Medical–surgical nursing
Nursing care of the hospitalised adult, system by system: assessment, monitoring, interventions, teaching and warning signs.
83 pages
Assessment
- Acute kidney injury: urine output, fluid balance, potassium and kidney-harming medicinesIn acute kidney injury the nurse watches urine output, weight, fluid status and potassium, and…
- After thyroid or parathyroid surgery: airway, bleeding, voice and the signs of low calciumAfter neck surgery the nurse watches the airway and the wound for a haematoma, listens to the…
- Allergy history, latex safety and anaphylaxis on the ward: the first nursing responseThe nurse records every allergy, keeps latex away from allergic patients and, if anaphylaxis…
- Bowel obstruction and ileus: the decompression tube, fluids, abdominal checks and when to callIn obstruction and ileus the nurse decompresses with the tube, replaces fluids, examines the…
- Calcium and magnesium imbalances: Chvostek and Trousseau signs, tetany, seizure and ECG watchLow calcium or magnesium irritates nerves and muscles (tingling, spasms, seizures); high levels…
- Cancer emergencies on the ward: cord compression, SVC syndrome, high calcium and tumour lysisNew back pain, a swollen face, confusion or a falling urine output in a person with cancer can…
- Compartment syndrome and fat embolism: catching them earlyTwo fracture complications the nurse must catch early: rising pressure inside a muscle…
- Dengue, malaria and other tropical fevers on the ward: warning signs, fluid monitoring and vector protectionThe nurse counts the days of fever, looks for warning signs at every check, monitors fluids…
- Diabetic ketoacidosis and the hyperosmolar state on the ward: monitoring, fluids, potassium and insulin-infusion checksOn the ward the nurse recognises a hyperglycaemic crisis, starts the first checks, calls early…
- Hypoglycaemia: recognising it and the nursing response, conscious and unconsciousA sudden change in behaviour in a person with diabetes is a low until proven otherwise: check…
- Low and high potassium: ECG watch, IV potassium safety and the patients at riskToo much or too little potassium can stop the heart: the nurse knows who is at risk, watches the…
- Multiple sclerosis, myasthenia gravis and Guillain–Barré: breathing watch, fatigue and crisesIn Guillain–Barré and myasthenia gravis the breathing muscles can fail within hours: the nurse…
- Pneumothorax, haemothorax and rib fractures on the ward: what to watch and when to callThe nurse checks breathing, pain and cough often in patients with chest injury and calls at once…
- Raised intracranial pressure on the ward and after head injury or brain surgery: signs, positioning, what to avoidOn the ward, the nurse spots rising pressure in the skull early (less alert, headache, vomiting…
- Sodium and water imbalances, including SIADH and diabetes insipidus: weights, intake–output and neuro signsSodium problems are mostly water problems: the nurse follows weight, intake and output and the…
- The diabetic foot: daily inspection, risk screening and foot-care teachingThe nurse examines both feet, tests sensation and pulses, sorts the risk of an ulcer and teaches…
- The patient with a fracture: neurovascular checks, elevation, pain and complicationsAfter a fracture the nurse checks the limb beyond the break again and again: colour, warmth…
- Upper and lower GI bleeding: recognising it, monitoring, two lines and getting ready for endoscopyIn GI bleeding the nurse spots the signs, watches for shock, places two wide IV lines and gets…
Safe practice
- Acute pancreatitis: pain, nothing by mouth, fluids and watching for complicationsAcute pancreatitis care: treat the pain early, give fluids with frequent checks, feed early as…
- Acute stroke: recognition, the first hours, swallow screening, positioning and neuro checksIn a stroke, time lost is brain lost: spot the signs, note the time they began, call at once…
- Adrenal disorders and long-term corticosteroids: Addison, Cushing, crisis signs and steroid teachingThe nurse watches glucose, blood pressure, infection and mood in patients on steroids, and knows…
- Amputation: stump care, positioning against contractures, phantom pain and getting ready for a prosthesisAfter an amputation the nurse protects the wound, shapes the stump, prevents joint contractures…
- Arthritis and lupus: joint protection, fatigue, morning stiffness and checks for medicines that suppress immunityIn arthritis and lupus the nurse balances activity and rest, protects joints, eases stiffness…
- Asthma in adults: assessing an attack, peak flow, inhaler technique and the action planThe nurse judges how severe an asthma attack is, measures peak flow, checks inhaler technique…
- Back pain and spinal surgery: log rolling, neurological checks of the legs and teachingAfter spine surgery the nurse compares leg power and feeling with the baseline, watches bladder…
- Bleeding and clotting disorders: haemophilia, ITP and watching for DICIn bleeding disorders the nurse prevents injury, adapts injections, recognises bleeding early…
- Breast cancer surgery: the drain, arm exercises, lymphoedema prevention and body imageAfter breast surgery the nurse teaches drain care, gentle use of the arm, how to protect it from…
- Care after abdominal surgery (appendix, gallbladder, bowel, hernia): drains, return of bowel function and leak warning signsAfter abdominal surgery: watch the pulse, the abdomen and the drains, help bowel function…
- Care after lung surgery and thoracotomy: chest drain, pain, lung expansion and the shoulderAfter lung surgery the nurse controls pain so the patient can breathe deeply and cough, watches…
- Caring for the hospitalised patient with diabetes: glucose checks, meals, fasting for procedures and illnessIn hospital the nurse times glucose checks and insulin to the meals, plans fasting for…
- Caring for the patient with a laryngectomy: the stoma, humidification, communication and teachingAfter a total laryngectomy the patient breathes only through the neck stoma; the nurse keeps it…
- Caring for the patient with obesity and after bariatric surgery: safe handling, the airway and dumpingThe nurse uses lifting equipment, protects breathing during sleep, prevents clots and teaches…
- Cataract and retinal surgery: eye drops, the shield, positioning and warning signsAfter eye surgery the nurse protects the eye, teaches clean eye-drop technique, helps keep the…
- Cellulitis, impetigo, scabies and lice: nursing care, isolation and teachingThe nurse watches cellulitis for spread, stops impetigo, scabies and lice passing to others, and…
- Chronic kidney disease: fluid and diet limits, protecting the fistula arm, medicines and teachingIn chronic kidney disease the nurse helps the patient keep to fluid and diet limits, protects…
- Chronic venous insufficiency and venous leg ulcers: compression, elevation and leg careVenous ulcers heal with compression, raising the legs, walking and skin care; the nurse checks…
- Cirrhosis: ascites, weight and girth, encephalopathy, variceal bleeding and the skinCirrhosis care means daily weights, low-salt meals, a sharp eye for confusion, bleeding and…
- Diabetes self-management teaching before discharge: monitoring, food, activity and sick-day rulesBefore discharge the patient and family learn their medicines, glucose checks, lows, food…
- Giving chemotherapy safely: hazardous-drug handling, extravasation, spills and wasteChemotherapy drugs can harm staff and tissue: the nurse wears the right protection, watches the…
- Glaucoma: eye-drop adherence and acute angle-closure as an emergencyThe nurse keeps glaucoma drops going in hospital, teaches correct technique and treats a sudden…
- Hearing loss and vertigo: hearing-aid care, communication, ear surgery and fall safetyThe nurse adapts how they talk to a person with hearing loss, keeps hearing devices in use and…
- Hip and knee replacement: dislocation precautions, VTE prevention, mobilisation and going homeAfter a hip or knee replacement the patient gets up early, prevents clots, protects the new…
- Hip fracture in the older adult: before and after surgery, delirium, positioning and early mobilisationAn older adult with a hip fracture needs pain relief, delirium and pressure-injury prevention…
- Inflammatory bowel disease: diarrhoea, fluids, nutrition, flares and medicine teachingIn Crohn disease and ulcerative colitis the nurse tracks stools and fluids, supports nutrition…
- Inpatients with influenza or COVID-19: isolation, oxygen, cohorting and vaccinationThe nurse isolates patients with flu or COVID-19, wears the right protection, watches their…
- Kidney stones: pain, straining the urine, fluids and care after stone proceduresWith a kidney stone the nurse controls the pain, strains all urine to catch the stone…
- Leukaemia, lymphoma and stem-cell transplant: nursing care and graft-versus-host warning signsBlood cancers and transplant mean long periods of low counts: the nurse prevents infection and…
- Living with epilepsy: medication adherence, triggers, safety at home and status warning signsTaking anti-seizure medicines daily as prescribed prevents most seizures; the nurse also teaches…
- Meningitis and encephalitis: droplet precautions, neuro checks, comfort and contactsSuspected bacterial meningitis is an emergency: treatment starts at once, droplet precautions…
- Neutropenia and low platelets: infection and bleeding precautions, and fever as an emergencyWith few neutrophils a fever is an emergency; with few platelets small injuries bleed: the nurse…
- Nursing care in acute coronary syndrome: chest pain, the first hour, the ward and secondary preventionChest pain is an emergency until proven otherwise: call for help, get a 12-lead ECG within 10…
- Nursing care in anaemia: fatigue, pacing activity, iron teaching and transfusionThe nurse watches how anaemia affects breathing, heart rate and safety, paces activity, and…
- Nursing care in atrial fibrillation: apical–radial pulse, stroke warning signs and teaching about anticoagulantsIn atrial fibrillation the nurse counts the apical pulse, watches for low cardiac output and…
- Nursing care in deep vein thrombosis and pulmonary embolism: recognising them, the first response and mobilisationA swollen, painful, warm leg can be a clot; sudden breathlessness or chest pain can mean it…
- Nursing care in HIV: adherence, opportunistic-infection watch, confidentiality and preventionThe nurse helps the person with HIV take treatment every day, watches for infections, keeps the…
- Nursing care in hypo- and hyperthyroidism, and the warning signs of a thyroid storm or myxoedema comaThe nurse watches heart rate, temperature and mental status, gives thyroid medicines correctly…
- Nursing care in pneumonia: oxygenation, positioning, fluids and preventing hospital-acquired pneumoniaThe nurse watches breathing and oxygen, helps the patient sit up, cough and move, and prevents…
- Nursing care of the inpatient with hypertension and a hypertensive crisis on the wardThe nurse measures blood pressure well, checks before each antihypertensive, recognises very…
- Nursing care of the patient with COPD: exacerbations, controlled oxygen, breathing techniques and inhaler teachingThe nurse spots a COPD flare-up early, gives oxygen to a lower target, teaches calm breathing…
- Nursing care of the patient with heart failure: daily weights, fluid balance, warning signs and teachingIn heart failure the nurse catches fluid build-up early: the same-scale morning weight, intake…
- Parkinson's disease: medicine timing, falls, swallowing and communicationIn hospital, Parkinson's medicines must be given on the patient's own schedule; the nurse also…
- Patients on anticoagulants: bleeding watch, monitoring tests, interactions and teachingAnticoagulants and antiplatelets prevent clots but cause bleeding: the nurse checks the right…
- Patients with a pacemaker or ICD: care after implant, wound and arm care, device teachingAfter a pacemaker or defibrillator implant, the nurse watches the rhythm and wound, limits the…
- Peptic ulcer and reflux: teaching, medicines and the warning signs of perforationNursing care in ulcer and reflux: medicines at the right time, no NSAIDs, no tobacco or alcohol…
- Peripheral artery disease and acute limb ischaemia: limb checks, positioning and foot careIn artery disease the leg gets too little blood: the nurse compares pulses, colour and warmth…
- Radiation therapy: skin care, fatigue, and safety with implants and radioactive sourcesThe nurse protects the treated skin, eases the side effects of the treated area and follows…
- Side effects of cancer treatment: nausea, mucositis, hair loss, fatigue and appetiteThe nurse asks about, prevents and eases the common effects of cancer treatment, and knows which…
- Spinal cord injury: spinal precautions, log rolling, autonomic dysreflexia, bladder and bowelAfter a spinal cord injury the nurse keeps the spine aligned, turns the patient in one piece…
- Stroke rehabilitation nursing: the weak side, shoulder, neglect, aphasia, continence and the familyRehabilitation starts on the ward: position the weak side, protect the shoulder, help with…
- Tuberculosis nursing: airborne isolation, directly observed treatment, contacts and adherenceThe nurse isolates the patient with infectious tuberculosis, protects staff with a respirator…
- Urinary tract infection and pyelonephritis: the clean specimen, fluids, teaching and catheter-related infectionIn a urinary infection the nurse takes a clean sample, encourages fluids, gives the antibiotics…
- Viral hepatitis: precautions by type, vaccination, rest, nutrition and teachingIn viral hepatitis the type sets the precautions: stool for A and E, blood for B, C and D…
- Ward care after heart surgery (bypass, valve replacement): sternal wound, lungs, mobilisation and going homeAfter heart surgery the ward nurse protects the breastbone, helps the lungs expand, walks the…
Procedure
- Assisting paracentesis: before, during and afterParacentesis drains ascitic fluid with a needle: the nurse prepares, keeps the field sterile…
- Assisting thoracentesis and caring for the patient with a pleural effusionThe nurse prepares and positions the patient, keeps them still and monitored while the doctor…
- BPH and prostate surgery: continuous bladder irrigation, clots, TUR syndrome and continenceAfter prostate surgery the nurse keeps the catheter draining with irrigation, watches the urine…
- Care after cardiac catheterisation and PCI: access site, distal pulses, bleeding and lying-flat timeAfter a catheter through the groin or wrist, the nurse checks the site, the pulse and colour of…
- Cast and splint care: drying, checks, skin, itching and teachingA new cast or splint is kept dry and uncovered while it sets, the limb is raised and checked…
- Giving insulin safely: types by action, pens and syringes, sites, rotation and storageInsulin is a high-alert medicine: the nurse checks the glucose, the product and the meal before…
- Haemodialysis: caring for the fistula, graft or catheter, and before and after a sessionThe ward nurse checks the dialysis access every day, weighs and assesses the patient before and…
- Parenteral nutrition: line care, glucose checks, refeeding risk and monitoringParenteral nutrition runs through a central line by pump: strict asepsis, scheduled glucose…
- Peritoneal dialysis: exchanges, the exit site and the signs of peritonitisIn peritoneal dialysis fluid goes into the abdomen through a catheter and drains out; the nurse…
- Traction and external fixators: alignment, weights hanging free and pin-site careIn traction the weights hang free, the body stays aligned and the pin sites are watched for…
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← Nursing: fundamentals and procedures
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Representative model, for educational purposes only.