Brain Injuries and Arrtythmias

Question 1

What to Assess if there is a suspected brain injury?

Answer 1

1. Heart rate
2. Respiratory rate
3. O2 sat
4. PEERLA
5. Temperature
6. Glasgow Coma Scale

Question 2

What is Intracranial pressure?

Answer 2

Increased pressure within the cerebrum. This is a medical emergency!

Question 3

Signs and Symptoms of ICP?

Answer 3

• Headache
• Nausea
• Double vision
• Decreased mental awareness
• Shallow breathing

Question 4

What is cerebral edema?

Answer 4

Cerebral edema is brain swelling following a primary brain injury! Caused increase in fluid in the extravascular space and ICP. It can be caused by infections, injury

Question 5

What is vasogenic Cerebral Edema?

Answer 5

this occurs when the blood-brain barrier is compromised. Mainly a result of head injury, hemorrhage OR CNS infection which leads to inflammation. The increased blood flow causes edema

Question 6

What is Cytotoxic Cerebral Edema?

Answer 6

Increased Intracellular fluid shift into the cells, causing an increased ICP
Extracellular Na+ and other cations enter into neurons and astrocytes and accumulate intracellularly

Question 7

What is a Cerebrovascular Accident?

Answer 7

A stroke!

Question 8

What is a thrombotic/ischemic stroke?

Answer 8

This is caused by a thrombus found within a blood vessel in the ebrain. This blockage causes decreased blood flow, decreased oxygenation resulting in necrosis.

Question 9

What is Hemorrhagic Stroke?

Answer 9

This is caused by a rupture of cerebral vessels . hemorrhagic bleeding interferes with the brain’s ability to function

Question 10

Hemorrhagic Stroke Treatment?

Answer 10

• Osmotic Diuretics
• Hypertonic NS
• Optimize Perfusion

Question 11

What is a Transient Ischemic Attack?

Answer 11

Look like strokes in terms of signs and symptoms, but they are temporary. It is a huge warning sign to indicate that an individual is at high risk for a stroke!

Question 12

What is the FAST acronym?

Answer 12

Face drooping
Arms (can you raise both?)
Speech (slurred or jumbled)
Time (call 9-1-1 immediately)

Question 13

Treatment of Cerebral Vascular Accidents.

Answer 13

Thrombolytics! Lyse the blood clot and regain blood flow immediately

Question 14

What is an Aneurysm?

Answer 14

a bulge in a blood vessel caused by a weakness in the blood vessel wall. As blood passes through the weakened blood vessel, the blood pressure causes a small area to bulge outwards like a balloon.

Question 15

How are Cerebral Aneurysms Treated?

Answer 15

Through coiling or flow diversion! During this process, a catheter is inserted into an artery into the leg. The tube is guided through a network of blood vessels until it reaches the site of the aneurysm. Tiny platinum coils are passed through into the aneurysm

Question 16

What is an arrhythmia?

Answer 16

Dysrhythmia is a disturbance to a normal rhythm.

Question 17

What is the normal range for Heart rate?

Answer 17

60-100 beats per minute

Question 18

What is Sinus Bradycardia?

Answer 18

when the SA node fires less than 60 times per minute resulting in a slower heart rate

Question 19

What is Sinus Tachycardia?

Answer 19

when the SA node fires more than 100 beats per minute generating a faster heart rate

Question 20

What is Atrial Flutter?

Answer 20

caused by an electrical impulse that travels around in a localized self-perpetuation loop in the right atrium. This causes the atrial rate to be higher than the ventricular rate

Question 21

What is Atrial fibrillation?

Answer 21

caused by multiple electrical impulses that are initiated randomly. These un-synchronized, chaotic electrical signals cause the atria to quiver or fibrillate rather than contract.

Question 22

What is Ventricular tachycardia?

Answer 22

caused by a single strong firing site or circuit in one of the ventricles. The beats produced are fast; ranging from 100-250 beats per minute.

Question 23

What is Ventricular Fibrillation?

Answer 23

v-fib is caused by multiple weak ectopic sites in the ventricles. These un-synchronized, chaotic electrical signals cause the ventricles to quiver or fibrillate rather than contract. The heart pumps little or no blood. V-fib can quickly lead to cardiac arrest

Question 24

How is Ventricular Fibrillation treated?

Answer 24

The first drug of choice is epinephrine (a.k.a adrenaline)!

Question 25

What is Right-Sided Heart Failure?

Answer 25

The right side of the heart is responsible for taking unoxygenated blood and bringing it to the lungs to be oxygenated. In right-sided heart failure, the right side of the heart is unable to pump leading to various complications.

Question 26

What are the signs and symptoms of Right-sided heart failure?

Answer 26

• Peripheral edema
• Ischemia: LOC changes, fatigue
• Ascites
• Weight Gain

Question 27

What is left-sided Heart failure?

Answer 27

It happens when the left ventricle has to pump harder than usual to try to deliver enough oxygenated blood to the body. Causing backflow and ‘pooling’ in the lungs.

Question 28

What are the signs and symptoms of Left-Sided heart failure?

Answer 28

• Pulmonary edema
• Hypoxia
• Hypoxemia
• Cyanosis
• SOB
• Crackles during auscultation
• Tachycardia
• Dyspnea

Question 29

How to treat heart failure?

Answer 29

1. decrease cardiac workload!
2. Increase O2 supply
3. Increase contractility! (Through medication intervention)

Question 30

What are the five drug classes used to treat Heart failure?

Answer 30

1. Diuretics
2. Ace inhibitors
3. Calcium channel blockers
4. Adregenic Agonists
5. Direct-acting Vasodilator

Question 31

What are cardiac Glycosides?

Answer 31

They inhibit the removal of Na (sodium) from the cell. The high Na+ within the cell causes the cell to depolarize, causing the calcium channels to open and therefore increasing contractility!

Question 32

What are Phosphodiesterase Inhibitors?

Answer 32

They promote blood vessel dilation (vasodilation) and smooth muscle relaxation. Used to treat people with pulmonary hypertension (PH).