Exam 1 Flashcards
what does your body need to clot effectively?
functioning liver, Ca, phospholipids, platelets
what labs measure clotting?
PT/INR, PTT<,aPTT, anti-Xa
what would you find on assessment if your patient has prolonged clotting?
bleeding, easy bruising, hematuria
what would you expect to find if pt has decreased clotting time?
-stroke, thrombosis, limb ischemia, renal injury, heart attack, DVT< PE
what are three different types of coagulation drugs?
antiplatelets (on arterial), anticoagulation (venous) , and thrombolitics (both )
when would your pt be on an antiplatelet vs an anticoagulant
venous clot vs arterial clot
anticoagulation– DVT, a-FIB (prevent a stroke that comes from the heart)
how does Coumadin/warfarin work?
reduces your risk of clots by reducing the time it takes to make a clot
what is sinus tacky caused by? how to treat?
external influences on the heart, NOT cardiac conditions –> treat the underlying cause
what are signs of a basilar skill fracture? why is this so dangerous?
racoon eyes and battles sign (behind the ears) - dangerous because you can get a CSF bleed -> infection (meningitis) & HA & herniation
SCI care: C5
breathing - yes
neuro - can move their face, can talk, but they are quadriplegic
cardiac - low cardiac output (we want to create constriction with ted hose and binding)
GI- incontinent, increased sphincter tone (we need stool softeners)
GU - spastic bladder
integ - risk for pressure injuries
SCI care: T3
a lot of the same as C5 applies, but there is more that they can do
-they might have some movement capabilities in their upper extremities
SCI care: T9
the big difference between T3 and T9 is that T9 has full function of their upper extremities
SCI care: L1
often independent in their wheelchairs
GI:
decreased tone –> we want to keep stools firm
GU - incontinent
the urine is flowing out but they are unable to completely empty the bladder so their is still some urinary retention
which patient would you educate about autonomic dysreflexia?
- incomplete spinal
-pt with T8 injury
-pt with complete T4
-all pts with spinal cord injury
complete at T6 or above
so the complete T4 is the right answer
what are the hallmarks of autonomic dysreflexia? how do we treat?
spike of hypertension
bradycardia
thermo disregulation
vasodilation above (flushing and hot)
vasoconstriction below (cold pale)
**
we treat by removing the stimulus
what are the differences between spinal and neurogenic shock
-spinal shock happens first, is a temporary loss of reflexes and sensations
-paralysis below the level of injury
-risk of secondary injury to the chord
—-
neurogenic shock is distributive shock, so it includes hypotension and bradycardia, loss of motor tone
warm or cold extremities
what are somethings we can do to limit secondary injuries?
-stabilize the spine
-keep pt calm
-catheter and ng tube
-monitor for resolution
TBI nursing management
managing ICP- positioning, medications, surgery , drain
prevent secondary injury
calm environment
sinus bradycardia treatment
atropine and possible pacing
first degree AV block treatment
monitor and continue to observe
Central cord syndrome manifestations
-more weakness in the upper extremities
- “man in a barrel”
anterior cord syndrome manifestations
-loss of pain and temperature sensation
-keep proprioception and vibration
brown-sequard syndrome manifestations & rap
-crossed symptoms
loss of ipsilateral motor sensation
loss of contraletal pain and temp
“Im a hip ViP, I walk with a limp”
“Contemplate the pain I will create”
as ICP goes up
CPP goes down
CO2 is a potent
vasodilator
