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Block 4 Exam 2 > CM/ss > Flashcards

CM/ss Flashcards

(67 cards)

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1
Q

Hope fostering activities

A

Spirituality
Relationships
Humor
Positive memories

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2
Q

Hope hindering activities

A

Isolation
Uncontrollable pain and discomfort
Abandonment

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3
Q

Double effect criteria

A

Action itself is good/neutral
Intends good, not evil
Good is not achieved by evil effect
Favorable balance of good over evil

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4
Q

Maslow hierarchy

A

Physiological needs
Safety and security
Belonging
Esteem
Self actualization

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5
Q

4 components of wellness

A

Capacity to perform
Adaptable
Feeling of well being
Harmony and balance

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6
Q

Aspects of critical thinking

A

Interpretation, Analysis, Evaluation
Inference
Explanation
Self reflection
Self regulation

Priorities
Validate info
Draw from past XP
Flexibility (outside the box)
Consider alternatives

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7
Q

Teleologic/consequentialism/utilitarianism

A

Greatest good for greatest number

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8
Q

Deontologic/formalist

A

Independent of consequence
Sense of duty

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9
Q

New grad competencies

A

Management of care
Safety and infection
Health promotion and maintenance
Psychosocial integrity
Basic care and comfort
Pharm and parenteral
Risk management
Physiological adaptation

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10
Q

Employer expectations

A

Theory
ADPIE
Know abilities and limitations
Communication
Delegation
Documentation
Basic skills
Information technology
Work ethics
Acceptable speed

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11
Q

Stages of Kubler Ross grief

A

Denial
Anger
Bargain
Depression
Acceptance

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12
Q

Principles of Kurt Lewin’s Force Field Theory of Change

A

Driving and restraining forces of change
3 phases: unfreezing (plan), movement (implement), refreeze (integration)

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13
Q

Neuro assessment: health hx

A

Pain
Seizures
Dizziness and vertigo
Visual
Weakness
Abnormal sensations
General hx

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14
Q

Complications for altered LOC

A

Respiratory
PNA
Aspiration
Pressure injury
DVT
Contractures

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15
Q

Early CM increased ICP

A

Altered LOC
Restless, confusion, drowsy, increased respiratory effort, purposeless movements
Pupils
Weakness at one side
HA

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16
Q

Late CM increased ICP

A

Cushing (high systolic BP, low HR, low RR)
Projectile vom
Respiratory and vasomotor
Hemiplegia, decorticate, decerebrate, flaccid
Respiratory
Loss of brainstem reflexes
Hyperthermia

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17
Q

Intracranial surgery complications

A

ICP
Bleeding, hypovolemic shock
Fluid and lytes
Infection
CSF leak
Seizures

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18
Q

Basilar skull fracture

A

Bleeding from nose, pharynx, ears
Battle sign (bruised behind ears)
CSF leak (halo sign around blood)

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19
Q

Epidural hematoma

A

Brief loss of consciousness
Then lucid
Then back to stupor

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20
Q

Concussion

A

Dizzy, vom
Lethargy, Hard to arouse
Changes in LOC, Confusion
Anxiety, Irritable
HA
Speech and movement difficulty

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21
Q

TBI complications

A

Decreased cerebral perfusion
Cerebral edema and herniation
Impaired O2 and vent
F lyte and nutrition
Seizures

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22
Q

Spinal shock

A

Sudden decrease in reflexes below SCI
Flaccid
Low reflexes
Decreased sensation
Can lead to paralytic ileus
May be hypotension and bradycardic

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23
Q

Neurogenic shock

A

Due to ANS dysfunction
Decreased BP, HR, CO
Resp issues (hypercap, hypoxia, p edema)
Secretion retention
Syncope
Warm dry skin
Pooling of blood increases DVT risk

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24
Q

Autonomic dysreflexia

A

Pounding HA
Increase BP
Diaphoresis
Nasal congestion
Bradycardia
Nausea

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25
SCI complications
DVT Ortho hypo Autonomic dysreflexia Death is most commonly associated with PE, PNA, and sepsis
26
Tetra/paraplegia comps
Spasticity Infection and sepsis
27
MS
Relapsing and recurring Fatigue Weakness Numbness Impaired coordination Loss of balance Pain Visual Depression Constipation and UTIs Contractures/spasticity, PNA, edema, pressure injuries (bed bound stuff) Risk for osteoporosis
28
Myasthenic crisis
Severe weakness Resp and bulbar weakness Can lead to respiratory failure
29
Cholinergic crisis
Severe weakness Resp and bulbar weakness Increase secretions: SLUDGE Saliva Lacrimation Urine Defecation Gastro Emesis
30
GBS
Ascending paralysis Impaired reflexes Weak CN demyelination May alter HR and BP (hyper or hypo) CSF has increased proteins but normal WBC Paresthesias and pain
31
Sympathetic storm syndrome
Loss of consciousness VS unstable Diaphoresis Agitation
32
Brain changes with older folks
Decreased volume and weight of brain Decreased NTs Decreased cerebral blood flow Decreased metabolism
33
In coma, abnormal pupil and motor=
Neuro disease
34
In coma, normal pupil=
Toxic or metabolic disorder
35
DI
Increased dilute urine output Increased serum OSM
36
SIADH
Hypervolemia and hyponatremia Decreased UOP
37
SCI
Retention and distention Decreased sweating Hypotension Acute pain back and neck Decreased resp func
38
Meningitis
HA Fever and chills Stiff neck Kernig and Brudzinski Photophobia Rash LOC and seizure ICP and hydrocephalus
39
MG
Ptosis Vision Facial weakness General weakness Dysphonia Dysphagia
40
Signs of imminent death
Mottling of skin Weak and irregular pulse Can’t swallow secretions May or may not have bowel incontinence
41
Compensatory shock
BP WNL Tachycardia Tachypnea Hypoperfusion Anxiety Confusion Cold, cool, clammy Deceased GI motility Decreased UOP
42
Progressive stage shock (overall ss and patho)
BP drop 40 from baseline or <100 MAP <65 Rapid shallow resp, crackles Chest pain Mental status AKI Liver failure GI bleeding Patho: HF, decreases cell perfusion, interstitial edema, anaerobic metabolism, increased clotting cascade/DIC/bruising Increase capillary permeability Increased lactic
43
Hypovolemic shock
Pale Cold Low BP Clammy Weak Fatigue Dizzy Thirst
44
Cardiogenic shock
Angina Arrhythmias, ECG Fatigue Doom Cardiac labs - BNP, CK, troponin Low CO, low BP Fluid in lungs/crackles
45
Septic shock
Hyperthermia Tachycardia Bounding pulses Hypotension Decreased UOP NV Decreased GI motility Warm flushed skin progresses into cool pale mottled skin Hepatic Hypercoagulation, increased CRP/procalcitonin/lactic
46
Anaphylactic shock
Acute onset Respiratory distress - dyspnea and bronchospasm GI distress Skin/mucosa irritation (pruritis and uticaria) CV compromise - arrhythmias, vasodilation, hypotension HA, flushing Decreased LOC Facial edema
47
Electrical burns
Dysrhythmia, cardiac arrest Myoglobinuria ATN and AKI Possible spinal injury - always C spine! Increased CK
48
Inhalation injury
Carbonaceous sputum Facial burns, redness, blistering, edema Singed nasal hair Hoarseness Painful swallow Dark oral and nasal membranes Clothing burns around neck and chest
49
Major burn injury complications
Fluid shift leading to shock F and lytes CV Hypermetabolic Pulmonary- airway, carbon monoxide Renal and GI Immunological Thermoregulation Low platelets - bleeding risk (In the hospital stuff) - PNA, UTI, respiratory failure, sepsis, cellulitis, wound infection, AKI, arrhythmias, HAI/CLABSI
50
Complications during emergent phase of burn injury
ARF Distributive shock AKI Compartment Paralytic ileus Curling’s ulcer
51
CV alterations in burn injuries
Immediate decreased CO Loss of fluid volume Compensatory vasoconstriction leads to increased workload and O2 demands Hypoperfusion and decreased O2 to body Low BP HF and pulmonary edema if too much fluid is infused
52
Fluid and electrolyte imbalances with burns
Rapid edema Fluid shifts, hypovolemia Hyperkalemia initially Hyponatremia Decreased peripheral circulation due to edema and eschar - need an escharotomy Dehydration Low blood volume/hemoconcentration Decreased UOP Metabolic acidosis
53
GI alterations in burn injuries
Paralytic ileus Curling’s ulcer Translocation of bacteria Vomiting and aspiration- need an NGT Decreased absorption
54
Thermoregulatory changes in burns
Skin loss Hypothermia (Need to prevent heat loss) Temp will rise during recovery
55
Complications in acute/intermediate phase burn injury (thermal and electrical)
ARF, ARDS HF, pulmonary edema Sepsis Delirium Visceral damage from electrical
56
F and lyte shifts in acute/intermediate phase burn injury
Hemodilution Increased UOP Hyponatremia due to diuresis Hypokalemia Metabolic acidosis
57
Respiratory ss with progressive shock
Acidotic Shallow and rapid Crackles, pulmonary edema Decreased surfactant/alveolar collapse ARDS
58
CV ss with progressive shock
Arrhythmias Ischemia Chest pain Tachycardia MI Increased troponin
59
Renal ss with progressive shock
AKI High BUN and Cr F and lyte and acid base
60
Hepatic ss with progressive shock
Jaundice Increased labs Increased waste Increased risk infection Hyperglycemia
61
GI ss with progressive shock
Stress ulcers GI bleed Bacterial translocation
62
SIRS
“Cytokine storm” in septic shock High or low WBC High HR High or low temp High RR
63
What is a negative Nikolsky sign
No separation from dermis when rubbing first degree burn
64
Burn patho
Decreased CO Capillary permeability leads to edema Increase SNS Vasoconstriction and decreased perfusion Hypovolemia and low BP
65
Kidney ss with burn injuries
Hypovolemia leads to injury Heme in urine due to RBC destruction Myoglobinuria due to muscle breakdown
66
Normal CPP
70 to 100
67
Normal ICP
0 to 15

Block 4 Exam 2 (4 decks)

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