ATI sample test NOTES Flashcards Preview

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Flashcards in ATI sample test NOTES Deck (31):
1

Cranial nerves

01 Olfactory (smell)

02 Optic (vision)

03 Oculamotor (lift eyelid)

04 Trochlear (turns eye)

05 Trigeminal (3 branches: Opthalmic, maxillary, mandibular)

06 Abducent (turn eye laterally)

07 Facial (expressions)

08 Vestibulocochlear (balance and hearing)

09 Glossopharyngeal (temp, pressure on tongue)

10 Vagus (taste and constrict muscles after swallow)

11 Spinal accessory nerve (

12 Hypoglassal nerve

A image thumb
2

Where there is neuro changes, how will changes progress?

1. LOC (earliest sign of change!)

2. then posturing, VS and focal neuro signs follow

3

Diabetes Insipidus

Can be a result of damage to hypothalamus or pituitary gland as a resut of surgery, infecin or tumor from cranial surgery

 

  • there will be inadequate ADH released
    • lead to POLYURIA
    • extremely low urine specific gravity (b/c so diluted 1.001 to 1.003)
      • *note > 1.03 = hypovolemia which occurs

4

Lab signs of Meningitis

5

Acute angle closure glaucoma

Open angle glaucoma

Cataract

Retinal detachment

Acute angle closure glaucoma

  • severe pain in affected eye, blurred vision, and bulging, increased IOP may cause N/V

Open angle glaucoma

  • vision is gradually lost, peripheral. No pain.
  • dilation increases IOP, no pseudoephedrine
  • mitoics reduce the pupil, but cause impaired night vision
  • laser surgery is helpful to reestablish flow of aqueous humor

Cataract

  • clouding of the lens of eye (over black pupil), can cause blindness
  • introcular lens implant is necessary
    • after avoid lifting, bending, coughing, valsalva

Retinal detachment

  • retina at back of eye pulls away (EMERGENCY!!!)
  • Will see sudden floaters, flashes of light, and then shadow or curtain of vision field as it progresses
  • Scleral buckle needed
    • a gas bubble is injected a applies pressure to back of eye to reinforce buckle and pt s/b prone with affected eye up so that the gas bubble floats up

6

Types of Aura

(signs that seizures is imminent)

hearing bells

seeing lights

smelling something

 

7

Meniere's disease

affects inner ear which controls:

balance and hearing

can cause:

  • vertigo, hearing loss, tinnitus

Tell pt to avoid:

  • sudden movements and bright lights/tv/reading

Tx: diuretics

8

ALS

no sensory or cognitive loss

A PROGRESSIVE NEURODEGENERATIVE DZ

attacks motor nerve cells in teh brain and spinal cord

 

Early symptoms: muscle weakness, especially distal arms and legs, speech, swallowing, breathing

 

Late stage: total paralysis b/c voluntary muscles affected

9

External otitis

swimmer's ear

10

TIA

warning sign of adv atherosclerosis dz

a temporary interuption of O2 to brain d/t thromboembolism

 

common symptoms:

loss of vision in one eye | inability to speak | transient hemiparesis | tinnitus | vertigo | diplopia | dysphagia | numbness | weakness

NEURO DEFICIT DISAPPEARS W/IN 24HR

no permanent disability

 

  • Pt may have carotid endarterectmy to reduce freqency of TIA and danger of CVA
    • carotid arteries are scraped to remove plaque

 

 

11

Right vs Left CVA

How is pt impaired?

**RIGHT: impulsive, neglect left (can't see or feel on left side)

**LEFT:  cautious, speech is affected

12

Ataxia

uncoordinated mvmts of extremiti

13

Cheyne-Stokes respirations vs Apneustic

C-S

over 1 minute, there is a 10-20 sec apnea or hypopnea, then followed by respirations of increased depth and frequency, then repeats

 

Apneustic

slow, w/ prolonged pause b/w inspire and expire

14

Autonomic dysreflexia

usually sustained cervical or thoracic above T6

 

  • mostly assoc. w/ full bladder and distended rectum
  • at risk for HTN crisis: 
    • extreme HTN, bradycardia, severe throbbing h/a, flushing of face and neck

15

VS associated w/ increase ICP

widening pulse pressure

decreasing HR

increasing temperature

16

Somogyi effect

"rebound hyperglycemia"

result of poor DM mgmt

(too much insulin or not enough snack at night)

  • blood sugar drops too low in the middle of the night, so body counters by releasing hormones to raise the sugar levels

17

early manifestations of hypoglycemia

drowsy

headache

shaky

nausea

18

manifestations of hyperglycemia

polyuria (urine freq)

polydipsia (thirst)

Polyphagia (hunger)

 

anorexia

dry mouth

19

What causes agromegaly?

too much SOMATOTROPIN hormone from pituitary gland after closure of epiphyses

 

  • tissues enlarge over bones of face, jaw, hands, feet, skull

20

Thyroid storm s/s

sudden tachycardia, fever, HTN, sweating, restlessness, tremors, abdominal pain

21

Mysedema

severe form of hypothyroidism

22

Graves disease

hyperthyroidism

  • diarrhea
  • heat intolerance
  • anxiety
  • difficulty sleeping
  • increased appetite, but weight loss occurs
  • exophthalmos, restlessness

23

Addison's dz

don't produce enough cortisol, sometimes aldosterone

Diet: needs to be high in salt, carbs and protein, low in potassium

 

Skin: bronze pigmentation of exposed and unexposed skin

24

when might a pt show jaundice of face and sclera

hepatic, biliary, or gallbladder dz

25

Cushing's disease

Can be a result of chronic corticosteroid use

 

  • complication is osteoporosis, risk of fractures

skin: purple striae on chest and abdomen b/c that's where the cushion :) is and it stretched the skin

26

What should be monitored following a thyroidectomy?

for thyroid storm and hypocalcemia

 

  • Chvostek's sign: facial spasm after tapping facial nerve in front of ear (indicates low Ca)
  • Trousseau's sign: inflate BP cuff to pressure greater than SBP and hold for 3 minutes to occlude brachial artery. --> if low in Ca it will cause neuromuscular irritiability and induce spasm in hand and forearm

27

When is a VMA test needed?

(vanillylmandelic acid)

this is 24hr urine test

for PHEOCHROMOCYTOMA

 

these benign tumors cause excell Epi and NE which regulate HR and BP

 

**dump first void and keep last.

28

HgbA1c

Urine sugar test

Glucose tolerance test

3-hr glucose testing

Fasting serum glucose test

HgbA1c: tells if pt compliant

Urine sugar: tells if controlled in last few hours

Glucose tolerance: used to diagnose type 2 DM

3-hr: to confirm if glucose tolerance test positive

Fasting: info for previous 24h

29

sign if increasing ICP

widing of pulse pressure (SBP-DBP)

increased temp

decreasing HR

30

Myasthenia Gravis

Causes fatigue of the muscles due to an autoimmune disease that affects the acetylcholine receptors that primarily affects the face and throat.

Pt is at risk for aspiration.

 

31

Guillain-Barre

rapid onset of ascending weakness and paralysis

but begins with weakness in lower extremities