Chapter 2: Medical-Surgical Nursing Essentials

Medical-Surgical Nursing Essentials underscores the pivotal role of the nurse as a coordinator of transitional care, implementing evidence-based strategies to reduce rehospitalization rates and improve patient outcomes through specialized roles such as the nurse navigator, case manager, and clinical nurse leader. The text explores the principles of rehabilitation nursing, which aims to restore functional capacity and maximize independence for individuals with disabilities or chronic conditions through a holistic, interdisciplinary team approach. A major focus is placed on the assessment of functional ability, distinguishing between personal Activities of Daily Living (ADLs) and complex Instrumental Activities of Daily Living (IADLs), while utilizing standardized assessment tools like the Functional Independence Measure (FIM), Katz Index, and Barthel Index. The chapter details nursing interventions for self-care deficits and impaired physical mobility, providing protocols for preventing musculoskeletal complications such as contractures, footdrop, and external rotation through proper positioning and therapeutic exercises, including passive, active, and isometric regimens. Additionally, it provides technical guidelines for safe patient handling during transfers and ambulation training, explaining the correct use of assistive technology and mechanical aids like walkers, canes, and crutches, along with specific gait patterns. Finally, the content addresses the specific requirements of home health nursing, including the use of the Outcome and Assessment Information Set (OASIS) for reimbursement, environmental safety assessments, medication reconciliation, and the critical process of discharge planning to ensure continuity of care across health settings.