Drugs
What drug(s) can you NOT administer if someone's RR is <12?
morphine, fentanyl
What is the difference between decorticate and decerebrate posturing?
- decorticate is stiff with bent arms inward, clenched fists held to chest, and legs out straight
- damage was done to the cerebral cortex and lateral corticospinal tract
- decerebrate is arms extended and rotated internally with plantar flexion in the feet, toes pointed
- damage was done below the red nucleus, in the brainstem
What is autonomic dysreflexia?
a sudden and severe spike in blood pressure in response to an irritating stimulus below the T6 vertebrae
What is pain tolerance?
amount of pain a person can endure without interfering with daily functions
What do infants have the inability to do when cold?
Shiver
What is acetaminophin's antidote called?
acetylcysteine
What are the seizure priorities?
1.) protect head and airway
2.) do not restrain
3.) document onset, duration, behavior
What are some manifestations of Parkinson's Disease?
- Rigid, stiff, short muscle movements
- Wide eyed, staring expression with stiff facial muscles
- Resting tremor
- Dementia, depression
What are A-delta fibers?
fastest impulse, sharp pain
Explain malignant hyperthermia
high body temp from muscle contractions after anesthetics
What does a narrow therapeutic effect mean?
What happens when a diffuse axonal injury (DAI) occurs?
brain moves rapidly back and forth inside the skull, stretching and tearing nerve fibers
ALS is the progressive degeneration of?
upper/lower motor neurons in the CNS
What part of the body regulates pain?
substantia gelatinosa in the spinal cord
What is a very common symptom of parasomnias?
night terrors
Describe the carbidopa-levodopa drug combination
- carbidopa inhibits the enzyme that converts levodopa to dopamine
- levodopa crosses the BBB bringing more dopamine
- indicated for parkinson's patients
List the 3 different kinds of TBIs and the differences
- Mild TBI: no loss of consciousness, immediate but diminishing symptoms/memory deficits
- Moderate TBI: LOC less than 30 mins, amnesia lasting 24 hrs, decerebrate/decorticate, mood changes, etc
- Severe TBI: LOC more than 30 mins, brainstem damage, amnesia lasting more than 24 hrs, increase ICP, permanent damage
Explain myasthenic crisis and cholinergic crisis
- Myasthenic crisis: severe weakening that leads to respiratory failure from UNDERMEDICATION (tachycardia, hypertension, bowel/bladder incontinence)
- Cholinergic crisis: looks like a myasthenic crisis but only after taking anticholinergic from OVERMEDICATION (hypotension, cramping, pupil constriction, increased salivation)
What is ischemic pain?
sensation of pain due to severely decreased blood flow
Glaucoma leads to...?
Age related macular degeneration - central vision loss
- Wet: most severe
-Dry: most common
What drug is used for seizures in newborns?
Phenytoin
What top 2 drugs are used to stop seizures?
Lorazepam and diazepam - BENZOS
Explain the difference between the "off" and "on" effects of Parkinson's patients
- Off: meds lose effectiveness towards the end of each dose, need complementary drugs (carbidopa-levodopa used adjunctly with selegiline)
- On: dyskinesia - difficulty with voluntary movements
(blank) transmits pain signals from body regions to the (blank) of the spinal cord and brain
1.) nociceptors
2.) dorsal root ganglia
What is spinal shock?
complete loss of reflexes, flaccid paralysis, sensory deficit, and incontinence