ATI Proctored Med Surg Focused Review: Details needed to Pass the Exam

Safety & Infection Control: Care of client with Halo device for spinal injury: • Clients who have cervical fractures may be placed in a halo fixation device or cervical tongs. Basic Care & Comfo rt: Fractures & Immobilization devices: Maintaining proper traction: Types of Immobilization Devices: • Casts • Splints/immobilizers • Traction • Correct or prevent further deformities. *Traction prescriptions should include the type of traction, amount of weight, and whether traction can be removed for nursing care. Classification of Traction: Prevention of skin breakdown: • Keep skin clean, dry, and intact. Provide a firm, wrinkle-free foundation with wrinkle-free linens. • Use pressure-reducing surfaces and devices. • Inspect the client’s skin frequently and document the client’s risk using a tool such as the Braden scale. Assessing implanted port: • Use a noncoring, non-barbed (Huber) needle. Noncoring needles have a deflected point that helps avoid septal injury by slicing through the septum without coring out a tiny piece of it each time the port is accessed. Most facilities policies allow access to the implanted port with the same needle for 7 days.Hemodynamic status is assessed with several parameters. Total parental nutrition: • Is a hypertonic intravenous (IV) bolus solution. The purpose of TPN administration is to prevent or correct nutritional deficiencies and minimize the adverse effects of malnourishment. • Administration is usually through a central line, such as a tunneled triple lumen catheter or a single- or double-lumen peripherally inserted central (PICC) line. Antimicrobial Therapy: • In a person who has an intact immune system, the antibiotic works with host defense systems to suppress organisms. Both bactericidal and bacteriostatic antibiotics may be used. • An immunocompromised person needs strong bactericidal antibiotics, as opposed to bacteriostatic medication. Post-op Total Hip Replacement: • Provide postoperative care, and prevent postoperative complications. • Deep vein thrombosis may develop and result in a pulmonary embolism, a life threatening complication after total hip arthroplasty. Renal Calculi- Assessing client pain: • Pain intensifies as the stone moves through the ureter. Stroke- thrombolytic therapy: • Thrombolytic medications reteplase recombinant (rtPA [Retavase]) - Give within 4.5 hours of the initial symptoms. Preventing catheter related infections: • Instruct the client to drink at least 3 L of fluid daily. • Instruct the client to bathe daily to promote good body hygiene. TB- client teaching: • Provide the client and family education because TB is often treated in the home setting. • Exposed family members should be tested for TB. Hemodialysis & peritoneal dialysis: Assess for: • Complications (hypotension, clotting of vascular access, headache, muscle cramps, bleeding) • Indications of bleeding, and/or infection at the access site Monitoring cardiac output: • Dx Procedure - Hemodynamic monitoring: Increased CVP, Increased R arterial P, Increased PAWP, Increased PAP, Decreased CO