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ADULT HEALTH 1 > Exam 3: Neuro & Cardiac > Flashcards

Exam 3: Neuro & Cardiac Flashcards

(67 cards)

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1
Q

DVT

A

patho: clot formed in large vein
etiology: virchow’s triad
signs: warmth, tenderness, swelling, pain
diagnostics: D dimer & venous duplex ultrasound
RN interv: greatest risk for PE, monitor O2, admin meds (heparin, tpa, coumadin, lovenox), monitor for bleeding, monitor PTT

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2
Q

virchow’s triad

A

3 causes for DVT:
venous stasis
vessel damage
hypercoagulability

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3
Q

anticoagulant

A

heparin, lovenox (LMWH), warfarin
monitor PTT and UHV and INR
if on Heparin drip, monitor PTT !!!
warfarin antidote= vit K

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4
Q

thrombolytic

A

tpa

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5
Q

antiplatelet

A

aspirin, plavix

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6
Q

Myocarditis

A

patho: damage to myocardium by virus
etiology: men & kids most
signs: heart failure, chest pain, carcinogenic shock, hypotension, tachycardia, tachyons, dysthymias, low O2
diagnostic: CRP and sed rate, troponin, echo, MRI, myocardial biopsy
RN interv: treat dysthymia’s and symptoms, admin steroids or immunosuppressants

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7
Q

pericarditis

A

patho: inflammation of pericardium
etiology: often post MI
diagnostic: EKG, CXR, echo, cardiac CT, MRI
signs: pleuritic chest pain, fever, ST elevation and PR depression, hypotension, tachycardia, tachypnea, pericardial friction rub, pulsus paradoxus
RN interv: alleviate pain by NSAIDs, anti inflammatories, aspirin.

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8
Q

pulsus paradoxus

A

on inspiration, systolic BP drops
assessed by arterial line montioring

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9
Q

infective endocarditis

A

patho: infection of mitral or aortic valves
etiology: age, immunodeficiency!!, IV drug use
diagnostics: blood cultures, echo, elevated WBC
signs: osler’s node (painful), janeway lesions(nonpainful), splinter hemorrhage, hypotension, tachycardia, murmur, fever, fatigue, confusion, weak peripheral pulses, pale cold extremeties
RN interv: IV antibiotic therapy via PICC for 4-6weeks, maintain IV access, provide social support, educate on oral hygiene and completing antibiotic regimen
complications: embolic event(leads to stroke), TIA(risk for strokes), sepsis,

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10
Q

to draw blood cultures

A

draw from 2 separate sites before antibiotics are started

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11
Q

valvular disease

A

patho: regurgitation or valvular stenosis.
diagnosis: echo, CXR, cardiac cath
signs: murmur, SOB, crackles, angina, weight gain, weak pulses
RN interv: ACEI (vasodilate to decrease BP), diuretics, valve replacement, restrict sodium and fluids, educate on med regimen, consider prophylactic antimicrobial

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12
Q

left sided heart failure

A

patho: pushes blood back into pulmonary
signs: orthopnea, hypoxia, crackles, pulmonary edema, dyspnea, S3

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13
Q

right sided heart failure

A

signs: peripheral edema, ascites, JVD, hepatomegaly

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14
Q

cranial nerve I

A

olfactory nerve
smell

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15
Q

cranial nerve II

A

optic nerve
visual acuity

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16
Q

cranial nerve III

A

oculomotor nerve
eye movement

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17
Q

cranial nerve IV

A

trochlear nerve
eye movement

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18
Q

cranial nerve V

A

trigeminal nerve
chewing and face sensation, jaw

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19
Q

cranial nerve VI

A

abducens nerve
eye movement

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20
Q

cranial nerve VII

A

facial nerve
facial expression

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21
Q

cranial nerve VIII

A

vestibulocochlear nerve
balance and hearing

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22
Q

cranial nerve IX

A

glossopharyngeal nerve
swallowing and taste

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23
Q

cranial nerve X

A

vagus nerve
parasympathetic nervous system

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24
Q

cranial nerve XI

A

spinal accessory nerve
shoulder shrug

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25
cranial nerve XII
hypoglossal nerve tongue movement
26
hypertension
etiology: increased salt= increased water retention= increased CO= increased BP signs: chest pain, SOB, fatigue, renal dysfunction diagnosis: 2 or more high blood pressure readings in 2 or more office visits RN interv: meds (statins, diuretics, ACEI, beta blockers, Ca channel blockers), educate lifestyle changes
27
peripheral arterial disease
patho: progressive chronic condition w obstruction of blood flow through peripheral arteries diagnostics: ABI below 0.9 signs: claudication, cool extremities, loss of hair and thickening toe nails RN interv: monitor ABI, palpate bilateral pulses, assess bilateral muscle tone, assess pain, keep limb dependent, no crossing limbs, at risk for becoming limb ischemia
28
carotid artery disease
patho: vessel wall thickening, plaque formation, occluding blood in carotid artery diagnosis: carotid duplex scan, CT angiography, carotid angiography signs: carotid bruit, slurred speech, facial droop, weakness, dizziness, RN interv: assess cranial nerves VII, X, XI, XII post CEA, admin antihypertensives and antiplatelets
29
how to position pt w hypotension
lay down flat
30
how to position pt w hypertension
elevate head of bed
31
aortic artery disease
aneurysm patho: media of artery is weakened, stretching intima, widening artery and increasing tension RN interv: admin statins
32
arterial lines
displays a constant systemic blood pressure used to obtain ABGs
33
central line
often connected to arterial line ensure no bubbles remove w one exhale to prevent air embolism
34
central venous monitoring
allows CVP monitoring, including RAP normal RAP: 5-10 high RAP: hypervolemic low RAP: hypovolemic
35
PA catheter "Swan"
through right side of heart into pulmonary artery
36
myocardial infarction
patho: dead heart muscle r/t lack of oxygen diagnosis: increased troponin, CK-MB, myoglobin NSTEMI- non ST elevation, partial occlusion STEMI- ST elevation, full occlusion, damage occuring RN interv: MONA (morphine, oxygen, nitro, aspirin) give 4 baby aspirin
37
post coronary artery bypass grafting assessment
hemodynamic monitoring (PAP, CVP) continuous tele heart sounds continuous pulse ox core temp (foley cath) assess I+O assess neuro monitor chest tube (should be less than 100cc per hr)
38
post CABG interventions
control bp admin fluids admin sedation rewarm pt slowly pulmonary hygiene sternal precautions monitor for infection
39
cardiogenic shock
patho: heart unable to pump for adequate tissue perfusion signs: tachycardia, hypotension, narrowed pulse pressure, decreased pulses, cool extremities RN interv: meds to increase bp, admin oxygen, anticipate intubation
40
pt w mechanical valve...
will need to be on anticoagulant for whole life
41
CSF should..
be clear, colorless have no bacteria have no RBCs WILL contain glucose
42
lumbar punctures
performed in pt w neuro changes and high WBC place pt in fetal position on side have pt lay flat for at least 1 hr after major SE: spinal headaches
43
cerebrovascular accident (stroke)
three types: -TIA: symptoms come and go, stroke precursor -ischemic: no blood flow to brain (if right sided stroke=manifestations on left side) -hemorrhagic: brain bleed (weakness + falls) CT scan is 1st line diagnostic test if suspected stroke
44
acute care for ischemic stroke
establish IV for CT possibly admin thrombolytic therapy (tPa) depending on last known well time NPO HOB at 30 keep systolic 160+ seizure precautions
45
acute care for hemorrhagic stroke
keep systolic below 160 degree seizure prophylaxis meds clips and coils may be needed
46
core measures
hospital regulated pts in afib need to be on anticoagulants need to be on bp meds at discharge documented stroke education
47
tension headache
stress headache bilateral pressing, tightening tylenol or NSAIDs can be used assess alcohol consumption
48
migraine
recurring, unilateral throbbing try NSAIDs, triptans
49
cluster headaches
repeated, primarily men sharp, stabbing, pulsing pain use triptans and provide oxygen
50
seizure
transient, uncontrolled electric discharge of neurons four phases: -prodromal -aural (seizure occurs after) -ictal -postictal
51
focal seizure
one side of brain alert/simple focal=sensing things that are not there altered/complex focal=unaware of consciousness, dangerous
52
generalized seizures
both sides of brain either probable altered or brief altered
53
probable altered consciousness
tonic clonic- falling, body jerk movements absence- in kids, daydreaming
54
brief or possible altered consciousness
myoclonic- sudden excessive muscle jerking atonic- loss of muscle tone, falling tonic- very stiff, usually in sleep clonic- jerking rhythmic movement
55
status epilepticus
continuous seizure activity that lasts longer than 5 minutes pt unconscious admin IV loraz and diaz lay on left side
56
multiple sclerosis
patho: chronic, progressive, autoimmune degenerative disease of myelin sheath diagnosis: increased protein and WBC in CSF, MRI shows plaques on brain signs: bowel/bladder dysfunction, ataxia, slowed movements, diplopia, fatigue RN interv: meds for best QOL (baclofen, steroids, immunosupressents)
57
myasthenia gravis
patho: autoimmune, antibodies attack Ach receptors signs: facial drooping, oxygenation issues, risk for aspiration treat: steroids or thymectomy
58
guillan barre syndrome
patho: rapidly progressing flaccid paralysis to lower extremities etiology: usually post infection diagnosis: EMG (shows decreased nerve conduction velocity) RN interv: plasmapheresis, IVIG, high risk for DVTs, admin enteral feedings
59
trigeminal neuralgia
cranial nerve V disorder sudden unilateral stabbing pain in jaw treat w AED(carbamezapine and gabapentin, and muscle relaxant (baclofen) beware of tremors w high doses of gabapentin
60
MAP calculation
(2x DBP) + SBP / 3
61
ACEI meds
end in -pril decrease afterload
62
beta blockers
increase contractility and therefore decrease workload of heart
63
dobutamine and milrinone
inotropic meds that increase contraction of heart
64
nitrates and diuretics
decrease preload
65
cardiomyopathy
dilated- ventricles enlarge hypertrophic- ventricle wall thickens restrictive- walls become stiff often treated w LVAD or pacemaker
66
Glascow coma scale
verbal response eye response motor response
67
normal pulmonary arterial pressure

ADULT HEALTH 1 (2 decks)

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