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Nurs 2500 > Lecture 8 review > Flashcards

Lecture 8 review Flashcards

1
Q

Scale of level of consciousness from most to least

A 
Alert
Lethargic 
Obtunded
Stupor
Coma
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2
Q

What kind of drug is diazepam (Valium)?

A

Long acting benzodiazepine. Onset: po 0.5-2 h; Half-life 100 h

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3
Q

What kind of drug is lorazepam (Ativan)?

A

Intermediate acting benzodiazepines. Onset: po 2-4 h, sl 1 h, IV 5-10 min; Half-life 10-20 hours

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4
Q

What kind of drug is midazolam (IM/ IV only)?

A

Short acting Benzodiazepines. Onset: IV 1.5-5 min; Half-life 1-4 hours

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5
Q

What kind of drug is Flumazenil (Anexate)?

A

Benzodiazepine reversal drug

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6
Q

What kind of drug is phenobarbital?

A

Barbiturate. Very narrow therapeutic index.

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7
Q

What kind of drug is zopiclone (Immovane)?

A

A miscellaneous CNS depressant

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8
Q

Flat affect (blunted affect)

A

Lack of emotional response, no expression

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9
Q

Depression

A

Sad, gloomy, dejected

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10
Q

Depersonalization

A

Loss of identity, feeling estranged, feels disconnected from everything

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11
Q

Elation

A

Joy and optimism, overconfidence

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12
Q

Euphoria

A

Cheerfulness and optimism that is inappropriate to the situation

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13
Q

Anxiety

A

Worried, uneasy, and apprehensive, but without specific cause

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14
Q

Fear

A

Worried, apprehensive

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15
Q

Irritability

A

Annoyed, easily provided, impatient

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16
Q

Rage

A

Furious, loss of control

17
Q

Ambivalence

A

Opposing emotions. Not sure what they’re feeling

18
Q

Labile

A

Rapid shift of emotions

19
Q

Inappropriate affect

A

Mismatch of affect with behaviour/ speech

20
Q

What is delirium?

A
  • An acute confusional state.
  • Consciousness clouded
  • Dulled cognition
  • impaired alertness
  • inattentive
  • incoherent
  • poor memory
  • agitated
  • hallucinations
21
Q

Causes of delirium

A
  • underlying medical condition
  • alcohol/ substances
  • medications
  • environment
22
Q

Physiological conditions that affect LOC

A
  • low blood glycose

- low oxygen

23
Q

Appropriate painful stimuli to central

A
  • trapezius squeeze
  • supraorbital pressure
  • mandibular pressure
  • sternal rub
24
Q

Decorticate posture

A

This is a type of flexed posturing and can indicate damage to the cerebral hemispheres.

There will be adduction and flexion of arms and hands will be closed shut (flexed). The legs will be rotated internally and feet plantar flexed.

Remember the letters COR in the word decorticate for the word “core”. The patient will bring their ARMS to the core of the body (middle).

25
Q

Decerebrate posture

A

This is a type of extended posturing and can indicate damage to the brain stem. This is the worst type of posturing between the two.

There will be adduction and extension of the arms and pronation of the hands and fingers will be flexed along with extended legs and plantar flexion of the feet.

Look at all the E’s in this word. There are a lot of them, so remember the word EXTENDED. The arms are going to be extended rather than flexed.

26
Q

Safest adjuvant medication

A

benzo-like

27
Q

Less safe adjacent medication

A

barbiturates

28
Q

What is GABA?

A

A neurotransmitter with inhibitory effect on CNS

29
Q

How do benzos and barbiturates work with GABA?

A

They bind to GABA receptor, opening the chloride channel, inhibiting the neuron from firing. Inhibitory effects of GABA are enhanced

30
Q

The inhibitory effects of GABA

A
  • anxiety is reduced
  • wakefulness is reduced
  • memory and awareness is affected
  • neuro-excitability is reduced
31
Q

Benzodiazepines compared to barbiturates

A

Benzodiazepines only potentiates GABA. Barbiturates enhances GABA and mimics GABA

32
Q

Barbiturates drug effects

A
  • notorious enzyme inducers
  • accumulation with liver impairment and in the elderly
  • reduced REM sleep
  • additive effect with alcohol and other CNS depressants
  • overdose frequently leads to respiratory depression and subsequent respiratory arrest
  • overdose produces CNS depression

Nurs 2500 (16 decks)

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