Perfusion 5

Question 1

side effects of Green Tea

Answer 1

has caffeine but labelled as not having

Question 2

HIbiscus tea

Answer 2

lower BP, a potent diuretic and ACE inhibitor

Question 3

Licorice

Answer 3

Increases BP, interferes at the renal level of neg feedback of cortisone (cortisone needs to be converted to its inactive form to not interfere with BP) licorice stops this conversion

Question 4

Coconut Oil

Answer 4

is a saturated fat, advertised as not

Question 5

Garlic

Answer 5

is an anti-inflammatory

Question 6

Ginger

Answer 6

anti-platelet

Question 7

Vit K rich foods would counter the ____ (which drug?)

Answer 7

warfarin

Question 8

Clotting antidotes

Answer 8

for heparins: ise protamin sulfate

coumadin - use vit k or FFP

Question 9

effect of diuretics

Answer 9

decrease preload, heart can pump more efficiently

Question 10

tx of A-fib

Answer 10

calcium channel blockers, beta blockers and anti coagulant/platelet

Question 11

tx of angina

Answer 11

nitro:
if it responds its stable angina.
unstable angina may end in MI

Question 12

tx of HF

Answer 12

ACE inhibitors. or ARBs which are less potent. likely will also be on diuretics or beta 1 blockers (atenolol)

Question 13

drugs to decrease HR

Answer 13

Calcium channel blockers, beta blockers.

Question 14

How soon can we give a thrombolytic for an MI?

Answer 14

within 6 hours.

Question 15

How soon can we give a thrombolytic for a stroke?

Answer 15

3 hours

Question 16

SE of Thrombolytics

Answer 16

risk of bleeding as it is plasminogen.

Question 17

When a atherosclerotic plaque begins to travel it is called a what?

Answer 17

a thrombus

Question 18

Risk factors for a thrombus/thromboembolism

Answer 18

• blood stasis
• high estrogen
• smoking
• blood clotting disorders
• injury to the vessel or embolus (why we treat prophylactically with warfarin during surgery)

Question 19

DVT

Answer 19

diagnosis made with ultrasound.
- pain in the affected area, redness, swelling and edema.
Always assess for symmetry

place pt on thrombolytics or anticoagulants.

Question 20

PE

Answer 20

Caused by DVT
S&S: low o2, compensatory mechanisms, chest pain

diagnosis made with a CT scan

tx: prevention: early mobilication post sx, anticoagulation pre/post/during sx (heparin, LMWH)
- thrombolytics - break the clot before it goes cerebral

Question 21

injury in the brain is a risk of

Answer 21

cerebral edema, increased ICP and brain damage

Question 22

Earliest symptom of increased ICP

Answer 22

LOC changes, can be as subtle as a headache or confusion

Question 23

Cushings Triad

Answer 23

• increased BP
• Decreased HR
• irregular BP

widening pulse pressure in resp to intracranial pressure increasing

Question 24

Vasogenic cerebral edema

Answer 24

BBB compromise

head injury, hematoma, hemorrhage, CNS infection leads to inflammation and increased permeability

Question 25

Cytotoxic cerebral edema

Answer 25

increased intracellular fluid shift, hypoosmotic states, ischemia leading to increased h20 shift into cells. increased ICP

Question 26

tx of cerebral edema

Answer 26

treat the underlying cause ex. fever, dehydration, do they need electrolytes

Question 27

Hypo-osmotic situation

Answer 27

someone sweating but only replacing with water. The blood will be high in water but not electrolytes. The cells will be high in electrolytes but the blood won't. water will move into the cells to balance causing intracellular fluid shift. When this happens in the brain this caused increased ICP.

Question 28

CVA: CT to confirm ischemic vs hemorrhagic

Answer 28

ischemic: 80% of all CVAs

Question 29

Risk factors for CVA

Answer 29

risk factors: htn, artherosclerosis, smoking, dyslipidemia, stenosis, diabetes, atrial fib, meds, age.....

Question 30

TIA

Answer 30

angina of the brain, often a warning sign of CVA risk. | often seen as a brief LOC change, may trip and fall w/o remembering

Question 31

FAST acronym for stroke

Answer 31

Facial Droop Arm Drift Speech slurring Time (call for help)

Question 32

Dysarrythria

Answer 32

weal muscle control (slurred speech)

Question 33

Aphasia

Answer 33

impairment of language (production or comprehension. wernickes or brocas area affected)

Question 34

tx of CVA

Answer 34

- Sx - antiplatelets, anticoagulants - tx htn, dyslipidemia

Question 35

Carotid endarterectomy

Answer 35

cut into carotid and take out the clot

Question 36

Endovascular tx.

Answer 36

following angiogram, the clot is then removed.

Question 37

Area most often affected by CVA

Answer 37

middle cerebral artery, upper limbs and face are the area supplied by this vessel. often affects motor and broca's area.

Question 38

hemorrhagic CVA

Answer 38

more often fatal. risks include htn, meds, age, arterial deficits, bleeding disorders. sudden onset of headache, vomiting. tx: stabilize and reverse anticoagulation. osmotic diuretics, hypertonic NS,

Question 39

Lab work for the CVA pt often includes...

Answer 39

Thrombocytopenia (low platlet count)

Question 40

Osmosis for tx

Answer 40

``` hypertonic NS (3% NaCl IV solution) osmotic diuretic: mannitol ``` the solution has so much solute in it that it will draw water out of the cell. make sure we do this slow or we kill the cells

Question 41

AVM: arteriovenous malformation

Answer 41

congenital defect: a bundle or arteries and veins lacking capillary network and lacking normal wall structure. - high pressure arterial flow enters veins with no capillaries and the vessels rupture. AVM will steal blood flow from surrounding area, causes slow onset neuro deficits, headaches and seizures.

Question 42

Sx tx of AVM

Answer 42

surgical removal or clipping of AVM, gamma knife radiation, embolization

Question 43

Aneurysms

Answer 43

80% of cerebral aneurysms are in the circle of willis which is an area of high pressure in the brain AAA (aortic abdominal aneurysm) causes systemic bleed. NEEDS SURGERY ASAP

Question 44

Risk factors for aneurysms

Answer 44

congentially malformed vessels, htn, atherosclerosis, age

Question 45

sx tx of aneurysms

Answer 45

coiling or flow diversion (similar to angioplasty but in the brain)

Question 46

meds for aneurysms

Answer 46

often started 3 months pre sx and continues 3 months post sx. - ASA, Clopidogrel (plavix) - if the pt is high risk for clotting then heparin immediately post and antiplatelets. MRI followup

Question 47

Why is aortic aneurysm more common in elderly

Answer 47

elastin is not synthesized in the elderly. after menopause with estrogen deficiency comes decreased elastin and collagen (vessels are less strong and flexible)

Question 48

Cardiac Tamponade

Answer 48

Blood in the heart muscle builds up and puts pressure on the heart. decreased CO, heart failure. tx" pericardiocentesis

Question 49

Intracerebral hemorrhage

Answer 49

can be caused by a ruptures aneurysm, AVM, stroke. if this is epidural burrholes may be appropriate.

Question 50

Epidural hematoma

Answer 50

caused by skull fx injury

Question 51

Subdural hematoma

Answer 51

Most common with accel/decel injuries leading to venous tearing.