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ABSN Cohort 19 > MedSurg2 Exam 2 -FINAL- > Flashcards

MedSurg2 Exam 2 -FINAL- Flashcards

1
Q

Types of Strokes (4)

A

TIAS (Transient Ischiemic Attacks)
Thrombolytic Strokes
Hemorrhagic Strokes
Embolic Strokes

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2
Q

Cause of TIAS and S/S (2)

A

Interruption of cerebral blood flow

impaired vision and speechlessness

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3
Q

Cause of Thrombolytic Strokes and…
Common in…?
Onset…?

A

Blood clot forms and obstructs blood flow
Common in elderly w/ atherosclerotic plaque deposits
Occurs rapidly, progresses slowly, occurs at rest

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4
Q

Cause of Embolytic Stroke and…
Common on…
Onset…?
Occurs when pt is…?

A

When traveling blood clot (embolism) travels to and lodges in artery of brain
Common in younger individuals
Appears suddenly w/ immediate neurological deficits
Occurs when awake and active

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5
Q

Cause of Hemorrhagic Stroke and what is it REKNOWN for?

A

Intracranial hemorrhaging: rupturing of vessels in vein

BEING W/OUT WARNING AND MOST FATAL

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6
Q

Zones of Injury (3)

A

Ischemic - will recover w/ blood flow
Injury - some recover/some don’t
Necrotic - CANNOT be recovered and contraction inhibited

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7
Q

Stroke Fx: Aspiration 5 Interventions

A 
Provide nutritional support
Evaluate swallowing (dysphagia = cranial nerve lesions)
Assess cognition
Assess positioning during eating
Monitor throat clearing/coughing
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8
Q

Stroke Fx: Impaired Mobility Tx Premise (3 interventions to prevent 3 s/s)

A

Rehab, SCD tockings, and Anticoagulants to prevent pulmonary embolism, VTE, or DVT

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9
Q

Stroke Fx: Communication 4 Types of Aphasia, premise, and intervention focus

A

Expressive/Brocas - difficulty speaking/writing, ↑ reliable language output
Receptive/Wernickes - difficulty understanding, ↑ comprehension
Mixed - combo of 2 above, both interventions
Global - Zero language capacity, ↑ non-verbal comms

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10
Q

Stroke Fx: Urinary Elimination

Hypo/HyperReflexia and Diapers?

A

Hypo - indwelling cath ASAP, output should not ne > 400mL
Hyper - establish voiding sched.
NO DIAPERS

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11
Q

Stroke Fx: GI Elimination
Constipation r/in…?
How do we influence BM?

A

Constipation - this ↑ BP

Diet/Meds that promote BM

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12
Q

Stroke Fx: Sensory Perception
Key Care
R Hemisphere Issues
L Hemisphere Issues

A

Prevent ulcers, neglect, assess agnosia (counter w/ consistency)
R - visual/spatial perception
L - memory deficit

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13
Q 
Stroke Fx: Body Neglect
Which side ↑% injury?
Educate pt to...?
Dress which side first...?
Why turn pt head...?
A

R side
Use both sides of body
Affected Side
↑ Visual field

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14
Q

Stroke: Mnemonic F.A.S.T S/S

A

Facial Drooping
Arm WEakness
Speech
Time

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15
Q

Burn Pt Key Tx
How many/IV Types?
Med for Propylaxis
Burned extremities vs. Normal?

A

2 Large bores (14-16 gauge)
Tetanus Toxoid
Neutral Burned, Elevate Normals

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16
Q

3 Burn phases and Main Issues

A

Emergency/Resuscitation - 24 - 48 hrs, pain meds
Acute - 2 weeks - 18 months, infection
Rehabilitation - Ø time, self-image

17
Q 
Management of...
Flame
Chemical
Electrical
Radiation burns (2 ea)
A

smother flames, remove clothing/metal objects
Ø wet! ascertain type before neutralizing
start cardiopulmonary resuscitation, get EKG
undress/bath pt, send to decontamination

18
Q

What to monitor in burns and topical med of choice

A 
Urine Creatinine (14 - 26)
Gentamicin Sulfate (Garamycin)
19
Q

Full Thickness Burn:
Skin Level Effected
General Look (color spread, blisters?, level edema)
Dermis look & sensation

A

Entire epidermis and dermis (no cells to repopulate)
red - white, Øblisters, severe edema
Leathery firm, Øsensation

20
Q

Full Thickness Tx Goals (4)

A

Secure Airway
Circulation
Ø Infection
Maintain Temp

21
Q

Burn Grafts:
Auto
Xeno (Hetero)
Allo (Homo) (2 ea)

A

Auto - butt to arm, 10 - 14 heal time
Xeno - animals like pigs, temp due to rejection until Allo available
Allo - humans (family, donors), triggers rejection

22
Q

Isograft/Syngraft

A

Transplantation between identical twins

23
Q

Electrical Burns:
“Grand Masquerader”
Conversion…?
4 Emergency Management Notes

A

surface injury small, internal huge
electrical converted to heat

Separate pt from current
Smother flames
Cardiopulmonary resuscitation
Get ECG

24
Q

Traumatic Brain Injury (TBI) 4 main causes and 4 mechanisms w/ examples!

A

Falls, Motor accidents, drugs, alcohol
Acceleration/Deceleration - bat/wall
Rotational - left hook
Penetrating - headshot!

25
Q

TBI Ischemic Tx

AGGRESSIVE (4) !!!

A

AGGRESSIVE tx hypoxia/hypoTN
Give O2
Fluid Resuscitation

26
Q

Halo Vest Care
Can I touch it…?
Abnormalities…?
2 scheduled (qXhr) interventions.

A

Don’t touch anything unless CPR req. Then remove.
Report abnormalities to doc.
Assess motor fx q2-4hr, turn q2hr

27
Q 
Spinal Fusion Post-Op Key interventions
Check for... (3)
Perform...
2 qXhr interventions
Follow...
PCA or PO Analgesia?
A 
bleeding, CSF, void ability
neuro assessments
log roll and deep breath q2h (counters atelectasis)
exercise program
BOTH OK!
28
Q

Fx of…
Lower Motor Neurons (r/t CNS, T/L location, s/s)
Upper Motor Neurons (r/t CNS, T/L location, s/s)
Guillain-Barre Syndrome (what is, development s/s)

A

leaves CNS - ↓L1, Øreflex/spasm but +pain
don’t leave CNS, T12 - L1, spasticity/paralysis
When immune system attacks nerves.
Begins w/ weakness/tingling and becomes paralysis

29
Q

3 Types of Hematomas, location and cause

A

Subdural - in outer (dura mater) - venous bleeding
Subarachnoid - between arachnoid/pia (inner matter)
Epidural - epidural skull down spinal cord - arterial bleeding into space or fracture

30
Q

Post-Op Neuro Pt Key Ranges (2)

Key ABCS (2 ea)

A

Glasgow: 3 - 15
ICP: 10 - 15

Airway - ventilated? cervical spine injury?
Breathing - breathing? Hypercarbia -> ↑ ICP
Circulation - preserve cerebral perfusion by 30º the bed and NO VALSALVAS!

31
Q 
Post-Op Neuro Meds
Mannitol is for..., monitor...?
Pentobarbital is for...? 
Phenytoin is for..?
Morphine/Fentanyl are for...? monitor...(2)?
A

↓ cerebral edema, I&O’s
↑ coma to reduce metabolic demands (LAST RESORT)
↓ seizures
↓ pain, monitor BP and ABGs

32
Q 
Shock Labs FX
HH
BP/O2
PaCO2
PaHCO3
BUN/Creatinine
Lactate
A 
↑
↓
Variable, ↓ w/ ↑RR
↑ r/t poor kidney perfusion
↑ r/t poor kidney perfusion
↑
33
Q

SCI’s

Proprioception vs Dermatomes

A

Proprioception - awareness of body part location

Dermatomes - concept that specific section of spine senses topographical part of body

34
Q

Trauma Care - Primary Survey
ABCDE

AVPU

A

Airway
Breathing
Circulation
Disability (LoC/Motor Fx) - Alert, Verbal Stimuli, Painful Stimuli, Unresponsive
Exposure/Evacuation - assess external injury and temp

35
Q

Trauma Care - Secondary Survey

FHGI

A

Facilitate family presence
Give Comfort
Hx (HTT in 90 seconds)
Inspect posterior surfaces

36
Q

Trauma Care - Resuscitative Measures
FNFL

Occurs with what Survey?

A

Foley Insertion
NG insertion
Fluid Resuscitation
Labs (specifically Type/Cross-Match)

Occurs w/ Primary Survey

ABSN Cohort 19 (28 decks)

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