects; Physical, Emotional, Social, Intellectual, Spiritual, Occupational, Environmental - Environment; Social (Crime vs. safety, poverty vs. prosperity, peace vs. social unrest, and presence vs. absence of support from social networks ) ; Physical ( access to health care, sanitation, availability of clean water, and geographic location Ch. 2 Emergency Nursing Principles and Management Emergency Nursing Principles • Triage - Level 1; Resuscitation - Level 2; Emergent - Level 3; Urgent - Level 4; Less Urgent - Level 5; Nonurgent • Primary Survey; rapid assessment of life threatening conditions; completed systematically; standard precautions; guided by ABCDE principle ABCDE Principle - Airway; maintain airway, head -tilt/chin -lift if unresponsive - DO NOT perform is potential cervical spine injury; if trauma suspected use modified jaw thrust maneuver; bag valve mask w/ 100% O2 w/ nonrebreather for spontaneous breathers - Breathing; if NOT breathing manual vent w. bag valve mask or mouth to mouth - Circulation; HR, BP , pulses, cap refill; To restore circulation; CPR, assess for internal bleed, hemorrhage control; IV access; Isotonic fluids/blood To alleviate shock; O2, pressure to bleed, elevate lower extremities, IV fluids & blood, VS, stay w/ pt. - Disability; assess LOC ; GCS; AVPU - Exposure; complete physical assessment; clothing removed; hypothermia primary concern • Poisoning ; medical emergency; hx, type of poison,; resp support, circulation, restore fluids, BP/EKG, ingested poison use activated charcoal, gastric lavage (done w/I 1hr) aspiration ; diazepam if seizures occur • Rapid response team ; respond to emergency when pt. has indications of rapid decline; early recognition before resp/cardiac arrest or stroke occurs; • Cardiac emergency - Cardiac arrest; - Vfib/ Pulseless VT= defibrillate , CPR, admin IV antidysrhythmic (epi, amiodarone, lidocaine, magnesium sulfate) - Ventricular asystole - Pulseless electrical activity (PEA) & Asystole; CPR, if shockable used Defib, IV access, Epi IVP Q3 -5 min Emergency Meds; • Epi; stimulate alpha 1 (vasoconstrict), beta 1 ( HR), beta 2 (bronchodilator); superficial bleeding, BP , AV block, cardiac arrest, & asthma ; A/e; HTN crisis, dysrhythmias, angina • Dopamine; renal blood vessel dilation, beta 1 ( HR) Shock, HF, AKI; A/E; dysrhythmias, angina • Dobutamine; beta 1 ( HR) HF NEUROLOGIC Ch. 3 Neurologic Diagnostic Procedures Cerebral Angiography ; visualization of cerebral blood vessels, assess blood flow in brain, ID aneurysms - Do NOT perform if pregnant, NPO for 4 -6hrs prior, assess allergy to shellfish or iodine, assess bleeding risk/ use of anticoag, assess BUN & Creat; monitor area for clotting after procedure; void immediately after; may experience metallic taste or feeling of warmth ; movement restricted CT; cross section image of cranial cavity - Supine, no jewelry; if contrast dye used take precautions EEG ; ID brain wave abnormalities, seizure activity &sleep disorder - Wash hair prior, be sleep deprived, expose to flashing lights or hyperventilate for 3 -4 min; avoid stimulants/sedatives 12 -24 hr. prior; 45 -120 min ICP Monitoring; performed by neurosurgeon in operating room, used for ICP , GCS score of 8 or <, complication of infection • 3 Types ICP Monitoring - Intraventricular Catheter; fluid filled cath connected to sterile drainage system inserted into burr hole, allows simultaneous drainage & monitoring by transducer connected to monitor - Subarachnoid screw or bolt; hollow threaded screw or bolt connected to transducer, placed thru burr hole - Epidural or subdural sensor; fiber optic sensor inserted thru burr hole - S/S ICP (normal 10 -15)= IRRITABILITY first sign, severe headache, decrease loc, dilated/ pinpoint pupils, altered breathing pattern (Cheyne -stokes), hyperventilation, apnea, abnormal posturing Lumbar Puncture ; w/draw CSF to diagnose MS, syphilis, meningitis - Void prior, assume cannonball position, monitor puncture site, remain lying still on back after procedure for several hours Complications; headache from leaking CSF, give opioids /pain meds, fluid intake MRI ; NPO 4 -8 hr. prior; remove jewelry, not claustrophobic, give earplugs; w/ contrast dyes: assess for allergies for shellfish; no metal implants (IUD, aneurysm clip, ortho joint, artificial heart valve, pacemaker) PET & SPECT Scan ; Positron emission tomography and single -photon emission computed tomography scans; nuclear medicine procedures produce 3D images of head; images can be static (depicting vessels) or functional (depicting brain activity); captures reginal metabolic proces ses (tumor activity, dementia) - Radiation risks X-ray; reveal fracture or curvature; no pregnant pts, no jewelry Ch. 4 Pain Management Pain Assessment ; location, quality, measures/intensity/severity, timing/onset/duration, setting/ how it affects daily life, associated manifestations, aggravating/relieving factors Nonpharm Pain Management ; tens, heat, cold, massage, relaxation, imagery Pharm management - Nonopioid; mild -moderate pain, 4g Tylenol, monitor for salicylism (tinnitus, vertigo, decreased hearing), gi upset, bleeding - Opioid= moderate -severe pain, around clock admin, cause constipation, hypotension, urinary retention, n/v, sedation, respiratory depression, have naloxone ready Ch. 5 Meningitis - Inflammation of meninges, viral most common and resolves w/o treatment , fungal common in AIDS pt.; bacterial is contagious w/ high mortality Prevention; Hib vaccine, PPSV & MCV4 vaccine (college students) s/s: excruciating constant headache, stiff neck, photophobia, fever and chills, n/v, altered loc, positive Kernig sign (resistanceThe benefits of buying summaries with Stuvia:
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