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Block 4 Exam 2 > CM/ss > Flashcards

CM/ss Flashcards

1
Q

Hope fostering activities

A

Spirituality
Relationships
Humor
Positive memories

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2
Q

Hope hindering activities

A

Isolation
Uncontrollable pain and discomfort
Abandonment

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3
Q

Double effect criteria

A

Action itself is good/neutral
Intends good, not evil
Good is not achieved by evil effect
Favorable balance of good over evil

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4
Q

Maslow hierarchy

A

Physiological needs
Safety and security
Belonging
Esteem
Self actualization

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5
Q

4 components of wellness

A

Capacity to perform
Adaptable
Feeling of well being
Harmony and balance

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6
Q

Aspects of critical thinking

A

Interpretation, Analysis, Evaluation
Inference
Explanation
Self reflection
Self regulation

Priorities
Validate info
Draw from past XP
Flexibility (outside the box)
Consider alternatives

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7
Q

Teleologic/consequentialism/utilitarianism

A

Greatest good for greatest number

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8
Q

Deontologic/formalist

A

Independent of consequence
Sense of duty

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9
Q

New grad competencies

A

Management of care
Safety and infection
Health promotion and maintenance
Psychosocial integrity
Basic care and comfort
Pharm and parenteral
Risk management
Physiological adaptation

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10
Q

Employer expectations

A

Theory
ADPIE
Know abilities and limitations
Communication
Delegation
Documentation
Basic skills
Information technology
Work ethics
Acceptable speed

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11
Q

Stages of Kubler Ross grief

A

Denial
Anger
Bargain
Depression
Acceptance

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12
Q

Principles of Kurt Lewin’s Force Field Theory of Change

A

Driving and restraining forces of change
3 phases: unfreezing (plan), movement (implement), refreeze (integration)

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13
Q

Neuro assessment: health hx

A

Pain
Seizures
Dizziness and vertigo
Visual
Weakness
Abnormal sensations
General hx

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14
Q

Complications for altered LOC

A

Respiratory
PNA
Aspiration
Pressure injury
DVT
Contractures

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15
Q

Early CM increased ICP

A

Altered LOC
Restless, confusion, drowsy, increased respiratory effort, purposeless movements
Pupils
Weakness at one side
HA

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16
Q

Late CM increased ICP

A

Cushing (high systolic BP, low HR, low RR)
Projectile vom
Respiratory and vasomotor
Hemiplegia, decorticate, decerebrate, flaccid
Respiratory
Loss of brainstem reflexes
Hyperthermia

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17
Q

Intracranial surgery complications

A

ICP
Bleeding, hypovolemic shock
Fluid and lytes
Infection
CSF leak
Seizures

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18
Q

Basilar skull fracture

A

Bleeding from nose, pharynx, ears
Battle sign (bruised behind ears)
CSF leak (halo sign around blood)

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19
Q

Epidural hematoma

A

Brief loss of consciousness
Then lucid
Then back to stupor

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20
Q

Concussion

A

Dizzy, vom
Lethargy, Hard to arouse
Changes in LOC, Confusion
Anxiety, Irritable
HA
Speech and movement difficulty

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21
Q

TBI complications

A

Decreased cerebral perfusion
Cerebral edema and herniation
Impaired O2 and vent
F lyte and nutrition
Seizures

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22
Q

Spinal shock

A

Sudden decrease in reflexes below SCI
Flaccid
Low reflexes
Decreased sensation
Can lead to paralytic ileus
May be hypotension and bradycardic

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23
Q

Neurogenic shock

A

Due to ANS dysfunction
Decreased BP, HR, CO
Resp issues (hypercap, hypoxia, p edema)
Secretion retention
Syncope
Warm dry skin
Pooling of blood increases DVT risk

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24
Q

Autonomic dysreflexia

A

Pounding HA
Increase BP
Diaphoresis
Nasal congestion
Bradycardia
Nausea

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25
Q

SCI complications

A

DVT
Ortho hypo
Autonomic dysreflexia

Death is most commonly associated with PE, PNA, and sepsis

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26
Q

Tetra/paraplegia comps

A

Spasticity
Infection and sepsis

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27
Q

MS

A

Relapsing and recurring
Fatigue
Weakness
Numbness
Impaired coordination
Loss of balance
Pain
Visual
Depression
Constipation and UTIs
Contractures/spasticity, PNA, edema, pressure injuries (bed bound stuff)
Risk for osteoporosis

28
Q

Myasthenic crisis

A

Severe weakness
Resp and bulbar weakness
Can lead to respiratory failure

29
Q

Cholinergic crisis

A

Severe weakness
Resp and bulbar weakness
Increase secretions: SLUDGE
Saliva
Lacrimation
Urine
Defecation
Gastro
Emesis

30
Q

GBS

A

Ascending paralysis
Impaired reflexes
Weak
CN demyelination
May alter HR and BP (hyper or hypo)
CSF has increased proteins but normal WBC
Paresthesias and pain

31
Q

Sympathetic storm syndrome

A

Loss of consciousness
VS unstable
Diaphoresis
Agitation

32
Q

Brain changes with older folks

A

Decreased volume and weight of brain
Decreased NTs
Decreased cerebral blood flow
Decreased metabolism

33
Q

In coma, abnormal pupil and motor=

A

Neuro disease

34
Q

In coma, normal pupil=

A

Toxic or metabolic disorder

35
Q

DI

A

Increased dilute urine output
Increased serum OSM

36
Q

SIADH

A

Hypervolemia and hyponatremia
Decreased UOP

37
Q

SCI

A

Retention and distention
Decreased sweating
Hypotension
Acute pain back and neck
Decreased resp func

38
Q

Meningitis

A

HA
Fever and chills
Stiff neck
Kernig and Brudzinski
Photophobia
Rash
LOC and seizure
ICP and hydrocephalus

39
Q

MG

A

Ptosis
Vision
Facial weakness
General weakness
Dysphonia
Dysphagia

40
Q

Signs of imminent death

A

Mottling of skin
Weak and irregular pulse
Can’t swallow secretions
May or may not have bowel incontinence

41
Q

Compensatory shock

A

BP WNL
Tachycardia
Tachypnea
Hypoperfusion
Anxiety
Confusion
Cold, cool, clammy
Deceased GI motility
Decreased UOP

42
Q

Progressive stage shock (overall ss and patho)

A

BP drop 40 from baseline or <100
MAP <65
Rapid shallow resp, crackles
Chest pain
Mental status
AKI
Liver failure
GI bleeding

Patho: HF, decreases cell perfusion, interstitial edema, anaerobic metabolism, increased clotting cascade/DIC/bruising
Increase capillary permeability
Increased lactic

43
Q

Hypovolemic shock

A

Pale
Cold
Low BP
Clammy
Weak
Fatigue
Dizzy
Thirst

44
Q

Cardiogenic shock

A

Angina
Arrhythmias, ECG
Fatigue
Doom
Cardiac labs - BNP, CK, troponin
Low CO, low BP
Fluid in lungs/crackles

45
Q

Septic shock

A

Hyperthermia
Tachycardia
Bounding pulses
Hypotension
Decreased UOP
NV
Decreased GI motility
Warm flushed skin progresses into cool pale mottled skin
Hepatic
Hypercoagulation, increased CRP/procalcitonin/lactic

46
Q

Anaphylactic shock

A

Acute onset
Respiratory distress - dyspnea and bronchospasm
GI distress
Skin/mucosa irritation (pruritis and uticaria)
CV compromise - arrhythmias, vasodilation, hypotension
HA, flushing
Decreased LOC
Facial edema

47
Q

Electrical burns

A

Dysrhythmia, cardiac arrest
Myoglobinuria
ATN and AKI
Possible spinal injury - always C spine!
Increased CK

48
Q

Inhalation injury

A

Carbonaceous sputum
Facial burns, redness, blistering, edema
Singed nasal hair
Hoarseness
Painful swallow
Dark oral and nasal membranes
Clothing burns around neck and chest

49
Q

Major burn injury complications

A

Fluid shift leading to shock
F and lytes
CV
Hypermetabolic
Pulmonary- airway, carbon monoxide
Renal and GI
Immunological
Thermoregulation
Low platelets - bleeding risk

(In the hospital stuff) - PNA, UTI, respiratory failure, sepsis, cellulitis, wound infection, AKI, arrhythmias, HAI/CLABSI

50
Q

Complications during emergent phase of burn injury

A

ARF
Distributive shock
AKI
Compartment
Paralytic ileus
Curling’s ulcer

51
Q

CV alterations in burn injuries

A

Immediate decreased CO
Loss of fluid volume
Compensatory vasoconstriction leads to increased workload and O2 demands
Hypoperfusion and decreased O2 to body
Low BP
HF and pulmonary edema if too much fluid is infused

52
Q

Fluid and electrolyte imbalances with burns

A

Rapid edema
Fluid shifts, hypovolemia
Hyperkalemia initially
Hyponatremia
Decreased peripheral circulation due to edema and eschar - need an escharotomy
Dehydration
Low blood volume/hemoconcentration
Decreased UOP
Metabolic acidosis

53
Q

GI alterations in burn injuries

A

Paralytic ileus
Curling’s ulcer
Translocation of bacteria
Vomiting and aspiration- need an NGT
Decreased absorption

54
Q

Thermoregulatory changes in burns

A

Skin loss
Hypothermia
(Need to prevent heat loss)
Temp will rise during recovery

55
Q

Complications in acute/intermediate phase burn injury (thermal and electrical)

A

ARF, ARDS
HF, pulmonary edema
Sepsis
Delirium
Visceral damage from electrical

56
Q

F and lyte shifts in acute/intermediate phase burn injury

A

Hemodilution
Increased UOP
Hyponatremia due to diuresis
Hypokalemia
Metabolic acidosis

57
Q

Respiratory ss with progressive shock

A

Acidotic
Shallow and rapid
Crackles, pulmonary edema
Decreased surfactant/alveolar collapse
ARDS

58
Q

CV ss with progressive shock

A

Arrhythmias
Ischemia
Chest pain
Tachycardia
MI
Increased troponin

59
Q

Renal ss with progressive shock

A

AKI
High BUN and Cr
F and lyte and acid base

60
Q

Hepatic ss with progressive shock

A

Jaundice
Increased labs
Increased waste
Increased risk infection
Hyperglycemia

61
Q

GI ss with progressive shock

A

Stress ulcers
GI bleed
Bacterial translocation

62
Q

SIRS

A

“Cytokine storm” in septic shock
High or low WBC
High HR
High or low temp
High RR

63
Q

What is a negative Nikolsky sign

A

No separation from dermis when rubbing first degree burn

64
Q

Burn patho

A

Decreased CO
Capillary permeability leads to edema
Increase SNS
Vasoconstriction and decreased perfusion
Hypovolemia and low BP

65
Q

Kidney ss with burn injuries

A

Hypovolemia leads to injury
Heme in urine due to RBC destruction
Myoglobinuria due to muscle breakdown

66
Q

Normal CPP

A

70 to 100

67
Q

Normal ICP

A

0 to 15

Block 4 Exam 2 (4 decks)

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