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Critical Care Nursing > FINALS Review > Flashcards

FINALS Review Flashcards

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1
Q

pts with upper motor neuron injuries will develop this type of bladder and voiding for male (2) and female (1)

A

spastic bladder male-micturation reflex and condom cath female- in/out cath

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2
Q

lower motor neuron injury will result in this type of bladder; voiding for men/women (2)

A

flaccid bladder male and female - crede and in/out catheter

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3
Q

interventions neurogenic bladder (2)

A

1stool softener or bulk forming laxative daily 2dulcolax suppository or digital stim only as ordered.

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4
Q

how to assess an ileus (1)

A

listening bowel sounds

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5
Q

type of plegia with t1 injury

A

paraplegia

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6
Q

type of plegia with c level injury

A

quadraplegia

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7
Q

major concern with c4 level injury, interventions (6)

A

respiratory: ventilator, sp 02, oxygen, cough and deep breathing exercises, suction, cough assist

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8
Q

interventions neurogenic shock main problem(1) - plus 3 smaller resulting problems

A

tissue perfusion dt hypotension, edema and loss of temp regulation postural hypotension -attention with safe transfer safety thrombophlebitis- anticoagulant

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9
Q

muscle tone in injury above L1-L2?

A

spastic

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10
Q

muscle tone in injury below L1-L2

A

flaccid

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11
Q

interventions for muscle strength and tone (2)

A

active and passive ROM

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12
Q

areflexic bowel

A

flaccid bowel

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13
Q

reflexic bowel

A

spastic bowel

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14
Q

result of damage to the clonus medularis and cauda (3) equina -lower ext -bladder -bowel

A

flaccid lower extremities, areflexic bowel and bladder

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15
Q

nuerogenic shock is usually with injuries at this level

A

t6 and above

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16
Q

signs of spinal shock- (3)

A

loss of reflexes loss of sensation flaccid paralysis below level of injury

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17
Q

signs of neurogeic shock (6)

A

hypotension, bradycardia, decreased cardiac output, peripheral vasodiation, venous pooling, loss of ns stimulation

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18
Q

decreased stimulation of the systemic ns would result in (3) which is characterisctic of neurogenic shock

A

perifpheral vasodilation venous pooling decreased cardiac output

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19
Q

ipsilateral loss of motor function, position and vibratory sense, vasomotor paralysis

A

brown sequard

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20
Q

contralateral loss of pain and temperature

A

brown sequard

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21
Q

motor paralysis and loss of pain and temperature

A

anterior cord syndrome

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22
Q

pain and temperature and motor functions intact

A

posterior cord syndrom

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23
Q

loss of propioception

A

posterior cord syndrome

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24
Q

sensation, touch position vibration and motion intact

A

anterior cord syndrome

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25
Q

motor weakness and sensory loss in upper and lower extremeties

A

central cord syndrome

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26
Q

upper extremities are more affected in this cord syndrome than lower

A

central

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27
Q

movement of these are intact with c8 injury

A

arms

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28
Q

risk for these conditions after craniotomy

A

DI and siadh

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29
Q

give this med for DI to retain urine, same action as __

A

DDAVP or desmopressin same action as ADH

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30
Q

phenytoin side effects and interventions

A

gingival hyperplasia- oral care skin rash- notify md dysrhythmias/ hypotension- decrease infusion rate CNs effects- notify MD teratogenic cleft palate, heart defects-avoid during pregnancy

31
Q

CNS effects of phenytoin (4)

A

ataxia, nystagmus, double vision, cognitive impairment

32
Q

substances increase effects of phenytoin (5)

A

alcohol, diazepam, cimetidine, valproic acid, cns depressants

33
Q

substances decreases effects of phenytoin (3)

A

alcohol, carbamazepine, phenobarbital

34
Q

phytoin decreases effects of ex: (3)

A

hepatic drug-metabolizing enzymes; glucocorticoids, warfarin, oral contraceptives

35
Q

pt teaching re phenytoin (4)

A

do not stop abruptly no driving take with meals oral hygiene dt gingival hyperplasia

36
Q

prioritization of patient in disaster triage

A

based on ABCDEFGHI Airway Breathing Circulation Disability Environment F

37
Q

hypoventilation leading to respiratory distress in spinal cord injury is due to (2) can result in (2) interventions (4)

A

due to decreased vital capacity and intercostal and diaphragmatic muscle dysfunction – results in secretion pooling and ineffective cough – suction and mechanical ventilator,02, assist coughing

38
Q

areas to assess for respiratory function in sc injury (10), pt who is unable to do this without taking a breath needs immediate attention

A

breath sounds ABGs PaCO2 60 respiratory effort/ pattern subjective comments amount and color of sputum tidal volume vital capacity skin color cannot count to 10 without taking a breath needs immediate attention

39
Q

contraindications for jeart transplant

A

->70 yo -severe pulmonary disease with likely vent dependent status post transplant -malignancy or life threatening condition with

40
Q

indications for heart transplant

A

-end stage heart disease -inoperable valve disease -recurrent life threatening dysrhythmias unresponsive to interventions - function limiting cadiac abnormalities with mortality risk of >50% at 2 year

41
Q

transplant donation are matched based on (5)

A

hla typing or match, abo compatibility, geographical location, time on the wait list, and medical urgency

42
Q

positive crossmatch vs negative crossmatch and what type of transplant is crossmatch done

A

crossmatch is absolutely done for kidney transplants. a negative crossmatch mean no antibodies to the donar organ and it is safe to proceed with the transplant

43
Q

hyperactute rejection time frame

A

minutes to hours, rarely occurs because of hla typing just before transplant, the blood vessels are rapidly destroyed, removal of organ

44
Q

acute rejection time frame and fix, activated by these (2)

A

within 6 months, lymphocyte and antibodies react to the donated organ. fixed by immunosuppressive thereapy, corticosteriods, polyclonal and monoclonal antibodies. person is at risk for infection especially early in the transplant

45
Q

chronic rejection timeframe, caused by these antibodies. main and specific manifestations kidney, heart, lungs liver

A

months and years and no fix mainly supportive. caused by b and t cells. manifestations of fibrosis and scarring kidney- glomerulopathy/fibrosis heart- advance CAD lungs- loss of bile ducts liver- bronchiolitis obliterans

46
Q

risk when taking immunosuuppressants (2)

A

toxicity and increased risk for infection

47
Q

examples of immunosuppressants (7)

A

cyclosporin, tacrolimus, corticosteroids,mycophenolate mefetil, sirolimus, azathioprine, cyclophosphamide

48
Q

examples of monoclonal antibodies (3)

A

natalizumab, daclizumab, basiliximab, muromonal-Cd3

49
Q

se of cyclosporin (10)

A

neurotoxic, nephrototix, hepatotoxic, gingival hyperplasia, lymphoma, hypertension, hirsutism, leukopenia, seisures, tremors

50
Q

loss of consciousness in this type of seisure

A

tonic clonic

51
Q

definition of tonic

A

stiffening of the body

52
Q

definition of clonic

A

jerking of the body

53
Q

tonic clonic seisure has these three elements during a seisure and can have these (4)

A

loss of consciousness, tonic(stiffeining), clonic (jerking), can have excess drooling, cyanosis, incontinence, tongue or cheek biting

54
Q

s/sx of tonic clonic seisures postictal (3)

A

muscle soreness, tiredness, sleepy

55
Q

hyyperventilation and flashing lights may happen before this type of seisures, which manifest as __,usually seen in children only; seen on the eeg as this -___

A

absence seisure, staring or daydreamig that lasts for a few seconds. . see 3hz spike an wave pattern

56
Q

loss of consiousness and loss of muscle tone

A

clonic seisure

57
Q

sudden loss of muscle tone and drop to the ground, greatest risk for head injury, consciousness returns by the time person hits the ground

A

atonic siesure

58
Q

increased tone of extensor muscles, risk for falls in this type of seisure

A

tonic seisure

59
Q

types of generalized seisures (6)

A

tonic clonic absence atypical absence atonic tonic myoclonic

60
Q

sudden and excessive jerking of the body

A

myoclonic

61
Q

2 types of focal seisures and consciousness

A

simple focal- no loss of consciousness complex focal- loss of consciosness

62
Q

simple focal seizure s/sx

A

aura (unusual feelings or sensations) before a seizure may feel sad, anger, joy, nausea, may see hear, smell, taste or feel things that aren’t there

63
Q

complex focal s/sx, duration

A

loss of consciousness then automatism or repetitive movements such as lip smacking, picking at clothing, fumbling with objects, walking away, lasts for a few seconds.

64
Q

patient teaching re seizures about lifestyle (5)

A

get enough sleep, avoid alcohol and avoid fatige, proper diet, exercise

65
Q

the most dangerous type of seisure that could result in hypoventilation, hypoxemia, dysrhythmias, hyperthermia and systemic acidosis

A

tonic clonc status epilepticus

66
Q

topiramate and levetiracetam treat all types of seizures except this type

A

absence seisures

67
Q

important to monitor for leviteracetam

A

suicide

68
Q

cns effs of leviteracetam (6)

A

weakness, dizziness, agitation, anxiety, depression, suicide

69
Q

cns side effs of topiramate (6)

A

cns effs (somnolence, dizziness,ataxia, nervousness, diplopia, confusion, impaired cognitive fx)

70
Q

interventions for metab acido in topiramate monitor_ report (3) dose

A

monitor bicarb report hyperventilation, fatigue, anorexia dc or reduce dose

71
Q

meds decrease topiramate levels

A

phenytoin and carbamazepine

72
Q

topiramate increases level of __

A

phenytoin

73
Q

interventions re se of angle closure glaucoma in topiramate

A

1vision check to measure ocular pressure 2pt will experience pain, redness, blurring of vision

Critical Care Nursing (5 decks)

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