Final

Question 1

cerebellar strokes

Answer 1

BE FAST
- time of onset is important
> 3-4hr for ischemic strokes
> TPA
sudden onset of movement and coordination difficulties

Question 2

how are we responding to strokes?

Answer 2

1 ) neuro assessment w/ primary RN
2 ) VS
3 ) call MD after

Question 3

seizure precautions

Answer 3

prioritize safety
protect the head
maintain airway
- recovery position
do not restrain
don’t place anything in mouth
loosen clothing
time the seizure, movement, type

Question 4

CIWA assessment parameters

Answer 4

scoring on both obj/subj
- the higher the score, the higher chance of complications w/ their withdrawal

Question 5

Alcohol withdrawal-symptom onset (unmedicated)

Answer 5

abrupt stop
onset = 6-12h after last drink
> minor
24-48h = withdrawal seizures
48-96 = delirium tremens
> susceptible individuals

Question 6

alcohol intoxication

Answer 6

patho:
- ↓CNS depression
clinical man:
- altered LOC
- ataxia
- judgement, speech
diagnostic:
- blood alcohol
- 0 = no
tx:
- precautions
- recovery position
- hydration (IV)
- Intubation for at risk

Question 7

ETOH W/D

Answer 7

patho:
- ↑CNS
clin. man:
- agitation, anxiety
- tremors/NV/speech
- sweat/aud/vis/tactile
- headache
- ↑BP/HR
diagnostic:
- IV
- 0 BAC
tx:
- CIWA-AR
- Benzo’s
> ↓hyperactive cells

Question 8

hepatic encephalopathy

Answer 8

patho:
- ↑ammonia in brain
clin. man:
- altered LOC
- asterixis
diagnostic:
- serum ammonia
tx:
lactulose
> osmotic
> keeps ammonia from being reabsorbed
> 2-3 loose BM/day

Question 9

wernike’s encephalopathy

Answer 9

patho:
- malnutrition
- ↓thiamine
clin. man:
- altered LOC
- ataxia
- abnormal eye movement
diagnostic
- no labs
- hx?
tx:
- thiamine
> IV, PO

Question 10

rt-sided HF

Answer 10

• JVD
• pedal edema
• hepatomegaly

Question 11

lt-sided HF

Answer 11

• SOB(OE)
• fine crackles in lungs
• fatigue
• dry cough
• orthopnea

Question 12

lt-sided HF and pulmonary edema

Answer 12

fluid builds up in the lungs in the alveoli
interstitial edema > blocking diffusion
tx:
ByPAP
dry cough b/c it’s irritating but not accessible to cough out
> until pink-tinged sputum = bad

Question 13

tx for HF as nurse

Answer 13

1 ) O2 for hypoxia
2 ) start IV
3 ) diuretics (loops) = IV
4 ) other meds for HF
5 ) fluid and Na restriction

Question 14

leukocytosis

Question 15

leukopenia

Question 16

neutropenia

Answer 16

d/t to disease process OR tx
infection risk
reverse precautions
low amount of neutrophils (WBC)

SIRS criteria
Neutrophils = < 0.1 x 109/L
T = 38.0, go to ER

Question 17

hypoalbuminemia

Question 18

hyperalbuminemia

Question 19

hypokalemia

Question 20

hyperkalemia

Question 21

hypocalcemia

Question 21

hypercalcemia

Question 22

hyponatremia

Question 23

hypernatremia

Question 24

anemia

Question 25

common cancer complications -- infection

Answer 25

caused by: - ulceration/necrosis - compression of vital organs - neutropenia tx: - prevention - check labs - Granulocyte Colony-Stimulating Factors (G-CSF) - antibiotics

Question 26

common cancer complications -- malnutrition

Answer 26

depletion of fat and muscle intervention: - measure albumin

Question 27

oncologic emergencies obstructive -- superior vena cava syn.

Answer 27

d/t obstruction of vena cava by a tumor clin. man: - facial edema - periorbital edema - distended neck and chest veins - headache - seizure diagnosis: CXR tx: - urgent radiation therapy

Question 28

oncologic emergencies obstructive -- malignant spinal cord compression (MSCC)

Answer 28

d/t tumor compressing the spinal cord clin. man: - paralysis, loss of sensation - back pain - weakness, tingling - bowel/bladder function tx: - emergent glucocorticoids > dexamethasone - urgent radiation therapy - ↓inflammation

Question 29

oncologic emergencies obstructive -- intestinal obstruction

Answer 29

d/t complete or partial obstruction d/t swelling of the intestine or solid tumor invasion clin. man: - projectile vomit, odd smell - N/V, abdominal pain, distension tx: - NG tube on suction - surgery