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Med Surg 2 > Week 1 and 2 > Flashcards

Week 1 and 2 Flashcards

1
Q

Besideds FAST what is another symptom might be seen stroke pats

A

tongue deviation

mood changes

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2
Q

What needs to be checked for stroke pats before their next meal

A

gag reflex

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3
Q

Whhat are the types of aphasia

A

Receptive aphasia – loss of comprehension

Expressive aphasia – inability to produce language that is intelligible

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4
Q

What is nonfluent aphasia (Broca’s)

A

minimal speech activity with slow speech that requires concentrated efforts

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5
Q

What are fluent aphasia (Wernickes)

A

speech that normal speed but contains little language that is intelligible

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6
Q

What are soem diagnostics for strokes

A 
CT Scan
CT Angiography (CTA)
MRI
Magnetic resonance angiography (MRA)
CT/MRI perfusion and diffusion imaging
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7
Q

What is the initial test for strokes

A

CT without contrast

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8
Q

Why no contrast for stroke diag

A

could make bleeding worse

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9
Q

What arteries are assessed durign a stroke

A

the carotid to see if stenosis

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10
Q

What are the main prevention care for stroke pats

A 
Control of hypertension
Control of diabetes mellitus
Treatment of underlying cardiac problem
No smoking
Limiting alcohol intake
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11
Q

What is permissive HTN

A

a treatment for acute ischemic stroke with pats HTN over 200mg that lowers BP slowly to prevent kidney damage

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12
Q

What are the acute care interventions for stroke pats

A

Maintenance of airway
Fluid therapy
Treatment of cerebral edema
Prevention of secondary injury

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13
Q

What are things that change ICP

A

1) changes in arterial pressure; 2) venous pressure;
3) intraabdominal and intrathoracic pressure;
4) posture;
5) temperature
6) blood gases in particular CO2 levels

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14
Q

What is a CPP

A

cerebral perfusion pressure

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15
Q

What should your CPP be

A

60

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16
Q

How do you calculate your CPP

A

MAP-ICP

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17
Q

What is the required BP fpr keeping the brain alive

A

60mmHg

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18
Q

What might be symptoms of increased ICP

A 
HA
mild confusion 
shallow breathing 
elevated BP 
nausea
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19
Q

Why might a pat a few days after receiving CPR have a headache or confusion

A

cerebral edema

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20
Q

What is vasogenic cerebral edema

A

fluid leaks out of white matter capillaries into Ex cellular space

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21
Q

What is cytotoxic cerebral edema

A

happens from damage of cell membranes

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22
Q

What is cushings triad

A 
for increased ICP 
Systolic BP increases
Pulse and resp goes down
For shock 
BP goes down 
pulse and resp go up
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23
Q

How will cushings triad present itself

A

you’ll start to see the vital signs trending towards the triad

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24
Q

What are some things that may cause vasogenic cerebral edema

A

brain tumors,
abscesses,
ingested toxins

25
Q

What cause cytotoxic cerebral edema and what does it cause

A

destructive lesions or trauma to brain tissue

this edema would cause cerebral hypoxia or anoxia and syndrome of inappropriate antidiuretic hormone (SIADH)

26
Q

In alaska what is one of the things that indicates the need to call the organ donors company

A

Glascow coma scale less than 5

27
Q

when monitoring ICP what is a consideration for the transducer

A

it needs to be kept level with the ear

28
Q

What is a Battle sign

A

bruising behind the ear around the mastoid

29
Q

What is a Battle sign

A

bruising behind the ear around the mastoid

30
Q

Test questions on Tumors?

A

no

31
Q

What is used to control ICP when it cant be controled by meds or other interventions

A

ventriculoperitoneal shunt (VP shunt)

32
Q

What are meningitis pats need to isolated

A

bacterial

33
Q

What vertebre is where quadraplegia injuries happen

A

C4

34
Q

Why do quadraplegic pats get intubated

A

cant excrete secretion so at risk for infections/atelectasis

35
Q

What is the maintainance of cervical traction

A

need to be cleaned everyday using sterile technique

36
Q

What is the first intervention for pats that might be having autonomic dysreflexia

A

sit them up right

37
Q

What is bell’s palsy

A

acute facial paralysis from inflammatory of the facial nerve

38
Q

What happens in guillian barre

A

peripheral paralysis

39
Q

What is the most concerning prblem with guillain barre

A

inability to breath from spreading paralysis

40
Q

What is a big reason for depression in stroke paats

A

inability to communicate

41
Q

What is the monroe kelly doctrine

A

the idea that the brain needs certain percentages of its CSF, blood, and tissue to have normal ICP

42
Q

What drug is used for increased ICP

A

manitol- acts like brain lasics

or set up a drain

43
Q

What chemo drug will pass the BBB

A

temodar

44
Q

What type of drug is still given after a spinal cord injury and why

A

steroids bec reducing the inflammation could relieve the pressure on the cord and minimize damage

45
Q

What is bells palsy

A

inflammation of the facial nerve

46
Q

Is bells palsy permanent

A

usu not

47
Q

What is usu the steroid given to spinal cord injury pats

A

methylprednisone

48
Q

What drug is given to pats after a brain injury from bleeding (like a hemorrhagic stroke) that may also have vasospasms

A

nimotop

49
Q

With a basilar skull fracture what is a consideration for NG tubes or other things inserted into the nose

A

contact PCP before inserting bec the facture could have caused a hole that the object could fit through, possibly hitting the brain

50
Q

What is normal PTT

A

25-30

51
Q

What is normal PT

A

11-14

52
Q

What is theurapeutic range of PT/INR

A

2-3

53
Q

What are the rules of nines

A

9% per arm, head
36% for torso,
18 each legs
1 for gens

54
Q

What are the strength gradings

A 
0- no contractions
1- quiver
2- active movement, cant res gravity 
3- active movement against gravity 
4- active movement against res
5- normal strength
55
Q

What is heparins antidote and is it PT or PTT

A

PTT

Protamine Sulfate

56
Q

What is coumadines antidote and is it PT or PTT

A

PT

Vit K

57
Q

What is the first sign of increased ICP

A

LOC changes

58
Q

What are the signs of SIADH

A

high specific gravity
fluid retention
hyponatremia

59
Q

What are the treatments of SIADH

A

oral care
vasopressors and democlocycline to block ADH
lasix with vit K supp

Med Surg 2 (13 decks)

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