Perfusion
This is the standard imaging test used in diagnosis of DVT.
US
This is the first diagnostic test to be performed when a stroke is suspected.
CT without contrast
What is the nurse's priority in crisis management?
Safety! Consider if the individual is in danger of self-harm or harm from others, whether the person in crisis is a danger to others, and environmental safety. Once any immediate safety concerns addressed, can engage in appropriate crisis-management techniques
This priority assessment should be performed distal to the site of a fracture.
Neurovascular/CMS
This is an important modifiable risk factor in both ischemic and hemorrhagic strokes.
Hypertension
This is a lab test that may be used to help diagnose an MI.
Troponin, creatine kinase (CK), myoglobin
How many hours from the onset of a stroke for optimal t-PA administration?
Optimal = 3 hours (in some cases may stretch for 4.5 hours)
This is a six-part model that can be used to guide de-escalation and crisis intervention efforts.
SAFER-R
Signs of this condition that may occur after a fracture include respiratory distress, neurological changes, and petechiae.
Fat embolism syndrome
Acute coronary syndrome is a spectrum - list the conditions included.
Unstable angina, NSTEMI, STEMI
This procedure is preferred as the initial treatment for acute MI in all age groups and should be performed less than 60 minutes after arrival to ER.
Emergent percutaneous coronary intervention (PCI)
A patient with a stroke on this side may display increased distractibility, impulsive behavior, poor judgment, and lack awareness of these deficits
Right Hemispheric Stroke
To meet the definition of rapid cycling in bipolar, how many mood episodes (manic, mixed, hypomanic, or depressive) in a year must the patient experience?
Four or more
What is the difference between a strain and a sprain?
A strain: injury to muscle or tendon (overuse, overstretching, excessive stress)
Sprain: injury to ligaments and tendons surrounding a joint (twisting/hyperextension of joint)
What would the nurse expect to see in medical management of stable PE?
immediate anticoagulation to prevent recurrence/ extension of thrombus (examples - LMWH, unfractionated heparin, rivaroxaban)
long-term anticoagulation (warfarin, LMWH, or other DOACs) up to 6 months following PE, or longer if high risk for recurrence
List three potential signs of a PE.
Dyspnea, chest pain, anxiety, fever, tachycardia, tachypnea, cough, hemoptysis, diaphoresis, and syncope
This term refers to a verbal deficit where the patient cannot speak understandable words but their language comprehension remains intact.
Expressive aphasia
Describe three nursing actions related to suicide prevention in the hospital setting.
Identification of suicidal ideation (screening - can use tool like Columbia-Suicide Severity Rating Scale)
Assessment (evaluation of thoughts/plans/intentions/behaviors to gauge current risk/severity + note protective and risk factors)
Identifying in-room hazards (ligature points, other hazards)
Documentation (current level of risk, mitigation and safety plans in place - ex 1:1 sitter, removal of high-risk items from room, collaboration with provider/mental health team)
List the 5 "P"s of compartment syndrome
Bonus: what is the 6th "P"?
Pain, pallor, pulselessness, paresthesia, and paralysis
Poikilothermia
A provider may order this diagnostic scan to diagnose PE if a CT angiogram is not available or otherwise not used for a patient.
V./Q. scan
What is Virchow's triad?
Three factors believed to play a significant role in development of DVT/PE: endothelial damage, venous stasis, and altered coagulation
(see Hinkle p. 845)
A patient admitted several days ago after a hemorrhagic stroke now complains of a worsening headache, is increasingly lethargic, and is displaying new one-sided weakness. What complication does the nurse suspect?
Vasospasm - leads to increased vascular resistance, which impedes cerebral blood flow and causes brain ischemia (delayed cerebral ischemia) and infarction. Vasospasm can occur 3 to 14 days after subarachnoid hemorrhage. Vasospasm is often heralded by a worsening headache, a decrease in level of consciousness (confusion, lethargy, and disorientation), or a new focal neurologic deficit (aphasia, hemiparesis).
A patient with bipolar disorder presents with symptoms of lethargy, slurred speech, weakness, and nausea. What is a lab the nurse might expect to see checked?
Lithium levels - concern for toxicity
"If body fluid decreases significantly because of hot weather, strenuous exercise, vomiting, diarrhea, or drastic reduction in fluid intake for any reason, then lithium levels can rise sharply, causing an increase in side effects, progressing to lethal lithium toxicity."
List two points you would include in your education when teaching a patient about activity restrictions after a total hip arthroplasty.
Correct positioning is maintained at all times - the patient should be in a supine position with the head slightly elevated and the affected leg in a neutral position.
The use of an abduction splint, a wedge pillow (see Fig. 36-10), or two or three pillows placed between the legs prevent adduction beyond the midline of the body.
The patient should not be turned to the operative side, which could cause dislocation, unless specified by the surgeon.
The patient’s hip is never flexed more than 90 degrees.
When using a fracture bedpan, the nurse instructs the patient to flex the unaffected hip and to use the trapeze to lift the pelvis onto the pan. The patient is also reminded not to flex the affected hip.
In a patient who has had a stroke, the "penumbra" refers to this.
The area of ischemic tissue around the infarction that can still be salvaged with timely intervention