Deck 1

Question 1

Spinal cord injury level that causes difficulty breathing?

Answer 1

3-5 however ATI says C4

Question 2

Spinal cord injury level that causes difficulty breathing?

Answer 2

3-5 however ATI says C4

Question 3

What would you assess for with a Spinal cord injury T6 and above?

Answer 3

Autonomic dysreflexia (hypertension and bradycardia)

Question 4

What symptoms does autonomic dysreflexia cause?

Answer 4

hypertension and bradycardia

Bradycardia: (20-40 bpm) - lack of perfusion
Hypertension: (200-280 systolic) - can lead to stroke

Question 5

What are the triggers of autonomic dysreflexia?

Answer 5

Full bladder- administer in and out catheter (straight cath)
Full bowel- perform digital stimulation in the rectum to relieve bowel.
administer antispasmodics

Question 6

Normal value for ICP? KNOW THIS

Answer 6

10-15

Question 7

Findings of increased ICP?

Answer 7

-headache
-LOC changes
-seizures
-dilated pupils
-nausea and vomiting
-posturing

Question 8

1 intervention for Autonomic Dysreflexia and increased ICP

Answer 8

SIT PATIENT UP

Question 9

Decerebrate posturing

Answer 9

wrists turned outwards
damage to brainstem(which houses medulla oblongata) - controls breathing, heartrate, circulation
dangerous

Question 10

Decorticate posturing

Answer 10

arms towards the body’s core (de-CORE-ticate)
legs extended
damage is to the cerebrum - less dangerous

Question 11

What is your first intervention if a patient starts posturing?

Answer 11

Call the doctor as soon as possible, as this indicates a neuro change and possible increase in ICP

Question 12

Patients with a Frontal lobe injury

Answer 12

impulsive!
changes in personality - typically not very nice
very hypersexual
SET BOUNDARIES and document these boundaries.
SAFETY is priority.
Set bed alarm, bed in low position, room close to nurses station, and assign a sitter.

Question 13

C1-C7

Answer 13

Cervical Spine (The neck)

Question 14

Spinal shock

Answer 14

Means spinal cord is injured
irritates the sympathetic nervous system and causes it to work poorly.
leads to neurogenic shock

Question 15

Mannitol for ICP

Answer 15

Osmotic diuretic that pulls fluid from the brain’s cells and the rest of the body and into the vessels - gets secreted in urine

Question 16

What are adverse effects of Mannitol?

Answer 16

Dehydration of Brain
Pulmonary Congestion

Question 17

Cushing’s triad

Answer 17

-bradycardia
-widening pulse pressure
-HTN
“ominous sign” of increased ICP

Question 18

Neurogenic Shock

Answer 18

loss of sympathetic tone
Hypotension
Bradycardia

Question 19

Gillian-barre syndrome

Answer 19

Very similar to MS
autoimmune - affects myelin sheaths
Paralysis starts at the feet and ascends up both sides, and can be deadly as it paralyzes the diaphragm
they are going to need respiratory assistance ASAP!
Contact house supervision ASAP for a vent bed!

Question 20

Describe the paralysis pattern of Guillain-Barre Syndrome

Answer 20

Paralysis starts from the feet bilaterally and ascends up both sides (bilateral ascending pattern)

Question 21

Biggest complication for ALS (Amyotrophic lateral sclerosis, aka Lou Gehrigs disease), Myasthenia gravis, and Gillian-Barre?

Answer 21

Respiratory complications

Question 22

Biggest complication for ALS (Amyotrophic lateral sclerosis, aka Lou Gehrigs disease), Myasthenia gravis, and Gillian-Barre?

Answer 22

Respiratory complications

Question 23

What is DIC?

Answer 23

-Disseminated intravascular coagulation
Clotting and bleeding at the same time
- blood clots form throughout the body’s small blood vessels, using up clotting factors and platelets. → leading to severe bleeding and organ damage→which leads to more clotting = its a cycle

Question 24

What are the main findings of DIC?

Answer 24

Epistaxis (nosebleed)
look at their IV site (will be leaking)
blood-tinged urine
pale
low BP

Question 25

How do we treat DIC? (Disseminated intravascular coagulation)

Answer 25

Heparin