Test 3 Flashcards
Liver, Gall Bladder, Pancreas, Renal, Neuro, Renal Peds, Neuro Peds
0
Q
Functions of the liver (8)
A
- Glucose metabolism (gluconeogenesis)
- Ammonia conversion (excreted in urine)
- Protein metabolism
- Fat metabolism
- Vitamin and Iron storage
- Bile formation (bile salts from cholesterol help increase fat digestion)
- Bilirubin excretion (increased levels in blood indicate liver disease)
- Drug metabolism**
1
Q
Organ that is important in the regulation of glucose and protein metabolism, and secretes bile
A
The liver
2
Q
Caused by exposure to hepatotoxic chemicals, meds, and botanical agents
A
Toxic Hepatitis
3
Q
Signs and Symptoms of Toxic Hepatitis
A
Anorexia
Nausea/vomiting
Jaundice
Hepatomegaly
4
Q
This hepatitis has no effective antidote and has rapid recovery if toxin is removed early
A
Toxic Hepatitis
5
Q
Most common cause of acute liver failure
A
Drug-induced Hepatitis
6
Q
True hepatotoxins (4)
A
- Carbon tetrachloride
- Phosphorus
- Chloroform
- Gold compounds
7
Q
Drug-induced hepatitis clinical manifestations
A
Chills, fever Rash, pruritis Arthralgia Anorexia, vomiting Jaundice, dark urine, enlarged liver (late stages)
8
Q
Sudden and severely impaired liver function in a previously healthy person
A
Fulminant Hepatic Failure
9
Q
Most common cause of fulminant hepatic failure
A
Viral hepatitis
Can also be cause by: toxic meds, chemical exposure, metabolic disturbances
10
Q
Replacement of normal liver tissue with diffuse fibrosis
A
Cirrhosis
11
Q
Clinical manifestations of hepatitis
A
Fever Fatigue Anorexia/loss of appetite Nausea, vomiting Abdominal pain Gray-colored stools Joint pain Jaundice
12
Q
Types of cirrhosis (3)
A
- Alcoholic - most common (scar tissue around portal areas)
- Post-necrotic - acute viral hepatitis (broad bands of scar tissue)
- Biliary - chronic biliary obstruction and infection (scar tissue around biliary ducts)
13
Q
Cirrhosis nursing care
A
Promote rest Improve nutrition Provide skin care Decrease injury risk Monitor for complications (bleeding, hepatic encephalopathy, fluid excess)
14
Q
Hepatic cirrhosis is diagnosed by…
A
Liver biopsy
15
Q
Symptoms of hepatic dysfunction
A
Jaundice Ascites Esophageal varices Hepatic encephalopathy and coma Edema and bleeding Vitamin deficiency Metabolic disorders Pruritis/skin changes Liver abscess
16
Q
Caused by an elevated bilirubin blood level
A
Jaundice (greater than 2.5)
17
Q
Movement of fluid into the peritoneal cavity
A
Ascites
18
Q
Contributing factors to Ascites (3)
A
Portal hypertension
Increased capillary pressure
Obstruction of venous blood through liver
19
Q
Commonly manifested by increased abdominal girth and weight gain
A
Ascites
20
Q
Assessment of ascites
A
Percussion differences, daily weight and abdominal girth measurements
21
Q
Management of ascites
A
Decreased fluid intake Diuretics (aldactone) Decreased sodium diet Paracentesis Bed rest Electrolyte monitoring
22
Q
Development of dilated tortuous veins in the esophagus
A
Esophageal varices
23
Q
Manifested by coughing, throat discomfort, and spitting up blood
A
Bleeding esophageal varices (can result in hemorrhagic shock)
24
Esophageal varices assessment and management
Assessed using endoscopy
| Nursing management: support and bleeding prevention
25
Life threatening complication that can be reversible with recovery of liver function
Hepatic encephalopathy and coma
26
Major contributing factor of hepatic encephalopathy
Ammonia
27
Clinical manifestations of hepatic encephalopathy
```
Mental changes
Motor disturbances
Asterixis (hand tremors)
Constructional apraxia (inability to replicate shapes)
Fetor hepaticus (fecal breath)
```
28
Hepatic encephalopathy assessment and management
Assessed by EEG monitoring
| Managed by lactulose (decrease ammonia levels), monitoring of respiratory and mental status
29
Most common type of primary liver tumor
Hepatocellular carcinoma (HCC)
30
Manifested by weight loss, anemia, weakness, and pain
Liver metastases
31
DNA virus transmitted through blood
Hepatitis B (1-6 month incubation)
32
This is the most definitive diagnosis of liver cancer
Liver biopsy
33
Hepatitis B prevention
Screening blood
Good hygiene
PPE
Active/passive immunity (vaccinations)
34
Bloodborne transmission that has no vaccine and can result in a chronic carrier state
Hepatitis C (15-160 day incubation)
35
Requires Hepatitis B surface antigens for replication
Hepatitis D (30-150 day incubation)
36
Transmitted via a fecal-oral route, most commonly through contaminated water
Hepatitis E (15-65 day incubation) - self limiting
37
Cryptogenic virus that is commonly received via blood transfusions
Hepatitis G, GB virus C
38
Hollow, sac like organ that lies on the inferior surface of the liver
Gallbladder
39
When the flow of bile in the gallbladder is obstructed it causes... (Clinical manifestation)
darkened urine and clay colored stool
40
Signs/Symptoms of Cholecystitis
```
Fever and leukocytosis (inflammation)
Nausea and vomiting
Pain in the upper right quadrant
Anorexia/Loss of appetite
Abdominal distension and feeling of fullness
```
41
Acute inflammation of the gallbladder
Cholecystitis
42
Caused by an obstruction created by a gallbladder stone
Calculous Cholecystitis (most common)
43
Acute gallbladder inflammation without an obstruction
Acalulous Cholecystitis (can occur after surgery or trauma - bile stasis and increased viscosity)
44
Another name for calculi or gallstones
Cholelithiasis
45
This type of stone cannot be dissolved and doesn't react to lithrotripsy
Pigment stone
46
This type of stone can be dissolved and is more common
Cholesterol stone
47
Risk factors of pigment stones
Liver cirrhosis
Hemolysis
Biliary tract infection
48
Signs/Symptoms of a gallstone
Pain - upper right quadrant
Biliary colic - associated with N/V; noticeable after heavy meal
Jaundice
Pruritis - Due to bile salts on the skin
Urine and stool changes - Darkened urine; clay colored stool
Vitamin deficiency - Can lead to bleed deficiencies (decreased Vitamin K levels)
50
Most common diagnostic test for gallstone diagnosis
Endoscopic Retrograde Cholangiopancreatoaphy (ERCP)
51
Nursing Care of cholelithiasis
```
Relief of pain
Maintaining respiratory status
Skin integrity
Nutritional status (low fat diet)
Monitoring for potential complications
```
52
Functions of the Pancreas
Exocrine - Secretion of amylase, tripsin, lipase, secretin
| Endocrine - Secretion of insulin, glucagon, somatostin; control of carbohydrate metabolism
53
Biliary tract disease or a history of alcoholism are risk factors for...
Acute pancreatitis
54
Caused by the self digestion of the pancreas by trypsin
Acute pancreatitis
55
Signs/Symptoms of Acute Pancreatitis
```
Acute onset of severe mid-epigastric pain (will cause patient to seek treatment)
Abdominal distention
Decreased peristalsis
Vomiting (gastric/bile)
Fever
Jaundice
Confusion
```
56
Abnormal lab values in acute pancreatitis can include...
Increased levels of serum amylase and lipase
Increased WBC
Hypocalcemia
Transient hyperglycemia/bilirubin levels
57
Nursing Management of acute pancreatitis/chronic pancreatitis
```
Pain relief
Pulmonary assessment
Nutritional assessment
Skin assessment
Monitoring for potential complications (ascites, hypovolemia, shock, renal failure)
```
58
An inflammatory process that is identified with progressive pancreas destruction
Chronic pancreatitis
59
Signs/Symptoms of Chronic Pancreatitis
```
Severe upper abdominal/back pain
Vomiting, weight loss
Malabsorption, impaired protein and fat digestion
Steatorrhea
Calcium stones in bile duct
```
60
This test is the most valuable in providing information regarding chronic pancreatitis
ERCP
61
Walled off fibrous tissue cysts resulting from necrosis with acute pancreatitis
Pancreatic Pseudocyst
62
Pain, jaundice, and weight loss are the classic signs of...
Pancreatic Cancer
63
Signs of insulin deficiency
Glucosuria
Hyperglycemia
Abnormal glucose tolerance test
64
Nursing management of Pancreatic Cancer
Pain management
Nutritional management
Palliative care
65
Tumors at the head of the pancreas signs/symptoms
Jaundice, clay-colored stool, dark urine
Malabsorption of nutrients/vitamins
Abdominal discomfort, pain
Anorexia, weight loss, malaise
66
Types of Pancreatic Islet Tumors (2)
Insulinoma
| Nonfunctioning islet cell cancer (doesn't affect insulin secretion)
67
This tumor causes the hypersecretion of insulin
Insulinoma
68
Nursing management of this type of tumor involves monitoring for hypoglycemia
Insulinoma
69
Normal GFR
85-105 ml/min
| less than 65 = abnormal kidney function
70
Reversible clinical syndrome with a sudden and almost complete loss of kidney function
Acute Renal Failure
71
Most common causes of ARF (2)
Ischemia (hypotension, hypovolemia, hypoperfusion)
| Nephrotoxins (medications, contrast dyes, endotoxins)
72
Categories of ARF (3)
1. Prerenal
2. Intra-renal
3. Post-renal
73
Results from impaired blood flow that leads to hypoperfusion of the kidneys (ARF category)
Prerenal (fix blood flow = fix kidney damage)
74
Results from actual parenchymal damage to the glomeruli (ARF category)
Intra-renal
75
Results from an obstruction somewhere distal to the kidney (ARF category)
Post-renal
76
Can cause an abrupt and progressive decline of renal function
Acute Tubular Necrosis (most common cause of ARF)
77
Phases of ARF (4)
1. Initiation (exposure to kidney damage)
2. Oliguria (Decreased output, increased BUN/Creatinine)
3. Diuresis (Improvement in kidney function)
4. Recovery (Normal kidney function)
78
Treatment for the Diuresis phase of ARF
HDTV (Hyperkalemia, Dilation of renal arteries, Total volume, Volume control)
79
Best form of prevention of ARF in high risk patients
Hydration
80
Major problems associated with ARF (3)
Fluid volume excess
Pulmonary edema
Electrolyte imbalances
81
Most life-threatening complication of ARF is
Hyperkalemia (Oliguric phase of ARF)
82
Renal diet for a patient with ARF
Low sodium/potassium, Low protein, Fluid restrictions
83
Nursing management of ARF
Monitor for fluid and electrolyte imbalances
Reduce metabolic rate (cluster care)
Promote pulmonary function (TCDB, Incentive spirometry)
Prevent infection
Promote skin integrity
Provide support
84
Progressive irreversible deterioration in renal function
Chronic Renal Failure
85
Stages of Chronic Renal Failure (4)
1. Reduced renal reserve
2. Renal insufficiency
3. Renal Failure
4. End Stage Renal Failure
86
CRF Clinical Manifestations
```
Confusion, altered mental status
Hypertension, edema, Hyperkalemia**
Crackles, Kussmaul's Breathing**
Anemia (decreased erythropoiten)**
Anorexia, Nausea, Ammonia odor (uremic fetor)**
Purpura**, Pruiritis, Ecchymosis
```
87
GFR less than 15, Increased creatinine and BUN, Metabolic acidosis, anemia, and altered calcium/phosphorus levels are all indicative of...
Chronic Renal Failure
88
Nursing Management of CRF
```
Fluid status assessment
Identifying sources of imbalance
Implementing dietary program
Promote positive self feelings
Education
```
89
Patients with CRF should contact their provider if...
Worsening signs/symptoms of renal failure
Signs/symptoms of hyperkalemia
Signs/symptoms of access problems
90
Complications of a hemodialysis access site include...
1. Thrombosis
| 2. Infection
91
Complications of hemodialysis include...
1. Disequilibrium syndrome (shift in CSF; HA and nausea)
2. Hypotension
3. Muscle cramps r/t electrolyte changes
4. Loss of blood
5. Sepsis
92
When preparing a patient for hemodialysis, the nurse should...
Assess vital signs
Assess the condition of the access device (thrill and bruit)
Weigh patient (before and after)
93
This is the biggest complication of PD
Peritonitis (Infection)
94
This type of dialysis doesn't require vascular access, has a more liberal diet, has an increased risk for infection, and increased serum triglycerides
Peritoneal Dialysis
95
This type of dialysis requires vascular access and heparin, can result in rapid fluid/electrolyte shift, has a more restrictive diet, and an improved control over serum triglycerides
Hemodialysis
96
Pediatric Renal Differences (4)
1. Function is reduced with stress
2. Premature infants can't concentrate urine
3. Young children have shorter urethras
4. Most children with ARF regain normal function
97
Pediatric symptoms of a UTI include...
Poor feeding, failure to gain weight
Persistent diaper rash, incontinence (in older children), foul smelling urine
Irritability, fever
98
Pediatric risk factors for UTI
1. Urinary stasis (i.e. ignoring urge to void, constipation)
2. Mechanical factors (i.e. bubble baths, tight diapers, incorrect wiping)
3. Sexual abuse
4. Vesicoureteral reflux
99
Inappropriate urination at least 2 times per week for at least 3 months in a child older than 5 years is referred to as...
Enuresis
100
Nursing interventions for Enuresis
Restrict fluids at bedtime
Bladder training schedule
Medications (as a very last resort)
101
Inflammation of the kidney than can progress to gram negative septic shock in children
Pyelonephritis
102
Backflow of urine up the ureter than leads to urinary stasis
Vesicoureteral reflux
103
Clinical manifestations of vesicoureteral reflux
Urinary frequency, urgency, dysuria, hematuria
Fever, flank/suprapubic tenderness
N/V/D
Irritability, poor feeding, toxic look
104
Nursing interventions for vesicoureteral reflux
Antibiotics
Encourage frequent voiding, frequent diaper changes
Push fluids
Teach proper cleansing (front to back)
105
Manifestation of glomerular damage and altered glomerular permeability (not a disease, but the first sign of damage)
Nephrotic Syndrome (occurs from chronic kidney conditions)
106
Symptoms of Nephrotic Syndome
```
Decreased urine output, proteinuria
Edema**, weight gain
Normal or HYPOtensive blood pressure
Dark, frothy urine
Poor appetite, irritability
Muehrcke bands (on finger nails)
Hyperlipidemia, hypoalbuminemia
```
107
Nephrotic Syndrome Treatment includes...
Prednisone and diuretics
108
Nursing Interventions for a child with Nephrotic Syndrome
Corticosteroids, diuretics, fluids
Assess I/O, daily weights, pulmonary status
Turn frequently, provide skin care
High protein diet, no salt
109
Active inflammation of the glomeruli
Acute glomerulonephritis
110
Symptoms of Acute Glomerulonephritis
Brown, tea colored urine**, decreased output
HYPERtension
Edema
Weakness, activity intolerance
111
The most common type of glomerulonephritis is...
Acute Post-Streptococcal Glomerulonephritis
112
One of the most common causes of sudden, short-term kidney failure in children
Hemolytic Uremic Syndrome (HUS)
113
Common cause and symptom of HUS
Eating foods contaminated with bacteria
| Noticeable by manifestation of bloody diarrhea**
114
A rapidly growing, encapsulated tumor of the kidney
Wilm's Tumor
115
Wilm's Tumor presentation in children
Swelling or mass within the abdomen (DO NOT PALPATE)
116
Treatment for Wilm's Tumor
Removal of affected kidney
117
Post-tumor removal education for children (Wilm's Tumor)
No contact sports, mountain biking, sky diving
| Prevent UTI's
118
Most common PERMANENT neurologic disability in children
Cerebral Palsy
119
NONPROGRESSIVE impairement of motor function control
Cerebral Palsy
120
Risk factors for cerebral palsy include...
Premature birth
Low birth weight**
Multiple birth
Cerebral infection (i.e. meningitis)
121
Early warning signs of cerebral palsy include...
Not meeting growth milestones (growth charts important)
Floppy or limb body in infants
Feeding difficulties
122
Nursing interventions for cerebral palsy
Approach child at appropriate developmental level
Include the family and follow child's usual care routine
Ensure adequate nutrition and skin care
Promote independence
123
Abnormal accumulation of cerebrospinal fluid in the ventricles of the brain, most commonly caused by blockage of flow
Hydrocephalus
124
Cerebrospinal fluid flow is blocked after it exits the ventricles (can move between ventricles) - Type of Hydrocephalus
Communicating
125
Cerebrospinal fluid flow is blocked along one or more of the narrow pathways that connect the ventricles - Type of Hydrocephalus
Non-communicating
126
Common sign of hydrocephalus
Protruding fontanel
127
Clinical manifestations of hydrocephalus in INFANTS
Increased head circumference**, wide-spread sutures
Vomiting (due to increased ICP)
Sunsetting (downward deviation of eyes)
128
Clinical manifestations of hydrocephalus in a CHILD
Headache, nausea, vomiting
Papilledema (swelling optic disc), sunsetting
Poor balance/coordination/gait**
Urinary incontinence**
129
Most common treatment for hydrocephalus
Shunt placement (diverts flow of CSF)
130
Nursing interventions for hydrocephalus
Monitor for infection post-op
Monitor head circumference**, neuro checks
Educate family on ICP and infections signs**
131
When the circumference of the head is smaller than normal, and will fail to grow as the child progresses through infancy
Microcephaly (can result in mental retardation and seizures)
132
A condition in which the cerebellum portion of the brain protrudes into the spinal canal
Chiari Malformation (can be manifested by difficulty swallowing)
133
An infection of the fluid around the spinal cord and the fluid that surrounds the brain
Meningitis
134
Most common form of meningitis that commonly resolves without treatment
Viral (aseptic) meningitis
135
Contagious form of meningitis with a high mortality rate
Bacterial meningitis
136
Classic symptoms of meningitis
Can develop over several hours or take 1-2 days**
Fever and chills**
Headache, stiff neck, nuchal rigidity**
Positive Brudzinski's sign (flexion of extremities occurring with flexion of neck)
Positive Kernig's sign (resistance to extension of child's leg from flexed position)
137
Symptoms of meningitis in infants
Tautness or bulging of soft spots
Poor feeding
Seizures or hearing loss
138
Most definitive way to diagnose meningitis is by...
Spinal tap, blood culture, CT scan
139
Treatment for meningitis
Antibiotics
Corticosteroids
Fluid replacement
Isolation
140
Nursing interventions for meningitis
Respiratory isolation
Immediate administration of antibiotics after cultures are drawn
Decrease environmental stimuli
141
Condition in which there is abnormal development of the spinal cord, spinal column, surrounding nerves, and neural tube
Spina Bifida (cleft spine)
142
Mild form of Spina Bifida that may be manifested by a hairy patch, dimple, or birth mark over the area
Spina Bifida Occulta
143
Moderate form of Spina Bifida in which a fluid filled sac is visible outside the body (can be transilluminated)
Spina Bifida Cystica
144
Severe form of Spina Bifida in which the spinal cord and nerves develop outside the body and are contained in a fluid filled sac (cannot be transilluminated)
Myelomeningocele
145
Major risk factor for neural tube defects
Lack of folic acid during pregnancy (found in leafy greens, beans, nuts, citrus fruits, fortified cereal)
146
Clinical manifestations of Spina Bifida include...
Abnormal appearance of back
| Bowel or bladder difficulties**
147
Most important management for a patient with Spina Bifida
Prevent infection
148
Positioning for a child with Spina Bifida
Prone (keep sac intact)
149
Common complications from Spina Bifida
Infection
| Hydrocephalus
150
When assessing a child for seizures, the most important aspect includes...
History (what happens before, during, and after event)
151
Seizure First Aid includes... (Important for family education)
1. Lowering patient to floor, positioning on side, head aligned straight with body
2. Remain with the child
3. Remove potentially harmful objects
4. Loosen tight clothing
5. Monitor ABC's
6. Do NOT restrain child or place anything in mouth
152
Normal intracranial pressure is...
0-10 mmHg (15 is the upper limit of normal)
153
Normal cerebral perfusion pressure (CPP) is...
70-100 mmHg
154
Cushing's Triad
1. Widening pulse pressure
2. Bradycardia
3. Decreased respirations
155
Cushing's Triad is a clinical manifestation of...
ICP
156
Clinical manifestations of ICP include
Change in LOC
Posturing (Decorticate, Decerebrate)
Cushing's Triad
Ocular changes (dilated pupils, slow eye response)
157
A patient experiencing decerebrate posturing will exhibit...
Extended and adducted arms
Pronated** and flexed wrists
Plantar flexion
158
A patient experiencing decorticate posturing will exhibit...
Flexed and adducted arms
Flexed wrists
Internally rotated legs
Plantar flexion
159
A lumbar puncture is used to test for ICP. True or False?
False - can cause too quick of a pressure release, resulting in herniation
160
Major red flag in ICP monitoring
Level of Consciousness change
161
Nursing interventions for ICP
Report any s/s of increasing ICP
Maintain patent airway
Prevent infection
162
Biggest risk in ICP monitoring
Infection!
163
Basilar fractures of the skull can result in...
CSF leak
164
A patient with a head injury is experiencing drainage from nose/ears, what should the nurse check for and how?
CSF using a dextrose stick (tests for glucose levels in fluid)
165
Signs/Symptoms of a concussion
Headache
N/V
Photophobia
Blurred vision
166
Signs/Symptoms of an epidural hematoma (indicative of worsening bleeding)
Restlessness, Agitation
Confusion
Coma
167
A sudden decrease in blood flow to a localized area of the brain
Stroke
168
Types of strokes (3)
1. Thrombotic - plaque + clot
2. Embolic - clot in a narrow artery
3. Hemorrhagic - ruptured blood vessel
169
The most effective way to decrease the burden of a stroke is through...
Prevention (modifiable/non-modifiable factors)
170
Most important initial diagnostic study for a transient ischemic attack or stroke
CT
171
Brief episode of neurologic dysfunction with clinical symptoms typically lasting less than 1 hour
Transient Ischemic Attack (blockage that resolves on it's own)
172
Most common clinical manifestations of a stroke
Weakness involving the face arm and sometimes leg
Communication loss
Sensory loss
173
The inability to use or understand language
Aphasia
174
Any disturbance in muscular content of speech
Dysarthria
175
Loss of half of the visual field of one or both eyes
Homonymous Hemianopsia
176
Inability to recognize one or more subjects that were previously familiar
Agnosia
177
Inability to carry out some motor pattern
Apraxia
178
Nursing management for a hemorrhagic stroke
ABC's and LOC
| Avoid: heparin, warfarin, aspirin, plavix
179
Right-sided brain damage can include...
Changes in visual perception and ADL's
180
Left-sided brain damage can include...
Memory deficits, loss of basic simple tasks
181
What nursing intervention is most important with stroke...
Patient education, assisting to adapt to changes
182
The degeneration of dopamine generating neurons
Parkinson's Disease
183
Clinical manifestations of Parkinson's
Tremor
Rigidity
Bradykinesia
Postural instability
184
Characteristics of Parkinson's Tremor
More prominent at rest
Aggravated by emotional stress or increased concentration
"Pill rolling"
185
A firm diagnosis of Parkinson's can be made....
When at least 2 of the 4 clinical manifestations are present
186
Goal of Parkinson's treatment
Correct imbalances of neurotransmitters (Drug)
| Alleviate bradykinesia problems (Physical)
187
Destruction of the myelin sheath around the axons of nerve cells
Multiple Sclerosis
188
Common clinical manifestations of MS
Blurred vision, diplopia, decreased visual acuity
| Numbness, tingling, buring
189
Defect in the number of acetylcholine receptors at the postsynaptic muscle membranes
Myasthenia Gravis
190
Myasthenia Gravis is characterized by...
Exacerbations and remissions
191
Initial sign of Myasthenia Gravis
Ptosis (eye drooping)
192
A patient is experiencing respiratory failure and hypertension with tachycardia. These symptoms improve with Tensilon. What is occurring?
Myasthenia Gravis Crisis
193
A patient is experiencing respiratory distress, bradycardia, and hypotension. These symptoms are made worse with Tensilon. What is occurring?
Cholinergic Crisis
194
Best diagnostic test for Myasthenia Gravis
Edrophonium (TENSILON) test (improved muscle tone within 30 to 60 seconds)
195
Diet for patient with Myasthenia Gravis
High protein, high bulk, high roughage diet
196
Also known as "Lou Gehrig's Disease"
Amyotrophic Lateral Sclerosis
197
Early sign of ALS
Fatigue while speaking
198
Immune-mediated syndrome characterized by widespread demyelination of nerves in the peripheral nervous system
Guillain-Barre
199
Clinical Manifestations of Guillain-Barre
Muscle weakness, diminished reflexes
Neuromuscular respiratory failure (Big complication)
Sensory symptoms
200
Disorder of the 5th cranial nerve
Trigeminal Neuralgia
201
Clinical manifestations of Trigeminal Neuralgia
Abrupt onset
Excruciating pain in lips, upper or lower gums, cheek, forehead, or side of nose (generally unilateral)
Attacks are brief in duration
Usually initiated by a trigger
202
Acute, benign facial paralysis (usually unilateral)
Bell's Palsy
203
Clinical manifestations of Bell's Palsy
```
Pain around/behind ear
Fever
Tinnitus
Flaccidity of affected side
Unilateral loss of taste
```
204
An injury at C4 results in...
Complete paralysis below the neck
205
An injury at C6 results in...
Partial paralysis of hands and arms, as well as paralysis of lower body
206
An injury at T6 results in...
Paralysis below chest
207
An injury at L1 results in...
Paralysis below the waist
208
A prognosis for a spinal injury can be made....
72 hours after the injury
209
Most important thing to do in a suspected spinal cord injury
Immobilization!
210
This condition occurs immediately as a response to a spinal injury, resulting in flaccid paralysis and loss of reflexes below the injury. Usually resolves within 24 hours.
Spinal shock
211
This condition develops due to the loss of autonomic nervous system function below the level of the injury
Neurogenic shock (decreased BP, HR, CO; pooling in extremities)
212
The most common precipitating factor of this condition is a distended bladder or rectum
Autonomic Dysreflexia
213
Clinical manifestations of Autonomic Dysreflexia
SEVERE hypertension
Bradycardia
Headache
Flushing, diaphoresis
214
Nursing interventions for Autonomic Dysreflexia
Elevate HOB
Assess the cause
Notify physician
Education
215
Patients with injuries at or above T6 are especially at risk for...
Respiratory problems
216
Especially important to assess for in patients with spinal injury
Areflexic bladder (leads to urinary retention)
