MED SURG PHARM REMEDIATION NR452

22 August 2024

Med Surg Remediation Assessment

1. Meningitis: Clarify Prescription With Provider

(Active Learning Template - Basic Concept, RM AMS RN 10.0 Chp 5)

  • Key Points:
    • Ensure all prescriptions for a patient with meningitis are appropriate for their condition, particularly concerning antibiotics, antivirals, or corticosteroids.
    • Clarify any unclear orders, especially regarding drug dosages and potential drug interactions.
    • Monitor for signs of increased intracranial pressure and adjust medications as necessary.

2. Angina and Myocardial Infarction: Preventing Coronary Artery Disease

(Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 31)

  • Key Points:
    • Educate patients on lifestyle changes to prevent coronary artery disease, such as smoking cessation, regular exercise, and a heart-healthy diet.
    • Discuss the importance of controlling blood pressure, cholesterol levels, and diabetes.
    • Recommend medications like statins, antiplatelets, and antihypertensives as preventive measures.

3. Musculoskeletal Trauma: Caring for a Client in Continuous Buck’s Traction

(Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 71)

  • Key Points:
    • Maintain the proper alignment of the limb in Buck’s traction.
    • Regularly assess the skin under the traction device for signs of breakdown or pressure ulcers.
    • Ensure weights are hanging freely and not resting on the floor, and check the patient’s neurovascular status regularly.

4. Blood and Blood Product Transfusions: Manifestation of Allergic Transfusion Reaction

(Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 40)

  • Key Points:
    • Symptoms of an allergic transfusion reaction include hives, itching, and anaphylaxis (dyspnea, hypotension).
    • Stop the transfusion immediately if a reaction is suspected.
    • Administer antihistamines, corticosteroids, or epinephrine as prescribed.

5. Kidney Transplant: Adverse Effects of Cyclosporine

(Active Learning Template - Medication, RM AMS RN 10.0 Chp 58)

  • Key Points:
    • Common adverse effects of cyclosporine include nephrotoxicity, hypertension, and gingival hyperplasia.
    • Monitor kidney function regularly through blood tests (creatinine, BUN).
    • Educate patients on the importance of regular dental hygiene to prevent gingival issues.

6. Medications Affecting Coagulation: Medication Interactions With Warfarin

(Active Learning Template - Medication, RM Pharm RN 7.0 Chp 25)

  • Key Points:
    • Warfarin has many drug interactions, including with NSAIDs, certain antibiotics, and herbal supplements like St. John’s Wort.
    • Patients should be advised to maintain a consistent intake of vitamin K-rich foods.
    • Regular monitoring of INR levels is crucial to adjust dosages appropriately.

7. Skin Disorders: Teaching About Adverse Effects of Topical Glucocorticoid Therapy

(Active Learning Template - Medication, RM AMS RN 10.0 Chp 74)

  • Key Points:
    • Potential adverse effects include skin thinning, stretch marks, and increased risk of infection.
    • Use topical glucocorticoids sparingly and only on affected areas.
    • Educate patients to avoid long-term use without medical supervision.

8. Cardiovascular Diagnostic and Therapeutic Procedures: Priority Intervention for Complication of Central Venous Catheter

(Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 27)

  • Key Points:
    • Complications may include infection, pneumothorax, and catheter occlusion.
    • If infection is suspected, remove the catheter and send the tip for culture.
    • Regularly assess the insertion site for signs of infection and ensure proper sterile technique during dressing changes.

9. Antibiotics Affecting the Bacterial Cell Wall: Client Education About Cephalosporins

(Active Learning Template - Medication, RM Pharm RN 7.0 Chp 44)

  • Key Points:
    • Educate patients about the potential for allergic reactions, particularly if they have a history of penicillin allergy.
    • Advise taking the full course of antibiotics, even if symptoms improve, to prevent antibiotic resistance.
    • Common side effects include gastrointestinal upset; taking the medication with food may help alleviate this.

10. Antilipemic Agents: Teaching About Colesevelam

(Active Learning Template - Medication, RM Pharm RN 7.0 Chp 24)

  • Key Points:
    • Colesevelam is used to lower LDL cholesterol; educate patients on taking it with meals.
    • It may interact with other medications, so advise patients to take other medications at least 4 hours before or after colesevelam.
    • Encourage patients to follow a cholesterol-lowering diet in addition to taking the medication.

11. Cardiovascular Diagnostic and Therapeutic Procedures: Care of a Peripherally Inserted Central Catheter (PICC) Infusion System

(Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 27)

  • Key Points:
    • Ensure proper dressing changes and aseptic technique to prevent infection.
    • Flush the catheter with saline as prescribed to maintain patency.
    • Educate the patient on signs of infection and when to seek medical attention.

12. Gastrointestinal Therapeutic Procedures: Assessing for Fat Overload Syndrome in Total Parenteral Nutrition (TPN)

(Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 47)

  • Key Points:
    • Fat overload syndrome is a rare but serious complication of TPN that can lead to fever, hyperlipidemia, and coagulopathy.
    • Regularly monitor liver function tests and serum triglyceride levels.
    • Watch for symptoms such as jaundice, respiratory distress, or signs of bleeding, and report them immediately.