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aa Orgo > 409 Final 1 > Flashcards

409 Final 1 Flashcards

1
Q

GBS is a ___ situation

A

acute

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2
Q

Overall description of GBS

A

Its an acute inflammatory syndrome, where the nerves lose their myelin sheath

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3
Q

GBS affects the peripheral nervous system which means it affects

A

sensory and motor stuff

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4
Q

GBS produces ____ motor weakness

A

progressive

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5
Q

GBS: where do the symptoms usually start

A

in the legs, and then work their way up

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6
Q

GBS: ascending paralysis means

A

the symptoms start in the legs and work their way up

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7
Q

How does healing occur in GBS

A

in the reverse order that symptoms progressed in

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8
Q

GBS: the general result of destruction of the myelin sheath is

A

it messes up nerve impulses

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9
Q

GBS is an acute disorder but it’s possible

A

to have permanent damage

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10
Q

GBS: the cause is unknown, but a clue can be that they had ___ or ___

A

epstein-barr or cytomega

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11
Q

GBS: Viruses like epstein-barr could cause the body’s

A

immune system to react in a messed up way and start attacking itself (which is GBS)

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12
Q

What do you teach PD patients about walking

A

do NOT look at your feet to prevent falls

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13
Q

PD: why might it be a bad idea to drive

A

they could have trouble sleeping at night, might fall asleep while driving

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14
Q

PD: they could have trouble communicating. What should you teach them

A

speak slowly, take deep breaths, exaggerate words if needed

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15
Q

PD: not all of them have dementia but

A

its common to have some kind of cognitive problem

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16
Q

PD: if they feel really embarrassed

A

dont FORCE them into social situations

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17
Q

Whats a good exercise for PD patients

A

light aerobic

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18
Q

PD: if drugs don’t help,

A

the last resort is surgery

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19
Q

Stereotactic Pallidotomy/Thalamotomy
Deep Brain Stim
Fetal Tissue Trans

A

Surgical tx for PD

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20
Q

A stroke happens when

A

there’s not enough blood to the brain

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21
Q

Stroke: There will be damage to the infarction area and maybe also

A

damage to the opposite side (contralateral) because of brain swelling

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22
Q

2 main types of stroke

A

Ischemic and Hemorrhagic

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23
Q

Types of ischemic stroke

A

Thrombotic and Embolic

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24
Q

Types of Hemorrhagic stroke

A

Aneurysm
HTN
Arteriovenous malformation

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25
Q

The most common type of stroke is

A

Ischemic (as opposed to hemorrhagic)

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26
Q

What kind of ischemic stroke develops slowly over minutes of hours

A

Thrombotic

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27
Q

In an embolic stroke, the emboli usually comes from

A

the heart

28
Q

Stroke at night vs stroke in the day

A

Both kinds of ischemic strokes happen at night, the hemorrhagic strokes happen in the day

29
Q

After the initial onset, hemorrhagic stroke signs

A

keep getting worse, because you keep bleedings (whereas with embolic stroke you might start to see some improvement after onset)

30
Q

Stroke: if the symptoms come and go,

A

that might just be a TIA or reversible ischemic neuro deficit

31
Q

Reversible ischemic neuro deficit last

A

longer than 24 hours

32
Q

Compared to Reversible ischemic neuro deficits, TIAs are

A

are shorter, sometimes only an hour

33
Q

Stroke: by the time they get to the ED its often resolved

A

TIA

34
Q

Medication for a TIA

A

clopi (antiplatelet)

35
Q

Stroke: if they suddenly say I have the worst headache of my life it could be

A

Aneurysm

36
Q

When a stroke patient comes to the ED, the most important thing to assess is

A

LOC

37
Q

To maintain perfusion during a stroke, you want the BP

A

to be a little high, 150/100

38
Q

Stroke: assess for emotional swings if

A

the frontal lobe is involved

39
Q

Stroke: the ECG might show

A

decreased T wave
ST depression
prolonged QT interval

40
Q

For ischemic strokes, start 2 IV lines with

A

non-dextrose saline

41
Q

Stroke: If the thrombus is in the carotid artery

A

they can do an endarterectomy, otherwise they need thrombolytics

42
Q

You need to give TPA within

A

3 hours

43
Q

Ischemic stroke: After you give TPA, if sys is greater than 180 or dys is greater than 105

A

they may need anti-hypertensives

44
Q

Ischemic stroke: Don’t insert a urinary catheter until they’re stable because

A

you don’t want to cause bleeding

45
Q

Ischemic stroke: If you detect ICP

A

escalate immediately

46
Q

ICP: only suction if

A

they really need it because suctioning increases ICP

47
Q

ICP: how should you handle various care tasks

A

do NOT cluster them because that’d increase ICP, you need to space them out

48
Q

ICP: if sys is greater than 200

A

notify provider and recommend anti-HTN meds

49
Q

Stroke: The goals of long term drug therapy are

A

Prevent future stroke

Prevent hypoxic damage to nerves

50
Q

Stroke: aspirin consideration

A

an initial dose should be given, but not if they got TPA within 24 hours

51
Q

Stroke: you may need a CCB to prevent

A

vasospasm

52
Q

Vasospasm tends to happen ____ after stroke

A

a week

53
Q

Stroke: What kind of environment do you want them to eat in

A

low stimulus (so they don’t get distracted and choke)

54
Q

Stroke: for patients with receptive aphasia, speak

A

slowly but not loudly

55
Q

Stroke: for patients with receptive aphasia, don’t communicate using

A

yes or no questions (because they might just give an automatic response)

56
Q

Stroke: You should approach the patient on their ___ side

A

unaffected

57
Q

Stroke: When getting dressed they should do their ___ side first

A

affected

58
Q

GBS: ask about pins and needles aka

A

parasthesias

59
Q

GBS: most people report a sudden

A

muscle weakness

60
Q

GBS: you don’t have problems with ___ or ___

A

LOC or pupils

61
Q

GBS: tx could include ___ or ___ but not both

A

PE or immunoglobulin

62
Q

GBS: don’t give ___ unless you really have to

A

steroids

63
Q

GBS: keep HOB

A

at least 45 degrees

64
Q

GBS: keep them on a cardiac monitor because

A

they’re at risk for dysrhythmia

65
Q

GBS: hypotn is treated with

A

fluids and place them in supine (unless they’re really having trouble breathing)

66
Q

GBS: bradycardia is treated with

A

Atropine

67
Q

GBS: pain is usually treated with opiates. We might use TCAs but don’t give them to

A

older adults

aa Orgo (196 decks)

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