week 10

Question 1

what is amyotrophic lateral sclerosis

Answer 1

muscles whither away, progressive paralysis (mind is intact)

Question 2

how long is the prognosis for ALS

Answer 2

2-6 years after diagnosis

Question 3

is there any treatment for ALS

Answer 3

no

Question 4

what is Gillian-barre syndrome

Answer 4

bodys immune system damaging nerve (usually follows infection)
- symmetrical paralysis starting at feet and goes up
- painful

Question 5

what is the treatment for Gillian barre syndrome

Answer 5

plasmapheresis and IVIG

Question 6

how does guillian barre present

Answer 6

starts as weakness and twitching, then gets worse within the hours

Question 7

what is Duchenne muscular dystrophy

Answer 7

the once that’s common in young boys, onset of weakness begins at age 4

Question 8

what is the disease progression of Duchenne muscular dystrophy

Answer 8

starts at age 4, unable to move independently by age 12
life expectancy 20-30 years old

Question 9

how does MS result in chronic inflammation and scarring

Answer 9

because myelin keeps trying to regenerate

Question 10

whats the main way to diagnose MS

Answer 10

evoked response testing

Question 11

why would MS patients be on Ritalin

Answer 11

to increase energy

Question 12

what is the anti spastic med used for MS

Answer 12

baclofen (to decrease muscle spasms

Question 13

what is the main patient education for a patient with MS on a corticosteroid

Answer 13

it increases risk of infection which could exacerbate MS

Question 14

what is the main anticholinergic used for MS and what is it for

Answer 14

ditropan used to increase bladder tone

Question 15

what is the ideal pain med for fractures

Answer 15

T 3

Question 16

what at the two ways to put a fractured bone back into place

Answer 16

• reduction: pull joint
• open method: surgery

Question 17

how often should you assess sites of an external fixation

Answer 17

every 8-12 hours

Question 18

should you remove pin site crust?

Answer 18

no

Question 19

how long should skin traction be used for

Answer 19

48-72 hours

Question 20

what is the weight for skin traction

Answer 20

2.3-4.5 kg

Question 21

what are the two way to treat compartment syndrome

Answer 21

cut cast
fasciotomy

Question 22

what do you do if a patient has a confirmed DVT clot

Answer 22

bolus heparin IV, then IV infusion heparin continuous
move to PO Coumadin after a couple of days

Question 23

what are the symptoms of fat embolism

Answer 23

sudden decreased oxygenation
suddenly confused, passed out, or restless
increase rr, sense of impending doom

Question 24

what is the treatment of fat embolism

Answer 24

nothing. just to supportive care

Question 25

which bone fracture could cause avascular necrosis

Answer 25

hip fracture in the femoral neck usually in displaced fractures

Question 26

what is a fascia iliac compartment nerve block

Answer 26

an anaesthetic that blocks nerves and is a good alternative to opioids

Question 27

how soon after a hip fracture will a patient need surgery

Answer 27

24-48 hours

Question 28

why is a pelvic fracture so dangerous

Answer 28

because its very vascular and close to organs - could lacerate organs (urethra, bladder, colon) or lacerate a vessel causing hemmorhage

Question 29

what is a non weight bearing pelvic fracture

Answer 29

non weight bearing part of pelvis is fractured - pubic rami - iliac crest 8 weeks of bed rest to heal

Question 30

what is a weight bearing fracture

Answer 30

pelvic ring or acetabulum needs surgery to heal

Question 31

what are some things to monitor for with a pelvic fracture

Answer 31

hypovolemic shock blood in urine and stool abdomen for rigidity and swelling

Question 32

what happens with an incomplete spinal cord injury

Answer 32

can move but cant feel

Question 33

what parts of the spine cause tetraplegia

Answer 33

C4-C6

Question 34

what parts of the spine cause paraplegia

Answer 34

T6-L1

Question 35

what do we do to prevent secondary spinal injury

Answer 35

collars, backboard patient at scene, methylprednisolone for the first 24-48 hours

Question 36

what is spinal shock

Answer 36

spine literally in shock and stops doing anything at time of injury can last days to months

Question 37

what is the treatment of spinal shock

Answer 37

none, just start rehab right away

Question 38

what is a fatal spinal fracture

Answer 38

C1-3, rarely do people live

Question 39

what is neurogenic shock

Answer 39

loss of sympathetic innervation (the thing that causes fight or flight) causes very low blood pressure

Question 40

what are the symptoms of neurogenic shock

Answer 40

low BP, low HR, skin is warm and dry

Question 41

which patients are at risk for neurogenic shock with SCI

Answer 41

T5 and above

Question 42

how does a SCI affect thermoregulation

Answer 42

it causes poikilothermia: body temp takes on environment

Question 43

how long does it take paraplegia to heal

Answer 43

6 months

Question 44

how long does it take quadriplegia to heal

Answer 44

1 year

Question 45

what are crutch field tongs

Answer 45

traction device with pins inserted into skill to immobilise the neck with weight

Question 46

can we as nurses loosen pins in a halo vest

Answer 46

no only MD can

Question 47

which medication increases BP in a SCI patient

Answer 47

Dopamine

Question 48

which med increase HR in a SCI patient

Answer 48

atropine

Question 49

what is a laminectomy

Answer 49

patient is in prone position, clean up bone fragments and put in hardware

Question 50

what is autonomic dysreflexia

Answer 50

massive uncompensated SNS response - vasoconstriction below injury - vasodilation above injury highhhhh BP

Question 51

what puts a patient at risk for autonomic dysreflexia

Answer 51

- patients with injury to T6 or above - comes with return of reflexes after spinal shock

Question 52

what are the symptoms of autonomic dysreflexia

Answer 52

- high bp - slow, bounding pulse - flush above level of injury - headache - blurred vision - seeing spots

Question 53

what are the main priorities for autonomic dysreflexia

Answer 53

- RAISE HOB - determine cause - deal with cause - monitor vitals Q 10-15 mins - give nitrate

Question 54

what are some of the main causes of autonomic dysreflexia

Answer 54

- full bladder - full bowel - shoes too tight - skin: pressure injury

Question 55

what are the main complications of autonomic dysreflexia

Answer 55

- seizure/stroke (high ICP d/t hypertension)

Question 56

what does phantom limb pain feel like

Answer 56

- intense burning, crushing, or cramping.

Question 57

what is a compound fracture

Answer 57

open fracture

Question 58

what should you do if you see a patient has fallen

Answer 58

- call for help - note positioning - immediate assessment (dont rush to get them up)

Question 59

how often should you do turns to prevent pressure sores

Answer 59

every 2 hours