Neuro
Differentiate between the symptoms of a ischemic and hemorrhagic stroke.
hemorrhagic- severe, headache, vomiting, ALOC, pain, nuchal rigidity, tinnitus
Ischemic-weakness/numbness/paralysis- one sided, slurred/garbled speech, vision changes, loss of balance/coordination, confusion/ALOC
What discharge instructions would you provide a client with a recent below the knee amputation?
Keep stump clean and dry, wear stocking with prosthesis, ensure that stump is completely dry prior to placing prosthesis, assess stump daily for any skin breakdown, ensure prosthesis fits proprerly
This is known as the pacemaker of the heart.
SA Node
List 3 characteristics about chronic angina.
relieved by Nitro and rest, predictable pattern, triggered by exertion or rest, often related to CAD
caused by a decrease in supply or an increased demand of oxygen to the heart
angina
What factors can contribute to the development of PVCs?
Stress, caffeine, hyperthyroidism, infection, hypokalemia, digoxin toxicity
Identify the side of the brain that is responsible for controlling emotions.
Right
How would you assess the neurovascular status of client who has recently underwent an ORIF of the left lower left.
assess pain, pulses, sensation (numbness/tingling), temperature
The electrical impulse travels from the AV node to this _______
Bundle of His
This wave form is peaked in a client with hyperkalemia.
T-wave
The amount of time a nitroglycerin patch should remain on.
12 hours
What is CPP? What does it measure? If its low what does it mean?
Cerebral Perfusion Pressure, the blood flow to the brain normal 60-80 low- can cause ischemia high-ICP
What are your nursing actions for a client that develops a severe headache following a lumbar puncture.
Encourage fluids, administer pain medication, keep the bed as flat as possible, administer ABT to treat infection, decrease light and stimulation in the clients room
How might a client with a dislocation present?
limited mobility, severe pain, visual deformity, swelling, numbness or tingling, muscle spasm
A client is newly started on SL Nitro to treat chronic angina. What education should you provide to the client?
If pain isn't improved within 5 minutes of taking Nitro call 911. Store in a cool dark place. Tingling sensation should occur when taking Nitro. Change positions slowly. Do not take more than 3 doses. Do not take with medication to treat erectile dysfunction
Why might Diltiazem be prescribed for a client with Prinzmetal angina?
prevent or reduce the incidence of coronary spasms
You just placed electrodes on a client scheduled for an ECG. The rhythm being displayed is showing a lot of artifact. What can be causing this?
moisture, excessive hair, excessive movement
A client with heart disease has developed increased incidence of confusion. Why is this alarming?
May indicate worsening heart disease that is effecting oxygenation.
A client presents with light sensitivity and stiffness in the neck. The nurse might expect this illness and anticipate the following orders.
Meningitis, CT, blood cultures, lumbar puncture for CSF
How might a client with a fat embolism present?
Difficulty breathing, tachycardia, mental status changes, vision changes, chest pain, petechiae on neck, chest, axilla
This type of angina most often occurs in women.
Microvascular
These wave forms on an EKG strip represent depolarization.
P wave and QRS wave
Why might a betablocker be contraindicated in a client with Heart Failure?
low heart rate, asthma
What does the acronym C.O.A.L stand for?
C-cane, O-Opposite, A-Affected, L-leg
List 3 modifiable risk factor for the development of stoke.
smoking, obesity, sedentary lifestyle, alcohol use, decongestant use, illegal substances
As nurse caring for a client in traction what should you as the nurse never do?
Adjust or remove weights
What does the QT interval represent?
The amount of time it it takes for ventricular depolarization and repolarization
Identify the potential treatment options for a client with atrial fibrillation.
Anticoagulants, synchronized cardioversion, radiofrequency ablation, antiarrhythmics
What serious complications can arise from infective endocarditis?
emboli
What is Cushing's Triad and why is it significant in a neuro client?
3 primary signs that indicate an increase in intracranial pressure (ICP): increased systolic BP, decreased pulse and decrease in respirations
You are a nurse caring for a client immediately following the administration of TPA. What is you priority safety measure?
Bleeding
You are caring for a client in skeletal traction. What are your priority assessments.
Assessment of pain, color, pulses, neurovascular status, skin integrity
This type of Angina occurs as a result of a vasospasm
Prinzmental
Your caring for a client who was recently diagnosed with CAD? Your education should primarily focus on what?
Measures to reduce modifiable risks such as decreasing cholesterol, medication, diet, exercise
A client is undergoing a transluminal balloon valvuloplasty how you would you explain this procedure. What benefits does this have over a valve replacement?
repair of valve by using a catheter and a balloon. Benefits: lower mortality rate, no need for for long-term anticoagulation
What diagnostic tools and labs are used to help diagnosis a client with infective endocarditis?
positive blood cultures, positive echo, fever, new regurgitant murmur, predisposing condition