Neuro
Stroking out!
Breathe in, breathe out
We need an intervention...
Mix and Match
100

Nursing intervention for a patient who was tackled by a linebacker and diagnosed with a concussion

Concussion protocol , what should we look out for?

100

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? 

Nopeity nope nope
100

Main differences in the physical exam of a patient with hemothorax and pneumothorax?

dullness on percussion and hypotension vs hyperresonance

100

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 

100

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.

200

Cranial nerve that affects patients with Bell's Palsy 

Facial (CN7)
200

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?

Neuro exam, call doctor
200
Risk factors for developing a pulmonary embolism?

Aging

Obesity

Smoking

Pregnancy

Immobility 

Hormone-related therapies, such as oral contraception or testosterone

Clotting-related diseases

 

200

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 

200

Nursing education that can decrease risks of strokes

diet, exercise, smoking cessation

300

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

300

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

300

What is the gold standard in diagnosing respiratory conditions?

Chest XR

300

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

300

Major symptoms for neurogenic shock?

bradycardia and hypotension

400

Cranial nerves that relate to the gag reflex

Glossopharyngeal (CN9), vagus (CN10)

400

Contraindications of tPA?

head trauma, previous intracranial hemorrhage, active bleed, SBP > 186 or DBP > 110, Plt < 100000, anticoagulant use 

400
Patient was hit in the chest with a baseball bat and is no exhibiting paradoxical breathing and tachypnea. What is the differential and treatment for this patient?

Flail chest

O2 therapy, pain management and maybe surgery

400

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

400

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 

500

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

500
How can you tell if someone is having a stroke?

BE-FAST

500

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

500

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 

500

Explain how spinal cord injuries can manifest in different body symptoms

Cardio

Resp

Urinary

Integumentary

GI

PVD