Quiz 5: Stroke, SIRS, Shock, Sepsis, Blood clots

Question 1

Why do we want to know if our patients are on anti-coagulation medications?

Answer 1

We conduct procedures that may cause bleeding.

Question 2

What are the two pathways that can be activated during a blood clot?

Answer 2

Intrinsic - changes to vascular epithelium

Extrinsic - tissue damage (trauma)

Question 3

What is the material that holds clots together?

Answer 3

Fibrin

Question 4

T/F: The body is always working towards homeostasis.

Answer 4

True.

Question 5

When balance of homeostasis is disrupted, it can lead to the development of:

Answer 5

Coagulopathies - leading to hypercoagulability (likely to develop excessive clots) or bleeding disorders (excessive bleeding)

Question 6

If a blood clot travels to another location, it is a(n):

a. thrombus
b. emboli
c. coagulation
d. all of the above

Answer 6

b. emboli

Question 7

If a blood clot remains in the vein, it is a(n):

a. thrombus
b. emboli
c. coagulation
d. all of the above

Answer 7

a. thrombus

Question 8

T/F: Antithrombotics are to prevent further formation of clots, while thrombolytics are to break up existing clots.

Answer 8

True.

Question 9

Which diagnostic is the GOLD standard for detecting pulmonary embolism?

a. V/Q scan
b. hemotology
c. CT pulmonary angiogram
d. MRI

Answer 9

c. CT pulmonary angiogram

Question 10

Which diagnostic test for pulmonary embolism is very accurate but very invasive?

a. pulmonary angiogram
b. hemotology
c. CT pulmonary angiogram
d. MRI

Answer 10

a. pulmonary angiogram

Question 11

Which of the following are preventative treatments of PE?

1. Ambulating
2. Exercise while sitting
3. Compression stockings
4. Drinking lots of fluids

Answer 11

1, 2, 3, and 4

Question 12

T/F: Cerebrovascular Accidents can be identified as mini strokes.

Answer 12

False. CVA is a stroke that can be ischemic or hemorrhagic. Transient Ischemic Attack is a mini stroke.

Question 13

T/F: TIAs are associated with higher chance of stroke.

Answer 13

True

Question 14

What is the acronym used for identifying a patient with a stroke?

Answer 14

F-A-S-T

Question 15

Loss of blood flow, therefore blocked blood vessels that cannot supply the brain tissue with oxygenated blood, best describes which type of stroke?

Answer 15

Ischemic (embolic):

Embolism, arteriosclerotic, vasoconstriction.

Question 16

What is the best treatment for ischemic strokes?

Answer 16

Thrombolytic medications to break up clot and and restore blood flow
Chance of bleeding.

Option 2: Vascular stenting/surgery

Question 17

Patient had an aneurysm post surgery and is now bleeding inside the brain. What type of stroke is this?

Answer 17

Hemorrhagic stroke (bleeding):
Post traumatic/surgical, aneurism, antiocoagulant therapy.

Question 18

Which of the following are treatments for hemorrhagic strokes?

1. Preventing hypertension
2. Keep HOB elevated
3. Minimize pt stimulation
4. Reverse anticoagulation if possible
5. Embolization, craniotomy

Answer 18

All of the above

Question 19

What is the time frame for door to needle stroke protocol?

Answer 19

60 min or less

Question 20

What acronym is associated with the treatment of ACS?

a. F-A-S-T
b. M-O-N-A
c. A-B-C-D-E
d. P-E-R-R-L-A

Answer 20

b. M-O-N-A

Morphine - relieve chest pain/cardiac workload
Oxygen - reduce myocardial workload
Nitroglycerine - dilate coronary arteries to improve blood flow
Aspirin - prevent further clotting

Question 21

T/F: You should always obtain a 12-lead EKG for ACS.

Answer 21

True.

This will show cardiology if there is a blockage and where exactly it is located. Monitor patient closely for deterioration and have crashcart nearby.

Question 22

What is the goal time for Percutaneous Coronary Intervention (PCI)?

a. 30 minutes
b. 60 minutes
c. 90 minutes

Answer 22

c. 90 minutes

90 minute door to balloon time or less.

Question 23

What is the goal time for fibrinolytic therapy?

a. 30 minutes
b. 60 minutes
c. 90 minutes

Answer 23

a. 30 minutes

30 minute door to needle time or less.