Week 1 and 2 Flashcards by Nick Wrobel

Besideds FAST what is another symptom might be seen stroke pats

tongue deviation

mood changes

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

gag reflex

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Whhat are the types of aphasia

Receptive aphasia – loss of comprehension

Expressive aphasia – inability to produce language that is intelligible

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What is nonfluent aphasia (Broca’s)

minimal speech activity with slow speech that requires concentrated efforts

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What are fluent aphasia (Wernickes)

speech that normal speed but contains little language that is intelligible

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What are soem diagnostics for strokes

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

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What is the initial test for strokes

CT without contrast

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Why no contrast for stroke diag

could make bleeding worse

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What arteries are assessed durign a stroke

the carotid to see if stenosis

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What are the main prevention care for stroke pats

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

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What is permissive HTN

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

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What are the acute care interventions for stroke pats

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

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What are things that change ICP

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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What is a CPP

cerebral perfusion pressure

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What should your CPP be

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How do you calculate your CPP

MAP-ICP

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What is the required BP fpr keeping the brain alive

60mmHg

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What might be symptoms of increased ICP

HA
mild confusion 
shallow breathing 
elevated BP 
nausea

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

cerebral edema

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What is vasogenic cerebral edema

fluid leaks out of white matter capillaries into Ex cellular space

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What is cytotoxic cerebral edema

happens from damage of cell membranes

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What is cushings triad

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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How will cushings triad present itself

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

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What are some things that may cause vasogenic cerebral edema

brain tumors,
abscesses,
ingested toxins

What cause cytotoxic cerebral edema and what does it cause

destructive lesions or trauma to brain tissue | this edema would cause cerebral hypoxia or anoxia and syndrome of inappropriate antidiuretic hormone (SIADH)

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

Glascow coma scale less than 5

when monitoring ICP what is a consideration for the transducer

it needs to be kept level with the ear

What is a Battle sign

bruising behind the ear around the mastoid

What is a Battle sign

bruising behind the ear around the mastoid

Test questions on Tumors?

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

ventriculoperitoneal shunt (VP shunt)

What are meningitis pats need to isolated

bacterial

What vertebre is where quadraplegia injuries happen

Why do quadraplegic pats get intubated

cant excrete secretion so at risk for infections/atelectasis

What is the maintainance of cervical traction

need to be cleaned everyday using sterile technique

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

sit them up right

What is bell's palsy

acute facial paralysis from inflammatory of the facial nerve

What happens in guillian barre

peripheral paralysis

What is the most concerning prblem with guillain barre

inability to breath from spreading paralysis

What is a big reason for depression in stroke paats

inability to communicate

What is the monroe kelly doctrine

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

What drug is used for increased ICP

manitol- acts like brain lasics | or set up a drain

What chemo drug will pass the BBB

temodar

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

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

What is bells palsy

inflammation of the facial nerve

Is bells palsy permanent

usu not

What is usu the steroid given to spinal cord injury pats

methylprednisone

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

nimotop

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

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

What is normal PTT

25-30

What is normal PT

11-14

What is theurapeutic range of PT/INR

2-3

What are the rules of nines

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

What are the strength gradings

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

What is heparins antidote and is it PT or PTT

PTT | Protamine Sulfate

What is coumadines antidote and is it PT or PTT

PT | Vit K

What is the first sign of increased ICP

LOC changes

What are the signs of SIADH

high specific gravity fluid retention hyponatremia

What are the treatments of SIADH

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