Professional Documents
Culture Documents
Med Surg
Med Surg
Lecturer: Prof. Ferdinand B. Valdez, RN, MAN, MPH January 13, 2023 (1:00-7:00 PM)
Aki 1 of 4
MEDICAL SURGICAL NURSING (DAY 1) COMPETENCY APPRAISAL 2
Lecturer: Prof. Ferdinand B. Valdez, RN, MAN, MPH January 13, 2023 (1:00-7:00 PM)
• C – cyanosis
- Nursing procedure that could lead to hypoxia:
suctioning.
Right sided heart failure
Signs and symptoms: (venous congestion)
• Jugular vein distention
• Pitting edema
• Ascites
• Weight gain
• Hepatosplenomegaly
• Abdominal pain
• Jaundice
• Pruritis/ urticaria
- Can RSHF leads to Left sided = No, bcz ung cause • Esophageal varices
ng RSHF ay tricuspid valve stenosis, ung backflow • Anorexia
nya papunta sa right, hindi papunta sa lungs • Generalized body malaise
- Can left sided leads to right = Yes, bcz ung cause Treatment for CHF (MAD DOG)
ng LSHF ay mitral valve, ung backflow nya papunta M – morphine SO4 (narcotic/ opioid analgesic):
sa right, clockwise sya - MOA: To induce vasodilation and decrease
Left sided heart failure levels of anxiety
Signs and systems: - Nursing care:
• Pulmonary edema/ congestion: 1) Monitor strictly VS especially BP and RR. If
o Dyspnea the RR is below 12 breaths/ min, notify the
o Paroxysmal nocturnal dyspnea – tuwing HCP and prepare for an antidote: Narcan/
gabi. Hindi sya makatulog kasi parang naloxone.
nalulunod sya. 2) Monitor side effects:
o Orthopnea – diff of breathing while lying a) Hypotension
down. (u give 2- 3 pillows or put into high b) Respiratory depression
fowlers position or tripod position ) A – aminophylline (theophylline): Bronchodilator
o Productive cough (blood tinged sputum) - MOA: it dilates the bronchial tree thereby
o Frothy salivation allowing more air to enter the lungs.
o Rales/ crackles - Nursing care:
o Bronchial wheezing 1) Monitor side effects: tachycardia,
• Anorexia and generalized body malaise palpitations, restlessness, irritability, and
• PMI is displaced laterally. (PMI – point of agitation.
maximum impulse, between 4th to 5th ICS, L 2) Instruct the client to avoid taking foods
MCL). Aka. apical pulse beverages high in caffeine/ stimulants.
• Cyanosis D – diuretics:
• S3 (ventricular gallop) (S4 = MI; S3 = CHF) a) Potassium wasting diuretics
Hypoxemia – decrease O2 in the blood - Ex:
- Leads to hypoxia (decrease O2 to tissues) • Bumex
- Normal po2: 80-100 • Furosemide (Lasix) – max therapeutic
- Early signs: effect = 6 hrs, IV push = 5-10 mins
• R – restlessness • Hydrochlorothiazide
• A – agitation • Mannitol (Osmitrol)
• T – tachycardia - Side effects:
- Late signs: • Hypovolemia
• B – bradycardia • Hypotension
• E – extreme restlessness • Hyponatremia
• D – dyspnea • Hypokalemia
Aki 2 of 4
MEDICAL SURGICAL NURSING (DAY 1) COMPETENCY APPRAISAL 2
Lecturer: Prof. Ferdinand B. Valdez, RN, MAN, MPH January 13, 2023 (1:00-7:00 PM)
Aki 4 of 4