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301 test 3 Flashcards

1
Q

CAGE assessment

A

C= have you ever tried to cut back on your use?
A= have you ever been annoyed/angered when questioned about your use?
G= have you ever felt guilt about your use?
E= have you ever had an eye-opener to get started I the morning?
quick questionnaire to help determine if an alcohol assessment is needed
if pt answers yes to two or more then assessment is advised

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2
Q

dysphasia

A

also called aphasia - difficulty speaking or understanding due to neurological changes

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3
Q

dysarthria

A

slurring

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4
Q

dysphagia

A

difficulty swallowing

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5
Q

first major component regarding care

A

safety

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6
Q

A&O X 4?

A

patient is aware of person, place, time, and situation

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7
Q

delirium

A

acute disorder of attention and global cognition (memory and perception)

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8
Q

essential features of delirium include:

A

acute onset, fluctuating course, inattention or distraction, disorganized thinking to altered LOC

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9
Q

delirium risk factors

A

dementia, electrolyte disorder/emotional, lung, liver, heart, kidney, brain, infection, Rx drugs, retention of urine, injury, pain, stress, unfamiliar environment, metabolic, MI

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10
Q

dementia

A

progressive decline in memory and as least one other cognitive area in an alert person

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11
Q

MMSE

A

mini mental status exam

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12
Q

dementia that occurs in younger people

A

Korsakoff’s dementia and pick’s disease

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13
Q

risk factors for dementia

A

age, brain/head injury, fewer years of education, female, genetics, alcohol

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14
Q

use opioids for

A

acute pain

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15
Q

two types of nerve fibers

A

A-delta and C-fibers

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16
Q

A-delta

A

large nerve fibers that conduct rapid pain impulses

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17
Q

C-fibers

A

small nerve fibers that conduct pain impulses slowly

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18
Q

Bradykinin

A

pain and inflammatory facilitating substance that is released at the site of injury and causes continued irritation at the site of injury

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19
Q

A-delta and C-fibers carry signals to

A

Central Nervous System

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20
Q

blocking impulses

A

stop pain

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21
Q

facilitating impulses

A

pass on pain

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22
Q

if pain continues the signal will

A

pass through the spinal cord to the thalamus ending in the limbic system

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23
Q

limbic system

A

emotions which control pain are produced. stimulus passed on to the cerebral cortex when sensation is recognized

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24
Q

opioids suppress pain

A

going up

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25
visceral pain
originates from the abdominal organs. is crampy or gnawing
26
somatic pain
originates from the skin, muscle, bones, and joints. aching or throbbing
27
cutaneous pain
originates from the dermis, epidermis, and subcutaneous tissue. described as sharp
28
referred pain
called radiculopathy. originates from a specific site but pain is at another site
29
phantom pain
originates from the nerve pathway from the amputated extremity
30
pain is
what the patient says it is, and exist whenever the patient says it is
31
acute pain
meant to warn the body that some type of injury has occurred. cause in known. duration is short, treatment consists of treating underlying cause
32
chronic pain
pain that lasts beyond the normal health period and has no role. cause if often unknown, treatment is often pain control not cure
33
neuropathic pain
peripheral sensitization by which peripheral nociceptors are sensitized to pain stimuli. causes cytokines and growth factors to be recruited prolonging inflammatory response.
34
analgesia
the inability to feel pain.
35
who is most likely to experience more side effects from analgesia
elderly
36
hierarchy of pain assessment
1. self report 2. pathological conditions 3. observe patient behaviors 4. surrogate reporting 5. attempt an analgesic trial
37
surrogate reporting
ask family members
38
self report
asking patient their pain based off of numerical scale
39
mild pain
1-3 range
40
moderate pain
4-6 range
41
severe pain
7-10 range
42
#2 pathologic conditions
searching for potential causes of pain
43
observe patient behaviors
can include CPOT, BPS, NIPS. when in absence of self report, observation of behavior is valid approach
44
CPOT
critical care pain observation tool
45
BPS
behavioral pain scale
46
NIPS
neonatal infant pain scale
47
examples of behavioral observations of pain
restlessness, guarding, pacing, grimacing, bracing, muscle tension
48
diaphoresis
sweating
49
wrong baker faces
designed for children 3 years and oldeirand with patients with language barrier. use six faces ranging from happy to face with tears
50
patient barriers to pain treatment
fear of side effects, addiction, tolerance, and lack go knowledge
51
different nervous systems
central, peripheral, somatic, and autonomic
52
central nervous system
brain and spinal cord. processes, interprets, and stops info. issues orders to muscles, glands, and organs
53
peripheral nervous sytem
transmits info to and from the CNS
54
protective structures of the central nervous system
meninges
55
layers of the meninges
dura matter - outer layer, arachnoid - middle layer, Pia matter - inner meningeal layer that contains blood vessels
56
cerebral spinal fluid contains
glucose, electrolytes, oxygen, water, CO2, protein, leukocytes
57
where is cerebral spinal fluid made
in the ventricle
58
how many ventricles are there
4- 1 lateral in each hemisphere, 3rd ventricle adjacent to the thalamus, 4th ventricle adjacent to the brainstem
59
grey matter
consists of cell bodies
60
white matter
myelinated nerve fibers
61
carotid arteries supply
blood to the brain
62
vertebral arteries branch into
posterior and anterior
63
frontal lobe
primary motor cortex responsible for functions related to voluntary motor activity. controls intellectual function, awareness of self, personality, and autonomic responses related to emotion
64
broca's area
in the left frontal lobe. formulation of words
65
parietal lobe
contains sensory cortex contains position sense, touch, shape, and texture objects
66
temporal lobe
contains primary auditory cortex, wernickes area
67
wernickes area
responsible for comprehension of speech, speech production, and interpreting sounds
68
when Broca and wernickes areas are damaged patient has
global aphasia
69
occipital lobe
primary visual cortex. responsible for reviewing visual information
70
diencephalon
made up of thalamus, hypothalamus, epithalamus, and subthalamus
71
hypothalamus
regulation of body temperature, hunger, thirst, formation of autonomic nervous system responses, storage and secretion of hormones from the pituitary gland
72
basal ganglia
creates smooth, coordinated voluntary movement by balancing the production of acetylcholine and dopamine
73
brain stem
10 of the 12 cranial nerves originate from the brainstem
74
medulla oblongata
contains reflux centers for controlling involuntary functions such as breathing, sneezing, swallowing, coughing, vomiting, and vasoconstriction
75
what is the number one cause of disability
stroke
76
first 7 pair of nerves exit _____ their corresponding vertebrae
above
77
remaining spinal nerves exit _____ the corresponding vertebrae
below
78
contributing factors to neurological conditions
PMH-HTN, HLP, DMII
79
HLP
Hyperlipoproteinemia
80
parkinsons causes
tremors at rest
81
cerebellar disorders cause
tremor with intentional movement
82
dysphagia
difficulty swallowing
83
dysphasia
difficulty speaking
84
aphasia
defective or absent language
85
Cranial nerve 2
optic nerve - presence of peripheral vision indicates function of CN
86
cranial nerve 3
oculomotor
87
cranial nerve 4
trochlear
88
cranial nerve 5
trigeminal - test for movement and sensation. wipe a cotton ball along branches of face
89
cranial nerve 6
abducens
90
what do cranial nerve 3,4,6 do
six cardinal fields of gaze and assessment of pupils via light for constriction
91
ptosis
eyelid dropping
92
cranial nerve 7
facial nerve - test for movement - have pt perform facial expressions
93
cranial nerve 8
acoustic nerve - test for hearing
94
cranial nerve 9
glossopharyngeal
95
cranial nerve 10
vagus nerve
96
what are you testing with cranial nerve 9 and 10
movement of the soft palate and gag reflex
97
cranial nerve 11
spinal accessory muscle
98
cranial nerve 12
hypoglossal nerve - movement of tongue
99
rombergs test
arms are by sides and assess sway
100
types of stroke
hemorrhagic and ischemic
101
primary cause for stroke
HTN
102
ASHD
Arteriosclerotic heart disease
103
what do you not want to have during a stroke
acute hypotension
104
what to do during a ischemic stroke
glycemic fluids should not be given, should be NPO to control sugars, anticoagulants should be avoided short term
105
what to do during hemorrhagic stroke
strict protocols for BP management, ICP monitoring, ventricular drain is placed
106
ICP
intracranial pressure
107
FAST
face- facial droop arm - hemiparesis speech - dysarthria/aphasia timing - 3 hr window for t-PA
108
hemiparesis
Muscle weakness or partial paralysis on one side of the body that can affect the arms, legs, and facial muscles.
109
stroke signs and symptoms
``` Facial droop Hemiparesis-Unilateral weakness opposite side of lesion Recent TIA-Transient ischemic event-This is essentially a stroke that symptoms resolve with in 24 hr. Dysphagia Dysphagia Dysarthria Apraxia Double vision Field cut Sexual disfunction ```
110
triad of doom
HTN,HLP, DMII - diseases that contribute to stroke
111
how do you differentiate between a DVT and cellulitis
use a doppler
112
CIPN
chronic illness polyneuropathy
113
Glioblastoma
A malignant tumor affecting the brain or spine. the most common brain cancer
114
SDH
subdural hematoma
115
SCI
spinal cord injury
116
SCI considerations
``` skin breakdown bowel and bladder programs - risk for UTI autonomic dysreflexia DVT and PE depression and 90% divorce rate ```
117
atherosclerosis
The build-up of fats, cholesterol, and other substances in and on the artery walls.
118
coronary vascular disease is a risk for
stroke
119
dementia vs delirium
delirium - Serious disturbance in mental abilities that results in confused thinking and reduced awareness of surroundings. dementia - A group of thinking and social symptoms that interferes with daily functioning.

NURSING School (17 decks)

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