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Clients with Health Challenges - N3600 > Acute intracranial disorders + Spinal cord trauma - red > Flashcards

Acute intracranial disorders + Spinal cord trauma - red Flashcards

1
Q

Increased ICP may significantly reduce cerebral blood flow leading to this CLASSIC sign.
This is a grave sign of ICP.

A

widening pulse pressure

Cushing’s Triad - bradycardia, HTN, bradypnea

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2
Q

What are the differenes between cardiogenic shock and IICP?

A

IICP
- HTN, bradycardia, bradypnea, widening pulse pressure

Cardiogenic shock:
- hypotension, tachycardia, tachypnea, narrowing pulse pressure

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3
Q

IICP:
- Early signs and symptoms?

Late signs and symptoms?

A

Early:

  • irritability and restlessness
  • Nuchal rigidity

Late:
- widening pulse pressure

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4
Q

most important nursing intervention to change in LOC?

A

Protect the airway

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5
Q

Decorticate posturing indicates a lesion in this area

A

mesencephalic or midbrain region

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6
Q

Decerebrate posturing indicates compression here.

A

Brainstem

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7
Q

Management of ICP:

- Most important drug for managing cerebral edema

A

Steroids (dexamethasone)

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8
Q

What is important to do for nursing interventions geared toward ICP in severe brain injuries?

A

Spread out nursing interventions (keep stimulation low)

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9
Q

Concussions can still happen if…

A

You do not lose consciousness

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10
Q

Symptoms of a concussion - most important one?

A

Sensitivity to light or noise

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11
Q

Important piece of teaching regarding concussions?

A

When in doubt, get checked out? (doubles for STI teaching)

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12
Q

Most important clinical manifestation of brain tumours?

A

Headache - usually dull and constant, worse at night

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13
Q

Most important treatment for brain tumours?

A

Dexamethasone (corticosteroid)

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14
Q

Bacterial meningitis?

  • What is it? (not definition)
  • Classic sign?
A

Medical emergency

Nuchal rigidity

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15
Q

What is the nurses priority for a client with decreased LOC?

A - Airway management 
B - Positioning
C - IV access
D - Fluid & nutritional support
E - All of the above
A

A

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16
Q

What are the symptoms that occur with Cushing’s Triad?

A

Bradycardia, HTN, bradypnea

17
Q

The nurse is aware that the most common
manifestation of a ruptured cerebral aneurysm
would be?

A - Tonic-clonic seizure
B - Decerebrate posturing
C - Narrowed pulse pressure
D - Sudden severe headache

A

D

18
Q

Scenarios:
Child with an oral temp of 40C.

A friend at a party, falls from 1st story balcony and walks away.

A

Bring child to ER

Bring friend to hospital

19
Q

damage to the spinal cord that results from direct injury to the cord itself or from indirect injury from damage to the bones, soft, tissue, blood vessels surrounding the cord

A

spinal cord trauma

20
Q

What is the most costly medical condition in Canada?

A

SCI

21
Q

Rick Hansen focuses on what?

A

the things HE CAN DO

22
Q

SCI is a medical _________

A

emergency

23
Q

Most important treatment for SCI?

A

Steroids to reduce swelling - methylprednisolone - ASAP

24
Q

What is the important complication of SCI?

A

Autonomic dysreflexia

25
Q

Massive uncompensated CV reaction. Simultaneous sympathetic and parasympathetic activity occurs

A

Autonomic dysreflexia

26
Q

Autonomic dysreflexia:

  • occurs in spinal cord injury above ___
  • life threatening
  • occurs in response to ________ stimulation. Most common causes?
A

T6
visceral
distended bladder, rectum or any wound

27
Q

Autonomic dysreflexia symptoms:

- most important one? What do we do as a result?

A

Sudden acute headache
(BP of 300 torr)
if c/o headache in SCI patient, sit them up, take BP and do head to toe screen

28
Q

Autonomic dysreflexia:

- it is important to teach patient and family the ______ and ______ of autonomic dysreflexia.

A

causes, symptoms

29
Q

Most important complication of immobility for SCI patients?

A

Pressure ulcers

30
Q

Rehabilitation nursing:

- Most important role?

A

Advocate

31
Q

To maintain skin integrity in a client with a SCI, the nurse should do which of the following?
A - Catheterize regularly
B - Reposition every 3 hours while up in the wheelchair
C - Eat a high caloric, high fibre diet
D - Keep skin clean and moisture-free

A

D

32
Q

Which of the following is an important teaching
point for bladder management?

A - Empty the bladder frequently
B - Over-hydrate (500ml/day)
C - Report concentrated urine to the physician
D - Wear loose fitting clothing

A

A

33
Q

Fred is in rehab for a SCI. While providing
care, the nurse observes that he is flushed,
diaphoretic, complaining of a headache,
nausea, and he is bradycardic.

What is going on?
What should the nurse do?

A

Autonomic dysreflexia

Sit up, take BP, look for stimulus

Clients with Health Challenges - N3600 (22 decks)

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