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Adult III > Exam 3 - Cindy's Flashcards > Flashcards

Exam 3 - Cindy's Flashcards

1
Q

Concussion

A

Mild brief loss of neurological function

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2
Q

DAI

A

Prolonged coma caused by coup/countercoup injury

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3
Q

Epidural hematoma (EDH)

A

ARTERIAL bleeding, bleeding between dura and skull; middle meningeal artery rupture, Brief loss of consciousness, followed, by a lucid period and then deep coma

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4
Q

Craniotomy Care

A

Post-Op: neuro checks, monitor for IICP, check airway, pain, nutritional status and any CSF leaks

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5
Q

Complications of SAH (subarachnoid hemorrhage)

A

Vasospasms
Rebleeds
Hydrocephalus

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6
Q

C-1 thru C-4 Cervical spine injury

A

Assess airway, lose diaphragm use, ventilator dependent

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7
Q

Major complications of spinal cord injuries

A

DVT / PE

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8
Q

Autonomic dysreflexia

A

Exaggerated autonomic response t visceral stimulation occurring with injuries above T6.
MEDICAL EMERGENCY

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9
Q

TX/Interventions for Autonomic dysreflexia

A

Elevate HOB, check for bowel impaction, bladder distenstion, and kinks in foley, evaluate skin for pressure areas. Medicate for HTN using HYPERSTAT, Resperpine or Atropine

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10
Q

Plasmaphresis

A

Infection, hypovolemia, clotting abnormalities, hypokalemia, hypocalcemia, hypotension, myasthenic and cholinergic crisis

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11
Q

Contusion

A

Bruising of the Brain

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12
Q

Subdural hematoma (SDH)

A

VENOUS bleeding, between dura and arachnoid layers; see progressive neuro changes over 2-4 weeks

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13
Q

SIADH

A

Complication post head injury, see coma, may have lung crackles decreased urine output

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14
Q

Subarachnoid hemorrhage (SAH)

A

Bleeding into subarachnoid space between pia and achachnoid layers, usually from rupture of Berry aneurysms.

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15
Q

Nimotop (nimodipine)

A

Prevents vasospasms, give for 21 days

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16
Q

Spinal shock

A

May last weeks to months, see flaccid paralysis below the level of lesion, lose temp control, see hypotension

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17
Q

Use of steroids in spinal cord injury

A

Treats secondary injuries, decreases swelling/inflammation of cord

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18
Q

S/S of Autonomic Dysreflexia

A 
Severe HTN
HA
Bradycardia
Flushing of the face/neck
pupil dilation
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19
Q

Myasthenia Gravis

A

Affects neuromuscular transmission of voluntary muscles. See excessive weakness and fatigue of voluntary muscles. Any age, more common in women ages 14-35 and men over 40. Tensilon test will confirm diagnosis

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20
Q

Guillian-Barre syndrome

A

Rapidly ASCENDING peripheral and cranial nerve dysfunction, leading to paralysis. Respiratory arrest is most common cause of death. check vital capacity and ABGs every shift in assessing respiratory function.

21
Q

Monroe-Kellie Doctrine

A

An increase in blood, CSF, or brain tissue is accompanied by a reciprocal change in the volume in one of the others

22
Q

How to estimate cerebral perfusion pressure. What is normal CPP?

A

CPP = MAP - ICP

Normal CPP is 60-100 mmHg

23
Q

Factors that increase ICP

A

Valsalva, coughing, sneezing, body positions, neck flexion

24
Q

Cushing’s Triad

A

Increased systolic pressure with decreased diastolic pressure (widened pulse pressure) and bradycardia

25
Q

ICP Monitoring

A

Zero and maintain at Foramen of Monroe (corner of eye) never flush if connected to hemodynamic system

26
Q

Pharmacological management of ICP

A

Mannitol, lasix, steroids, barbituates, and anticonvulsants

27
Q

Assessment of neuro status

A

Restlessness

28
Q

Basal skull Fracture s/s

A

Raccoon’s eyes, battles sign

29
Q

Kernig’s sign

A

Cannot extend leg when thigh flexed on abdomen (menningeal irritation)

30
Q

Posturing

A

Decorticate: flexion of arms to center
Decerebrate: extension of arms

31
Q

DKA

A

Glucose 200-800
Positive serum and urine ketones
Insulin dependent diabetics (TYPE 1)
Acetone smell to breath

32
Q

HHNS / HHNK

A 
Glucose 800-2000
No ketones
Serum osmolarity high
Elderly
Higher mortality rate
33
Q

DIC

A

Overstimulation of normal coagulation mechanisms, leading to microvascular thrombi, consumes all coagulation factors which leads to hemorrhage

34
Q

Labs in DIC

A

Platelets decreased
Fibrinogen level decreased
PT/PTT prolonged
Fibrin degradation products (FDP) increased

35
Q

Shock

A

hypo perfusion of body tissues

36
Q

Types of shock

A

Volume (hemorrhage)
Pump (cardiac)
Vessel (sepsis and anaphylaxis)

37
Q

MAST

A

Military anti-shock trousers, used to shunt blood from legs to abdomen and vital organs for perfusion

38
Q

Burn rule of 9s

A 
head & neck = 9
arm = 9 ea
trunk =18 front/ 18 back
legs = 18 ea
perineum = 1
39
Q

Calculation of fluid resuscitation for burns

A 
parkland formula
4mL/kg X %BSA burned = fluids for first 24hrs
-1st 8hrs = 1/2 total Amt
-2nd 8hrs = 1/4 total Amt
-3rd 8hrs = 1/4 total Amt

LR is solution of choice

40
Q

Shock stage of burns

A

Hypovolemic: fluids shift from vascular to interstitial space, see hemoconcentration and edema. Fluids and electrolytes are lost. HYPERKALEMIA, HYPONATREMIA

Diuretic phase: fluids shift back to vascular space, see hemodilution and diuresis.

41
Q

Priorities in burn care

A

-Airway management first, then fluid resuscitation

42
Q

Cause of myoglobinuria

A

Skeletal muscle breakdown, increased Ca+ in and destroys muscle fibers. urin is dark rusty brown to black

43
Q

Extremity management in burns

A

If circumferential, monitor pulses and venous return, monitor for numbness and pain. An escharotomy may be necessary.

44
Q

Wound care in burns

A 
Cleansing (hubbard tank)
debridement
Silvadene (painless)
Sulfamylon (painful)
Silver nitrate (stains black)
45
Q

Primary Assessment for Trauma

A

Airway breathing circulation, control and external hemorrhage, IV, MAST, immobilize potential fractures
Disability, Exposure Fahrenheit, Get full set of vitals, History

46
Q

Secondary assessment for trauma

A

More thorough and complete assessment
Intubate, Place on 100% O2, Stabilize fractures
Additional labs and x-rays, possible peritoneal lavage or abdominal scan, OR, ICU, ongoing assessments

47
Q

Factors that have contributed to success of organ transplantation

A

Cyclosporine
Surgical techniques
Organ and tissue preservation
Legal definition of brain death

48
Q

Drugs used to prevent rejection

A

Cyclosporine, steroids, prograf

Adult III (14 decks)

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