Download mobility notes medsurg and more Cheat Sheet Nursing in PDF only on Docsity!
🦴 ATI Medical-Surgical: Musculoskeletal – Subscale Topics and
Subtopics
1 ⃣ Fractures and Immobilization Devices
● Types of fractures (open vs. closed, comminuted, greenstick, pathologic, stress) ● Priority assessments (neurovascular checks – 6 Ps) ● Traction care (skin vs. skeletal traction) ● Cast care and patient teaching ● External and internal fixation devices ● Complications: ○ Compartment syndrome ○ Fat embolism syndrome ○ Infection ○ DVT ○ Delayed union or malunion
2 ⃣ Amputations
● Types (AKA, BKA, upper extremity) ● Pre- and postoperative nursing care ● Prevention and management of complications: ○ Hemorrhage ○ Infection ○ Phantom limb pain ○ Flexion contractures ● Priority assessments: ○ Skin flap integrity ○ Circulation and perfusion ● Psychological support and body image ● Limb shaping and prosthesis prep
3 ⃣ Osteoarthritis vs. Rheumatoid Arthritis
● Etiology and pathophysiology (OA = wear and tear; RA = autoimmune)
● Joint manifestations and deformities (RA: swan neck, boutonnière deformity) ● Medication management: ○ NSAIDs (e.g., celecoxib) ○ DMARDs (methotrexate, hydroxychloroquine) ○ Steroids (prednisone) ● Nonpharmacological interventions: ○ Heat/cold therapy ○ Rest vs. activity ○ Assistive devices
4 ⃣ Osteoporosis
● Risk factors (postmenopausal women, smoking, low Ca++/Vit D) ● Diagnostic testing (DEXA scan) ● Medication management: ○ Bisphosphonates (alendronate) ○ Calcium and Vitamin D supplements ● Fall prevention strategies ● Lifestyle modifications (weight-bearing exercise, smoking cessation)
5 ⃣ Back Pain and Herniated Disks
● Acute vs. chronic back pain ● Herniated intervertebral disks: ○ S/S of nerve compression ○ Diagnostic imaging (MRI) ○ Conservative treatment vs. surgical (laminectomy, discectomy) ● Body mechanics education ● Post-op spinal surgery care: ○ Logrolling technique ○ Neuro checks ○ Drain assessment
6 ⃣ Musculoskeletal Trauma and Emergency Care
● Strains vs. sprains ● RICE protocol (rest, ice, compression, elevation)
● Ankylosing spondylitis ● Paget’s disease ● Carpal tunnel syndrome ● Bursitis and tendinitis
🌬 ATI Medical-Surgical: Respiratory – Subscale Topics and
Subtopics
1 ⃣ Respiratory Assessment
● Anatomy and physiology review (upper/lower airway) ● Normal vs. abnormal breath sounds (crackles, wheezes, rhonchi, stridor) ● Pulse oximetry interpretation ● Arterial blood gases (ABGs) – interpretation of PaO₂, PaCO₂, HCO₃⁻, pH ● Sputum culture collection ● Early vs. late signs of hypoxia ● Assessing for respiratory distress: use of accessory muscles, cyanosis, nasal flaring
2 ⃣ Oxygen Therapy
● Nasal cannula, simple face mask, Venturi mask, nonrebreather mask ● High-flow vs. low-flow oxygen systems ● Humidification with oxygen ● Complications of oxygen use: oxygen toxicity, CO₂ retention ● Patient education for home oxygen use
3 ⃣ Airway Management
● Suctioning techniques (oral, nasal, tracheal) ● Tracheostomy care and suctioning ● Endotracheal intubation – nursing role during intubation/extubation ● Mechanical ventilation: ○ Settings (FiO₂, PEEP, rate)
○ Alarms (high pressure = obstruction, low pressure = disconnection/leak) ○ Complications: barotrauma, VAP (ventilator-associated pneumonia)
4 ⃣ Acute Respiratory Disorders
● Pneumonia : ○ Risk factors (aspiration, elderly, immunocompromised) ○ Manifestations: fever, crackles, productive cough ○ Treatment: antibiotics, oxygen, fluids ● Asthma : ○ Triggers, bronchodilators (albuterol), corticosteroids ○ Status asthmaticus (life-threatening) ● COPD : ○ Emphysema and chronic bronchitis ○ Manifestations: clubbing, barrel chest, dyspnea ○ Medications: bronchodilators, corticosteroids, mucolytics ○ Oxygen therapy: target SpO₂ 88–92%, avoid high O₂ flow ● Pulmonary embolism : ○ S/S: sudden dyspnea, chest pain, tachypnea ○ Diagnostic: D-dimer, CT scan, V/Q scan ○ Prevention: anticoagulants, mobility ● Pneumothorax/Hemothorax : ○ Manifestations: tracheal deviation, absent breath sounds ○ Chest tube management and troubleshooting
5 ⃣ Chronic Respiratory Disorders
● Tuberculosis (TB) : ○ Airborne precautions (N95, negative pressure) ○ Symptoms: night sweats, hemoptysis, weight loss ○ Medications: isoniazid, rifampin, ethambutol ○ DOT (directly observed therapy) for compliance ● Cystic fibrosis : ○ Respiratory & GI implications ○ Chest physiotherapy, enzyme replacements ● Sleep apnea : ○ CPAP use, lifestyle modifications
○ Pulmonary hygiene (incentive spirometer, deep breathing) ○ Early ambulation ○ Monitoring for respiratory complications (atelectasis, pneumonia)
🔟 Patient Education & Health Promotion
● Smoking cessation ● Use of incentive spirometer ● Flu and pneumonia vaccines ● Inhaler use (MDI vs. DPI technique) ● Breathing techniques: pursed-lip, diaphragmatic breathing ● Energy conservation techniques
Would you like this turned into a color-coded study guide, NCLEX-style cheat sheet , or test-ready chart with prioritization cues and red flags for each subtopic?
4o
You said:
test-ready chart with prioritization cues and red flags for each subtopic? also nursing process stops and nursing interventions in order of priority.
ChatGPT said:
Absolutely! Here's your test-ready respiratory system chart for ATI/NCLEX prep , organized by subtopic with:
✅ Prioritization cues 🚨 Red flags 🧠 Nursing process steps (ADPIE) Priority interventions (in order)
🫁 Respiratory Subscale – NCLEX/ATI Test-Ready Chart
Subtopic Red Flags 🚨 Prioritization Cues ✅
Nursing Process (ADPIE) 🧠
Priority Interventions
Pneumonia Confusion in older adults, O2 sat < 90%, ↑ RR, crackles
Impaired gas exchange, ineffective airway clearance
A: Breath sounds, VS, ABGs, WBC D: Impaired gas exchange, risk for sepsis P: Maintain oxygenation, infection control I: O2, antibiotics, fluids, IS E: O2 sat > 92%, clear breath sounds
- Administer O
- Collect sputum culture
- Start IV antibiotics
- Encourage fluids/IS
- Position upright
COPD Wheezing, cyanosis, confusion, CO2 retention
Chronic hypoxia, risk for exacerbation
A: SpO2, ABGs, respiratory effort D: Ineffective breathing pattern P: Improve ventilation, prevent complications I: O2 (88–92%), bronchodilators, corticosteroids E: Decreased dyspnea, stable ABGs
- Apply low-flow O
- Administer bronchodilator
- Elevate HOB
- Encourage pursed-lip breathing
- Monitor for CO2 narcosis
Pneumothorax / Chest Tube
Tracheal deviation, absent breath sounds, sudden dyspnea
Impaired ventilation, tension pneumothorax risk
A: Breath sounds, chest expansion, O D: Impaired gas exchange P: Re-expand lung, prevent recurrence I: Chest tube care, monitor drainage E: Lung sounds return, O2 stable
- Monitor chest tube function
- Keep system below chest
- Report >70 mL/hr drainage
- Seal any disconnection with sterile dressing
- Monitor for subcutaneous emphysema
Mechanical Ventilation
High-pressure alarm, decreased breath sounds, agitation
Risk for VAP, impaired spontaneous breathing
A: VS, breath sounds, tube placement D: Risk for infection, ineffective breathing P: Maintain airway, prevent complications I: HOB >30°, suction, sedation, oral care E: Stable ABGs, no VAP
- Check alarm cause (obstruction/disconnection)
- Elevate HOB ≥ 30°
- Oral care Q2H with chlorhexidine
- Sedation protocol/PRN suctioning
- Daily sedation vacation
Tuberculosis (TB)
Night sweats, hemoptysis, weight loss, persistent cough
Airborne transmission risk
A: TB skin test, sputum AFB, chest X-ray D: Risk for infection transmission P: Isolate, initiate drug therapy I: N95 mask, airborne isolation, 4-drug therapy E: Negative cultures x
- Airborne precautions/N mask
- Private negative-pressure room
- Start RIPE therapy (rifampin, isoniazid, etc.)
- Educate on medication compliance
- DOT if needed
Oxygen Therapy
Confusion, O sat < 90%, restlessness
Hypoxia, risk for oxygen toxicity (esp. in COPD)
A: SpO2, respiratory effort, skin breakdown D: Impaired gas exchange P: Increase oxygenation safely I: Choose correct delivery device, humidify PRN E: SpO2 ≥ 92%, normal RR
- Apply appropriate device
- Titrate to order (watch for O2 toxicity in COPD)
- Assess skin under device
- Monitor SpO continuously
- Encourage coughing/deep breathing
Topic Key Nurse Teaching Points for New Nurses
Oxygen Therapy - Know each oxygen delivery device and its FiO₂ range (e.g., NC: 24–44%)
- Always humidify O₂ >4 L/min
- Watch for skin breakdown under mask/nose
- In COPD, keep SpO₂ between 88–92%
Airway Management - Suction only when needed (gurgling, low SpO₂)
- Keep suction sterile
- Limit suction time to 10–15 sec
- Monitor for hypoxia/bradycardia during suctioning
Tracheostomy Care - Use sterile technique
- Keep extra trach, obturator, and ambu bag at bedside
- Assess for signs of infection or displacement
- Never change trach ties for first 24–48 hrs post-op
Chest Tubes - Always keep system below chest level
- Monitor for continuous bubbling in suction chamber
- Report output >70 mL/hr
- Tape connections, check for leaks
Mechanical Ventilation - Know vent settings and alarms (high = blockage; low = disconnect)
- HOB ≥30° to prevent VAP
- Oral care q2h with chlorhexidine
- Perform sedation vacations & assess readiness to wean
Pneumonia & COPD - Know difference between early/late hypoxia
- In COPD, never give high-flow O₂ (can suppress drive)
- Promote pursed-lip breathing, small frequent meals
Emergency Signs - Tracheal deviation = medical emergency
- Silent chest in asthma = status asthmaticus
- Sudden dyspnea + chest pain = suspect PE
ABG Interpretation - Know basic ranges: pH: 7.35–7. PaCO₂: 35–45 mmHg HCO₃⁻: 22–26 mEq/L PaO₂: 80–100 mmHg
- Recognize signs of respiratory vs metabolic acidosis/alkalosis
II. Teaching for Clients & Family Members (Simple, Safe, Empowering)
Topic Key Teaching Points for Clients & Families
Oxygen Use at Home - No smoking near oxygen
- Store oxygen upright and secured
- Avoid petroleum-based products on face
- Check tubing for kinks; clean nasal cannula regularly
Inhaler Use (MDI/DPI) - Shake MDI before use
- Exhale, then inhale slowly and deeply while pressing inhaler
- Hold breath for 10 sec
- Rinse mouth after steroid inhalers to prevent thrush
Breathing Techniques - Pursed-lip breathing : Inhale through nose, exhale slowly through pursed lips
- Diaphragmatic breathing : Focus on belly rising
- Use during dyspnea episodes
Signs to Report Immediately - Blue lips or fingers
- Increased shortness of breath
- High fever or productive cough
- Sudden chest pain or confusion
Chest Tube Care at Home (if applicable)
- Keep tubing coiled and below chest
- Do not strip or milk the tubing
- If tube disconnects: clamp briefly or place end in sterile water
- Monitor for drainage changes
Preventing Infection (e.g., TB, pneumonia)
- Cough/sneeze into tissue
- Avoid crowds during flu season
- Stay up to date on flu and pneumococcal vaccines
- Complete full course of prescribed antibiotics
Lifestyle Modifications - Smoking cessation is the most important intervention
- Eat small, high-protein meals if fatigued
- Avoid extreme temperatures and strong scents
- Use energy conservation techniques
Pulmonary Rehabilitation - Encouraged for COPD and chronic lung disease
- Includes exercise, breathing training, and counseling
- Helps improve quality of life and reduce hospital visits
O2 Sat < 90% Despite Oxygen
Even with oxygen therapy Indicates oxygenation failure
Stridor or "Silent Chest" No audible air movement in asthma or stridor post-extubation
Sign of complete airway obstruction
Restlessness, Confusion, Irritability
Especially in elderly or postop Early sign of hypoxia
Sudden Chest Pain + Dyspnea
Especially with tachycardia or hemoptysis Suspect pulmonary embolism (PE)
Post-Thoracentesis SOB or Chest Pain
With absent breath sounds Could indicate collapsed lung (pneumothorax)
New Onset Confusion in Elderly
Especially in patients with pneumonia or UTI
Can be a sign of hypoxia or sepsis
👣 Who Should the Nurse See First?
Use ABC , Maslow , and Safety First prioritization models:
Client Presentation See First? ✅ / ❌
Why
Client with tracheal deviation & dyspnea
✅ YES – first Tension pneumothorax – life-threatening
Post-op client with SpO₂ 85% on room air
✅ YES –
second
Hypoxia – address breathing
Client with chest pain and tachypnea ✅ YES Suspect PE – high risk for sudden death
Client with asthma using accessory muscles
✅ YES Status asthmaticus can rapidly worsen
Client due for PRN pain med, stable vitals
❌ NO Comfort issue, not urgent
Client who needs assistance with ambulation
❌ NO Fall risk, but not life-threatening
Client scheduled for discharge teaching
❌ NO Can be deferred if others are unstable
Client who is confused but stable VS ❌ Maybe wait
Assess soon but not before respiratory distress cases
Client with cough and SpO₂ 94% ❌ No Mild symptoms – not priority
🧠 Nurse Test Tips – Prioritization Rules
● Airway obstruction = first every time ● O₂ sat < 90% = red flag ● Think: Airway > Breathing > Circulation > Safety > Comfort > Teaching ● Confusion + low SpO₂ = early hypoxia — act fast ● Use clinical judgment language from ATI: “First,” “Next,” “Immediate,” “Priority”
Would you like a printable prioritization decision tree or a set of NCLEX-style practice questions using these examples?
4o
You said:
nurse is discussing the greatest risk factors
ChatGPT said:
Absolutely! Here's a test-ready guide to help you discuss and identify the greatest risk factors —especially useful for ATI/NCLEX questions where you must recognize what puts a client at the highest risk for complications, decline, or mortality.
🧠 "Greatest Risk Factors" – Nursing Exam Strategy Guide
🔑 How to Approach These Questions:
- Use Clinical Judgment — Consider who has the greatest likelihood of harm or deterioration.
- Apply Maslow’s Hierarchy & ABCs — Prioritize Airway > Breathing > Circulation.
Condition Greatest Risk Factors Why it Matters
Tuberculosis - Homelessness
- Incarcerated individuals
- HIV or immunosuppressed clients
- Foreign-born individuals
These groups have higher exposure and poor treatment access
Pneumothorax - Chest trauma
- Tall, thin males (spontaneous)
- Central line insertion
- Mechanical ventilation
Risk for tension pneumothorax = medical emergency
ARDS - Sepsis
- Trauma
- Aspiration
- Multiple blood transfusions
Causes refractory hypoxemia and multisystem failure
Mechanical Ventilation Complications
- Sedation
- Long intubation period
- Improper oral care
- Supine positioning
Risk for VAP and ventilator dependency
When Teaching New Nurses: Focus on High-Risk Identification
Teach them to ask:
● Who is most likely to crash? ● Who has an unstable airway or breathing? ● Who has the most risk factors stacked together? ● What intervention could save a life?
🧩 Red Flag Risk Combinations to Teach Nurses to Watch For:
Combo Risk
Age > 65 + recent surgery + immobility Risk for PE or pneumonia
Confusion + low SpO₂ + COPD Early hypoxia – respiratory failure risk
Long-term steroid use + diabetes Infection risk (e.g., TB, pneumonia)
Central line + mechanical ventilation Sepsis or pneumothorax
Aspiration + dysphagia + altered LOC Aspiration pneumonia or ARDS
Airway swelling + stridor Obstructed airway (EMERGENCY)
Would you like me to turn this into a risk-factor flashcard deck , a bedside prioritization cheat sheet , or build scenario-based NCLEX questions from this content?
4o
You said:
which of the following is true manifestations
ChatGPT said:
Great! When you see a question that says "Which of the following is a true manifestation..." , it's testing your knowledge of expected signs and symptoms (S/S) for a condition.
Here’s how to approach this kind of question using the Respiratory system as an example:
🧠 Strategy for “Which of the Following is a True Manifestation?”
- Recall hallmark or textbook signs for that specific disease.
- Watch for distractors that are either opposite , not associated , or rare.
- Eliminate mild , nonspecific , or atypical symptoms unless the question stem is detailed.
🌬 Examples – True Manifestations by Respiratory Condition
Condition True Manifestations ✅ Not True (Distractors) ❌
