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3512 > week 10 > Flashcards

week 10 Flashcards

1
Q

what is amyotrophic lateral sclerosis

A

muscles whither away, progressive paralysis (mind is intact)

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2
Q

how long is the prognosis for ALS

A

2-6 years after diagnosis

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3
Q

is there any treatment for ALS

A

no

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4
Q

what is Gillian-barre syndrome

A

bodys immune system damaging nerve (usually follows infection)
- symmetrical paralysis starting at feet and goes up
- painful

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5
Q

what is the treatment for Gillian barre syndrome

A

plasmapheresis and IVIG

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6
Q

how does guillian barre present

A

starts as weakness and twitching, then gets worse within the hours

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7
Q

what is Duchenne muscular dystrophy

A

the once that’s common in young boys, onset of weakness begins at age 4

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8
Q

what is the disease progression of Duchenne muscular dystrophy

A

starts at age 4, unable to move independently by age 12
life expectancy 20-30 years old

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9
Q

how does MS result in chronic inflammation and scarring

A

because myelin keeps trying to regenerate

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10
Q

whats the main way to diagnose MS

A

evoked response testing

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11
Q

why would MS patients be on Ritalin

A

to increase energy

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12
Q

what is the anti spastic med used for MS

A

baclofen (to decrease muscle spasms

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13
Q

what is the main patient education for a patient with MS on a corticosteroid

A

it increases risk of infection which could exacerbate MS

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14
Q

what is the main anticholinergic used for MS and what is it for

A

ditropan used to increase bladder tone

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15
Q

what is the ideal pain med for fractures

A

T 3

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16
Q

what at the two ways to put a fractured bone back into place

A
  • reduction: pull joint
  • open method: surgery
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17
Q

how often should you assess sites of an external fixation

A

every 8-12 hours

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18
Q

should you remove pin site crust?

A

no

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19
Q

how long should skin traction be used for

A

48-72 hours

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20
Q

what is the weight for skin traction

A

2.3-4.5 kg

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21
Q

what are the two way to treat compartment syndrome

A

cut cast
fasciotomy

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22
Q

what do you do if a patient has a confirmed DVT clot

A

bolus heparin IV, then IV infusion heparin continuous
move to PO Coumadin after a couple of days

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23
Q

what are the symptoms of fat embolism

A

sudden decreased oxygenation
suddenly confused, passed out, or restless
increase rr, sense of impending doom

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24
Q

what is the treatment of fat embolism

A

nothing. just to supportive care

25
Q

which bone fracture could cause avascular necrosis

A

hip fracture in the femoral neck
usually in displaced fractures

26
Q

what is a fascia iliac compartment nerve block

A

an anaesthetic that blocks nerves and is a good alternative to opioids

27
Q

how soon after a hip fracture will a patient need surgery

A

24-48 hours

28
Q

why is a pelvic fracture so dangerous

A

because its very vascular and close to organs
- could lacerate organs (urethra, bladder, colon)
or lacerate a vessel causing hemmorhage

29
Q

what is a non weight bearing pelvic fracture

A

non weight bearing part of pelvis is fractured
- pubic rami
- iliac crest
8 weeks of bed rest to heal

30
Q

what is a weight bearing fracture

A

pelvic ring or acetabulum
needs surgery to heal

31
Q

what are some things to monitor for with a pelvic fracture

A

hypovolemic shock
blood in urine and stool
abdomen for rigidity and swelling

32
Q

what happens with an incomplete spinal cord injury

A

can move but cant feel

33
Q

what parts of the spine cause tetraplegia

A

C4-C6

34
Q

what parts of the spine cause paraplegia

A

T6-L1

35
Q

what do we do to prevent secondary spinal injury

A

collars, backboard patient at scene, methylprednisolone for the first 24-48 hours

36
Q

what is spinal shock

A

spine literally in shock and stops doing anything at time of injury
can last days to months

37
Q

what is the treatment of spinal shock

A

none, just start rehab right away

38
Q

what is a fatal spinal fracture

A

C1-3, rarely do people live

39
Q

what is neurogenic shock

A

loss of sympathetic innervation (the thing that causes fight or flight)
causes very low blood pressure

40
Q

what are the symptoms of neurogenic shock

A

low BP, low HR, skin is warm and dry

41
Q

which patients are at risk for neurogenic shock with SCI

A

T5 and above

42
Q

how does a SCI affect thermoregulation

A

it causes poikilothermia: body temp takes on environment

43
Q

how long does it take paraplegia to heal

A

6 months

44
Q

how long does it take quadriplegia to heal

A

1 year

45
Q

what are crutch field tongs

A

traction device with pins inserted into skill to immobilise the neck
with weight

46
Q

can we as nurses loosen pins in a halo vest

A

no only MD can

47
Q

which medication increases BP in a SCI patient

A

Dopamine

48
Q

which med increase HR in a SCI patient

A

atropine

49
Q

what is a laminectomy

A

patient is in prone position, clean up bone fragments and put in hardware

50
Q

what is autonomic dysreflexia

A

massive uncompensated SNS response
- vasoconstriction below injury
- vasodilation above injury
highhhhh BP

51
Q

what puts a patient at risk for autonomic dysreflexia

A
  • patients with injury to T6 or above
  • comes with return of reflexes after spinal shock
52
Q

what are the symptoms of autonomic dysreflexia

A
  • high bp
  • slow, bounding pulse
  • flush above level of injury
  • headache
  • blurred vision
  • seeing spots
53
Q

what are the main priorities for autonomic dysreflexia

A
  • RAISE HOB
  • determine cause
  • deal with cause
  • monitor vitals Q 10-15 mins
  • give nitrate
54
Q

what are some of the main causes of autonomic dysreflexia

A
  • full bladder
  • full bowel
  • shoes too tight
  • skin: pressure injury
55
Q

what are the main complications of autonomic dysreflexia

A
  • seizure/stroke (high ICP d/t hypertension)
56
Q

what does phantom limb pain feel like

A
  • intense burning, crushing, or cramping.
57
Q

what is a compound fracture

A

open fracture

58
Q

what should you do if you see a patient has fallen

A
  • call for help
  • note positioning
  • immediate assessment
    (dont rush to get them up)
59
Q

how often should you do turns to prevent pressure sores

A

every 2 hours

3512 (19 decks)

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