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Nursing School: Terms and Abbreviations > Assessments and Diagnostics > Flashcards

Assessments and Diagnostics Flashcards

1
Q

Guaiac test

A
  • Hemoccult, Fecult
  • chemical test to ID blood in stool
  • possible causes: cancer, hemorrhoids, GI bleed
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2
Q

upper GI series

A
  • series of barium X-rays (oral) of esophagus, stomach, small intestines
  • used to ID problems with swallowing, stomach ulcers, twisting of small intestine
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3
Q

lower GI series

A
  • series of barium X-rays (enema) to show large intestine and rectum
  • can ID diverticulitis/diverticulosis, tumors, etc.
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4
Q

endoscopy

A
  • flexible, fiberoptic instrument with camera used to visualize esophagus, stomach, large bowel
  • different names used for each area explored (colonoscopy)
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5
Q

colonoscopy

A

flexible, fiberoptic instrument with camera used to visualize large bowel

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6
Q

ultrasonography (ultrasound)

A
  • high-frequency sound waves used to visualize internal organs
  • primarily for abdominal and pelvic organs
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7
Q

pitting scale

A
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8
Q

Braden scale

A
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9
Q

delirium rating scale

A
  • tool used to determine level of delirium or likelihood of pt becoming delirius
  • Fundamentals Ch. 25
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10
Q

blanch (capillary refill) test

A
  • tests integrity of circulation by applying, then releasing pressure to a fingernail or toenail
  • expected: regains color in 2-3 sec.
  • > 3 sec. indicates impaired blood flow
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11
Q

jugular/neck vein distension

A
  • visualized with pt supine, HOB about 45°, head turned to side, tangential light
  • can palpate to determine if pulsation is from vein or artery (vein easily occluded)
  • sign of increased venous pressure
  • used to estimate right atrial pressure
  • indicates backup of blood from heart
  • seen in heart failure, superior vena cava obstruction, tricuspid valve disease, and pericardial disease
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12
Q

corneal light reflex

A
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13
Q

accommodation

A
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14
Q

red reflex

A
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15
Q

red reflex

A
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16
Q

accommodation

A
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17
Q

corneal light reflex

A
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18
Q

jugular/neck vein distension

A
  • visualized with pt supine, HOB about 45°, head turned to side, tangential light
  • can palpate to determine if pulsation is from vein or artery (vein easily occluded)
  • sign of increased venous pressure
  • used to estimate right atrial pressure
  • indicates backup of blood from heart
  • seen in heart failure, superior vena cava obstruction, tricuspid valve disease, and pericardial disease
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19
Q

blanch (capillary refill) test

A
  • tests integrity of circulation by applying, then releasing pressure to a fingernail or toenail
  • expected: regains color in 2-3 sec.
  • > 3 sec. indicates impaired blood flow
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20
Q

delirium rating scale

A
  • tool used to determine level of delirium or likelihood of pt becoming delirius
  • Fundamentals Ch. 25
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21
Q

Braden scale

A
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22
Q

pitting scale

A
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23
Q

otoscope

A

instrument with light designed to examine outer ear and tympanic membrane

uses disposible specula in 4 mm for adults and 2 mm for peds

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24
Q

nares

A
  • nostrils
  • inspect for alignment of septum, drainage (note purulence, blood content, viscosity), coloration of nasal mucosa, edema
  • occlude one at a time to check for patency
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25
Q

CN I

A
  • olfactory
  • (assess patency of nostrils) coffee/mint smell test
  • sensory
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26
Q

CN II

A
  • optic
  • Snellen chart
  • sensory
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27
Q

CN III

A
  • oculomotor
  • draw H to test EOM, test pupillary reflex (PERRLA)
  • motor
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28
Q

CN IV

A
  • trochlear
  • draw H to test EOM, test PERRLA
  • motor
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29
Q

CN V

A
  • trigeminal
  • test
    • motor: palpate temporal and masseter muscles as the person clenches the teeth
    • sensory: light touch on forehead (ophthalmic), cheek (maxillary), and chin (mandibular); also corneal reflex test, which we don’t do
  • both
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30
Q

CN VI

A
  • abducens
  • draw H to test EOM, test for PERRLA
  • motor
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31
Q

CN VII

A
  • facial
  • test
    • motor: smile and frown, close eyes tightly, lift eyebrows, show teeth and puff cheeks (press cheeks to check for even air escape)
    • sensory: test sense of taste with lemon, salt, etc., which we don’t do
  • both
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32
Q

CN VIII

A
  • acoustic
  • test hearing: whisper test, normal conversation, Weber & Rinne tuning fork tests (which we don’t do)
  • sensory
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33
Q

CN IX

A
  • glossopharyngeal
  • test
    • motor: gag reflex
    • sensory: none; taste from back of tongue, sensory from sinuses, etc.
  • both
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34
Q

CN X

A
  • vagus
  • test
    • motor: say “ah” to check for midline soft palate rise and fall; listen for smooth, unstrained voice and speech
    • sensory: none
  • both
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35
Q

CN XI

A
  • spinal accessory
  • test sternomastoid and trapezius muscle strength and symmetry with hand pushing against each cheek and down on shoulders
  • motor
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36
Q

CN XII

A
  • hypoglossal
  • stick out tongue, should be midline with no tremor; say “light, tight, dynamite”
  • motor
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37
Q

pulse deficit

A

difference between peripheral and apical pulses

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38
Q

pulse pressure

A

difference between systolic and diastolic blood pressures

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39
Q

tragus

A
  • projection in front of the ear
  • used to block hearing in one ear for testing
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40
Q

tympanic membrane

A
  • eardrum
  • expected: shiny and pearly gray with reflected cone of light
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41
Q

hyperthyroidism

A
  • ultrasound of thyroid gland
  • thyroid scan
  • serum levels of free and total T4, T3, and calcitonin
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42
Q

AKI

A

acute kidney injury

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43
Q

ADR

A

adverse drug reaction

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44
Q

GCS (Glasgow Coma Scale)

A
  • indications: LOC changes in encephalitis, cerebral lesions and infarctions, head injuries
  • eye-opening response
    • 4 - spontaneous
    • 3 - to voice
    • 2 - to pain
    • 1 - none
  • verbal response
    • 5 - oriented
    • 4 - confused
    • 3 - inappropriate words
    • 2 - incomprehensible sounds
    • 1 - none
  • motor response
    • 6 - obeys commands
    • 5 - localizes pain
    • 4 - withdraws
    • 3 - flexion
    • 2 - extension
    • 1 - none
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45
Q

AVPU

A
  • Alert
  • responsive to Voice
  • responsive to Pain
  • Unresponsive
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46
Q

common causes of pulseless electrical activity

A
  • 5 Hs
    • hypovolemia
    • hypoxia
    • H+ accumulation → acidosis
    • hypothermia
  • 5 Ts
    • toxins (accidental or deliberate drug OD)
    • tamponade (cardiac)
    • tension pneumothorax
    • thrombosis (coronary)
    • thrombosis (pulmonary)
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47
Q

OLDCARTS

A
  • onset
  • location: site/radiation
  • duration
  • character
  • alleviating/aggravating factors
  • time
  • severity
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48
Q

Alzheimer’s dz stages

A
  • stage 1: no apparent manifestation
  • stage 2: forgetfulness, esp. of everyday objects; looks like normal age-related change
  • stage 3: mild cognitive decline
    • losing important things
    • short-term memory loss noticeable to close relatives
    • ↓ ability to plan
    • ↓ attention span
    • diffculty remembering names, words
    • difficulty in social/work situations
    • can get lost while driving
  • stage 4: mild to moderate decline
    • personality changes
    • obvious memory loss
    • ↓ knowledge and memory or recent events
    • difficulty with tasks that need planning/organizing
    • difficulty with complex math
    • depression/social withdrawal
  • stage 5: moderate decline
    • ↑ cognitive deficits
    • inability to recall important details
    • memory of info about self and family remains intact
    • assistance with ADLs necessary
    • disorientation/confusion about time and place
  • stage 6: moderate to severe decline
    • memory problems ↑
    • recalls name, but not personal Hx
    • significant personality changes: hallucinations, delusions, compulsion)
    • wandering
    • assistance with ADLs, personal care
    • sleep/wake cycle disrupted
    • ↑ urinary/fecal incontinence episodes
  • stage 7: severe decline
    • no ability to respond, speak, control movement
    • urinary incontinence
    • impaired swallowing
    • requires help eating
    • gradual loss of ability to move extremeties (ataxia)
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49
Q

MS labs and diagnostic procedures

A
  • labs
    • CSF: ↑ protein
    • slight ↑ WBC count
  • diagnostic procedures
    • MRI: plaques of brain and spine
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50
Q

cerebral angiography

A
  • visualization of cerebral blood vessels
  • tracks blood flow to and within brain
  • indications
    • aneurysms
    • surgical planning for tumors
    • inject meds for Tx of blood clots
    • inject chemo
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51
Q

cerebral CT scan

A
  • cross-sectional images of cranial cavity
  • indications
    • find tumors, infarctions, abnormalities
    • monitor response to Tx
    • guide needles used for Bx
52
Q

EEG

A
  • noninvasive
  • assess electrical activity to find abnormalities in brain wave patterns
  • indications
    • find and determine sz activity
    • sleep disorders
    • behavioral changes
53
Q

ICP monitoring

A
  • device inserted into cranial cavity that shows pressure waveforms on monitor
    • intraventricular cath (ventriculostomy): drains and monitors pressure via picture
    • subarachnoid screw or bolt: hollow with fluid-filled tubing and transducer
    • epidural or subdural sensor: fiber-optic, does not penetrate dura (noninvasive); numerical value
  • indications
    • early ID and Tx of ↑ ICP: pts comatose or GCS < 8
    • s/sx of ↑ ICP: severe HA, ↓ LOC, dilated or pinpoint pupiles, slow rxn, irritability, restlessness, alteration in breathing pattern, ↓ motor fxn, abnormal posturing
54
Q

LP (lumbar puncture, spinal tap)

A
  • CSF sample collection
  • indications
    • presence of dz: MS, syphilis, meningitis
    • infection
    • malignancies
    • ↓ CSF pressure
    • Dx by instillation of contrast or air
    • Tx with meds or chemo
55
Q

MRI of head and spine

A
  • cross-sectional images of cranial cavity
  • contrast may be used
  • uses magnets, no radiation
  • not suitable for those with artificial implanted devices
  • discriminate soft tissue from tumor or bone
  • indications
    • find abnormalities
    • monitor response to Tx
    • guide needles for Bx
    • determine tumor size and blood vessel location
56
Q

PET and SPECT scans of head and spine

A
  • nuclear medicine procedures
  • 3-D image of head
  • static or functional
  • captures regional metabolic processes
  • PET: glucose-based tracer injected
  • SPECT: uses radioisotope tracer
  • may be followed by CT for overlay/add location info
  • indications
    • most useful in determining tumor activity or response to Tx
    • able to Dx dementia: inability of brain to respond to tracer
57
Q

X-ray of skull and spine

A
  • electromagnetic radiation
  • captures images of internal structures
  • indications for skull and spine
    • fx
    • curvature
    • bone erosion
    • dislocation
    • soft-tissue calcification
58
Q

pain categories

A
  • acute
  • chronic
  • nociceptive
    • somatic
    • visceral
  • neuropathic
59
Q

acute pain

A
  • protective
  • temporary
  • usually self-limiting
  • resolves with tissue healing
  • physiological response: fight-or-flight
  • behavioral response
    • grimacing
    • moaning
    • flinching
    • guarding
  • no response ≠ no pain
  • causes: surgical incision, wounds from injury
60
Q

chronic pain

A
  • not protective
  • ongoing or recurs frequently
  • > 3 mo
  • persists beyond tissue healing
  • physiological response
    • not usually ↑ VS
    • VS can be ↓ than normal
    • depression
    • fatigue
    • ↓ fxn level
    • disability
  • can be idiopathic
  • may not respond to Tx
  • classified: cancer or non-cancer pain
  • examples: OA, neuropathy
61
Q

nociceptive pain

A
  • damage to or inflammation of tissue not in PNS or CNS
  • result of activation of normal processing of painful stimuli
  • throbbing, aching, localized
  • types
    • somatic: bones, joints, muscles, skin, connective tissue
    • visceral: internal organs; can be referred
62
Q

neuropathic pain

A
  • abnormal or damaged pain nerves
  • abnormal processing or painful stimuli
  • includes: phantom pain, pain below spinal injury, diabetic neuropathy
  • intense, shooting, burning, “pins and needles”/tingling
63
Q

labs and procedures to Dx meningitis

A
  • culture and sensitivity of urine, throat, nose, and blood: not Dx, but can guide intial antimicrobial choice
  • CBC: ↑ WBC count
  • CSF analysis (definitive): ↑ WBC, protein, glucose, pressure; cloudy vs clear (bacterial vs. viral); CIE determines if viral or protozoal
  • CT scan, MRI: ↑ ICP and/or abscess
64
Q

sz risk factors

A
  • genetic predisposition: absence sz; children, familial
  • acute febrile state: esp. < 2 yo
  • head trauma: early or late onset (≤ 9 mo); ↑ if skull fx
  • cerebral edema: esp. acute; sz gone when edema treated
  • abrupt cessation of antiepileptics: rebound
  • infection: ↑ ICP or persistent fever
  • metabolic: insufficient or excess chemicals in brain; glucose, Na+
  • toxins: esp. pesticide, CO, lead
  • stroke: mostly in 1st 24 hr because of ↑ ICP
  • heart dz: common cause of new-onset sz in adults
  • brain tumor: increased bulk if benign; ability to fxn if malignant
  • hypoxia: ↓ O2 in brain = ↓ fxn
  • acute withdrawal: dehydration = toxic level of substance
  • fluid-electrolyte imbalance
  • associated with cerebrovascular dz in older adults
65
Q

sz triggering factors

A
  • ↑ physical activity
  • excessive stress
  • hyperventilation
  • overwhelming fatigue
  • acute ETOH ingestion
  • excess caffeine
  • flashing lights
  • cocaine, aerosols, inhaled glue
66
Q

tonic-clonic sz findings

A
  • tonic episode
    • duration: a few sec
    • stiffening of muscles
    • possible apnea
    • LOC
  • clonic episode
    • duration: 1-2 min
    • follows tonic phase
    • rhythmic jerking of extremities
    • irregular breathing
    • possible cyanosis
    • biting cheek or tongue
  • incontinence
  • postictal: period of confusion and sleepiness
67
Q

tonic sz findings

A
  • generally < 30 sec, but up to several min
  • sudden LOC
  • sudden ↑ muscle tone
  • autonomic manifestations
    • arrhythmia
    • apnea
    • vomiting
    • incontinence
    • salivation
68
Q

clonic sz findings

A
  • duration: several min
  • muscles contract and relax
  • rhythmic, jerking movements of face, neck, arms
69
Q

myoclonic sz findings

A
  • duration: seconds
  • brief jerking or stiffening of extremities
  • symmetrical or asymmetrical
70
Q

atonic or skinetic sz

A
  • duration: a few seconds
  • muscle tone lost
  • followed by period of confusion
  • frequent results in falling
71
Q

partial or focal/local sz

A
  • occur in only one hemisphere
  • types
    • complex partial sz
    • simple partial sz
72
Q

complex partial sz

A
  • automatisms: pt unaware; lip smacking, picking at clothes
  • LOC/blackout for several min
  • amnesia possible immediately before and after
73
Q

simple partial sz

A
  • consciousness maintained
  • can include
    • unusual sensations
    • sense of déjà vu
    • autonomic abnormalities: HR changes, flushing
    • unilateral abnormal extremity movements
    • pain
    • offensive smell
74
Q

unclassified/idiopathic sz

A
  • half of all sz activity
  • no known cause/reason
  • don’t fit into other categories
75
Q

labs and diagnostics for sz

A
  • labs
    • alcohol/illicit drug screen
    • HIV test
    • screen for excess toxins
  • diagnostic procedures
    • EEG: activity and origin
    • MRI, CT, CAT, PET, X-ray
    • CSF analysis
76
Q

Parkinson’s risk factors

A
  • onset at 40-70 yo
  • more common in males
  • genetic predisposition
  • environmental toxins and chemical solvents
  • chronic use of antipsychotic meds
77
Q

Parkinson’s findings

A
  • fatigue
  • ↓ manual dexterity over time
  • stooped posture
  • slow, shuffling, propulsive gait
  • tremors/pill-rolling tremor of fingers
  • muscle rigidity
  • bradykinesia/akinesia
  • masklike expression
  • orthostatic hypotension
  • flushing
  • diaphoresis
  • difficulty chewing and swallowing
  • drooling
  • dysarthria
  • progressive ADL difficulty
  • mood swings
  • cognitive impairment
78
Q

Parkinson’s labs and diagnostics

A
  • there are no labs or diagnostics for Parkinson’s
  • diagnosed based on s/sx and ruling out other dz
79
Q

Alzheimer’s risk factors

A
  • advanced age
  • chemical imbalance
  • family hx of AD or Down syndrome
  • genetic predisposition, apolipoprotein E
  • herpes
  • metal or toxic waste
  • previous head injury
  • more common in females
  • ↑ risk in AA and Hispanic (APOE and ABCA7 genes)
80
Q

Alzheimer’s findings

A
  • different for each client
  • no universal scale for stages and manifestations
81
Q

Alzheimer’s labs and diagnostics

A
  • labs
    • genetic test for predisposition
    • tests to rule out other causes of dementia
  • diagnostics
    • only definitive procedure: postmortem brain tissue exam
    • MRI, CT/CAT, PET, EEG: rule out other causes
    • LP: ↓ sBPP supports Dx of AD
82
Q

brain tumor risk factors

A
  • genetics
  • environmental agents
  • ionizing radiation
  • electromagnetic fields
  • previous head injury
83
Q

brain tumor findings

A
  • all types
    • dysarthria
    • dysphagia
    • positive Romberg
    • positive Babinski
    • vertigo
    • hemiparesis
    • cranial nerve dysfxn
      • inability to discriminate sounds
      • loss of gag reflex
      • loss of blink response
    • papilledema
  • supratentorial
    • severe HA; worse on awakening, coughing, straining
    • visual: blurring, field deficit
    • sz
    • loss of voluntary movement/control of movement
    • change in cognitive fxn (memory, language)
    • change in personality
    • inability to control emotions
    • paralysis
  • infratentorial
    • hearing loss, ringing
    • visual changes
    • facial drooping
    • dysphagia
    • nystagmus, crossed eyes, ↓ vision
    • ANS dysfxn
    • ataxia or clumsiness
    • hemiparesis
    • cranial nerve dysfxn
      • sounds
      • gag
      • blink
84
Q

lab tests for brain tumors

A
  • CBC and diff: r/o anemia, malnutrition
  • blood ETOH and tox: rule out causes
  • TB and HIV screening if indicated
85
Q

diagnostics for brain tumor

A
  • X-ray, CT, MRI, brain scan, PET, cerebral angiography: size, location, extent of tumor
  • LP: ICP
  • EEG
  • labs for endocrine fxn, renal status, electrolyte balance
  • cerebral Bx: cell pathology
86
Q

MS findings

A
  • fatigue
  • pain or paresthesia
  • diplopia
  • change in peripheral vision
  • ↓ visual acuity
  • scotomas
  • periods of total blindness
  • Uhthoff’s sign
  • tinnitus
  • vertigo
  • ↓ hearing
  • dysphagia
  • dysharthria
  • muscle spasticity
  • ataxia or muscle weakness
  • nystagmus
  • bowel dysfxn (constipation, incontinence)
  • bladder dysfxn
  • cognitive changes (↓ memory, judgment)
  • sexual dysfxn
87
Q

migraine findings

A
  • photophobia
  • phonophobia
  • N&V
  • stress and anxiety
  • unilateral pain, esp. behind one eye or ear
  • health and family Hx for HA pattern
  • alterations in ADLs for 4-72 hr
  • similar manifestations with each HA
88
Q

migraine categories

A
  • with aura (classic)
  • without aura (common)
  • atypical
89
Q

migraine with aura findings

A
  • prodromal stage
  • awareness for hr or days before
    • irritability
    • depression
    • food cravings
    • diarrhea/constipation
    • frequent urination
  • aura stage
    • develops over mins to 1 hr
    • numbness and tingling of mouth, lips, face, hands
    • acute confusion
    • visual disturbances (light flashes, bright spots)
  • second stage
    • severe, incapacitating, throbbing HA
    • intensifies over several hr
    • N&V, drowsiness, vertigo
  • third stage
    • 4-72 hr
    • HA dull
  • recovery
    • pain and aura subsiding
    • muscle aches and contraction of head and neck muscles common
    • physical activity worsens pain
    • pt may sleep
  • older adults may experience aura without pain: visual migraine
90
Q

migraine without aura findings

A
  • pain aggravated by physical activity
  • unilateral, pulsating pain
  • oe or more of: photophobia, phonophobia, nausea, vomiting
  • duration: 4-72 hr
  • occurs
    • early in morning
    • periods of stress
    • with premenstrual tension
    • with fluid rentention
91
Q

atypical migraine findings

A
  • status migrainous: > 72 hr
  • migrainous infarction
    • neurologic s/sx for 7 days
    • neuroimaging can indicate ischemic infarct
  • unclassified: does not fit other criteria
92
Q

migraine diagnostics

A

neuroimaging if findings present or pt > 50 yo with new onset

93
Q

cluster headache risk factors

A
  • more frequent in spring and fall
  • more common in males 20-50 yo
94
Q

cluster headache findings

A
  • brief episode of intense, unilateral, nonthrobbing pain
  • duration: 15 min to 3 hr
  • can radiate to forehead, temple, or cheek
    • occurring daily 1-8x/day
    • followed by period of remission
  • no aura or preliminary s/sx
  • less common than migraines
  • tearing of eye with runny nose and nasal congestion
  • facial sweating
  • drooping eyelid and eyelid edema
  • pupil constriction
  • N&V
  • bradycardia
  • facial pallor or flushing
  • pacing, walking, or sitting and rocking
95
Q

macular degeneration types

A
  • dry
  • wet
96
Q

macular degeneration risk factors

A
  • dry
    • smoking
    • HTN
    • female
    • short stature
    • family Hx
    • lack of carotene and vitamin E
  • wet: can occur at any age
97
Q

macular degeneration findings

A
  • lack of depth perception
  • objects appear distorted
  • blurred vision
  • loss of central vision
  • blindness
98
Q

macular degeneration diagnostics

A
  • ophthalmoscopy: fundus of eyeball examined (retina, optic disc, macula, blood vessels)
  • visual acuity test: Senllen and Rosenbaum charts
99
Q

cataracts causes

A
  • age-related: drying of lens, ↑ density
  • traumatic: blunt or penetrating injury, foreign body, radiation, UV light
  • toxic: long-term use of corticosteroids, phenothiazine derivatives, beta blockers, miotic meds
  • associated: DM, hypoparathyroidism, Down syndrome, chronic sunlight exposure
  • complicated: intraocular dz (retinitis pigmentosa, glaucoma, retinal detachment)
100
Q

cataracts risk factors

A
  • advanced age
  • DM
  • heredity
  • smoking
  • eyetrauma
  • excessive sun exposure
  • chronic use of corticosteroids, phenothiazine derivatives, beta blockers, miotic meds
101
Q

cataracts findings

A
  • ↓ visual acuity
    • color perception
    • Rx changes
    • ↓ night vision
  • blurred vision
  • diplopia
  • progressive, painless loss of vision
  • visible opacity of lens
  • absent red reflex
102
Q

cataracts diagnostics

A

exam of lens using ophthalmoscope

103
Q

types of glaucoma

A
  • primary open-angle glaucoma (POAG)
  • primary angle-closure glaucoma
104
Q

POAG findings

A
  • gradual onset/IOP buildup
  • HA
  • mild eye pain
  • loss of peripheral vision
  • ↓ accomodation
  • halos around lights
  • ↑ IOP (> 21 mm Hg, usually 22-32)
105
Q

primary angle-closure glaucoma findings

A
  • sudden ↑ IOP (≥ 30 mm Hg)
  • ↓ or blurred vision
  • colored halos around lights
  • pupils nonreactive
  • severe pain and nausea
  • photophobia
106
Q

glaucoma risk factors

A
  • age
  • infection
  • tumor
  • DM
  • genetics
  • HTN
  • eye trauma
  • severe myopia
  • retinal detachment
107
Q

glaucoma diagnostics

A
  • visual assessment: acuity and peripheral
  • tonometry: measures IOP
  • gonioscopy: determines drainage angle of anterior chamber
108
Q

middle and inner ear disorder risk factors

A
  • middle ear
    • recurrent colds and otitis media
    • enlarged adenoids
    • trauma
    • changes in air pressure (SCUBA, flying)
  • inner ear
    • viral or bacterial infection
    • damage due to ototoxic meds
109
Q

findings of middle ear disorders

A
  • hearing loss
  • feeling of fullness and/or pain in ear
  • red, inflamed ear canal and TM
  • bulging TM
  • fluid and/or bubbles behind TM
  • diffuse appearance of or inability to visualize normal light reflex
  • fever
110
Q

findings of inner ear disorders

A
  • hearing loss
  • tinnitus
  • dizziness or vertigo
  • vomiting
  • nystagmus
  • alterations in balance
111
Q

diagnostics for middle- and inner-ear disorders

A
  • audiometry: noninvasive, tests hearing ability; frequency, pitch, intensity
  • tympanogram: measures mobility of TM and middle ear structures
  • WEBER and Rinner tests: tuning forks; tests for presence of hearing loss
  • otoscopy: exam of canal, TM, malleus bone
  • ENG: detects involuntary eye movement to test for vestibular dysfxn
  • caloric testing: concurrent w/ ENG
112
Q

types of brain injury

A
  • concussion (mild traumatic brain injury)
  • contusion
  • diffus axonal injury
  • intracranial hemorrhage
113
Q

brain injury risk factors

A
  • MVA or motorcycle accident
  • illicit drug and ETOH use
  • sports injuries
  • assault
  • gunshot wound
  • falls
114
Q

brain injury findings

A
  • amnesa before or after injury
  • LOC: duration significant
  • CSF leakage from nose and ears: basilar skull fx; + halo sign
  • s/sx of ↑ ICP
    • severe HA, N&V
    • ↓ LOC, restlessness, irritability
    • dilated or pinpoin nonreactive pupils
    • cranial nerve dysfxn
    • alteration in breathing pattern
    • ↓ motor fxn, abnormal posturing
    • Cushing’s triad: late finding
    • sz
115
Q

halo sign

A
  • clear or yallow-tinted ring surround drop of blood on gauze
  • indicates CSF drainage
116
Q

electronystagmography (ENG)

A

used to test for vestibular disorders via measurement of nystagmus, usually in response to temperature change in ear

117
Q

Cushing’s triad

A
  • severe HTN
  • widening pulse pressure
  • bradycardia
118
Q

labs for brain injury

A
  • ABGs
  • CBC with diff
  • BG level
  • electrolytes
  • blood and urine osmolarity
  • toxicology screen
  • anti-sz med blood levels (monitor)
119
Q

diagnostic procedures for brain injury

A
  • cervical spine films to Dx injury
  • CT and/or MRI of head and/or neck (w/ or w/o contrast)
  • calculation of cerebral perfusion using ICP monitor
120
Q

types of strokes

A
  • hemorrhagic
  • thrombotic
  • embolic
  • ischemic
121
Q

risk factors for stroke

A
  • smoking
  • cerebral aneurysm
  • arteriovenous (AV) malformation
  • DM
  • obesity
  • HTN
  • atherosclerosis
  • hyperlipidemia
  • hypercoagulability
  • atrial fibrilation
  • oral contraceptives
  • cocaine
122
Q

stroke findings

A
  • TIA
    • can warn of impending stroke
    • antithrombotic meds and/or surgical removal of plaques can prevent subsequent stroke
  • left hemisphere: language, math, analysis
    • receptive and expressive aphasia
    • agnosia
    • alexia
    • agraphia
    • right extremity hemiplegia or hemiparesis
    • slow, cautious behavior
    • depression, anger, frustration
    • visual changes (hemianopsia)
  • right hemisphere: visual and spatial awareness, proprioception
    • altered perception of deficits
    • unilateral neglect syndrome (left side; more common in right hemisphere stroke)
    • loss of depth perception
    • poor impulse control/judgment
    • visual changes (hemianopsia)
123
Q

stroke diagnostics

A
  • non-contrast CT: initial, within 25 min of pt arrival
  • MRI: edema, necrosis, ischemia
  • MRA or cerebral angiography: hemorrhage, vessel structures, blood flow
  • LP: blood in CSF
  • GCS: check for changes in LOC
124
Q

spinal cord injury risk factors

A
  • high-risk activities
  • impact sports
  • acts of violence
  • substance use
  • dz (cancer, arthritis of spine)
  • falls, esp. in older adults
125
Q

spinal cord injury findings

A
  • lack of sensation of dermatomes below lesion
  • report of neck or back pain
  • inability to
    • feel light touch
    • discriminate between sharp and dull
    • discriminate between hot and cold
  • absent DTRs
  • flaccidity of muscles
  • hypotension, more severe sitting upright
  • shallow respirations
  • spinal shock
    • total, temporary loss of reflexive, autonomic fxn below injury
    • duration: days to wks
126
Q

spinal injury labs and diagnostics

A
  • urinalysis
  • Hgb
  • ABG
  • CBC
  • X-ray, MRI, CT/CAT

Nursing School: Terms and Abbreviations (15 decks)

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