Medical Surgical Nursing

Description of Course

Medical-surgical nursing focuses on adult patients with acute or chronic illness and their responses to actual or potential alterations in health. Medical-surgical nursing is one of many specialties in nursing, yet its scope is much broader than such specialties as cardiovascular or orthopedic nursing.

Medical-surgical nurses assume diverse roles and responsibilities. They may work in any health care setting, but most are employed by acute care facilities. Because they care for a wide range of patients in terms of age and illness, medical-surgical nurses need a broad knowledge of the biological, psychological, and social sciences. In addition, because the typical medical-surgical patient is older than age 65, a strong background in gerontology is required.

Recent changes in health care reflect changes in the populations requiring nursing care and a philosophical shift toward health promotion rather than treatment of illness. The role of the medical-surgical nurse has broadened in response to these changes. Medical-surgical nurses are caregivers, as always, but now they’re also educators, advocates, coordinators, change agents, discharge planners, and researchers.

Purpose of Activity

Recent changes in health care reflect changes in the populations requiring nursing care and a philosophical shift toward health promotion rather than treatment of illness. The role of the medical-surgical nurse has broadened in response to these changes. Medical-surgical nurses are caregivers, as always, but now they’re also educators, advocates, coordinators, change agents, discharge planners, and researchers.

The purpose of this CE activity is to help a nurse assume all these expanded roles as the situation demands.

Author

Jane F. Marek, MSN, RN

Clinical Specialist and Adult Nurse Practitioner, Instructor of Nursing, Frances Payne Bolton School of Nursing, Case Western University, Cleveland, Ohio.

Learning Objectives
After completing the course, you’ll be able to: 

Chapter 1: Caring for the Whole Person

  1. Summarize two theories of adult development.
  2. Discuss the effects of the environment on the ill adult.
  3. Explore the roles of the family, body image, and sexuality during an acute illness.

Chapter 2: Adult Respiratory Distress

  1. Identify three catastrophic conditions that may lead to the development of adult respiratory distress syndrome.
  2. Describe the signs and symptoms of adult respiratory syndrome.
  3. Discuss the collaborative management of adult respiratory syndrome.

Chapter 3: Bronchogenic Carcinoma

  1. Describe the causes of bronchogenic carcinoma
  2. Discuss the signs and symptoms of bronchogenic carcinoma.
  3. Identify three nursing diagnoses related to bronchogenic carcinoma.
  4. Formulate a plan of care based of the nursing diagnoses.

Chapter 4: Chest Trauma

  1. Identify the pathophysiology of two types of chest trauma: pneumothorax and hemothorax.
  2. Differentiate among the signs and symptoms of pneumothorax, hemothorax and cardiac tamponade.
  3. Identify three nursing diagnoses that can be used to plan nursing care.
  4. Formulate a plan of care based on the nursing diagnoses.

Chapter 5: Chronic Obstructive Pulmonary

  1. Identify the differences in pathophysiology among asthma, bronchitis, and emphysema.
  2. Describe the signs and symptoms of chronic obstructive pulmonary disease.
  3. Identify three nursing diagnoses that can be used to plan nursing care.
  4. Formulate a plan of care based on the nursing diagnoses.

Chapter 6: Pneumonia

  1. Differentiate among the causes and signs and symptoms of viral, bacterial, and aspiration pneumonia.
  2. Describe the nursing management of the patient with pneumonia.
  3. Identify three complications of pneumonia.

Chapter 7: Pulmonary Embolism

  1. Discuss the pathophysiology of pulmonary embolism.
  2. Describe the signs and symptoms of impending pulmonary embolism.
  3. Identify factors that place patients at risk for pulmonary emboli.
  4. Identify nursing diagnoses that can be used to manage pulmonary embolism.
  5. Formulate a plan of care based on the nursing diagnoses.

Chapter 8: Thoracic Surgery

  1. Define the different types of thoracic surgery.
  2. Describe the complications of thoracic surgery.
  3. Identify three nursing diagnoses that can be used to plan nursing care after thoracic surgery.
  4. Formulate a plan of care based on the nursing diagnoses.

Chapter 9: Tuberculosis

  1. Identify three important factors that may lead to the development of tuberculosis.
  2. Describe the signs and symptoms of tuberculosis.
  3. Discuss the collaborative management of tuberculosis, using the nursing process.

Chapter 10: Aneurysms

  1. Describe the primary causes of aneurysms.
  2. Identify assessment findings in patient with an aneurysm
  3. Describe important interventions for the patient with an aneurysm, using the nursing process.

Chapter 11: Cardiac Arrest and Sudden

  1. Define cardiac arrest and sudden cardiac death.
  2. Identify the causes of cardiac arrest and sudden cardiac death.
  3. Discuss the nurse’s role in defibrillation.

Chapter 12: Cardiac Surgery and Heart Transplantation

  1. Discuss nursing interventions for patients with cardiomyopathy and congestive heart failure.

Chapter 15: Coronary Heart Disease and Myocardial Infarction

  1. Describe the pathophysiology of coronary heart disease and myocardial infarction.
  2. Identify signs and symptoms of myocardial infarction.
  3. Describe the surgical procedures used in coronary artery bypass grafting and heart valve replacement.
  4. Describe techniques used to diagnose myocardial infarction.
  5. Discuss nursing management of patients with coronary heart disease of myocardial infarction.

Chapter 16: Disseminated Intravascular Coagulation

  1. Describe the causes of intravascular coagulation (DIC).
  2. Identify the pathophysiologic events that occur in DIC.
  3. Discuss nursing interventions for the patient with DIC.

Chapter 17: Arrhythmias

  1. Describe the causes of cardiac arrhythmias.
  2. Identify the characteristics of 10 common arrhythmias, and describe the treatment for each one.
  3. Discuss nursing management of patients with arrhythmias.

Chapter 18: Hypovolemic Shock

  1. Describe the main causes of hypovolemic shock.
  2. Identify early signs and symptoms of hypovolemic shock.
  3. Discuss nursing management of patient with hypovolemic shock.
  4. Describe the causes of intravascular coagulation (DIC).
  5. Identify the pathophysiologic events that occur in DIC.
  6. Discuss nursing interventions for the patient with DIC.

Chapter 19: Hypertension

  1. Describe the causes of primary secondary hypertension.
  2. Identify early and late signs of hypertension.
  3. Calculate a patient’s mean arterial blood pressure.
  4. Discuss nursing management of patients with hypertension.

Chapter 20: Infective Endocarditis, Myocarditis, and Pericarditis

  1. Discuss nursing management of patients with these disease.

Chapter 21: Invasive Cardiac Diagnostic Tests and Therapies

  1. Describe the purpose and uses of cardiac catheterization.
  2. Define infective endocarditis, myocarditis, and pericarditis.
  3. Identify signs and symptoms of these diseases
  4. Discuss nursing assessment of the patient scheduled for an invasive cardiac test or therapy.
  5. Identify two important nursing diagnoses for the patient undergoing an invasive cardiac diagnostic test or therapy.
  6. Identify the laboratory findings the nurse should monitor when caring for a patient who is recovering from an invasive cardiac test or therapy.
  7. Discuss nursing management of the patient after cardiac catheterization.

Chapter 22: Pacemakers

  1. Identify the major components of a pacemaker.
  2. Describe the general technique by which a pacemaker stimulates the heart.
  3. Discuss the differences between fixed-rate pacing and demand pacing.
  4. Discuss nursing management of the patient with pacemaker.

Chapter 23: Valvular Heart Disease

  1. Discuss the pathophysiology of valvular heart disease. Describe signs and symptoms valvular stenosis and valvular insufficiency.
  2. Discuss nursing management of patients with valvular heart disease.

Chapter 24: Sodium and Chloride Imbalance

  1. Describe the actions of sodium and chloride within the body
  2. Discuss the signs and symptoms of sodium and chloride imbalance.
  3. Formulate a nursing care plan for a patient with a sodium and chloride imbalance.

Chapter 25: Potassium Imbalance

  1. Identify the functions of potassium in the body.

Chapter 28: Acid-Base Imbalance

  1. Discuss the role of acid-base balance in the body.
  2. Describe the signs and symptoms of metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis.
  3. Formulate a nursing care plan for a patient with an acid-base imbalance.
  4. Describe the signs and symptoms Metabolic acidosis

Chapter 29: Water Imbalance and Intravenous Therapy

  1. Describe the signs and symptoms of water deficit or excess.
  2. Discuss the nursing management of a patient with a water deficit or excess.
  3. Describe the difference between a colloid and crystalloid fluid.
  4. List the specific interventions necessary for rapid volume replacement with intravenous fluids.

Chapter 30: Acute Renal Failure

  1. Describe the causes of acute renal failure.
  2. Summarize the pathophysiology of intrarenal acute renal failure.
  3. Discuss the nursing management of patients with acute renal failure

Chapter 31: Chronic Renal Failure

  1. Discuss the physiologic changes that occur in chronic renal failure.
  2. Summarize the nursing implications of caring for patients receiving peritoneal dialysis and hemodialysis.
  3. Describe the information that patients with chronic renal failure need to understand before discharge.

Chapter 32: Pyelonephritis and Cystitis

  1. Describe the changes in the kidney and bladder that occur with pyelonephritis and cystitis.
  2. Identify the most common causative agents for pyelonephritis and cystitis.
  3. Summarize the nursing management of patients with pyelonephritis or cystitis.

Chapter 33: Glomerulonephritis

  1. Describe the pathphysiologic changes that occur in glomerulonephritis.
  2. Summarize the signs and symptoms that occur in patients with acute glomerulonephritis.
  3. Discuss specific nursing interventions for patients with glomerulonephritis.

Chapter 34: Renal Transplantation

  1. List the indications for renal transplantation.
  2. Summarize the lifestyle changes necessary for a patient who has had a renal transplantation.
  3. Discuss the nursing management of a patient who has had a renal transplantation.

Chapter 35: Brain Tumor

  1. Briefly describe the pathophysiology of a brain tumor.
  2. Identify the major complications of a brain tumor.
  3. Discuss nursing management of patients with brain tumor.

Chapter 36: Cerebral aneurysm and Cerebrovascular Accident

  1. Describe the pathophysiology of cerebral aneurysm and cerebrovascular accident.
  2. Identify risk factors associated with cerebral aneurysms and cerebrovascular accidents.
  3. Discuss nursing management of patients with cerebral aneurysms or cerebrovascular accidents.

Chapter 37: Meningitis and Encephalitis

  1. Explain the causes of encephalitis and meningitis.
  2. Discuss the pathophysiology of encephalitis and meningitis.
  3. Describe nursing management for patients with encephalitis and meningitis.

Chapter 38: Epilepsy

  1. Explain the causes of epilepsy.
  2. Discuss the pathophysiology of epilepsy.
  3. Describe the nursing management of patients with epilepsy.

Chapter 39: Head Trauma and Spinal Cord

  1. Discuss the pathophysiology of traumatic injury to the central nervous system.
  2. Identify the signs and symptoms of head trauma and spinal cord injury.
  3. Describe nursing interventions for patients with head trauma and spinal cord injury.

Chapter 40: Multiple Sclerosis and Myasthenia

  1. Identify the possible causes of multiple sclerosis and myasthenia gravis.
  2. Discuss the pathophysiology of multiple sclerosis and myasthenia gravis.
  3. Describe nursing management of patients with multiple sclerosis and myasthenia gravis.

Chapter 41: Appendicitis

  1. Describe the major cause of appendicitis.
  2. Explain the pathophysiology of appendicitis.
  3. Develop a nursing care plan for the patient with appendicitis.

Chapter 42: Cholecystitis

  1. Describe the major causes of cholecystitis.
  2. Explain the pathophysiology of cholecystitis.
  3. Develop a nursing care plan for a patient with cholecystitis.

Chapter 43: Cirrhosis, Acute Liver Failure and Liver Transplantation

  1. Discuss the most common causes of cirrhosis.
  2. Summarize the pathophysiology of cirrhosis.
  3. Develop a nursing care plan for the patient with cirrhosis.
  4. List pertinent nursing diagnoses for the patient with acute liver failure and liver transplantation.

Chapter 44: Colorectal Cancer

  1. Describe the major causes of Colorectal cancer.
  2. Explain the possible complications of colorectal cancer.
  3. Develop a nursing care plan using nursing diagnoses for the patient with colorectal cancer.

Chapter 45: Inflammatory Bowel Disease: Ulcerative Colitis and Crohn’s Disease

  1. Identify the major signs and symptoms of ulcerative colitis and Crohn’s disease.
  2. Summarize the pathophysiology of inflammatory bowel disease.
  3. Develop a nursing care plan for the patient with inflammatory bowel disease.

Chapter 46: Pancreatitis

  1.  Describe the major causes of pancreatitis.
  2.  Explain the pathophysiology of pancreatitis.
  3. Develop a nursing care plan using nursing diagnoses for the patient with pancreatitis.

Chapter 47: Peptic Ulcers

  1. Discuss the causes and location of peptic ulcers.
  2. Explain the pathophysiology of peptic ulcers.
  3. Develop a nursing plan of care for the patient with peptic ulcers.

Chapter 48: Viral Hepatitis

  1. Describe the major causes of viral hepatitis.
  2. Explain the differences in the pathophysiology and signs and symptoms of hepatitis A, hepatitis B, and other forms of hepatitis.
  3. Develop a nursing plan of care for the patient with viral hepatitis.

Chapter 49: Addison’s Disease and Cushing’s Syndrome

  1. Explain the role of cortisol and Aldosterone in the body.
  2. Discuss the pathophysiology of Addison’s disease and Cushing’s syndrome.
  3. Describe nursing management for patients with Addison’s disease and Cushing’s syndrome.

Chapter 50: Alcohol Withdrawal

  1. Describe the causes of withdrawal.
  2. Discuss the difference between the signs and symptoms of early alcohol withdrawal and late alcohol withdrawal
  3. Explain the rationale and mechanism for fluid replacement during alcohol withdrawal.
  4. Identify the nurse’s responsibilities in managing sensory and perceptual deficits during alcohol withdrawal.
  5. Explain the rationale and mechanism for fluid replacement during alcohol withdrawal.
  6. Identify the nurse’s responsibilities in managing sensory and perceptual deficits during alcohol withdrawal.

Chapter 51: Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone

  1. Explain the role of antidiuretic hormone is the body.
  2. Discuss the pathophysiology of syndrome of inappropriate antidiuretic hormone and diabetes insipidus.
  3. Describe the nursing management for patients with syndrome of inappropriate antidiuretic hormone and diabetes insipidus.

Chapter 52: Diabetes Mellitus and Acute Hypoglycemia

  1. Explain the role of insulin in the body.
  2. Discuss the pathophysiology of diabetes mellitus and acute hypoglycemia.
  3. Describe the nursing management of patients with diabetes mellitus and acute hypoglycemia.

Chapter 53: Hypothyroidism and Hyperthyroidism

  1. Describe the role of thyroid in the body.
  2. Discuss the pathophysiology of hypothyroidism and hyperthyroidism.
  3. Summarize the nursing management of patients with hypothyroidism or hyperthyroidism.

Chapter 54: Burns

  1. Identify the three major types of burns.
  2. Discuss the pathophysiology of burn injury.
  3. Compare partial-thickness and full-thickness burns.
  4. Describe nursing management of patients with burns.

Chapter 55: Human Immunodeficiency

  1. Identify the transmission modes for human immunodeficiency virus (HIV).
  2. Discuss the pathophysiology of HIV infection.
  3. Describe the nurse’s role in managing patients with HIV infection and acquired immunodeficiency syndrome (AIDS).
  4. Explain the role of insulin in the body.
  5. Discuss the pathophysiology of diabetes mellitus and acute hypoglycemia.
  6. Describe the nursing management of patients with diabetes mellitus and acute hypoglycemia.
Comments

" I really enjoyed the book and the information present in the book."  -  D.E., Fresno, CA

" Test was very good. Thank you very much."  -  K.R., Fullerton, CA

" I liked that the chapters weren't long but very informative. It is a well written text."  -  D.W., El Cajon, CA

"I was surprised how much I had forgotten. This was an excellent review for me. I feel I learned a lot! Tough questions!" - M.K., RN, NM
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