Medical Surgical Nursing

(Tina Sui) #1

  1. Maintaining Tissue Integrity



  • Assess skin frequently, especially areas with high potential for breakdown

  • Frequent turning; use turning schedule

  • Careful positioning in correct body alignment

  • Passive ROM

  • Use of splints, foam boots, trochanter rolls, and specialty beds as needed

  • Clean eyes with cotton balls moistened with saline

  • Use artificial tears as prescribed

  • Measures to protect eyes; use eye patches cautiously as the cornea may contact patch

  • Frequent oral care



  1. Maintaining fluid status



  • Assess fluid status by examining tissue turgor and mucosa, lab data, and I&O.

  • Administer IVs, tube feedings, and fluids via feeding tube as required— monitor
    ordered rate of IV fluids carefully.



  1. Maintaining body temperature



  • Adjust environment and cover patient appropriately.

  • If temperature is elevated, use minimum amount of bedding, administer


acetaminophen, use hypothermia blanket, give a cooling sponge bath, and allow fan to


blow over patient to increase cooling.



  • Monitor temperature frequently and use measures to prevent shivering.



  1. Promoting Bowel and Bladder Function



  • Assess for urinary retention and urinary incontinence

  • May require indwelling or intermittent catherization

  • Bladder-training program

  • Assess for abdominal distention, potential constipation, and bowel incontinence

  • Monitor bowel movements

  • Promote elimination with stool softeners, glycerin suppositories, or enemas as


indicated



  • Diarrhea may result from infection, medications, or hyperosmolar fluids

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