Exam II Flashcards
(161 cards)
1
Q
A(n) _____ injury is caused by an external force contacting the head, suddenly placing the head in motion
A
Acceleration
2
Q
A(n) _____ injury occurs when the moving head is suddenly stopped or hits a stationary object
A
Deceleration
3
Q
A _____ brain injury is confined to a specific area of the brain and causes localized damage.
A
Focal
4
Q
_____ injuries are characterized by damage throughout many areas of the brain.
A
Diffuse
5
Q
Which type of brain injury is detected with CT scan or MRI?
A
Focal brain injury
6
Q
Which type of brain injury may not initially be detectable by CT scan?
A
Diffuse
7
Q
What type of skull fracture is associated with open dramatic brain injury?
A
- linear
- depressed
- open
- comminuted
- basilar
8
Q
With this type of fracture a simple, clean break in which the impacted area of the bone bends inward and the area around it bends outward.
A
Linear
This is the most common type of skull fracture
9
Q
With this type of skull fracture in the bone is pressed inward into the brain tissue to at least the thickness of the skull
A
Depressed fracture
10
Q
This type of skull fracture involves fragmented bone with depression into brain tissue
A
Comminuted
11
Q
With this type of skull fracture the scalp and dura are lacerated, creating a direct opening to the brain tissue
A
Open fracture
12
Q
This type of skull fracture occurs at the base of the skull, usually extending into the anterior, middle, or posterior fossa, and can result in cerebrospinal fluid leakage from the nose or ears
A
Basilar
13
Q
A central nervous system infection can occur when this problem presents as a result of a skull fracture
A
Cerebrospinal fluid leakage
14
Q
This type of skull fracture presents an increased risk for hemorrhage caused by damage to the internal carotid artery. It can also cause damage to cranial nerves I, II, VII, and VIII
A
Basilar
15
Q
Contusion is a bruising of the brain tissue and is most commonly found at the site of impact which is called ?
A
Coup
16
Q
A contusion is a bruising of the brain tissue and is most on only caused at the site of impact, called the _____ while the site opposite impact is called _____?
A
- Coup
- Contrecoup
Most common at the base of the frontal and temporal lobes
17
Q
This type of injury is usually related to high-speed acceleration/deceleration, is typically seen in motor vehicle crashes. It causes shearing of marginal fibers and stretching of blood vessels in many areas of the brain
A
Diffuse Axonal Injury (DAI)
Can cause bleeding and biochemical cascade of toxic substances into the brain after the initial injury
18
Q
What are the most prominent manifestations of DAI?
A
- Cognitive impairment
- Disorganization
- impaired memory
- inattentiveness
- coma
19
Q
How is the severity of TBI determined?
A
- Glasgow Coma Scale
- CT
- MRI
- presentation of symptoms
20
Q
Mild traumatic brain injury is also called _____
A
Concussion
21
Q
What are the characteristics of mild traumatic brain injury/concussion?
A
- a blow to the head, transient confusion or feeling dazed/disoriented and one of the following:
- loss of consciousness for up to 30 minutes
- loss of memory for events immediately before or after accident
- focal neurologic deficits
- No evidence of brain damage on CT or MRI
22
Q
What are the characteristics of moderate traumatic brain injury?
A
- loss of consciousness for 30 minutes to six hours
- GCS 9 to 12
- amnesia that may last up to 24 hours
Often hospitalization to monitor for edema, bleeding, or in adequate perfusion is necessary
23
Q
What are the characteristics of severe traumatic brain injury?
A
- loss of consciousness for greater than six hours
- GCS 3 to 8
- focal and diffuse damage to the brain, cerbrovascular vessels/ventricals
Requires critical care monitoring of hemodynamics, neurological status, and intracranial pressure. There is a high risk for secondary brain injury from cerebral edema, hemorrhage, reduce perfusion, and biomolecular cascade
24
Q
What is the normal level for intracranial pressure ?
A
10-15 mm Hg
25
How does the nurse manage cerebral edema?
- Provide oxygen
- Keep systolic BP within therapeutic range
- Balance fluid intake and output
- Balance fluid and electrolytes
26
This type of edema has abnormal permeability of cerebra vessels and plasma leaks out into the extracellular space and collects in white matter.
Vasogenic Edema
27
This type of edema occurs as a result of a hypoxic event. The brain no longer receives oxygen and starts to use anaerobic metabolism. This can also lead to vasogenic edema
Cytotoxic Edema
28
This type of edema creates fluid accumulation between the cells and is associated with increased BP or ICP
Interstitial Edema
29
What are the three major types of hemorrhage(Hematoma) that present after TBI?
- Epidural
- Subdural
- Intracerebral
30
This type of hematoma results from arterial bleeding into the space between the dura and the inner skull and is often caused by a fracture of the temporal bone.
Epidural hematoma
31
This type of hematoma results from venous bleeding into the space beneath the skull and dura but above the arachnoid and most often is caused by tearing of the bridging veins or laceration of brain tissue.
Subdural Hematoma
This hematoma bleeds more slowly than an epidural hematoma
Either acute, subacute or chronic
32
This type of subdural hematoma presents within 48 hours of impact
Acute Subdural Hematoma
33
Type type of subdural hematoma presents within 48 hours to 2 weeks of impact
Subacute Subdural Hematoma
34
This type of subdural hematoma presents from 2 weeks to several months after injury
Chronic Subdural Hematoma
35
This type of hemorrhage is the accumulation of blood within the brain tissue caused by tearing of small arteries and veins in the subcortical white matter
Intracerebral hemorrhage
Can produce ICP and edema
36
This is an abnormal increase in CSF.
Hydrocephalus
37
What are the two types of brain herniation?
Uncal and Central
38
This type of brain herniation is caused by the shift of one or both of the temporal lobes and is life threatening
Uncal herniation
39
This type of brain herniation is caused by a downward shift of the brainstem and the diencephalon from a surpatentorial lesion
Central herniation
40
What are the signs and symptoms of Uncal herniation?
- Ptosis (drooping eye lids)
- Dilated and non-reactive pupils
- Rapid and deteriorating LOC
41
What are the signs and symptoms of Central herniation?
- Cheyne-Stokes respirations
- Pinpoint and non-reactive pupils
- Hemodynamic instability
42
What is Cushing's Triad?
Classic but late sign of ICP:
- Manifested by severe HTN
- Widened pulse pressure (increased difference between diastolic and systolic)
- Bradycardia
Typically indicates imminent death
43
What type of patient history should be collected with TBI?
- When, where, how injury occurred
- Loss of consciousness, how long?
- Change in LOC since injury?
- Any seizure activity?
- Which is dominant hand?
- Any eye disease or injuries?
- Allergies?
- Drug or alcohol use?
- Violence in the home?
44
What are the clinical manifestations of TBI?
- increased ICP
- Hypotension
- Hypoxemia
- Hypercarbia
Subtle changes in BP, LOC and pupillary response to light can help determine neurologic deterioration
45
What are the priority nursing interventions in the ED with TBI patient?
- Assess ABCs (airway, breathing circulation)
- Spine precautions
- Assess sensory perception
- Glascow coma scale assessment
- Vitals (Cushing's Triad)
- Pupil response
- Motor responses (decerebrate, decorticate, flaccid)
- CSF leak
46
What are spinal precautions?
- Bedrest
- No neck flexion with pillow or neck roll
- No thoracic or lumbar flexion with HOB elevation
- Manual control of cervical spine when collar is off
- Log roll for positioning
47
Which two manifestations suggest hypovolemic shock with TBI patients?
- Hypotension
- Tachycardia
48
What are the late signs of ICP?
- Nausea/Vomiting
- Severe headache
- Seizures
49
What is the abnormal body posturing that involves the arms and legs being held straight out, the toes pointed downward, and the head and neck being arched backward?
Decerebrate posture
50
What is the abnormal body posturing in which a person is stiff with bend arms, clenched fists, and legs held out straight. The arms are bent toward the body and the wrists and fingers are bent and held to the chest?
Decorticate posture
51
Bruising behind the ear or lower jaw is called \_\_\_\_\_?
Battle sign or Mastoid Ecchymosis
52
This type of fever presents with an absence of sweating and no diurnal (night and day variation). The fever is high and lasts several days to weeks and responds better to cooling measures than antipyretics.
Central fever
Caused by hypothalamic damage
53
What is therapeutic hypothermia and why is it used?
Rapidly cooling the patient's core temperature between 89.6 and 93.2 for 24-48 hours after injury
This reduces brain metabolism and prevents the cascade of molecular and biochemical events that contribute to secondary brain injury in moderate to severe TBI
54
What are the four prerequisites of brain death?
- Coma
- Normal/Near normal core body temp
- Normal systolic BP (\>=100 mm hg)
- At least one neurologic exam
55
What are the pharmacological interventions for TBI?
- Mannitol (Osmitrol): osmotic diuretic for cerebral edema; most effective as bolus; Use filter
- Furosemide (Lasix): loop diuretic, reduces rebound from Mannitol and also enhances Mannitol by reducing edema, blood volume and sodium uptake
- Propofol (Diprivan): sedative - manage agitation
- Morphine/Fentanyl: Opioids - agitation from pain; naloxone for reversal; Fentanyl has fewer effects on BP
- Phenytoin (Dilantin): Antiepileptic - prevent seizures
\*\* Dethamethasone (decadron) & Methylprednisolone: glucocorticoids - No benefit!
56
Which drugs are used to induce barbiturate coma?
pentobarbital (Nembutal, Novapentobarb): mechanical vent required complications include: decreased GI motility, Cardiac dysrhythmias from hypokalemia, hypotension, fluctuation in body temperature
57
What are the surgical interventions for TBI?
- ICP management devices: keyhole craniotomy - inserted through a burr hole
- Decompressive craniotomy: removal of a section of the skull
- Craniotomy: skull opening immediately followed by closing
- Evacuation of epidural or subdural hematoma
side lying restrictions and protective care
58
What is the discharge teaching for TBI?
- assess family dynamics/coping strategies
- Assess for patient care needs (24 hr care?)
- Discuss memory and personality changes
- Discuss support groups and respite care
59
\_\_\_\_\_ is a progressive, permanent change in cognition
Dementia
60
\_\_\_\_\_ is reversible change in cognition with treatment
Delerium
61
What are the risk factors for cognitive impairment?
- advanced age
- behaviors (substance abuse, poor decisions)
- environmental exposure (lead, toxins)
- congenital/genetic (FAS, Downs)
- health related
62
Which diagnostic test is done to detect infarcts (vascular dementia)?
MRI PET
63
What is the function of the liver?
Clears toxins from the body
64
What is cirrhosis?
extensive, irreversible scarring of the liver
65
What are the most common causes of cirrhosis?
- chronic alcoholism (Laennec's)
- chronic viral hepatitis (post necrotic cirrhosis)
- nonalcoholic steatohepatitis (NASH); fatty liver
- bile duct disease (biliary cirrhosis)
- genetic diseases (biliary cirrhosis)
66
With this type of cirrhosis the liver is scarred but can still perform essential functions without causing major symptoms
Compensated cirrhosis
67
With this type of cirrhosis the liver function is impaired with obvious manifestations of liver failure
decompensated
68
What are the complications of cirrhosis?
- portal hypertension (increased pressure in portal vein)
- ascites (3rd spacing)
- esophageal varices (thin veins in esophagus)
- coagulation defects
- jaundice (bilirubin build up)
- portal systemic encephalopathy (PSE) (build up of ammonia)
- splenomegaly (enlarged spleen)
- destroys platelets, risk for thrombocytopenia
69
In this stage of PSE the patient is unresponsive, has a positive Babinski reflex, and significant ammonia build up, muscle rigidity, seizures
Stage 4 (non-reversible)
70
In this stage of SPE the patient is disoriented to time/place/person and has asterixis (hand flapping)
Stage 2 (reversible)
71
In this stage of SPE the patient is confused; is stuporous but arousable; has muscle twitching; hyperreflexia; and asterixis (hand flapping)
Stage 3 (non reversible)
72
In this stage of SPE the patient has personality changes; behavioral changes (belligerent, agitated); unable to concentrate; emotional labile (euphoria, depression); fatigued; slurred/slow speech; disturbed sleep patterns
Stage 1 (reversible)
73
What are the risks for cirrhosis and liver failure?
- Hepatitis C (2nd leading cause)
- Hepatitis B & D (combined)
- Nonalcoholic Fatty Liver disease
- Alcohol abuse
74
How much alcohol does it take to cause cirrhosis?
Women: 2-3 drinks per day over minimum 10 years Men: 6 drinks per day over minimum 10 years
75
What are we assessing for to determine liver disease?
- Petechiae (red dots present on face/chest)
- Ecchymosis (bruising from impaired clotting)
- Spider angiomas (nose, cheeks, upper thorax, shoulders)
- Ascites/Abdominal girth (daily weight/measurement)
- Jaundice (yellowing of skin, bilirubin build up) - Fector hepaticus (fruity breath)
- Palmar erythema (warm, bright red palms of hands)
- Dry skin
- Rashes
- Vitamin deficiency (fat soluble - A, D, E, K)
76
What are the expected lab results for cirrhosis/liver disease?
Increased: ALT, AST, LDH, Alkaline phosphatase, bilirubin, ammonia
Prolonged: Pr/INR
Decreased: Protein, albumin, platelets, RBC, WBC
77
What are the diagnostic tests for cirrhosis/liver disease?
- xray
- MRI
- ultrasound
- biopsies
- EGD (exploratory scope)
78
What type of diet is given to a patient with ascites?
Low sodium
Requires Thiamine, Folate & Multivitamin supplements given via IV (Liver cannot store vitamins)
79
What type of diet is given to a patient with cirrhosis?
- High carb
- High protein
- Moderate fat
80
What are the treatments for managing hemorrhage?
- Inderal: Beta blocker to control BP, for prevention
- Vassopressin & Octreotide acetate: vasoconstrics
- Banding of esophageal varices
- Sengstaken-Blakemore tube
- Transjugular intrahepatic portal systemic shunt (TIPS)
81
What are the complications when using a Sengstaken-Blakemore tube?
- Aspiration
- Asphyxia
- Perforation
82
What is the purpose for giving Neomycin, Flagyl or Vanco to a patient with liver disease?
- They are intestinal antisceptics
- They diminish protein breakdown
- They decrease rate of ammonia production
83
Why is vasopressin given to patients with liver disease?
- Vasoconstrictor
Helps control hemmhorage
84
Why is octreotide acetate given to patients with liver disease?
Suppresses secretions
85
Why is aldactone given to patients with liver disease?
Diuretic used for ascites; helps maintain sodium and potassium balance
86
Why is thiamine given to patients with liver disease?
- Helps with sodium replacement with ascites
- Helps with alcohol withdrawal
87
Why is lactulose given to patients with liver disease?
- It is a syrup given orally that helps reduce ammonia in the body.
- Often used with hepatic encephalopathy
- Monitor for hypokalemia and dehydration
88
What are the two types of temporary pacers?
- Transcutaneous: Outside the body with externally applied electrodes
- Transvenous: Electrodes/Leads are threaded through the subclavian or femoral vein into the right atrium
89
What is the function of temporary pacers?
Stimulate ventricular depolarization (contraction)
90
What does a P wave on an EKG strip represent?
Atrial depolarization (contraction)
91
What does a QRS complex represent on an EKG strip?
Ventricular depolarization
92
What does a T wave represent on an EKG strip?
Full ventricular repolarization
93
What are the important assessments to make on an EKG strip?
- Determine heart rate: normal/abnormal
- Determine rhythm: regular/irregular
- Analyze P waves: Present?
- Measure QRS: Consistent?
- Analyze T wave: Present?
94
What are the causes of Atrial irritability?
- Stress
- Fatigue
- Anxiety
- Inflammation
- Infection
- Caffeine, nicotine, alcohol
- Drugs such as epinephrine, amphetamines, Digitalis, anesthetics
- Electrolyte imbalance
95
What are the signs and symptoms of atrial irritability, which causes premature atrial complexes?
Palpitations (not always present)
96
What are the interventions for premature atrial complexes?
none, treat palpitations, or if they are frequent and lead to other dysrhythmias antidysrhythmics may be used
97
What are the signs and symptoms of sustained ventricular response (Supraventricular Tachycardia 100-280 bpm)?
- palpitations
- chest pain
- weakness
- fatigue
- SOB
- nervousness
- anxiety
- hypotension
- syncope
98
What is the preferred treatment for supraventricular tachycardia?
- Cardioversion: emergency situations (with mild sedative)
- Adenosene: emergency situations if cardioversion unsuccessful (IV push 1-3 seconds)
- Radiofrequency catheter ablation: recurrent episodes
99
Patients with atrial fibrillation are at risk for...
- Clots
- Stroke
- Decreased perfusion (can decrease as much as 20-30%)
Common with HTN, DM, HF, CAD
100
What is the pharmacological treatment for atrial fibrillation?
- Antidysrhythmics: Amiodarone, Multaq (rapid administration, followed by saline bolus)
- Carotid sinus massage (few seconds, not common)
- Cardioversion (mild sedative)
- Radiofrequency catheter ablation: recurrent episodes
- Bi-ventricular pacing
101
Hypokalemia or Hypomagnesaemia can cause this type of dysrhythmia?
Premature Ventricular Contractions
102
What is the criteria for placing a patient with PVCs on beta blockers?
5000 PVCs in 24 hour period
103
A build up of nitrogen waste in the body is called \_\_\_?
Azotemia
104
This condition manifests with n/v, muscle cramps, edema, dyspnea, paresthesia and metallic taste in the mouth
Uremia azotemia with manifestations
105
What is normal GFR?
greater than 90mL/hr
106
What are the risk factors for kidney disease?
- infection
- inflammation
- pregnancy
- dehydration
- hypotension
- hypertension
107
What are the best ways to slow the progression of CKD?
careful management of diabetes, HTN, and heart failure
ACE inhibitors slow the progression of CKD in patients with HTN
108
With this stage of kidney disease a person is at risk and has normal kidney function and GFR. Screenings take place and education to manage care for risk factors takes place
Stage 1: At risk
109
With this stage of kidney disease GFR is reduced to less than 15mL/min, fluid and electrolyte/acid base balance required and excess amounts of urea and creatinine build up in the blood. Renal replacement therapy or kidney transplant required
Stage 5: End stage kidney disease
110
With this stage of kidney disease GFR is reduced to 30-59 mL/min, azotemia is present and focus is placed on managing underlying conditions such as diabetes and blood pressure
Stage 3: Moderate CKD
111
With this stage of kidney disease GFR is reduced to 60-89 mL/min, slight elevation of metabolic wastes appear in blood but BUN, creatinine, uric acid and phosphorus are not well defined. Urine output is increased and dilute often causing dehydration.
Stage 2: Mild CKD
112
With this stage of kidney disease GFR is reduced to 15-29 mL/min, excessive amounts of BUN and creatinine build up in the blood, kidney's cannot maintain homeostasis, severe fluid and electrolyte/acid base impairment, education is done to prepare patient for renal replacement therapy
Stag 4: Severe CKD
113
What are the changes to urine output and osmolality as kidney disease progresses?
- Urine output deceases
- Osmolarity becomes fixed
114
Creatinine comes from ____ in skeletal tissue. Excretion depends on muscle mass, physical activity and diet.
protein
115
What are the electrolyte changes (sodium, potassium, acid base, calcium, phosphorus) that take place with CKD?
- Sodium:
early stages-hyponatremia (lost in urine),
late stages-hypernatremia (decreased urine output)
- Potassium:
late stages-hyperkalemia (decreased urine output)
- Acid-base imbalance: later stages-metabolic acidosis, kussmaul breathing
- Calcium/Phosphorus:
early stage- Calcium decreased, Phosphorus increased,
later stages-parathyroid compensates by creating more calcium and both calcium and phosphorus are increased
116
Which vitamin is needed to enhance intestinal absorption of calcium?
Vitamin D - calcium binds to vitamin D
117
What are the cardiac changes that take place with CKD?
- HTN: secondary to sodium retention
- Hyperlipidemia: fat retention
- HF: workload of heart increased
- Pericarditis: pericardial sac becomes inflamed by uremic toxins or infection
- Anemia: later stages - Clotting/Platelet impairment: increased bleeding
118
What are the GI changes that take place with CKD?
- Halitosis (bad breath): excess ammonia due to uremia
- Stomatitis (mouth inflammation): excess ammonia due to uremia
- Anorexia/Nausea & Vomiting - Peptic ulcer disease
119
What are the neurological manifestations of CKD?
- Confusion
- Lethargy
- Weakness/pain in lower extremities
- Seizures
120
What are the cardiovascular manifestations of CKD?
- HTN
- Cardiomyopathy
- Pericarditis
121
What are the respiratory manifestations of CKD?
- Tachyapnea
- Uremic halitosis
- SOB
- Crackles
- Kussmaul breathing
122
What are the hematologic manifestations of CKD?
- anemia
- bruising
- bleeding
123
What are the GI manifestations of CKD?
- anorexia
- nausea/vomiting
- metallic taste in mouth
- stomatosis
124
What are the muscular skeletal manifestations of CKD?
- Muscle cramping
- prone to fractures
125
What are the urinary manifestations of CKD?
- Polyuria (early stages)
- Dilution (early stages)
- Oliguria (late stages)
- Concentration (late stages)
126
What are the integumentary manifestations of CKD?
- Yellow/Gray pallor
- Pruritus (itching)
- Ecchymosis (bruising)
- Purpura (purple patches)
127
What are the psychosocial assessments for CKD?
- coping
- understanding of disease
- advanced directives
128
What are the lab assessments for CKD?
Early stages:
- Increased protein, glucose, RBC, WBC - Fixed/decreased urine osmolality - Dilute urine
Late stages: - Increased osmolality - Urine output decreased and concentrated - Protein should be controlled
129
Patients should not gain/lose more than ___ lbs between dialysis sessions
2 lbs
130
What is the nursing care priority with regard to monitoring pulmonary edema and patients taking diuretics?
Watch for ototoxicity
131
What is the priority nursing care for decreased cardiac output?
- Control BP!
- Patient has decreased stroke volume and increased output.
- ACE inhibitors and CCBs help with GFR
132
What are the dietary restrictions for a patient with CKD?
- reduced protein (protein main cause of uremia)
- supplement iron and calcium (r/t anemia and increased phosphorous which decreases calcium)
- sodium restriction (edema)
- Potassium restriction (prevent dysrhythmias)
- Phosphorous restriction (avoid hypocalcemia)
133
What is the antidote for heparin?
Protamine Sulfate
134
How long is heparin active in the body after dialysis?
4-6 hours
135
What is the most effective type of cardiac drug for slowing the progression of CKD in patients with HTN?
ACE Inhibitors
136
What is the most effective type of cardiac drug for improving GFR and blood flow to the kidneys?
CCBs-Amiodarone
137
What dietary changes take place when a patient is on dialysis?
Protein is increased.
Protein is lost thru dialysis and is measured by Albumin levels (decreased indicate protein deficiency)
138
Which over the counter medication should be avoided by patients with CKD?
Antacids containing magnesium These patients cannot excrete magnesium
139
Which manifestations of CKD are used to determine candidates for hemodialysis?
- Fluid overload not responsive to diuretics
- Symptomatic hyperkalemia
- Uremic manifestations present (n/v, decreased cognition, pruritus, decreased attention span)
140
What nursing assessments are important for a patient with a arteriovenous fistula?
- Palpate for thrills/Auscultate for bruits
- Check distal pulses
141
What are the complications with arteriovenous fistulas?
- Thrombus
- Infection
- Ischemia
- Heart failure
142
What are essential post-dialysis assessments?
- Weight
- Vitals
- Hypotension (bolus of normal saline)
- Headache
- Nausea/vomiting
- Malaise/dizziness
- Muscle cramps
- Bleeding
143
What are the complications of peritoneal dialysis?
- peritonitis
- infections
- poor dialysate flow
- leakage
144
What is the criteria for kidney donation?
- no HTN
- no kidney disease
- no systematic disease or infection
- matching blood type
145
What is the preop care for a patient undergoing kidney transplant?
- dialysis within 24 hours of surgery
- blood transfusion from donor before surgery
146
What is the postop care for a patient undergoing kidney transplant?
- evaluate labs to determine kidney function
- assess for signs of infection/rejection
- assess urine output hourly within first 48 hours (pink/bloody after surgery)
- vitals (especially BP)
- Watch for chest pain, edema, crackles
- monitor weight
147
What are the complications of kidney transplantation?
- Rejection
- Thrombosis
- Renal artery stenosis
148
What is the most important patient education for kidney transplant patients?
Stick to drug regimen Critical to avoiding rejection!!
149
What are the risk factors for v-fib?
* MI
* Hypokalemia
* Hypomagnesemia
* Hemmorage
* Drug therapy
* SVT
* shock
150
What are the risk factors for PSE
* high protein diet
* hypovolemia
* hypokalemia
* constipation
* gi bleed
* drug use
151
What are the risk factors for ventricular tachycardia 140-180 bpm?
* ishemic heart disease
* MI
* cardiomyopathy
* hypokalemia
* hypomagnasemia
* valvular heart disease
* heart failure
* drug toxicity
* hypertension
152
What are the pharmacological treatments for ventricular tachacardia?
* mexiletine
* sotalol
Monitor HR, BP; watch for tremors, dizziness, blurred vision, ataxia, confusion
153
What is the treatment recommended for stable ventricular tachycardia?
Cardioversion
may require ablation for persistent episodes
Unstable is treated same as v-fib
154
How long can a person survive while in v-fib?
3-5 minutes
155
What are the mainfestations of v-fib?
* patient becomes faint
* immediate loss of consciousness
* pulseless
* apneic
* seizures may occur
156
What are the priority interventions for v-fib?
defibrilate immediately
if not available, use CPR
157
Why is nitroglycerin used in treatment of kidney disease?
To reduce pulmonary pressure/edema
158
What heart conditions are treated with Amiodarone (CCB, antidysrhythmic)?
* A-fib
* V-tach
Monitor BP, QT, HR, Rhythm, hypotension, use sunscreen)
159
Why is Atproine used for heart disease?
Bradycardia
Can increase ICP
160
Why is Adenosine (antidysrhythmic) used for heart disease?
Supraventricular Tachycardia
Administered via IV push quickly (1-3 seconds)
Immediately followed by asystole
Monitor HR and Rhythm
161
Why is Mexiletine (antidysrhythmic) used for heart disease?
* V-tach
* PVCs
* V-fib
Monitor HR & BP
watch for tremors, dizziness, blurred vision, ataxia, confusion
