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AE 3 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Nearsightedness

A

Myopia

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2
Q

Farsightedness

A

Hyperopia

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3
Q

Blurred to distorted vision

A

Astigmatism

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4
Q

Loss of eye lens flexibility, comes with age, blurred near vision

A

Presbyopia

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5
Q

Glaucoma patho

A

Increased IOP causes peripheral visual loss

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6
Q

IOP in primary open glaucoma

A

greater than 21mm Hg

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7
Q

Normal IOP range

A

10-21 mmHg

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8
Q

Other signs of closed angle glaucoma

A

Halos, rainbows, pain

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9
Q

IOP in acute closed angle glaucoma

A

greater than 30 mmHg

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10
Q

What is the test for IOP?

A

Tonometry

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11
Q

When should IOP measurements start?

A

With annual eye exams from age 40

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12
Q

Drug categories: decrease aqueous humor production

A
  • Beta Adrenergic Blockers
  • Alpha Adrenergic
  • Cholinergic agents
  • Carbonic anhydrase Inhibitors
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13
Q

Beta Adrenergic Blockers (2)

A

Reduce aqueous humor production

  • Betoptic
  • TImoptic
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14
Q

Alpha adrenergic (1)

A

Reduce aqueous humor production

- Alphagan

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15
Q

Cholinergic agents (1)

A

Reduce aqueous humor production

- Pilocarpine

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16
Q

Carbonic Anhydrase Inhibitors (2)

A

Reduce aqueous humor production

  • Diamox
  • Trusopt
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17
Q

Drugs that increase aqueous humor outflow

A

Prostaglandin Agonist

- Xalatan

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18
Q

Closed angle glaucoma treatment

A

Surgery

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19
Q

Cataracts patho

A

Progressive opacity or clouding of the LENS

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20
Q

Which condition has poor night vision and inability to do simple things?

A

Cataracts

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21
Q

What is AMD?

A

Degeneration of the fovea that causes blurry central vision

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22
Q

Classic symptom of AMD

A

Scotoma = blind spots

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23
Q

What are the two categories of AMD?

A

Dry (atrophic) - dilated eye exam

Wet (exudative) - amsler grid

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24
Q

Collaborative management for AMD (4)

A
  • Laser surgery for Wet (once a month)
  • Antioxidant supplements - C, E, beta-carotene, zinc+copper
  • Supportive care for low vision
  • Smoking cessation
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25
Q

Diabetic Retinopathy

A

Gradual blindness from damaged blood vessels within the retina

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26
Q

Diabetic Retinopathy treatment

A
  • Laser therapy
  • Vitrectomy
  • MANAGE THE CHRONIC DISEASE
  • REPORT CHANGES ASAP
  • PREVENT IN THE FIRST PLACE - annual exams
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27
Q

Blindness acuity

A

20/200

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28
Q

How can you correct myopia?

A

Keratorefractive surgery

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29
Q

Pre-anesthetic medications (eyes)

A
  • Mydratic eye drops - cyclogyl

- Cycloplegic eye drops - paralysis

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30
Q

What does cyclogyl do?

A

Dilates pupil

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31
Q

What kind of assessment should you get pre op

A

BASELINE assessment

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32
Q

Memory loss is ____ a normal part of the aging process

A

NOT a normal part of the aging process

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33
Q

Dementia is ____ ____ and other cognitive _____

A

Memory loss and other cognitive decline

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34
Q

STOMP B - clinical manifestations of AZ

A 
Speech 
Thinking abstractly 
Object identification 
Motor / memory 
Personality 
Behavior
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35
Q

Prodromal stage of dementia

A

MCI = mild cognitive impairment

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36
Q

Most common form of dementia

A

Alzheimers

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37
Q

Goal of alzheimer management

A

Maintain function for as long as possible

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38
Q

Meds for alzheimer

A

Acetylcholinesterase Inhibitors (Memantine)

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39
Q

Meds for psychotic behaviors, manage agitation, agression in alzheimers

A

Haldol, benzos

*watch out for orthostatic hypotension

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40
Q

CAMS

A

AIDA

  1. Acute onset
  2. Inattention
  3. Disorganized thinking
  4. Altered level of consciousness
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41
Q

Severe on the geriatric scale

A

12-15

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42
Q

Increased CBF causes (4)

A
  • systemic hypotension
  • increase in body metabolic rate (fever, pain)
  • systemic acidosis (hypercapnia, ischemia)
  • cerebral vasodilation
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43
Q

Decreased CBF causes (6)

A
  • Systemic hypertension
  • Decrease in metabolic rate (sedation, paralysis, hypothermia)
  • Systemic alkalosis (hypocapnia)
  • Cerebral edema
  • Low cardiac output
  • Cerebral vasoconstriction
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44
Q

First sign of neurological deterioration

A

Decrease in LOC

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45
Q

Arousal is ______

A

Alertness

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46
Q

Content is _______

A

Awareness

47
Q

Arousal is an evaluation of ___

A

RAS

48
Q

Components of Glasgow

A
  • Motor response
  • Verbal response
  • Eye opening
49
Q

Decorticate posturing indicates dysfunction of ____

A

cerebral hemisphere

50
Q

Decerebrate posturing indicates dysfunction of ____

A

brainstem

51
Q

Which is worse, decorticate or decerebrate?

A

Decerebrate

52
Q

A x O is under arousal or content?

A

Content

53
Q

Reflexes that indicate brain dead

A

Oculocephalic reflex - Doll’s eye movement

Oculovestibular reflex - Cold caloric test

54
Q

Early indicators of increased ICP

A
  • Change in LOC
  • Papilledema
  • Slurring of speech
  • Delay in response
  • Vomiting
55
Q

Late indicators of increased ICP

A
  • Further decrease in LOC
  • Cushing’s triad
  • Pupil changes
  • Altered respiratory patterns
  • Posturing
56
Q

ICP monitoring nursing care

A
  • INFECTION CONTROL
  • aseptic technique
  • vitals
  • IV therapy
  • Antipyretics and cooling blankets
  • Avoid movements that increase ICP
  • Log roll technique
  • Maintain ventilation
  • SAFETY
57
Q

What med can you give for increased ICP?

A

Mannitor *Monitor serum osmolality!

  • Sedatives + Paralytics
  • Opioids
  • Benzos (Ativan)
58
Q

FAST

A

face, arm speech, time

59
Q

Risks for hemorrhagic stroke

A
  • Uncontrolled HTN

- Ruptured aneurysm

60
Q

NIH stroke rating scale

A

42 = worst (higher the worse)

61
Q

Stroke clinical manifestations

A
  • Risk for aspiration (assess swallowing)
  • Decreased muscle sensation (ROM)
  • Slower movement
  • Sensory changes
  • Elimination issues (bladder/toilet schedule)
  • Personality and emotional lability
  • Aphasia
62
Q

Ongoing med management for stroke

A
  • Anticoagulants (Aspirin)
  • Antihypertensives
  • Steroids
  • Anti-Epileptic drugs
  • Anti-anxiety
  • Vitamin K, FFP for hemorrhagic
63
Q

Primary head injury

A

Occurs as direct result of impact

64
Q

Secondary brain injury can be prevented with

A

hypertonic fluids

65
Q

What can you administer for open skull fractures?

A

Abx

66
Q

Basilar skull fracture – worry about:

A

Meningeal tear - TEST DRAINAGE FOR GLUCOSE (CSF)

  • rinorrhea
  • otorrhea
  • facial nerve paralysis
  • periorbital and mastoid ecchymosis
67
Q

Epidural hematoma

  • Source
  • Location
  • Classic presentation
A

Source - arterial
Location - temporal bone
Classic presentation - loss of consciousness, then AOx3 then loss of consciousness

68
Q

In which closed head injury will you see nuchal rigidity?

A

Subarachnoid hematoma

69
Q

Complications of closed head injury

A

DI, SIADH, CSW, herniation, seizures

70
Q

Where do you see urine output more than 200 mL/hr

A

DI

71
Q

Where do you see specific gravity less than 1.005

A

DI

72
Q

Where do you see serum Na greater than 145?

A

DI

73
Q

Where do you see fluid overload and urine output less than 400 mL/day

A

SIADH

74
Q

Where do you see specific gravity greater than 1.02?

A

SIADH

75
Q

CSW is a state of….

A

hypovolemia and hyponatremia

76
Q

Where do you see dilutional hypontaremia?

A

SIADH

77
Q

Epilepsy

A

2 or more unprovoked (primary) seizures

78
Q

Examples of provoked (secondary) seizures

A
  • brain tumor
  • metabolic disorder
  • acute alcohol withdrawal
  • electrolyte disturbance
  • high fever
  • stroke
  • head injury
  • substance abuse
  • heart disease
79
Q

Generalized seizures (4)

A
  • Tonic-clonic
  • Absence
  • Myoclonic
  • Atonic
80
Q

Simple seizures

A

Remain conscious, may have an aura

81
Q

Complex seizures

A

Loss of consciousness, “syncope”

82
Q

What should patients with Atonic wear

A

a helmet

83
Q

Med for status epilepticus

A

Ativan

84
Q

Which skull fractures can heal on their own?

A

Linear and basilar

85
Q

For which skull fractures should you perform surgical intervention?

A

Depressed, Open, and basilar if it doesn’t heal in 2 weeks

86
Q

Drugs for all types of seizures (3)

A
  • Depakote
  • Depakene
  • Dilantin
87
Q

Drugs for partial and general tonic-clonic

A
  • Tegretol
  • Barbita
  • Mysoline
88
Q

4 cardinal symptoms of PD

A

Bradykinesia, rigidity, resting tremors, postural instability

89
Q

Diagnosis of PD

A

Response to antiparkinsonian drugs

90
Q

Trio of symptoms of hydrocephalus

A
  • gait disturbance
  • dementia
  • urinary incontinence
91
Q

pre HTN

A

120-129 / 80-89

92
Q

HTN stage 1

A

130 - 159 / 90-99

93
Q

HTN stage 2

A

160 + / 100 +

94
Q

If older than 60, you want to start HTN tx if BP is

A

150 + or 90 +

95
Q

If younger than 60, have DM, or CKD, start HTN tx if BP is

A

140 + or 90+

96
Q

Leading causes of PAD

A

atherosclerosis and smoking

97
Q

Drug therapy for PAD

A
  • Plavix
  • ASA
  • Trental
  • Pletal
  • *Teach about bleeding precautions
98
Q

What type of assessment do you want to perform after PTCA?

A

Neruvascular assessment

  • pulses
  • cap rephil
  • temp, color
  • sensation
99
Q

Which has pain with dependent positions PAD or PVD?

A

PVD

100
Q

Which has intermittent claudication?

A

PAD

101
Q

Which has dependent rubor

A

PAD

102
Q

Which do you want to elevate?

A

PVD - or if you have both

103
Q

Which do you want moist dressing environment PAD or PVD

A

PVD

104
Q

Which do you want to give compression PAD or PVD

A

PVD

105
Q

Leading cause of blindness

A

Diabetic Retinopathy

106
Q

Main risk factor for PD

A

Age

107
Q

What meds do you caution post op eye surgery and why?

A

Opioids for pain because of post-op vomiting and constipation (both can increase IOP)

108
Q

Ongoing medication for stroke

A
  • Anti HTN
  • Anticoagulants
  • Anti-seizure
  • Steroids to reduce edema
  • Anti-anxiety
109
Q

Anomia

A

Inability to find words

110
Q

Apraxia

A

Inability to use words appropriately

111
Q

Aphasia

A

Inability to speak or understand

112
Q

Agnosia

A

Loss of sensory comprehension

113
Q

What should you avoid in acute stroke care?

A

Interventions that increase O2 demand - suctioning, multiple tasks at once

AE 3 (8 decks)

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