week 10 Flashcards
what is amyotrophic lateral sclerosis
muscles whither away, progressive paralysis (mind is intact)
how long is the prognosis for ALS
2-6 years after diagnosis
is there any treatment for ALS
no
what is Gillian-barre syndrome
bodys immune system damaging nerve (usually follows infection)
- symmetrical paralysis starting at feet and goes up
- painful
what is the treatment for Gillian barre syndrome
plasmapheresis and IVIG
how does guillian barre present
starts as weakness and twitching, then gets worse within the hours
what is Duchenne muscular dystrophy
the once that’s common in young boys, onset of weakness begins at age 4
what is the disease progression of Duchenne muscular dystrophy
starts at age 4, unable to move independently by age 12
life expectancy 20-30 years old
how does MS result in chronic inflammation and scarring
because myelin keeps trying to regenerate
whats the main way to diagnose MS
evoked response testing
why would MS patients be on Ritalin
to increase energy
what is the anti spastic med used for MS
baclofen (to decrease muscle spasms
what is the main patient education for a patient with MS on a corticosteroid
it increases risk of infection which could exacerbate MS
what is the main anticholinergic used for MS and what is it for
ditropan used to increase bladder tone
what is the ideal pain med for fractures
T 3
what at the two ways to put a fractured bone back into place
- reduction: pull joint
- open method: surgery
how often should you assess sites of an external fixation
every 8-12 hours
should you remove pin site crust?
no
how long should skin traction be used for
48-72 hours
what is the weight for skin traction
2.3-4.5 kg
what are the two way to treat compartment syndrome
cut cast
fasciotomy
what do you do if a patient has a confirmed DVT clot
bolus heparin IV, then IV infusion heparin continuous
move to PO Coumadin after a couple of days
what are the symptoms of fat embolism
sudden decreased oxygenation
suddenly confused, passed out, or restless
increase rr, sense of impending doom
what is the treatment of fat embolism
nothing. just to supportive care
which bone fracture could cause avascular necrosis
hip fracture in the femoral neck
usually in displaced fractures
what is a fascia iliac compartment nerve block
an anaesthetic that blocks nerves and is a good alternative to opioids
how soon after a hip fracture will a patient need surgery
24-48 hours
why is a pelvic fracture so dangerous
because its very vascular and close to organs
- could lacerate organs (urethra, bladder, colon)
or lacerate a vessel causing hemmorhage
what is a non weight bearing pelvic fracture
non weight bearing part of pelvis is fractured
- pubic rami
- iliac crest
8 weeks of bed rest to heal
what is a weight bearing fracture
pelvic ring or acetabulum
needs surgery to heal
what are some things to monitor for with a pelvic fracture
hypovolemic shock
blood in urine and stool
abdomen for rigidity and swelling
what happens with an incomplete spinal cord injury
can move but cant feel
what parts of the spine cause tetraplegia
C4-C6
what parts of the spine cause paraplegia
T6-L1
what do we do to prevent secondary spinal injury
collars, backboard patient at scene, methylprednisolone for the first 24-48 hours
what is spinal shock
spine literally in shock and stops doing anything at time of injury
can last days to months
what is the treatment of spinal shock
none, just start rehab right away
what is a fatal spinal fracture
C1-3, rarely do people live
what is neurogenic shock
loss of sympathetic innervation (the thing that causes fight or flight)
causes very low blood pressure
what are the symptoms of neurogenic shock
low BP, low HR, skin is warm and dry
which patients are at risk for neurogenic shock with SCI
T5 and above
how does a SCI affect thermoregulation
it causes poikilothermia: body temp takes on environment
how long does it take paraplegia to heal
6 months
how long does it take quadriplegia to heal
1 year
what are crutch field tongs
traction device with pins inserted into skill to immobilise the neck
with weight
can we as nurses loosen pins in a halo vest
no only MD can
which medication increases BP in a SCI patient
Dopamine
which med increase HR in a SCI patient
atropine
what is a laminectomy
patient is in prone position, clean up bone fragments and put in hardware
what is autonomic dysreflexia
massive uncompensated SNS response
- vasoconstriction below injury
- vasodilation above injury
highhhhh BP
what puts a patient at risk for autonomic dysreflexia
- patients with injury to T6 or above
- comes with return of reflexes after spinal shock
what are the symptoms of autonomic dysreflexia
- high bp
- slow, bounding pulse
- flush above level of injury
- headache
- blurred vision
- seeing spots
what are the main priorities for autonomic dysreflexia
- RAISE HOB
- determine cause
- deal with cause
- monitor vitals Q 10-15 mins
- give nitrate
what are some of the main causes of autonomic dysreflexia
- full bladder
- full bowel
- shoes too tight
- skin: pressure injury
what are the main complications of autonomic dysreflexia
- seizure/stroke (high ICP d/t hypertension)
what does phantom limb pain feel like
- intense burning, crushing, or cramping.
what is a compound fracture
open fracture
what should you do if you see a patient has fallen
- call for help
- note positioning
- immediate assessment
(dont rush to get them up)
how often should you do turns to prevent pressure sores
every 2 hours
