Introduction to Medical Surgical Nursing Lecture Notes

What is Medical Surgical Nursing?
AKA: Adult Health Nursing
“Where nurses promote, restore, or maintain optimal health for patients from 18 years to older than 100”
Where Do We Practice?
Acute Care Facilities
Skilled Nursing Facilities
Home Care Agencies
Ambulatory Care Clinics
What is the Role of the Nurse?
Care Coordinator
Caregiver
Patient Education
Patient and Family Advocate
Why Must Nurses Have a Broad Knowledge Base?
Rapid Advances in Technology
Massive Increases in Available Knowledge
Dramatic Changes in Healthcare Delivery
Here is the Reality
44,000-98,000 deaths resulting from preventable errors. (Institute of Medicine, 2000)
According to the Joint Commission (2012) ineffective communication is the cause of 80% of medical errors in healthcare settings.
Quality and Safety Education for Nurses (QSEN)
Provide patient centered care
Collaborate with the interdisciplinary team
Implement evidence-based practice
Use quality improvement in patient care
Use informatics
Safety
Family Centered Care
Speak up
– S: speak up if you have questions or concerns, and if you don’t understand, ask again. It’s your body and you have a right to know.
– P: pay attention to the care you are receiving. Make sure you’re getting the right treatments and medications by the right health care professional. Don’t assume anything.
– E: educate yourself about your diagnosis, the medical tests you are undergoing, and your treatment plan.
– A: ask a trusted family member or friend to be your advocate
– K: know what medications you take and why you take them. Medication errors are the most common health care errors.
– U: use a hospital, clinic, surgery center, or other type of health care organization that has undergone a rigorous on-site evaluation against established state-of-the-art quality and safety standards, such as that provided by TJC.
– P: participate in all decisions about your treatment. You are the center of the health care team.
Respect Diversity
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Communication and Collaboration
Situation, Background, Assessment, Recommendation
Delegation
Right Task – the task is within the UAP’s scope of practice and competence
Right Circumstance – the patient care setting and resources are appropriate for the delegation
Right Person – the UAP is competent to perform the delegated task or activity
Right Communication – the nurse provides a clear and concise explanation of the task or activity, including limits and expectations
Right Supervision – the nurse appropriately monitors, evaluates, intervenes, and provides feedback on the delegation process as needed
A nurse is caring for a postoperative patient on the surgical unit. The patient’s blood pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is best?

A. Call the Rapid Response Team.
B. Document and continue to monitor.
C. Notify the primary care provider.
D. Repeat blood pressure measurement in 15 minutes.

A. Call the Rapid Response Team.
What is the purpose of the Rapid Response Team?

A. Provide Code Blue teams in case of simultaneous emergencies.
B. Enable the nurse to recognize changes in patient status before an acute emergency.
C. Replace immediate consultation with the physician or medical resident.
D. Provide teams of staff already familiar with the patient’s medical diagnosis.

B. Enable the nurse to recognize changes in patient status before an acute emergency.
A new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises the student that which is the priority when working as a professional nurse?

A. Attending to holistic patient needs
B. Ensuring patient safety
C. Not making medication errors
D. Providing patient-focused care

B. Ensuring patient safety
Which is the best way for the nurse to assess the patient’s learning after teaching?

A. Have the patient write a summary of the points covered.
B. Ask the patient to repeat the information back.
C. Quiz the patient on relevant points in the instruction.
D. Repeat the important points to the patient.

B. Ask the patient to repeat the information back.
Which important aspect of coordinating care within the interdisciplinary team is facilitated by use of the “SBAR” procedure?

A. Communication
B. Implementation
C. Policymaking
D. Protocol development

A. Communication
Bedside computers are an example of informatics used in health care primarily for which purpose?

A. Documenting interdisciplinary care
B. Enhancing collaboration and coordination of care
C. Offering clients access to e-mail and the Internet
D. Retrieving data for evidence-based practice

A. Documenting interdisciplinary care

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