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NU 454 Test III 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
Decreased respiratory reserve
C5-T6
26
Bradycardia, hypotension, postural hypotension, absence of vasomotor tone
Lesions above T5
27
Prophylactic DVT medications
Heparin and Lovenox
28
Antispasmodic Drugs used for hyperreflexia
Baclofen (Lioresal) Dantrolene (Dantrium) Tizanidine (Zanaflex)
29
``` Hypertension (>300 SBP) Throbbing HA Diaphoresis above the lesion Bradycardia (<30-40) Piloerection Flushing Blurred Vision Nasal Congestion Anxiety Nausea ```
Clinical Manifestions of Autonomic Dysreflexia
30
A-Adrenergic Blocker used to tx Autonomic Dysreflexia
Nifedipine (Procardia)
31
Identifies life threatening injuries
Primary Survey: A-E
32
Identifies ALL injuries in more detail
Secondary Survey: F-I
33
Most common potentially LETHAL chest injury
Pulmonary Contusion
34
Tension pneumothorax percussion
Hyperresonance
35
Hemothorax percussion
Dullness
36
Pneumothorax percussion
Hyperresonance
37
Purplish discoloration of umbilical area indicative of blood in abdominal wall
Cullen's Sign
38
Ecchymosis in flank area indicative of retroperitoneal bleeding
Grey Turner's Sign
39
Controls shivering in heat stroke patients
Thorazine IV
40
Drug to tx cerebral edema form submersion injuries
Mannitol
41
Normal water seal chamber for chest tubes
2 cm
42
Normal suction control pressure for chest tubes
20 cm
43
Fluids used to treat trauma victims
Lactated Ringers and Normal Saline
44
A
Airway/C Spine stabilization
45
B
Breathing/Ventilation
46
C
Circulation/Perfusion
47
D
Disability/Neuro Status/PERRLA
48
E
Exposure - remove clothing
49
F
Focal Adjuncts (Interventions), Family education, full set of vital signs
50
G
Give comfort and pain control
51
AVPU
Alert Verbal Response Pain Response Unresponsive
52
H | AMPLE
History/Head to toe exam ``` Allergies Medications Past medical history Last meal Event leading to problem ```
53
I
Inspect posterior surfaces - logroll
54
Most lethal chest injury d/t no s/s
Pulmonary Contusion
55
"Down with good lung"
Pulmonary Contusion
56
Injured lung down
Every chest injury besides pulmonary contusion
57
Most common abdominal injured organ
Spleen
58
Most common FATAL abdominal injured organ
Liver
59
Major complication of heat injury
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
3 medical signs associated with cardiac tamponade 1. distant/muffled heart sounds 2. distended neck veins 3. low blood pressure
Bex Triad
61
Severity of the burn injury is hard to assess d/t it being beneath the skin
The Iceberg Effect
62
Rule of Nines Head & Neck Right Arm Left Arm
9%
63
Rule of Nines Anterior Trunk Posterior Trunk Right Leg Left Leg
18%
64
Rule of Nines Perineum
1%
65
Blunt Cardiac Injury: Myocardial Contusion s/s
Mimic Heart Attack
66
Formula for Fluid Resuscitation for burns
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
Normal Cardiac Output
4-8L
68
Normal Ejection Fraction
60-70%
69
Antidysrhythmics
Amiodarone and Lidocaine
70
3-1 Rule
3mL of (isotonic/crystalloid) fluid for every 1mL of blood loss
71
Neosynephrine
Vasoconstricts and increases BP; give through central line for Neurogenic Shock
72
Nebulizer eppy tx given in response to anaphylactic shock
Racemic Eppy
73
Pulls fluids INTO the vasculature
Colloids
74
- 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
Septic Shock
75
``` A drug with two-fold effects 1. anti-inflammatory 2. anti-thrombotic SE: BLEEDING Very costly, one tx = $8,000 ```
Drotrecogin (Xigris)
76
Reversal agent for Coumadin (Warfarin)
Vitamin K
77
Reversal agent for Heparin
Protamine Sulfate
78
Albumin, Hespan, and Dextran
Colloids - given later to treat shock as volume expanders
79
Drip used to treat anxiety in shock patients
Diprovan
80
Wrap with clean, cool, dampened towel
Small thermal burns
81
Wrap with clean, DRY towel; do not immerse in cool water or wrap with ice
Large thermal burns
82
``` Silver sulfadiazine (Silvadene) Mafenide acetate (Sulfamylon) ```
Topical ointments for burn treatment
83
Goal temperature for hyperthermic patient
102 degrees
84
Use LR cautiously under what conditions?
Treatment of shock d/t liver converting LR to bicarb and liver is not working properly >> overabundance of lactate in the body
85
Risks of dysrhythmias in burn patients
High potassium levels d/t electrolyte imbalances and electrical burns
86
Rarest form of shock d/t impairment of the sympathetic nervous system -s/s: hypotension, BRADYCARDIA, all pressure low d/t vasodilation
Neurogenic shock
87
Secretes myocardial depressant factor which causes the HR to decline
Ischemic pancreas
88
Heparin reversal agent
Protamine sulfate

Medical/Surgical (3 decks)

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