Med-Surg Class

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So I am in my third semester of nursing school and now doing Med-Surg 1 (of 3). I did great in the other 2 semesters and here I come and was introduced to Med-Surg. The questions seem totally different and the critical thinking is very much different. My professor gave us some case studies and I did not know how to answer. I am now stressed over not knowing what is Med-Surg and my expectations for this class. Like...what is expected of me as a nurse if a patient has...let's say, End-Stage Renal Failure. How do I study for Med-Surg??? The chapters are so loooong and repetitive and I spent the whole week studying for this one class, and when it comes to doing the case study, I do not know what interventions to do. Am I overthinking?? Any advice would be great!!! Thanks in advance

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you should study your book first and foremost. Then you can used supplemental materials like an nclex book or most books have study guides that accompany them and there is usually a student resource website. What book are you using? Don't worry the critical thinking comes with time. I am in MS 3 and my critical thinking skills are so much better now than in the first MS course. Good Luck

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Specializes in med/surg, telemetry, IV therapy, mgmt.

part of studying med/surg is learning about many different diseases. that includes learning the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for a medical disease or condition. this includes knowing about any medical procedures that will need to be performed on the patient, their expected consequences during the healing phase, and potential complications. surgery is a treatment for a disease or condition.

click on the link at the bottom of this post, the critical thinking flow sheet for nursing students, and print it out. use this to help you learn all the elements you need to know about each medical disease/condition you will be studying in your course. to determine priority of treatments and interventions consider the sequence of the appearance of symptoms and/or maslow's hierarchy of needs (http://en.wikipedia.org/wiki/maslow's_hierarchy_of_needs)

a case study is a nursing care plan in an essay format. the nursing process is a tool we use to help us solve problems. here is the nursing process applied to a common everyday problem:

you are driving along and suddenly you hear a bang, you start having trouble controlling your car's direction and it's hard to keep your hands on the steering wheel. you pull over to the side of the road. "what's wrong?" you're thinking. you look over the dashboard and none of the warning lights are blinking. you decide to get out of the car and take a look at the outside of the vehicle. you start walking around it. then, you see it. a huge nail is sticking out of one of the rear tires and the tire is noticeably deflated. what you have just done is step #1 of the nursing process--performed an assessment. you determine that you have a flat tire. you have just done step #2 of the nursing process--made a diagnosis. the little squirrel starts running like crazy in the wheel up in your brain. "what do i do?" you are thinking. you could call aaa. no, you can save the money and do it yourself. you can replace the tire by changing out the flat one with the spare in the trunk. good thing you took that class in how to do simple maintenance and repairs on a car! you have just done step #3 of the nursing process--planning (developed a goal and intervention). you get the jack and spare tire out of the trunk, roll up your sleeves and get to work. you have just done step #4 of the nursing process--implementation of the plan. after the new tire is installed you put the flat one in the trunk along with the jack, dust yourself off, take a long drink of that bottle of water you had with you and prepare to drive off. you begin slowly to test the feel as you drive. good. everything seems fine. the spare tire seems to be ok and off you go and on your way. you have just done step #5 of the nursing process--evaluation (determined if your goal was met).

it is easily adaptable to care planning.

  1. assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
    • a physical assessment of the patient
    • assessment of the patient's ability and any assistance they need to accomplish their adls (activities of daily living) with the disease
    • data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians
    • knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. this includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. if this information is not known, then you need to research and find it.
    • https://allnurses.com/forums/f205/medical-disease-information-treatment-procedures-test-reference-websites-258109.html - medical disease information/treatment/procedures/test reference websites

[*]determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)

  • it helps to have a book with nursing diagnosis reference information in it. there are a number of ways to acquire this information.
  • your instructors might have given it to you.
  • you can purchase it directly from nanda. nanda-i nursing diagnoses: definitions & classification 2007-2008 published by nanda international. cost is $24.95 http://www.nanda.org/html/nursing_diagnosis.html
  • many authors of care plan and nursing diagnosis books include the nanda nursing diagnosis information. this information will usually be found immediately below the title of a nursing diagnosis.
  • the nanda taxonomy and a medical disease cross reference is in the appendix of both taber's cyclopedic medical dictionary and mosby's medical, nursing, & allied health dictionary
  • there are also two websites that have information for about 75 of the most commonly used nursing diagnoses that you can access for free:

[*]planning (write measurable goals/outcomes and nursing interventions)

  • goals/outcomes are the predicted results of the nursing interventions you will be ordering and performing. they have the following overall effect on the problem:
    • improve the problem or remedy/cure it
    • stabilize it
    • support its deterioration

    [*]interventions are of four types

    • assess/monitor/evaluate/observe (to evaluate the patient's condition)
    • care/perform/provide/assist (performing actual patient care)
    • teach/educate/instruct/supervise (educating patient or caregiver)
    • manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)

[*]implementation (initiate the care plan)

[*]evaluation (determine if goals/outcomes have been met)

good luck with your studies. we all went through this, so when things get hairy remember that the thousands who went before you went through the same anxieties and head banging! it truly helps to have patients in clinicals with some of these conditions. this is advice that is given to medical students and it applies to nursing students as well:

learn from your patients. in particular, those with chronic or unusual diseases will likely know more about their illnesses then you. find out how their diagnosis was made, therapies that have worked or failed, disease progression, reasons for frustration or gratitude with the health care system, etc. realize also that patients and their stories are frequently more interesting then the diseases that inhabit their bodies.

become involved (within reason) in all aspects of patient care. look at the x-ray, examine the sputum, talk with the radiologist, watch the echo being performed. this will allow you to learn more and gain insight into a particular illness/disease state that would not be well conveyed by simply reading the formal report. it will also give you an appreciation for tests and their limitations. caring for patients is not a spectator sport. as an active participant in the health care process (rather then simply a scribe who documents events as they occur) you will not only help deliver better medical care but will also find the process to be more rewarding and enjoyable.

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Thak you so much NurseeGurl and Daytonite. I really appreciate what Daytonite said and I will take all you said into consideration. The critical flow sheet helped me last semester a lot. I used it for Pathophysiology and I got an A in that class. Thanks to that form. Now, for Med-Surg, I am going to refer back to those charts and fill in interventions because last semester I did not have to do interventions. I am very grateful for this community.

Thanks:heartbeat

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