Exam 1

Question 1

what does your body need to clot effectively?

Answer 1

functioning liver, Ca, phospholipids, platelets

Question 2

what labs measure clotting?

Answer 2

PT/INR, PTT<,aPTT, anti-Xa

Question 3

what would you find on assessment if your patient has prolonged clotting?

Answer 3

bleeding, easy bruising, hematuria

Question 4

what would you expect to find if pt has decreased clotting time?

Answer 4

-stroke, thrombosis, limb ischemia, renal injury, heart attack, DVT< PE

Question 5

what are three different types of coagulation drugs?

Answer 5

antiplatelets (on arterial), anticoagulation (venous) , and thrombolitics (both )

Question 6

when would your pt be on an antiplatelet vs an anticoagulant

Answer 6

venous clot vs arterial clot

anticoagulation– DVT, a-FIB (prevent a stroke that comes from the heart)

Question 7

how does Coumadin/warfarin work?

Answer 7

reduces your risk of clots by reducing the time it takes to make a clot

Question 8

what is sinus tacky caused by? how to treat?

Answer 8

external influences on the heart, NOT cardiac conditions –> treat the underlying cause

Question 9

what are signs of a basilar skill fracture? why is this so dangerous?

Answer 9

racoon eyes and battles sign (behind the ears) - dangerous because you can get a CSF bleed -> infection (meningitis) & HA & herniation

Question 10

SCI care: C5

Answer 10

breathing - yes
neuro - can move their face, can talk, but they are quadriplegic
cardiac - low cardiac output (we want to create constriction with ted hose and binding)
GI- incontinent, increased sphincter tone (we need stool softeners)
GU - spastic bladder
integ - risk for pressure injuries

Question 11

SCI care: T3

Answer 11

a lot of the same as C5 applies, but there is more that they can do
-they might have some movement capabilities in their upper extremities

Question 12

SCI care: T9

Answer 12

the big difference between T3 and T9 is that T9 has full function of their upper extremities

Question 13

SCI care: L1

Answer 13

often independent in their wheelchairs
GI:
decreased tone –> we want to keep stools firm
GU - incontinent
the urine is flowing out but they are unable to completely empty the bladder so their is still some urinary retention

Question 14

which patient would you educate about autonomic dysreflexia?
- incomplete spinal
-pt with T8 injury
-pt with complete T4
-all pts with spinal cord injury

Answer 14

complete at T6 or above
so the complete T4 is the right answer

Question 15

what are the hallmarks of autonomic dysreflexia? how do we treat?

Answer 15

spike of hypertension
bradycardia
thermo disregulation
vasodilation above (flushing and hot)
vasoconstriction below (cold pale)
**
we treat by removing the stimulus

Question 16

what are the differences between spinal and neurogenic shock

Answer 16

-spinal shock happens first, is a temporary loss of reflexes and sensations
-paralysis below the level of injury
-risk of secondary injury to the chord
—-
neurogenic shock is distributive shock, so it includes hypotension and bradycardia, loss of motor tone
warm or cold extremities

Question 17

what are somethings we can do to limit secondary injuries?

Answer 17

-stabilize the spine
-keep pt calm
-catheter and ng tube
-monitor for resolution

Question 18

TBI nursing management

Answer 18

managing ICP- positioning, medications, surgery , drain
prevent secondary injury
calm environment

Question 19

sinus bradycardia treatment

Answer 19

atropine and possible pacing

Question 20

first degree AV block treatment

Answer 20

monitor and continue to observe

Question 21

Central cord syndrome manifestations

Answer 21

-more weakness in the upper extremities
- “man in a barrel”

Question 22

anterior cord syndrome manifestations

Answer 22

-loss of pain and temperature sensation
-keep proprioception and vibration

Question 23

brown-sequard syndrome manifestations & rap

Answer 23

-crossed symptoms
loss of ipsilateral motor sensation
loss of contraletal pain and temp
“Im a hip ViP, I walk with a limp”
“Contemplate the pain I will create”

Question 24

as ICP goes up

Answer 24

CPP goes down

Question 25

CO2 is a potent

Answer 25

vasodilator