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Medical/Surgical > NU 454 Test III > Flashcards

NU 454 Test III Flashcards

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USMLE® Step 1 flashcards
1
Q

Tetraplegia

A

Quadriplegia - paralysis of both arms and legs

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2
Q

Apoptosis

A

Cell Death

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3
Q

TEMPORARY Neurologic Syndrome characterized by: < reflexes, loss of sensation, flaccid paralysis below the level of injury

  • Lasts days to months
  • Rehab can begin during this phenomenon
A

Spinal Shock

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4
Q

Neurologic Syndrome caused by loss of vasomotor tone cause by injury characterized by: hypotension, bradycardia
Loss of sympathetic nervous system
-peripheral vasodilation
-venous pooling in the legs
-decreased cardiac output
Associated with cervical or high thoracic injury (T6 or higher)

A

Neurogenic Shock

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5
Q

Most common injuries d/t flexibility and movement

A

Cervical/Lumbar Injury

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6
Q

Results in tetraplegia; however, low rarely includes the arms

A

Cervical Injury

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7
Q

Injury resulting in paraplegia

A

Thoracic/Lumbar

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8
Q

Phrenic Nerve

A

C3-C5 keep the diaphragm alive

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9
Q

Motor weakness and sensory loss are present in both upper and lower extremities, but the upper are more effected than the lower

  • cervical cord region
  • older adults
A

INCOMPLETE Degree of Injury: Central Cord Syndrome

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10
Q

Damage to the Anterior Spinal Artery resulting in compromised blood flow d/t acute compression of anterior SC often by flexion injury

  • motor paralysis
  • loss of pain and temperature below injury

-sensations of touch, position, vibration, and motion are intact (POSTERIOR)

A

INCOMPLETE Degree of Injury: ANTERIOR Cord Syndrome

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11
Q

Damage to one half of the spinal cord

  • loss of motor function, position, and vibratory sense
  • vasomotor paralysis on the same side as the lesion (ipsilateral)
  • loss of pain and temperature sensation (contralateral)
  • typically from a penetrating injury
A

INCOMPLETE Degree of Injury: Brown-Sequard Syndrome

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12
Q

Compression or damage to the posterior spinal artery; rare

  • loss of proprioception
  • pain, temp, motor function remain INTACT
A

INCOMPLETE Degree of Injury: POSTERIOR Cord Syndrome

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13
Q

Damage to the very lowest portion of the spinal cord and lumbar/sacral nerve roots (L3)

  • flaccid paralysis of lower limbs
  • flaccid bladder and bowel
A

INCOMPLETE Degree of Injury: Conus Medullaris Syndrome and Cauda Equina Syndrome

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14
Q

Lowest portion of spinal cord

A

Conus

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15
Q

Lumbar and sacral nerve roots

A

Cauda Equina

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16
Q

Used to treat delayed gastric emptying

A

Metoclopramide (Reglan)

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17
Q

Zantac and Pepcid

A

H2 Receptor blockers

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18
Q

Protonix, Prilosec, Prevacid

A

PPIs

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19
Q

The adjustment of the body temperature to the room temperature

A

Poikilothermism

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20
Q

Steroid that improves blood flow and reduced edema to the spinal cord

-must be given EARLY (<8 h after admission)

SE: immunosuppresion, GI bleeds, increased risk for infection

A

Methylprednisolone (MP)

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21
Q

Ideal MAP for spinal cord injury

A

> 90 mmHG

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22
Q

Vasopressor used to sustain increased MAP

A

Dopamine (Intropin) and Levophed

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23
Q

Apnea, inability to cough

A

C1-3

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24
Q

Poor cough, diaphragmatic breathing, hypoventilation

A

C4

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25
Q

Decreased respiratory reserve

A

C5-T6

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26
Q

Bradycardia, hypotension, postural hypotension, absence of vasomotor tone

A

Lesions above T5

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27
Q

Prophylactic DVT medications

A

Heparin and Lovenox

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28
Q

Antispasmodic Drugs used for hyperreflexia

A

Baclofen (Lioresal)
Dantrolene (Dantrium)
Tizanidine (Zanaflex)

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29
Q 
Hypertension (>300 SBP)
Throbbing HA
Diaphoresis above the lesion
Bradycardia (<30-40)
Piloerection
Flushing
Blurred Vision
Nasal Congestion
Anxiety Nausea
A

Clinical Manifestions of Autonomic Dysreflexia

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30
Q

A-Adrenergic Blocker used to tx Autonomic Dysreflexia

A

Nifedipine (Procardia)

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31
Q

Identifies life threatening injuries

A

Primary Survey: A-E

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32
Q

Identifies ALL injuries in more detail

A

Secondary Survey: F-I

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33
Q

Most common potentially LETHAL chest injury

A

Pulmonary Contusion

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34
Q

Tension pneumothorax percussion

A

Hyperresonance

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35
Q

Hemothorax percussion

A

Dullness

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36
Q

Pneumothorax percussion

A

Hyperresonance

37
Q

Purplish discoloration of umbilical area indicative of blood in abdominal wall

A

Cullen’s Sign

38
Q

Ecchymosis in flank area indicative of retroperitoneal bleeding

A

Grey Turner’s Sign

39
Q

Controls shivering in heat stroke patients

A

Thorazine IV

40
Q

Drug to tx cerebral edema form submersion injuries

A

Mannitol

41
Q

Normal water seal chamber for chest tubes

A

2 cm

42
Q

Normal suction control pressure for chest tubes

A

20 cm

43
Q

Fluids used to treat trauma victims

A

Lactated Ringers and Normal Saline

44
Q

A

A

Airway/C Spine stabilization

45
Q

B

A

Breathing/Ventilation

46
Q

C

A

Circulation/Perfusion

47
Q

D

A

Disability/Neuro Status/PERRLA

48
Q

E

A

Exposure - remove clothing

49
Q

F

A

Focal Adjuncts (Interventions), Family education, full set of vital signs

50
Q

G

A

Give comfort and pain control

51
Q

AVPU

A

Alert
Verbal Response
Pain Response
Unresponsive

52
Q

H

AMPLE

A

History/Head to toe exam

Allergies
Medications
Past medical history
Last meal
Event leading to problem
53
Q

I

A

Inspect posterior surfaces - logroll

54
Q

Most lethal chest injury d/t no s/s

A

Pulmonary Contusion

55
Q

“Down with good lung”

A

Pulmonary Contusion

56
Q

Injured lung down

A

Every chest injury besides pulmonary contusion

57
Q

Most common abdominal injured organ

A

Spleen

58
Q

Most common FATAL abdominal injured organ

A

Liver

59
Q

Major complication of heat injury

A

Rhabdomylosis: breakdown of muscle tissue, CK levels are high, myoglobin in urine (tea colored) pink, to red, to brown

This can lead to renal failure

60
Q

3 medical signs associated with cardiac tamponade

  1. distant/muffled heart sounds
  2. distended neck veins
  3. low blood pressure
A

Bex Triad

61
Q

Severity of the burn injury is hard to assess d/t it being beneath the skin

A

The Iceberg Effect

62
Q

Rule of Nines

Head & Neck
Right Arm
Left Arm

A

9%

63
Q

Rule of Nines

Anterior Trunk
Posterior Trunk
Right Leg
Left Leg

A

18%

64
Q

Rule of Nines

Perineum

A

1%

65
Q

Blunt Cardiac Injury: Myocardial Contusion s/s

A

Mimic Heart Attack

66
Q

Formula for Fluid Resuscitation for burns

A

4 mL LR x kilograms x % TBSA

1/2 of total in first 8 hours
1/4 of total in second 8 hours
1/4 of total in third 8 hours

67
Q

Normal Cardiac Output

A

4-8L

68
Q

Normal Ejection Fraction

A

60-70%

69
Q

Antidysrhythmics

A

Amiodarone and Lidocaine

70
Q

3-1 Rule

A

3mL of (isotonic/crystalloid) fluid for every 1mL of blood loss

71
Q

Neosynephrine

A

Vasoconstricts and increases BP; give through central line for Neurogenic Shock

72
Q

Nebulizer eppy tx given in response to anaphylactic shock

A

Racemic Eppy

73
Q

Pulls fluids INTO the vasculature

A

Colloids

74
Q
  • Sepsis with hypotension unresponsive to fluid resuscitation
  • Widening pulse pressure
  • Neutrophil bands < 4,000 or > 12,000
  • Skin warm and pink
  • Hyperglycemia > 140 w/o DM
A

Septic Shock

75
Q 
A drug with two-fold effects
1. anti-inflammatory
2. anti-thrombotic
SE: BLEEDING
Very costly, one tx = $8,000
A

Drotrecogin (Xigris)

76
Q

Reversal agent for Coumadin (Warfarin)

A

Vitamin K

77
Q

Reversal agent for Heparin

A

Protamine Sulfate

78
Q

Albumin, Hespan, and Dextran

A

Colloids - given later to treat shock as volume expanders

79
Q

Drip used to treat anxiety in shock patients

A

Diprovan

80
Q

Wrap with clean, cool, dampened towel

A

Small thermal burns

81
Q

Wrap with clean, DRY towel; do not immerse in cool water or wrap with ice

A

Large thermal burns

82
Q 
Silver sulfadiazine (Silvadene)
Mafenide acetate (Sulfamylon)
A

Topical ointments for burn treatment

83
Q

Goal temperature for hyperthermic patient

A

102 degrees

84
Q

Use LR cautiously under what conditions?

A

Treatment of shock d/t liver converting LR to bicarb and liver is not working properly&raquo_space; overabundance of lactate in the body

85
Q

Risks of dysrhythmias in burn patients

A

High potassium levels d/t electrolyte imbalances and electrical burns

86
Q

Rarest form of shock d/t impairment of the sympathetic nervous system

-s/s: hypotension, BRADYCARDIA, all pressure low d/t vasodilation

A

Neurogenic shock

87
Q

Secretes myocardial depressant factor which causes the HR to decline

A

Ischemic pancreas

88
Q

Heparin reversal agent

A

Protamine sulfate

Medical/Surgical (3 decks)

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