Neuro
When can tPA be given? Type of stroke and amount of time
Ischemic stroke. Give within 3-4.5 hours of symptom onset
Where do people usually experience gout pain? What meds do you give?
Big toe. Cholchine and allopurinol
Pretend I am your patient that is about to get a bone marrow aspiration and educate me on the procedure.
Done to find the cause of blood disorders. Will be given antianxiety meds, done while awake but with a local anestheic. We will need to hold your antiplatelet meds. You will feel pain only when they aspirate the bone marrow.
What meds are aPTT, PTT, and INR associated with?
aPTT- Heparin
PTT/INR- Warfarin
List A1C values of prediabetes and diabetes
Prediabetes= 5.7-6.5%
Diabetes= >6.5%
Which area is affected when a patient has receptive aphasia? What will be their problem?
Wernicke's area. They will have a hard time understanding others and reading.
Precautions for patient post hip replacement
Crossing the legs, don't sit or stand for too long, orthostatic precautions. Use abduction pillow
Signs and symptoms of TACO and how to treat it.
Rales, dyspnea, hypoxemia, pulmonary edema, circulatory overload, decreased EF, high BNP, hypertension, JVD, transudate edema fluid. Treat with diuretics.
What cardiac changes happen with hyper and hypokalemia?
Hyperkalemia= tall tented T waves, wide QRS, flat P
Hypokalemia= ST depression, flat/inverted T waves, U wave
Hallmark sign of Lyme disease and how to remove a tick
Bullseye rash. Twist and pull up to ensure you get the head out
What is the pathophysiology of Parkinson's? What meds will you use to treat it?
Dopamine depletion from degeneration of basal ganglia, causes difficulty with movements. Treat with Carbidopa/levadopa
Signs of compartment syndrome and how to treat it
Pain, paralysis, pulseless, pallor, paresthesia, poikilothermia. Fasciotomy
Your patient is having a hemolytic reaction to a blood transfusion! Quick, what do you do!?
Stop the transfusion, call the provider, disconnect the blood from the patient, run normal saline through a new line, get two blood samples below infusion site, treat any symptoms
Double Jeopardy!!!!!!!!!!
What ABG imbalance is this?
pH= 7.32 PaCO2= 51 HCO3= 22
What kind of patient would have this?
Respiratory acidosis. Commonly seen in asthma and COPD
How does metformin work? What side effects do you have to look out for?
Increases insulin sensitivity and decreases glucose production. Watch out for GI upset and renal damage
Name 6 seizure precautions
O2 and suction set up, good IV access, side rails up and padded, bed alarm on, get patient side lying after seizure, NPO until fully alert, no tongue blades, no restraints
What is this patient suffering from? Patient comes in with broken femur, 3 hours after admission patient spikes a fever, becomes tachypneic, and develops a petechial rash
Fat embolism
Name all the RANDI precautions and what kinds of patients you would use them for.
Electric razor, no aspirin, decrease needle sticks, prevent injuries. Any patient that has low platelets
Name the heart rhythm with unrecognizable P waves, and irregular QRS. How do you treat it?
A. fib
CCB, beta blockers, anticoags, amiodarone
Your patient has returned from a thyroidectomy and you have assessed that their airway is not swollen, on the rest of your assessment you notice that the patient tingling in their hands and feet, and that their arm was twitching when you took their BP. What is their problem?
Hypocalcemia from accidental removal of the parathyroid glands.
Name the cranial nerves in charge of eye movement, facial droop and smile, phonation and gag reflex, shrug, and tongue control.
Eyes= 3, 4, 6
Face and smile= 5 and 7
Phonation and gag= 9 and 10
Shrug= 11
Tongue= 12
List differences between rheumatoid and osteo arthritis
Osteo: deterioration of joints. Pain after activity, decreases with rest. Unilateral. Treat with hip replacement
Rheumatoid: Autoimmune destruction of joints. Symmetrical. Pain after rest, decreases with movement. Treat with Paquenil and Prednisone
Which diet would be appropriate for a patient with leukemia?
Cereal with unpasteurized milk from the family's farm, pancakes, and bacon.
Mashed potatoes, steak, steamed peas, and cake.
Turkey sandwich with lettuce and tomato, and chips.
Mashed potatoes, steak, steamed peas, and cake.
They should not be eating or drinking anything raw! No raw fruits or veggies, or raw milk
Your patient in AKI is being put on a diuretic to treat their fluid overload. Which order would you question?
Hydrochlorothiazide, lasix, or spironolactone
Spironolactone. Because they are fluid volume overloaded, they are in the oliguric phase and will be hyperkalemic, we do not want them to hang onto even more potassium
Your patient requests to take their synthroid with their breakfast, and says they like to take their meds with milk. What do you educate them on?
You must take synthroid on an empty stomach at 6 am for the rest of your life. You can not take it with milk because it decreases the absorption of the medicine.