1. Introduction
Definition:
Medical–Surgical Nursing deals with the care of adult patients suffering from medical (diseases) or surgical (operation-related) conditions.
It focuses on prevention, treatment, and rehabilitation of illness.
Goals:
• Restore health of the patient.
• Prevent complications.
• Educate patient and family.
• Promote physical and emotional well-being.
2. Role of the Nurse in Medical–Surgical Units
1. Pre-operative care – prepare patient for surgery.
2. Intra-operative care – assist surgeon, maintain asepsis.
3. Post-operative care – monitor recovery, prevent complications.
4. Observation & reporting – record vital signs, changes in condition.
5. Patient education – regarding medication, diet, lifestyle.
6. Rehabilitation support – help regain independence after illness/surgery.
3. Common Medical Conditions & Nursing Care
🫀 Cardiovascular System
• Common diseases: Hypertension, Heart failure, Myocardial infarction (Heart attack).
• Nursing care:
• Monitor pulse, BP, ECG.
• Give prescribed medicines (e.g., antihypertensives).
• Advise low-salt diet, rest, avoid stress.
🌬️ Respiratory System
• Common diseases: Asthma, Pneumonia, Tuberculosis, COPD.
• Nursing care:
• Maintain airway (positioning, suction if needed).
• Administer oxygen as prescribed.
• Encourage deep breathing & coughing exercises.
• Teach use of inhaler, importance of avoiding dust/smoke.
🍽️ Digestive System
• Common diseases: Gastritis, Peptic ulcer, Diarrhea, Constipation, Hepatitis.
• Nursing care:
• Provide soft, easily digestible diet.
• Maintain hydration (oral/IV fluids).
• Record intake and output.
• Maintain oral hygiene and rest.
💧 Urinary System
• Common diseases: Urinary tract infection (UTI), Kidney stones, Renal failure.
• Nursing care:
• Encourage fluid intake (unless contraindicated).
• Maintain cleanliness around genital area.
• Observe urine output, color, and odour.
• Provide catheter care if required.
🧠 Nervous System
• Common diseases: Stroke, Meningitis, Epilepsy.
• Nursing care:
• Maintain airway and prevent aspiration.
• Keep patient in safe position (side-lying for unconscious).
• Prevent bedsores, provide passive exercises.
• Observe for convulsions, give anticonvulsant as prescribed.
💪 Musculoskeletal System
• Common diseases: Fracture, Arthritis, Osteoporosis.
• Nursing care:
• Support injured part (splinting, traction).
• Encourage gentle movement as advised.
• Provide calcium-rich diet.
• Prevent pressure sores in immobilized patients.
🔹 4. Pre-operative Nursing Care
1. Assessment: History, allergy, vital signs.
2. Preparation:
• Shaving and cleaning the site.
• Empty stomach (NPO 6–8 hours before).
• Remove jewelry, dentures, nail polish.
3. Psychological support: Relieve fear and anxiety.
🔹 5. Post-operative Nursing Care
• Monitor vital signs frequently.
• Check surgical site for bleeding/infection.
• Maintain airway and proper positioning.
• Encourage deep breathing & leg exercises.
• Manage pain and IV fluids.
• Record intake/output and wound condition.
🔹 6. Common Surgical Procedures
• Appendectomy – removal of appendix.
• Cholecystectomy – removal of gall bladder.
• Hysterectomy – removal of uterus.
• Hernia repair, Fracture fixation, Tonsillectomy, etc.
🔹 7. Infection Prevention in Surgical Ward
• Use of sterile instruments.
• Strict hand washing before & after every procedure.
• Use of gloves, mask, and gown.
• Proper waste disposal (bio-medical waste management).
• Disinfect operation tables, beds, and equipment regularly.
🔹 8. Pain Management
• Types:
• Acute pain – short-term (e.g., post-surgery).
• Chronic pain – long-term (e.g., arthritis).
• Nursing measures:
• Repositioning and relaxation techniques.
• Cold or hot compress.
• Analgesics as prescribed.
• Emotional support and reassurance.
🔹 9. Fluid and Electrolyte Balance
• Monitor: Input/output, edema, dehydration.
• Common IV fluids: Normal saline, Dextrose, Ringer’s lactate.
• Signs of dehydration: Dry mouth, low urine output, weakness.
• Signs of fluid overload: Swelling, breathlessness, raised BP.
🔹 10. Patient Education and Discharge Planning
• Explain medication schedule and side effects.
• Dietary advice for recovery.
• Instructions for wound care at home.
• Importance of follow-up visits.
• Encourage positive attitude and family support.
🧠 Quick MCQ Practice
1. Founder of modern nursing — Florence Nightingale ✅
2. Before surgery, patient should be —
(A) Given meal (B) Kept NPO ✅
3. Main symptom of dehydration — Low urine output ✅
4. Post-operative patient’s position to prevent aspiration — Side-lying ✅
5. Fracture immobilization helps — Prevent movement and pain ✅