Neuro
Nursing intervention for a patient who was tackled by a linebacker and diagnosed with a concussion
Concussion protocol , what should we look out for?
At 0700 today, a patient is brought in because his wife notices the patient slurring his speech. Patient's wife notes that patient woke up like this, and he went to bed at 2000 last night. Is this patient a candidate for tPA?
Main differences in the physical exam of a patient with hemothorax and pneumothorax?
dullness on percussion and hypotension vs hyperresonance
Your patient is on a heparin drip for a pulmonary embolism. What are important things to watch for with your patient?
Bleeding, lab work, fall risk, mental status
Your patient's chest tube fell out ! What do you do? What do you do if patient tubing becomes unattached from drainage container?
OUT OF PATIENT- Place petroleum dressing over chest wound site.
UNATTACHED FROM CONTAINER- Place end in sterile water or reattach parts after wiping with alcohol.
Cranial nerve that affects patients with Bell's Palsy
You round on your patient, who starts asking repetitive questions even though you already answered them. With you standing in front of the patient, patient is able to track your finger to the right, but stops tracking when you move the finger to the left. What do you do next?
Aging
Obesity
Smoking
Pregnancy
Immobility
Hormone-related therapies, such as oral contraception or testosterone
Clotting-related diseases
A patient with no PMHx arrives via ambulance for a MVC, where his car rolled over. Patient arrived on a backboard, due to complaints of back pain. Patient starts yelling nonsense words and sweating profusely on his face. His BP is 194/98. What is your next action?
Call MD, remove backboard, elevate HOB
Autonomic dysreflexia
Nursing education that can decrease risks of strokes
diet, exercise, smoking cessation
A patient comes in from a MVC after being rear ended at about 30 miles an hour. Patient is complaining of neck pain, but denies LOC or weakness in his extremities. What differentials does this patient have?
Coup-contrecoup injury
Explain how a stroke in different areas in the brain present (frontal, Broca's, occipital, Wernicke's)
Frontal - weakness, personality differences
Broca’s - speak short sentences, understand others and that they can’t say what they want to, frustrated
Occipital - visual deficits
Wenicke’s - speak long sentences that don’t make sense, but may not know it doesn’t make sense
What is the gold standard in diagnosing respiratory conditions?
Chest XR
59 year old male presents with a severe cough and saying two to three word sentences. Patient is tripoding and appears uncomfortable. Patient's XR shows whiteness on the inferior aspects of his lung field. What is the dx and treatment for this patient?
Chylothorax
drainage, octreotide (to reduce lymph fluid), pleurodesis
Major symptoms for neurogenic shock?
bradycardia and hypotension
Cranial nerves that relate to the gag reflex
Glossopharyngeal (CN9), vagus (CN10)
Contraindications of tPA?
head trauma, previous intracranial hemorrhage, active bleed, SBP > 186 or DBP > 110, Plt < 100000, anticoagulant use
Flail chest
O2 therapy, pain management and maybe surgery
Patient is vomiting and screams "TURN OFF THE LIGHT" when you enter the room. What are some nursing interventions for this patient?
abx, pain management, seizure precautions and droplet precautions
Name the condition:
Patient has an O2 saturation of 85%
Patient has arterial blood O2 (paO2) below 75 mmHg (decreased)
Patient has a paCO2 level of 55
Hypoxia
Hypoxemia
Hypercapnia
A patient recently traveled to the West Nile presents with a temperature of 101.1 degrees F and decreased LOC. What are the differentials?
Encephalitis
BE-FAST
How can you tell if someone is having a pulmonary embolism? How do you diagnose and treat them?
pleuritic chest pain, SOB, anxiety, hemoptysis
CT w/ IV contrast, VQ scan, D dimer, ultrasound
Blood thinner, surgery
Nursing intervention for a mother who brings in her infant who is non-consolable, not eating, and fussy. The mother notes that she recently hired a new babysitter as well. On exam, patient has decreased LOC, cerebral edema and increased ICP.
Diffuse axonal injury - steroid, rest, pain management
Explain how spinal cord injuries can manifest in different body symptoms
Cardio
Resp
Urinary
Integumentary
GI
PVD