MED SURGE HESI CONCEPTS (Latest-2021)(Download to Score A)

1. Teaching-AGN- diet instructions: a. Acute Glomerulonephi immunological reaction. b. Cause by streptococcal infection c. Complications: kidney failure, pulmonary edema, HF Assessment: periorbital and facial edema, decrease urinary output, hematuria, hypertension, proteinuria (excessive foam in urine), increased BUN and creatinine e. Risk for fluid volume overload- measuring daily weight and assessing for changes is the most useful and effective measure for determining fluid balance f. DIET RESTRICTIONS: restrict sodium intakepotassium may be restricted during periods of oliguria g. Diuretics are usually administered with edema, antihypertension for hypertension and antibiotics for infection. 2. NP-Diabetes-Hypoglycemic shock:& altered LOC a. Hypoglycemic shock signs and symptoms: headache, nausea, sweating, tremors, lethargy, hunger, confusion, slurred speech, tingling around mouth, anxiety, nightmares, altered LOC b. Nursing Action: life threatening, check glucose- may seize if Oliguria > Anuria (too much> too little > can’t produce urine) 3. Teaching-CVA-Visual perception: a. Cerebral Vascular Accident (CVA): also known as a stroke/Brain attack. Sudden loss of brain function resulting from a disruption in the blood supply to a part of the brain; classified as thrombotic or hemorrhagic. b. CNS involvement related to cause of stroke: i. Hemorrhagic: caused by a slow or fast hemorrhage into the brain tissue; HTN ii. Embolic: caused by a clot that has broken away from a vessel and has lodged in one of the arteries of the brain, blocking the blood supply. It is often related to atherosclerosis (may occur again) iii. TROPONIN is the diagnostic test that is most sensitive to MI Risk factors: HTN; pervious ischemic attacks; smoking; diabetes; cardiac disease Findings: Jugular vein distention, Palpable cervical lymph node, Carotid bruit, Nuchal rigidity, decreased BP, crackles in lungs e. Expressive aphasia:communicate with picture boards(visual perception) f. Be consistent in using the same words each time a question is asked 4. Leadership-Rheumatoid Arthritis-pain diagnosis: a. Rheumatoid Arthritis: Chronic systematic progressive deterioration of the connective tissue (SYNOVIUM) of the joints, characterized by inflammation : Inflammatory injury in the glomerulus caused by qo b. Assessment: fatigue, weakness, weight loss, anorexia, morning stiffness, joint pain c. Confirmed Lab results: confirmed by Elevated ESR, ASO; positive rheumatoid factor, presence of antinuclear antibody;abnormal synovial fluid; C-reactive protein Diagnosis: Impaired peripheral mobility relate to join pain Pain management: do not exercise painful swollen joints; do not exercise any joint to the point of pain, perform exercises slowly and smoothly; avoid jerky movements- therapeutic exercise daily. 5. Nutrition-Osteomalacia diet: a. Osteomalacia: softening of the bones due to deficiency of VITAMIN D b. Risk for injury c. Increase diet of high calcium and high vitamin D: i. Fortified milk and cereal ii. High in vitamin D: oily fish (salmon, mackerel, sardines) and egg yolks 6. NP-Urolithiasis-lithotripsy: (Nephrolithiasis) a.