exam 2 Flashcards
(47 cards)
ICU drug of choice for agitation?
Propofol
Glasgow coma scale indicating severe brain damage?
3-8
8 we intubate.
Signs that indicate brain death?
o Coma
o absence of brain stem reflexes
apnea
Early signs of ICP
o CUSHINGS TRIAD-
Systolic htn: widening pulse pressure.
Bradycardia: full and bounding pulse
Irregular respirations
ICP Ocular Signs:
o Dilation of pupil of same side (ipsilateral)
o Unequal pupils in any form/side
o Ptosis (droopy lid)
o Diplopia
o Doll’s Eye (tip back, eye go back instead of opposite direction)
o Sluggish/Blurred
Baclofen medication teaching?
o do not stop taking suddenly.
o do not drink alcohol
Mild concussion discharge instructions?
Return if you have:
persistent headache
lethargy
changes in behavior
shortened attention span.
change in intellectual abilities.
Closed Head Injury- worsening assessment:
o Battles signs (behind ear)
o Raccoon eyes (under eyes)
o CSF leak (rhinorrhea, otorrhea): risk for meningitis
o ** glucose test; halo sign (tests spinal fluid leak)
Which order would you question for an incontinent spinal cord patient injury?
o No foley cath
o ** pt at risk for bladder issue in future
Symptoms of autonomic dysreflexia
o (EMERGENCY) ** head of bed up
blinding headache
increase BP.
bladder full get spasms.
Spinal cord injury at T5 level? What are things the patient should not do?
o Avoid raising knees.
o ** @ risk for DVT
Dilantin Patient teaching?
o Headache
o Nausea/Vomiting
o Constipation
o Trouble sleeping
o Need back up oral BC.
Posturing that happening in ICP patients?
o Decorticate (flexor)
o Decerebrate (extensor)
What drug is used to decrease cerebral inflammation?
o corticosteroid
Dantrolene (used to manage muscle spasms) teaching
o severe hepatic impairment (liver testing needed)
o diarrhea
o anorexia
o nervousness
o hyperkalemia
What to do to prevent complications from a traumatic brain injury TBI
nutrition
o monitor I&O
o monitor: glucose, Na, K, Mg
o protect from injury.
DIC lab values
o LOW platelet
o LOW fibrinogen
o HIGH d-dimmer
o HIGH aPTT
o HIGH PT
What would you not want to inject into a DIC patient?
o Vitamin K
What sign in a critically ill pt would indicate they could be developing DIC?
o petechiae
o bleeding mucus membranes
o tachycardia
o hypotensive
o low temp
What pt are at highest risk for developing DIC?
o sepsis
o abruptia placenta
o trauma
o malignancy
o shock
o toxins
o allergic reactions
What is DIC?
o Inflammatory response (trigger) initiates a process of inflammations and coagulation
(clotting)
o ** result = bleeding/clotting condition
Characteristics of cardiac tamponade?
o sudden chest pain
o SOB
o tachypnea
o dyspnea
o JVD
o hypotension
o pulses paradox
Interventions for cardiac tamponade?
o ** quick removal of paracardial fluid!!
o Pericardiocentesis (needle & small cath into the pericardium)
Abdominal Aortic Aneurysm assessment findings?
o abdominal pain
o persistent or intermittent low back or flank pain
o pulsating abdominal mass
o systolic bruit
