TOPIC 3 Midterm Flashcards by Emely Eseo

is a medical imaging procedure that uses x-rays and digital computer technology to create detailed pictures of the body

Computerized tomography (CT) Scan

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is a test that uses powerful magnets, radio waves, and a computer to make detailed pictures of the inside of your body

Magnetic resonance imaging (MRI)

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is a type of nuclear medicine imaging.

Positron emission tomography (PET)

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is a nuclear imaging technology that enables visualization of metabolic processes in the body.

Positron emission tomography (PET)

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is an angiographic procedure that involves inserting a catheter into a blood vessel in the groin or arm.

Cerebral angiography

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In Cerebral angiography patient will be monitored for

4-6 hrs

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is the pressure required to move sufficient amounts of blood to the brain

Cerebral perfusion pressure (CPP)

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the ones whose patient care requires ICP monitoring as they have expertise in neurological assessment and monitoring device management.

Neuroscience nurses

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is a pressure wave along the artery that offers various information on cardiovascular conditions

Pulse wave form

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is a non-invasive, painless ultrasound technique that uses high-frequency sound waves to measure the rate and direction of blood flow inside vessels

Transcranial Doppler

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The test examines and records the speed of the blood flow in arteries known as the

Circle of Willis

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a valuable tool to assess brain function

Continuous electroencephalogram (EEG)

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is the most common scoring system used to describe the level of consciousness in a person following a traumatic brain injury.

Glasgow Coma Scale (GCS)

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is a standardized tool that is commonly used to assess patients suspected of experiencing an acute cerebrovascular accident

National Institutes of Health Stroke Scale (NIHSS)

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commonly used to assess a patient’s cognitive status when there is a concern of cognitive impairment

Mini-Mental Status Exam (MMSE)

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can be assessed by asking the patient to turn their head to each side, against the examiner’s resistance

Sternocleidomastoid

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can be assessed by asking the patient to shrug their shoulders, against the examiner’s resistance

Trapezius

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type of stroke is caused by a blockage in an artery that supplies blood to the brain

Acute ischemic stroke

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traumatic injury leading to damage of the spinal cord, resulting in temporary or permanent change to neurological function, including paralysis.

Traumatic spinal cord injury

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TSCI can be classified:

Complete injury
Incomplete injury

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damage occurring across the whole spinal cord width

Complete injury

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the injury is spread across part of the spinal cord

Incomplete injury

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the neurosurgeon will create one or two small holes within the skull, followed by an incision in the dura if necessary, in order to drain the blood clot.

Burr hole drainage

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the neurosurgeon will remove a section of bone to create access, then remove the blood clot

Craniotomy

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are compounds in foods that scavenge and neutralize free radicals

Antioxidants

chemicals found in plants that protect plants against bacteria, viruses, and fungi.

Phytochemicals

reduced inflammation and blood sugar levels

Bilberry

Bilberry fruit contains chemicals known as

anthocyanosides

scavenge damaging particles in the body and helping prevent or reverse damage to cells

free radicals

Sensation requires both light touch and pin prick assessment

Trigeminal nerve

Initially assess for symmetry in the face at rest

Facial nerve

Hearing can be assessed by whispering a number into each ear separately

Vestibulocochlear Nerve CN VIII

is instructed to walk placing one foot directly in front of the other, heel to-toe

Gait tandem

consists of testing of the primary sensory modalities which include pain, proprioception, vibration and light touch

Sensory evaluation

psychologically traumatic or occur within a broader context of psychological trauma

Traumatic brain injury

Evaluate stroke patient using

FAST

life-threatening condition that occurs when the body is not getting enough blood flow

Shock

become more permeable, and fluids and electrolytes seep from and into the cell

cell swells and the cell membrane

Stages of shock

Compensatory, Progressive, Irreversible

blood pressure remains within normal limits

Compensatory

to maintaining adequate cardiac output. release of catecholamines

Vasoconstriction HR, and contractility of the heart contribute

The patient displays the often-described fight or flight” response

Compensatory

In compensatory the body shunts blood from organs such as

the skin, kidneys, and gastrointestinal tract

mechanisms that regulate blood pressure can no longer compensate and the MAP falls below normal limits

Progressive

represents the point along the shock continuum at which organ damage is so severe that the patient does not respond to treatment

Irreversible

can occur as a progression along the shock continuum or as a syndrome unto itself

Multiple organ dysfunction

Overall management in shock

Fluid replacement Vasoactive medications Nutritional support

administered in all types of Shock

Fluid replacement

are administered in all forms of shock to improve the patient’s hemodynamic stability when fluid therapy alone cannot maintain adequate MAP

Vasoactive medications

Classification of shock

Hypovolemic Cardiogenic Obstructive Distributive

occurs when there is LOW fluid volume in the intravascular system

Hypovolemic shock

shock occurs when there is a reduction in intravascular volume of 15% to 25%. This would represent a loss of 750 to 1,300 mL of blood in a 70-kg (154-lb) person

Hypovolemic shock

The average human blood volume

occurs when the heart’s ability to contract and to pump blood is impaired

Cardiogenic shock

causes of cardiogenic shock are known as either

coronary or non-coronary

seen most often in patients with myocardial infarction

Coronary cardiogenic

be related to metabolic problems and tension pneumothorax

Non-coronary

INITIATION OF FIRST-LINE TREATMENT

Supplying supplemental oxygen Controlling chest pain Providing selected fluid support Administering vasoactive medications Controlling heart rate with medication

a form of shock associated with a physical obstruction/ blockage of the great vessels

Obstructive shock

Three of the most common examples of obstructive shock

Cardiac tamponade Tension pneumothorax Pulmonary embolism

Obstructive Shock: Management

Control airway Intubation Treat the underlying cause

maldistribution or mismatch of blood flow to the cells

Circulatory or distributive shock

Normal adults < 10 - 15 mm Hg

Intracranial pressure monitoring

Commonly used mnemonic regarding assessment of individuals suspected of experiencing a stroke is

BEFAST

Prior to administering the MMSE, ensure the patient is wearing

Glasses or hearing aids

A disorder that commonly results in decreased or absent tendon reflexes is

Adie's tonic pupil

Two surgical treatment options to remove the blood clot

1.Burr hole drainage 2. Craniotomy

shock state resulting from displacement of blood volume creating a relative hypovolemia and inadequate delivery of oxygen to the cells

distributive shock

may be administered to increase the intravascular volume

Crystalloids, colloids, and blood products

Classification of Circulatory shock

Septic shock Neurogenic shock Anaphylactic shock

It can occur in any person with impaired immunity, but elderly people are at greatest risk

Septic shock

The disorder is thought to be a response to that release microbes or immune mediators, such as tumor necrosis factor and interleukin- 1

Septic shock

Is a shock state resulting from loss of sympathetic tone causing relative hypovolemia.

Neurogenic shock

is caused by a severe allergic reaction when a patient who has already produced antibodies to a foreign substance (antigen)develops a systemic antigen– antibody reaction.

Anaphylactic shock

occurs rapidly and is life threatening.

Anaphylactic shock

overwhelming inflammatory response in the absence of infection causing relative hypovolemia and decreased tissue perfusion.

Inflammatory response syndrome (SIRS)

Four sirs criteria

1. Tachycardia- heart rate >90 beats/min 2. Tachypnea- respiratory rate >20 3. Fever or hypothermia- temperature >38 or <36 °C 4.Leukocytosis, leukopenia, or bandemia- white blood cells >1,200/mm3, <4 ,000/mm3 or bandemia ≥10%

is a bedside prompt that may identify patients with suspected infection who are at greater risk for a poor outcome outside the intensive care unit (ICU).

Q Sofa

3 component assessment system with Q Sofa

• Systolic blood pressure ≤100 mmHg • Highest respiratory rate ≥22 breaths per min • Lowest Glasgow coma score <15

an illness severity score commonly used in critical care medicine to predict mortality upon admission to an intensive care unit.

Acute Physiology and Chronic Health Evaluation (APACHE) score

the best-known & most widely used score with good calibration & discrimination.

The APACHE

was released in 1985 and included a reduction in the number of variables to 12.

The APACHE II scoring system

was designed to predict an individual's risk of dying in a hospital.

APACHE III

is a mortality prediction score that is based on the degree of dysfunction of 6 organ systems

Sequential Organ Failure Assessment (SOFA)

score stratifies mortality risk in ICU patients without restricting the data used to admission values.

Sofa

is an objective and useful index.

logistic organ dysfunction system (LODS) score

assesses six systems in terms of the extent of dysfunction on the first day of an intensive care unit (ICU) stay.

LODS

6 s ystems in LODS

Neurologic, Cardiovascular, Renal, Pulmonary, Hematologic, and Hepatic systems

was designed to combine measurement of the severity of multiple organ dysfunctions into a single score.

LODS

is altered organ function in an acutely ill patient that requires medical intervention to support continued organ function.

Multiple organ dysfunction syndrome (MODS)

isn’t an illness itself; rather, it’s amanifestation of another progressive, underlying condition

Multiple organ dysfunction syndrome

organ system failure is due to a direct injury such as trauma or a primary disorder that usually involves the lungs,

Primary Mods

It occurs most often in the patient with septic shock and progressively unfolds over about 1 month.

Secondary mods

TOPIC 3 Midterm Flashcards

(93 cards)