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Critical Care Nursing > Diganositic Studies > Flashcards

Diganositic Studies Flashcards

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1
Q

EEG studies detect (4)

A

seisures, sleep disorders, cerebrovascular lesions, brain injury

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2
Q

lumbar puncture is contraindicated in these conditions3

A

increased icp, bleeding disorders and infection at the site

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3
Q

positions during lumbar puncture

A

lying on the side cannon ball or seated over the overbed table

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4
Q

sensation during needle insertion during lumbar puncture

A

pain radiating down the leg

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5
Q

monitor for these during lumbar puncture (4)

A

headache, nuchal rigidity, hematoma, pain

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6
Q

normal csf pressure

A

60-150mmHG

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7
Q

what is in csf?

color/ ph/ sp gravity

A

little protein, some glucose, no rbc, no wbc, no microbes, clear, colorless, odorless, ph 7.35, sp grav 1.007,

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8
Q

sensation felt when the contrast dye is injected during a cereral angiogram- taste and warmth over (5)

A

metallic taste, warm sensation on the face, jaw, tongue, lips and behind the eyes

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9
Q

location of catheter placement during an angiogram (2)

A

groin or neck

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10
Q

post procedure angiogram check (5) things

A

check insertion site for clotting, check the extremity distal to the puncture site for color, temp, pulses, cap refile

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11
Q

if bleeding after angiogram, do this

A

put pressure on the artery and notify MD

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12
Q

during an eeg pt is subjected to__ and aske to ___

A

flashing lights and asked to hyperventilate

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13
Q

before the eeg, pt instructions (2)

A

to wash hair and to be sleep deprived

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14
Q

before lumbar puncture have the client needs to (2)

A

remove all jewelry, and empty the bladder

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15
Q

post lumbar puncture have client do this to prevent headaches and bleeding

A

lie on the back for at least 4 hours

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16
Q

post lumbar interventions (4)

A

lie flat for several hours, hydration, pain meds, check site for csf leak/ bleedin

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17
Q

normal icp

A

10-20mmhg

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18
Q

indications for icp monitoring (2)

A

comatose pt and gcs score of 8

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19
Q

interventions post surgical icp monitoring (3)

A

check site q24hr for redness swelling, drainage
recalibrate monitoring device q24hr per protocol
obeserve icp waveforms and observe for icp 15 or more

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20
Q

measures to prevent infection and bleeding at icp site (5)

A 
aseptic technique
limit monitoring for 3-5 days
sterile dressing
closed drainage system
irrigate only as needed
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21
Q

GCS

E4V5M6

A 
Eye opening:
1 no response
2 for eye open to voice
3 for eye open to pain
4 for spontaneous eye opening

Verbal response
1 for no response
2 for moans/sounds
3 for inappropriate words 
4 for incoherent sentence
5 for coherent sentence

Motor response
1for no response
2 decerebrate
3 decorticate
4 generalized pain response
5 for localized pain response
6 for follow commands
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22
Q

hold before eeg ( 3)

A

antionvulsants and cafeine and stimulants

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23
Q

formula to calculate CPP

A

MAP-ICP

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24
Q

formula for MAP

A

2DBP+1SBP/3= MAP

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25
s/sx increased icp (7)
``` restlessness, irritability dilated or pinpoint pupil slow to react altered breathing pattern (cheyne stokes apnea) deterioration motor response abnormal posturing ```
26
normal cpp
60-100
27
normal MAP
70-150
28
CPP OF 50 (2)
ischemia and neuronal death
29
what happens when cerebral blood vessels dilate?
there is decreased resistance, cerebral blood flow increases, resulting in loss of autoregulation or compliance; loss of compliance makes the brain sensitive to small volume reflected in increased ICP
30
conditions that promote cerebral vessel dilation (3)
increased paCO2 decreased PaO2 increased hydrogen ion creating an acidic environment
31
how does the brain respond to loss of autoregulation or compensation?
by increasing systolic BP resulting in -- cushings triad -widening pulse pressure, bradycardia with full bounding pulse, altered respirations, a medical emergency
32
cushings triad can lead to
herniation
33
decerebrate presentation upper extremities- lower extremities- feet-
upper extremities- extension lower extremities- extension feet-flexion
34
decorticate presentation upper extremities- lower extremities- feet-
upper extremities- flexion lower extremities- extension feet- flexion
35
Sumatriptans side effects and interventions
chest pain
36
sumatrptans contraindications
hypertension cad ishemic cardiac, cerebrovascular and peripheral vascular problems
37
best time to take sumatriptans
right after an aura or migraine starts
38
side effects of topiramate (4)
hypoglycemia, paresthesia, weight lss, cognitive changes
39
full effect of topiramate seen in this time frame
2-3 months
40
topiramate is an antiseisure also effective for __
migraines
41
abrupt dc of topiramate can cause __
seisures
42
to decrease kidney stones in topiramate do this
take lots of water
43
drugs that decrease tension type headaches (4)
topiramate, valproic acid, amitriptyline, mirtazapine
44
indications for stress test
angina MI dysrhythmias HF
45
fasting is for x hrs is required and avoid these (3) before stress test
2-4 hrs; avoid caffeine, alchohol, smoking
46
post procedure hemodynamic catheter placement (9)
``` chest xray vital signs heart rhythm sao2 resp rate and effort compare arterial bp with cuff bp observe waveform document catheter plaement secure all connections ```
47
obtain hemo reading (5)
``` hob 15-30 degrees level transducer at the axis zero sytem at atm pressure compare hemo redings with physical assessment monitor trends in values ```
48
complications of hemo catheter (6)
infection, bleeding, embolism, sepsis, dysrhythmias, pnemothorax
49
interventions to prevent embolism (2)
flush nacl, avoid introducing air
50
purpose of angiography (2), indications (2)
1. visualize clots narrowing or occlusion in the arteries 2.location and extent of heart disease unstable angina ecg changes
51
npo xhrs for angiography
8hrs
52
premedication before angiography
corticosteroids and antihistamine
53
intraoperative angiography (4)
give sedative/analgesia monitor v/s monitor dysrhythmias and ready to intervene have resuscitation equipment ready
54
postprocedure angiography | v/s frequency
``` v/s q15min x4, q30min x2, qhour x4, q4hr monitor for bleeding/hematoma thrombosis assess pedal pulse, color, temp bedrest in supine, extremities straightfor 4-6 hrs monitor dysrhythmias admin antiplatelet/thrombolytic agent admin ativan admin pain meds morphine monitor urine output increase fluids/admin iv hydration dt contrast media ```
55
complications of angiography (4)
cardiac tamponade artery restenosis hematoma retroperitoneal bleeding
56
interventions for cardiac tamponade
iv fluids chest xray to confirm diagnosis prepare for pericardiocentesis
57
what is cardiac tamponade
accumulation of fluids in the pericardial sac
58
s/s of cardiac tamponade (3)
- hypotension - paradoxic pulse (variance of 10 mm or more in sbp between expiration and inspiration - intracardiac and pawp are elevated and similar
59
hematoma interventions(2)
put pressure on the artery | monitor perifpheral circulation
60
restonosis of vessel time of occurence and interventions (4)
``` immediately or several weeks after procedure; monitor cardiac rhythm monitor chest pain notify md schedule pt to cadiac lab ```
61
retroperitoneal bleeding interventions (4)
assess flank pain assess hypotension notify md iv fluids/ blood
62
vascular acess is for administration of (4) both central and picc catheters terminate here
administration of blood, chemo, antibiotics, tpn | distal 1/3 of supervior vena cava
63
entry point veins used in central and picc line (2) each
``` central line (subclavian/ jugular) picc (basilic/ cephalic vein) one finger from the antecubital ```
64
timeframe for picc and central line
picc- more than 12 months | central line - short term use
65
complications with picc/central lines (6)
- emboli/thrombosis - phlebitis - infiltration/extravasation - occlusion - air emboli - mechanical complications
66
how to avoid damaging the mesh on the port catheters
use a noncoring (huber) needle
67
to prevent air emboli in central catheters; interventions for air embolus (4) to trap and aspirate the air
clamp all tubings | assess sudden sob, place in trendelenburg on left side, give 02, notify md
68
PAD/PAS mm Hg
PAD 5-15 | PAS 15-25
69
CVP/ PAWP
cvp- 1-8 | pawp 4-12
70
sv02
60-80%

Critical Care Nursing (5 decks)

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