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VN 42 Med Surg 3 > Test 2 disaters & brain/spinal injury > Flashcards

Test 2 disaters & brain/spinal injury Flashcards

1
Q
  1. Botulism manifestations (ch.15 pp slide 11)
A

 Diplopia
 Dysarthria
 Dysphonia
 Dysphagia

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2
Q
  1. Botulism complications (ch.15 pp slide 11)
A

 Paralysis of motor & autonomic nerves
 Drooping of eyes
 Generalized muscle weakness
 Paralysis of respiratory muscles

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3
Q
  1. Smallpox manifestations (ch.15 pp slide 12)
A

 Asymptomatic for 1st 7-14 days before rash develops
 High fever (101-104F)
 Rash beings on face, progresses to extremities (similar to chickenpox lesions)

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4
Q
  1. Anthrax nursing considerations and medical management (ch.15 pp slide 8)
A

 Treated w/antibiotic therapy: Cipro, Levaquin (tx lasts 4 weeks or longer)
 Use standard precautions/hand hygiene & appropriate PPE

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5
Q
  1. Nerve agent poisoning manifestations & medical management
A

Manifestations (CH.15 pp slide 15):

 Bradycardia
 Bronchoconstriction
 Increased GI motility (N/V , diarrhea)
 Cholinergic crisis including bilateral miosis (constricting of pupils)
 Weakness

Medical Management (CH.15 pp slide 16):
 Atropine sulfate
 Diazepam (Valium) – to control possible seizures

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6
Q
  1. Gas, radiological, and chemical exposure nursing management, and priority assessment (ch.15 pp slide 4)
A

Priority: to direct clients to decontamination area & assess for respiratory function

 With chemical inhalation advise clients to go to higher ground
 Administer substances that interfere w/organ concentration (lead) or speed up removal of radioactive substance
 Limit external contamination: stay indoors, go to centrally located room/basement w/few windows, turn off all fans, AC, forced air heating unites, remove & place clothing & shoes in plastic bag, shower/wash w/soap & water. Keep outdoor pets outside

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7
Q
  1. Cyanide medical management (ch.15 pp slide 17)
A

 Wear protective garments & respirator masks
 Administer cyanide antidote: amyl nitrite, sodium nitrite (IV route), IV sodium thiosulfate

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8
Q
  1. Triage steps for disasters (triage pp slide 2)
A

 Evaluate the emergency or disaster: type of incident, # of victims, resources
 Ask questions: sort victims, find emergency team & plan
 Follow the systematic route to victims: start in & work out quickly
 Evaluate & tag each victim
 Treat victims
 Document triage results

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9
Q
  1. Red tag
A

(immediate): can’t survive w/out immediate tx but have chance of survival requires tx w/in 5-30mins)
 Airway & breathing difficulties
 Uncontrolled or severe bleeding
 Decreased LOC
 Severe medical problems
 Shock (hypoperfusion)
 Severe burns

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10
Q
  1. Yellow tag
A

(delayed): require observation, condition stable, no immediate danger of death. Requires tx w/in 30mins-2hrs)
 Burns w/o airway problems
 Back injuries w/ or w/out spinal cord damage
 Major or multiple bone or joint injuries

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11
Q
  1. Green tag
A

(minor): Victims who are wounded but can walk, they will need medical care at some point after more critical injuries have been treated
 Minor fractures
 Minor soft tissue injuries

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12
Q
  1. Black tag
A

(deceased): victims who are dead or injuries are so extensive they will not able to survive
 Obvious death
 Obviously nonsurvivable injury (major open brain trauma)
 Full cardiac arrest

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13
Q
  1. CSF leakage manifestations (ch.39 pp slide 15)
A

 Clear drainage from nose (look for halo sign)

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14
Q
  1. Epidural hematoma manifestations (ch.39 pp slide 13)
A

 Loss of consciousness then a brief period of alertness followed again by LOC – COMA
 Increased ICP
 Most deadly (medical emergency due to increased ICP)
 Bleeding between dura mater & skull (usually arterial blood)
 N/V

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15
Q
  1. Epidural hematoma medical management (ch. 39 pp slide 12)
A

 Indications of surgical emergency: rapid change in LOC, signs of uncontrolled increased ICP
 Burr holes/ Trephining (surgery)
 Intracranial surgery (craniotomy, craniectomy & cranioplasty)

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16
Q
  1. Post intracranial surgery priority assessment. (ch.39 pp slide 16)
A

 Supine or side- lying position
 Regular monitoring (observe for increased ICP)
 Monitor temp: elevated can increase brain metabolism & damage
 Control thrombus or embolus, cerebral edema (limit fluids)

17
Q
  1. Subdural hematoma manifestations (ch.39 pp slide 14)
A

 Bleeding between dura mater & arachnoid (usually venous blood)
 CSF may leak into subdural space
 Increased ICP
 N/V
 Change in LOC
 Headache can come 24-48hrs after injury
 Some neurological deficits/confusion can still develop months after injury
 Later: bradycardia

18
Q
  1. Autonomic dysreflexia manifestations (ch.39 pp slide 20)
A

(Long term effect after spinal shock has resolved)
 Above T6
 Pressure ulcers
 Orthostatic hypotension
 DVT’s
 Diaphoresis
 Severe headache & nausea

19
Q
  1. ICP manifestations
A

 Decreased LOC
 Changes in pupils
 Headache (more sever in the morning)
 Vomiting
 Papilledema
 Restless, confused, periodic disorientation
 Cheyenne stokes respirations

20
Q
  1. Spinal shock client education and manifestations (ch.39 pp slide 20)
A

Manifestations:
 Loss of activity below the point of injury normally happens immediately
 Body will adjust and return
 Poikilothermia (body temperature of the environment)
 Paralysis, numbness
 Pain, difficulty breathing
 Hypotension, bradycardia
 Warm, dry skin

Client Education:
 Monitoring V/S is priority including temp (wont be able to perspire at point of injury, look for hyperthermia)
recovery can be a week to months

21
Q
  1. What are the primary survey triage letters and what do they stand for? (CH.15 pp slide 24)
A

A: airway
B: breathing
C: circulation
D: disability
E: exposure
(PRIMARY THINGS TO ASSESS)

22
Q
  1. Spinal cord injury functions C1-C3(PG.509 Table 39-3)
A

 Use power wheelchair w/movement of head & neck control
 Swallow & speak
 Operate computer or appliances (TV, lights) Using voice activation device or mouth stick
 Breathe w/assistance of ventilator

23
Q
  1. C4-C5
A

 Breathe w/ventilator assistance or possibly independently
 Use a power wheelchair w/sip-and-puff or hand control
 Drink independently using a long straw & bottle

24
Q
  1. C6-C8:
A

 Eat, groom, bathe & attain bed mobility w/assistive devices
 Transfer from bed to chair using a slide board
 Perform self-catheterization (men), more difficult for women
 Use manual wheelchair in flat environment
 Drive w/hand controls

25
Q
  1. T1-T6
A

 Perform personal care & household activities independently
 Use manual wheelchair, including up & down curbs
 Stand between bars w/leg splints

26
Q
  1. T7-T12
A

 Transfer from bed to wheelchair independently
 Propel wheelchair over uneven surfaces & rough terrain
 Care for bowel & bladder independently
 Perform light housekeeping & meal preparation
 balance on legs
 Walk w/splints or long leg braces

27
Q
  1. L1-L2
A

 Drive a car w/hand controls

28
Q
  1. L3-L5
A

 Walk w/support of walker or crutches

29
Q
  1. S1-S5
A

 Walk normally w/out assistive devices
 Control bladder, bowel & sexual functions

30
Q
  1. Spinal cord injury complications during recovery period (Pg. 509)
A

 Respiratory arrest & spinal shock

DVTS, Autonomic dysreflexia, orthostatic hypotension

31
Q
  1. Concussion client education (ch.39 pp slide 3)
A

 Contact primary provider, return to ED if sx of increased ICP occur:
-severe headache
-slurred speech
-vomiting
-unilateral weakness

32
Q
  1. Respiratory Toxin Poisoning nursing management (CH.15 pp slide 18)
A

 Remove victims clothing

 Remove contact lens

 Avoid fatality by assisting victims to fresh air, higher ground

 Wash skin w/soap & water

33
Q
  1. Role of nursing in a Disaster based on priority ABCs in a disaster (CH.15 pp slide 23)
A

 Preparation of public in case of disaster
 Triage: divided into triage categories/system (immediate, delayed, minimal, expectant)

34
Q
  1. Nursing interventions in a disaster ( ch.15 pp slide 23)
A

 Administer 1st aid to victims in immediate category by keeping airway open, covering wounds, controlling bleeding, splinting fxs
 Delegate the care of those w/minimal health needs to volunteers w/1st aid skills

VN 42 Med Surg 3 (14 decks)

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