comprehensive assessment Flashcards by Tanya Shaw

transmission of impulses from axon to dendrite is accomplished by?

neurotransmitters

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a lack or inadequate amount of which two substances c an cause a disruption in neuronal function and irreversible damage?

O2 and glucose

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control of the rate of respiration in the brain occurs in the?

pneumotaxic center

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which part of the brain is responsible for processing visual info?

occipital

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the right side of primary visual cortex deals with the left half og the field of view?

true

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a unilaterally dilated, nonreactive pupil indicates to what cranial nerve?

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if the right internal carotid artery is blocked so that inadequate blood flows to the cerebral arteries, O2 and nutrients to the brain:

can still be supported by the circle of willis

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damage to the upper portion of the reticular activating system results in which condition

vegetative state

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which part of the brain is responsible for hearing and memory

temporal lobe

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the parietal lobe is responsible for?

integration of sensory info, awareness of bodyparts, and interpretation of touch, pressure and pain

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what part of the nervous system is responsible for voluntary movement

somatic nervous system

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crossing of the motor fibers in the pyramids of the medulla is called?

decussation

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the spinal cord tracks lie in?

white matter

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a person with an injury to her frontal lobe may have difficulty :

reasoning and making decisions

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division of nervous system that controls involuntary muscles, organs and glands?

autonomic nervous system

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the central nervous system consists of ?

brain and spinal cord

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which of the following is part of the limbic system?3

amygdala, hippocampus, hypothalamus

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sensory receptor involved in regulating BP?

baroreceptors

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PT with severe neurological damage to their hypothalamus may commonly present with?

hyperthermia, resistant to antipyretics

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the blood-brain barrier

is permeable to H2O, CO2 and glucose.

is at the level of the brain capillaries

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most important indicator of neuro function and deterioration

change in LOC

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consciousness primarily mediated by

reticular activating system (RAS)

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RAS

number of structures that extend from the lower brainstem to the cerebral cortex, involved in sleep/wake cycle and arousal

cerebrum reflects awareness and cognition

can be assessed by observing a PTs bhvr in response to diff stimuli

alert to deep coma

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two major components of consciousness

arousal and awareness

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Assess of LOC includes which of the following>

1. GCS 2. motor function 3. eye opening

which of the following are focal signs?

pupils constrict asymmetrically to light and she opened her eyes to a noxious stimulus

what do focal signs tell the CC nurse about the PT

location of O2 supply and demand imbalance

testing coughing and gaging are part of the LOC assess?

false

the transducer on a hemodynamic monitoring system is leveled to the PT's phlebostatic axis. which is located where?

1. level of the right atrium | 2. 4th intercostal space mid-axillary

when does the transducer need to be zeroed

1. whenever there is a disconnection between the transducer and monitor 2. in order to obtain accurate readings 3. to negate the effects of atmospheric pressure

you notice your PT's arterial pressure waveform has a steep upstroke, an obvious dicrotic notch and a trough. you would?

consider this normal

the hemodynamic assess framework is? 3

1. is part of the O2 supply and demand framework 2. focuses primarily on heart rate and the determinants of CO 3. incorporates data from hemodynamic monitoring systems NOT- isolation to direct PT assessment

the purpose of assessing motor strength in each limb is to?

determine the focus of the lesion in the brain

which lab value best for eval AKI?

serum creatinine

Sue, a 38 year old woman, presents in ER complaining of acute onset of chest pain and feeling very short of breath. Her ABGS show the following: pH 7.48 PaO2 58 PaCO2 31 HCO3 25 SaO2 88 Given what you know of Sue’s situation, the most appropriate interventions at this time include:

immediate ECG and supplemental O2

Freda was admitted to ICU after an extensive bowel surgery 48 hours ago. She ahs been persistently drowsy and requires significant verbal and tactile stimuli to rouse her. She is receiving oxygen via nasal prongs at 4L/minute. Her ABGs were: pH 7.36 PaO2 66 PaCO2 51 HCO3 30 SaO2 92 The most likely cause of Freda’s acid-base imbalance is:

impaired vent due to drowsiness

ivy's pupils were 3mm round, and constricted brisk to direct and consensual light. there findings indicate which of the following?

cranial nerves II and III are intact and functional

do coughing and gagging affect a GCS score?

false

bc ivy tried to pull the endotrach tube when suctioned, nurse doesnt hae to do the trap squeeze to assess best motor response?

true

cough and gag which cranial nerves?

IX and X

test for cough and gag are part of LOC assess?

false

what does Franks MAP (92) indicate in terms of O2 supply to the tissues and end organs

his MAP is normal and indicates that his BP is adequate to provide O2 supply to his tissues and organs

Frank is bleeding into ABD, how will this affect his determinants of CO?

CO= HR x SV | the bleeding will result in decreased circulating Vol, causing decreased preload

what assess data can you use to determine the effect of this bleeding on Franks preload?

franks preload is low from flat jug veins and suspect bleeding in ABD

what assess data can you use to determine the effect of his bleeding on Franks afterload?

his afterload is HIGH based on decreased periph pulses and increased diastolic BP

would you expect to hear extra heart sounds (S3, S4) if you listened to Franks heart?

No, those sounds are normally heard with fluid vol overload or increased preload

what does franks assess data tell you about his O2 supply?

O2 supply to tissues and end organs is OK for now. His MAP of 92 indicates that his increased HR has compensated for his decreased preload

what does the assess data tell you about franks O2 demand?

franks O2 demand is elevated d/t elevated HR and increased afterload

what are you r conclusions about Ave's WOB

WOB elevated by: high RR, accessory muscles, labored breathing

If Ave's O2 on RA = 88%, is she had an ABG done what might her PaO2 be?

PaO2 would be low d/t shunt (bronchial breath sounds and course crackles)

O2 sat on RA = 88%, if she had a ABG, what might her PaCO2 be?

unchanged or slight low BC she is breathing rapidly

what do Ave's bronchial breath sounds indicate? course crackles?

bronchial = area of consolidation CC = fluid in alveoli or small airways

Ave's O2 supply is decreased d/t a gas exchange prob?

true

Ave's bronchial breath sounds indicated deadspace vent?

false

Ave's O2 demand is increased d/t a gas exchange prob?

false - Ventilation bc O2 demand is RR and WOB

Ave's resp increased WOB is reducing her gas exchange?

false- her increased WOB decreases her ventilation her poor diffusion and V/Q mismatch would be reducing gas exchange

Ave's O2 demand is increased d/t her increased WOB?

true

stimulation of parasymp produces which of the following on the GI system?

increased secretion of watery saliva

pH gastric juice not mixed with food

1.0 with food 2-3.0

what are produced by exocrine by pancrease

trypsin, amylase, lipase

what is produced from endocrine of pancrease

insulin (beta cells) glucagon (alpha) both directly into blood

vagal response from valsalva maneuver will?

stimulate gastric secretions plug nose and breath out hard from mouth will decrease your HR ?