Lecture Notes on Medical-Surgical Nursing

Introduction

Lecture covers basic concepts of Med-Surg Nursing.
General focus includes hospitals, skilled nursing facilities, ambulatory care, and community settings.
Age range for Med-Surg nursing: 18 to 100.
Under 18, categorized under pediatrics.

Key Roles: Care coordinators, caregivers, patient educators, leaders, and advocates.
Required knowledge, skills, and attitudes (KSAs).
QSEN (Quality and Safety Education for Nurses)
- Emphasizes patient safety and evidence-based practices.
- Nurses provide patient-centered care within an interdisciplinary health team.
Technology and Informatics: Utilization of computers and other informatics tools.

Key Components: Autonomy, cultural sensitivity, family-centered care.
Integrating family needs and values into patient care.
Importance of effective communication, including translation services for non-English speakers.
Healthcare disparities: Focus on access to care for minority populations.
- Example: Disparities in maternity care for African-American women.
Ethical considerations in healthcare: Balancing patient autonomy with hospital protocols.

Importance of interprofessional collaboration and communication tools like SBAR (Situation, Background, Assessment, Recommendation).
Delegation of tasks and supervision: Rights of Delegation (Right Task, Right Circumstances, Right Person, Right Communication, Right Supervision).
Evidence-Based Practice: Using research to guide clinical decisions.

Critical Thinking: Informed by nursing standards and practice.
Clinical Reasoning: Process of collecting and processing information to understand patient problems.
Clinical Judgment: Outcome of critical thinking and decision-making processes.
New NCLEX (Next Generation NCLEX) focuses on six functions of clinical judgment:
- Recognizing cues
- Analyzing cues
- Prioritizing hypotheses
- Generating Solutions
- Taking Action
- Evaluating Outcomes

Methodical approach: Emphasizes safety and quality improvement.
Interconnected healthcare systems: Pharmacy, nursing, healthcare providers, etc.
Focus on holistic care and transformative dynamic changes in nursing practice.
Ethical Principles in Nursing: Autonomy, beneficence, fidelity, justice, non-maleficence, veracity.

Healthcare Disparities: Result from communication issues, implicit biases, and healthcare access.
Populations affected: Older adults, racial/ethnic minorities, LGBTQ community.

Definition: Pain is what the patient says it is.
Types of Pain: Acute pain, chronic pain, cancer pain, diabetic neuropathy, nociceptive pain, neuropathic pain.
Psychological and Physiological Responses to Pain: Restlessness, grimacing, increased heart rate, and other symptoms.
Pain Assessment Tools: Self-reporting scales, behavioral observations.
Multimodal Analgesia: Combine two or more classes of analgesics to maximize relief.
Patient-Controlled Analgesia (PCA): Requires patient to be cognitively and physically able to use the equipment.

Examples: Physical therapy, hot and cold treatment, acupuncture, mindfulness strategies.

Principles: Start with low doses, switch medications cautiously, be aware of side effects.
Patient Education: Proper use of PCA pumps, recognizing side effects, ensuring patient and designated caregivers are properly informed.