TOPIC 3 Midterm Flashcards
is a medical imaging procedure that uses x-rays and digital computer technology to create detailed pictures of the body
Computerized tomography (CT) Scan
is a test that uses powerful magnets, radio waves, and a computer to make detailed pictures of the inside of your body
Magnetic resonance imaging (MRI)
is a type of nuclear medicine imaging.
Positron emission tomography (PET)
is a nuclear imaging technology that enables visualization of metabolic processes in the body.
Positron emission tomography (PET)
is an angiographic procedure that involves inserting a catheter into a blood vessel in the groin or arm.
Cerebral angiography
In Cerebral angiography patient will be monitored for
4-6 hrs
is the pressure required to move sufficient amounts of blood to the brain
Cerebral perfusion pressure (CPP)
the ones whose patient care requires ICP monitoring as they have expertise in neurological assessment and monitoring device management.
Neuroscience nurses
is a pressure wave along the artery that offers various information on cardiovascular conditions
Pulse wave form
is a non-invasive, painless ultrasound technique that uses high-frequency sound waves to measure the rate and direction of blood flow inside vessels
Transcranial Doppler
The test examines and records the speed of the blood flow in arteries known as the
Circle of Willis
a valuable tool to assess brain function
Continuous electroencephalogram (EEG)
is the most common scoring system used to describe the level of consciousness in a person following a traumatic brain injury.
Glasgow Coma Scale (GCS)
is a standardized tool that is commonly used to assess patients suspected of experiencing an acute cerebrovascular accident
National Institutes of Health Stroke Scale (NIHSS)
commonly used to assess a patient’s cognitive status when there is a concern of cognitive impairment
Mini-Mental Status Exam (MMSE)
can be assessed by asking the patient to turn their head to each side, against the examiner’s resistance
Sternocleidomastoid
can be assessed by asking the patient to shrug their shoulders, against the examiner’s resistance
Trapezius
type of stroke is caused by a blockage in an artery that supplies blood to the brain
Acute ischemic stroke
traumatic injury leading to damage of the spinal cord, resulting in temporary or permanent change to neurological function, including paralysis.
Traumatic spinal cord injury
TSCI can be classified:
Complete injury
Incomplete injury
damage occurring across the whole spinal cord width
Complete injury
the injury is spread across part of the spinal cord
Incomplete injury
the neurosurgeon will create one or two small holes within the skull, followed by an incision in the dura if necessary, in order to drain the blood clot.
Burr hole drainage
the neurosurgeon will remove a section of bone to create access, then remove the blood clot
Craniotomy
are compounds in foods that scavenge and neutralize free radicals
Antioxidants
chemicals found in plants that protect plants against bacteria, viruses, and fungi.
Phytochemicals
reduced inflammation and blood sugar levels
Bilberry
Bilberry fruit contains chemicals known as
anthocyanosides
scavenge damaging particles in the body and helping prevent or reverse damage to cells
free radicals
Sensation requires both light touch and pin prick assessment
Trigeminal nerve
Initially assess for symmetry in the face at rest
Facial nerve
Hearing can be assessed by whispering a number into each ear separately
Vestibulocochlear Nerve CN VIII
is instructed to walk placing one foot directly in front of the other, heel to-toe
Gait tandem
consists of testing of the primary sensory modalities which include pain, proprioception, vibration and light touch
Sensory evaluation
psychologically traumatic or occur within a broader context of psychological trauma
Traumatic brain injury
Evaluate stroke patient using
FAST
life-threatening condition that occurs when the body is not getting enough blood flow
Shock
become more permeable, and fluids and electrolytes seep from and into the cell
cell swells and the cell membrane
Stages of shock
Compensatory, Progressive, Irreversible
blood pressure remains within normal limits
Compensatory
to maintaining adequate cardiac output. release of catecholamines
Vasoconstriction HR, and contractility of the heart contribute
The patient displays the often-described fight or flight” response
Compensatory
In compensatory the body shunts blood from organs such as
the skin, kidneys, and gastrointestinal tract
mechanisms that regulate blood pressure can no longer compensate and the MAP falls below normal limits
Progressive
represents the point along the shock continuum at which organ damage is so severe that the patient does not respond to treatment
Irreversible
can occur as a progression along the shock continuum or as a syndrome unto itself
Multiple organ dysfunction
Overall management in shock
Fluid replacement
Vasoactive medications
Nutritional support
administered in all types of Shock
Fluid replacement
are administered
in all forms of shock to improve the patient’s hemodynamic stability when fluid therapy alone cannot maintain adequate MAP
Vasoactive medications
Classification of shock
Hypovolemic
Cardiogenic
Obstructive
Distributive
occurs when there is LOW fluid volume in the intravascular system
Hypovolemic shock
shock occurs when there is a reduction in intravascular volume of 15% to 25%. This would represent a loss of 750 to 1,300 mL of blood in a 70-kg (154-lb) person
Hypovolemic shock
The average human blood volume
5L
occurs when the heart’s ability to contract and to pump blood is impaired
Cardiogenic shock
causes of cardiogenic shock are known as either
coronary or non-coronary
seen most often in patients with myocardial infarction
Coronary cardiogenic
be related to metabolic problems and tension pneumothorax
Non-coronary
INITIATION OF FIRST-LINE TREATMENT
Supplying supplemental oxygen
Controlling chest pain
Providing selected fluid support
Administering vasoactive medications
Controlling heart rate with medication
a form of shock associated with a physical obstruction/ blockage of the great vessels
Obstructive shock
Three of the most common examples of obstructive shock
Cardiac tamponade
Tension pneumothorax
Pulmonary embolism
Obstructive Shock: Management
Control airway
Intubation
Treat the underlying cause
maldistribution or mismatch of blood flow to the cells
Circulatory or distributive shock
Normal adults < 10 - 15 mm Hg
Intracranial pressure monitoring
Commonly used mnemonic regarding assessment
of individuals suspected of experiencing a stroke is
BEFAST
Prior to administering the MMSE, ensure the patient is wearing
Glasses or hearing aids
A disorder that commonly results in decreased or absent tendon reflexes is
Adie’s tonic pupil
Two surgical treatment options to remove the blood clot
1.Burr hole drainage
2. Craniotomy
shock state resulting from displacement of blood volume creating a relative hypovolemia and inadequate delivery of oxygen to the cells
distributive shock
may be administered to increase the intravascular volume
Crystalloids, colloids, and blood products
Classification of Circulatory shock
Septic shock
Neurogenic shock
Anaphylactic shock
It can occur in any person with impaired immunity, but elderly people are at greatest risk
Septic shock
The disorder is thought to be a response to that release microbes or immune mediators, such as tumor necrosis factor and interleukin- 1
Septic shock
Is a shock state resulting from loss of sympathetic tone causing relative hypovolemia.
Neurogenic shock
is caused by a severe allergic reaction when a patient who has already produced antibodies to a foreign substance (antigen)develops a systemic antigen– antibody reaction.
Anaphylactic shock
occurs rapidly and is life threatening.
Anaphylactic shock
overwhelming inflammatory response in the absence of infection causing relative hypovolemia and decreased tissue perfusion.
Inflammatory response syndrome (SIRS)
Four sirs criteria
- Tachycardia- heart rate >90 beats/min
- Tachypnea- respiratory rate >20
- Fever or hypothermia- temperature >38 or <36 °C
4.Leukocytosis, leukopenia, or bandemia- white blood cells >1,200/mm3, <4 ,000/mm3 or bandemia ≥10%
is a bedside prompt that may identify patients with suspected infection who are at greater risk for a poor outcome outside the intensive care unit (ICU).
Q Sofa
3 component assessment system with Q Sofa
• Systolic blood pressure ≤100 mmHg
• Highest respiratory rate ≥22 breaths per
min
• Lowest Glasgow coma score <15
an illness severity score commonly used in critical care medicine to predict mortality upon admission to an intensive care unit.
Acute Physiology and Chronic Health Evaluation (APACHE) score
the best-known & most widely used score with good calibration & discrimination.
The APACHE
was released in 1985 and included a reduction in the number of variables to 12.
The APACHE II scoring system
was designed to predict an individual’s risk of dying in a
hospital.
APACHE III
is a mortality prediction score that is based on the degree of dysfunction of 6 organ systems
Sequential Organ Failure Assessment (SOFA)
score stratifies mortality risk in ICU patients without restricting the data used to admission values.
Sofa
is an objective and useful index.
logistic organ dysfunction system (LODS) score
assesses six systems in terms of the extent of dysfunction on the first day of an intensive care unit (ICU) stay.
LODS
6 s ystems in LODS
Neurologic, Cardiovascular, Renal, Pulmonary, Hematologic, and Hepatic systems
was designed to combine measurement of the severity of multiple organ dysfunctions into a single score.
LODS
is altered organ function in an acutely ill patient that requires medical intervention to support continued organ function.
Multiple organ dysfunction syndrome (MODS)
isn’t an illness itself; rather, it’s amanifestation of another progressive, underlying condition
Multiple organ dysfunction syndrome
organ system failure is due to a direct injury such as
trauma or a primary disorder that usually involves the lungs,
Primary Mods
It occurs most often in the patient with septic shock and progressively unfolds over about 1 month.
Secondary mods
