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HP&C > 3rd year semester 1 final exam > Flashcards

3rd year semester 1 final exam Flashcards

1
Q

Phlebitis

A 
Inflammation
Mechanical (movement) & chemical (the actual fluid given)
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2
Q

Late signs of ICP?

A 
decreased LOC
bradycardia
irregular respirations
cheyne stokes respirations
decerebrate or decorticate posturing
fixed and dilated pupils
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3
Q

what is stupor?

A

marked diminution in reactivity to environmental stimuli and can be aroused only by continual stimulation

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4
Q

what are the stages of shock?

A

compensatory, progressive, irreversible

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5
Q

what degree should the HOB be raised to with ICP?

A

approx. 30 degrees

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6
Q

how do you figure out hourly infusion rate for a child?

A

100mL/kg for first 10 kg, 50mL/kg second 10kg, then 20mL/kg for remainder
divide all that by 24 to get the hourly rate

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7
Q

early signs of ICP?

A 
headache
vomiting
blurred or double vision
dizziness
decreased pulse and respirations
increased BP and pulse pressure
pupil reaction time decreased, unequal or both
changes in LOC, irritability
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8
Q

how long is peripheral parenteral nutrition usually given?

A

5-7 days

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9
Q

expected urine output for child?

A

1-2 mL/kg/hr

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10
Q

Obtunded

A

decreased arousal and awareness, inability to follow commands

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11
Q

what are some overall management strategies for shock?

A

respiratory support
fluid replacement - crystalloids (eg. NS, LR) to add more fluid, colloids (albumin) to expand blood volume
vasoactive meds
nutritional support (d/t metabolic demands)

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12
Q

what is MAP and what is the norm?

A

Mean Arterial Pressure
CO x peripheral resistance
normal 70-105 mmHg

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13
Q

what signs show that death is inevitable?

A

coma with fixed dilated pupils

impaired respirations

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14
Q

what is the critical low of MAP and what does it mean?

A

65 mmHg or lower

inadequate perfusion

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15
Q

why do we use IVs?

A

fluid replenishment
fast pain management
blood products

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16
Q

what three things need to be adequate in order to properly perfuse tissues and organs?

A

cardiac pump
vasculature
blood volume

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17
Q

what are ways ICP is managed?

A

Sedation, osmotic diuretics, restricting fluids, draining CSF, controlling fever, oxygenation, managing BP

18
Q

what are the s&s of hypovolemic shock?

A

Skin cold and clammy
Disoriented
Restless

19
Q

what is cushings reflex?

A

results from significant decrease in cerebral blood flow
increased arterial blood pressure - Causes rise in SBP (as high as 270)
widening of the pulse pressure
slowing of the heart rate

20
Q

coma definition

A

state of unarousable unresponsiveness

no purposeful responses to internal or external stimuli Comas usually last 2-4 weeks

21
Q

Persistent vegetative state

A

wakeful after coma but devoid of cognitive or affective mental function

22
Q

name three things that can cause altered LOC

A
  • Alcohol
  • Epilepsy/ electrolytes
  • Infection
  • Overdose
  • Uremia
  • Trauma
  • Insulin
  • Psychosis
  • Stroke/ seizures
23
Q

Hematoma

A

collection or pocket of blood

24
Q

Shock

A

end organs receive insufficient oxygenation for normal metabolic processes

25
Q

what are the types of altered LOC?

A

neurologic
toxicologic
metabolic

26
Q

how often should an IV site be changed in an adult?

A

q72-96 hours

27
Q

what is cushings triad?

A

Bradycardia, HTN, irregular breathing pattern

Herniation, occlusion of blood flow

28
Q

s and s of compensatory shock

A 
cool & clammy skin
decreased urinary output
no bowel sounds
increased respiratory rate
narrowing/decreased pulse pressure
29
Q

Infiltration/extravasation

A

when fluids are leaking outside the IV. Certain fluids can cause damage in the tissues around the site

30
Q

what are reasons to use a central line?

A

lack of peripheral access
longer term
irritating solutions
rapid dilution

31
Q

which type of altered LOC includes an abnormal papillary response?

A

neurologic

32
Q

pH compatible with life?

A

6.8 - 7.8

33
Q

what’s a nursing action that you can do during compensatory shock?

A

apply supplemental oxygen

decreased metabolic demand

34
Q

what is the normal range of bicarb?

A

19-25

35
Q

what are some characteristics of progressive stage of shock?

A

decreased MAP
significant drop in SBP (<90 or 40 below baseline)
interstitial edema (pulmonary edema), SOB & crackles
low o2 sat
high RR
tachycardia
chest pain

36
Q

locked-in syndrome

A

lesion affecting the pons
results in tetraplegia
inability to speak
vertical eye movements and lid elevation remain intact

37
Q

what scenario would intraosseous infusion be used for?

A

emergency such as burn (pediatric clts)

38
Q

what are the two types of circulatory shock?

A

sepsis & anaphylactic

39
Q

Akinetic mutism definition

A

unresponsiveness

patient makes no voluntary movement or sound sometimes opens eyes

40
Q

what needs to be kept in mind when discontinuing central TPN?

A

abrupt d/c can lead to a drop in blood glucose d/t the dextrose in the sol’n

HP&C (8 decks)

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