CEA
The most common surgical procedure to prevent recurrent strokes
Carotid endarterectomy
tPA stands for
tissue plasminogen activator
Management of hemodynamics is all about
Tissue perfusion
Normal ETCO2
30-42
Name 2 complications related to carotid endarterectomy
MI
Stroke
Cervical hematoma
Nerve injuries
Wound infection
Hyperperfusion syndrome
Patient's with a last known well time of how long are eligible for tPA?
< 4.5 hours
Name 2 physical assessments related to hemodynamic status.
JVD
Cap refill
Mental status
Urine output
Edema
A sharkfin waveform on ETCO2 may indicate
Airway obstruction
Kinked circuit/airway
Bronchospasm
A headache that improves with upright posture is a sign of what complication of carotid endarterectomy?
Hyperperfusion syndrome
Continuous cardiac monitoring needs to be done for how long after tPA administration?
24 hours
This is the resistance to ventricular emptying during systole
Afterload or SVR
Name the PATIENT assessments for a patient with an A-line
Pain
Pulses
Pallor
Parasthesias
Paralysis
What invasive monitoring may be indicated to detect BP lability in a patient s/p carotid endarterectomy?
A-line
Name two examples of when you need to notify a provider.
Any change in mental status
Acute Hypotension or hypertension
N/V
Complaint of severe headache
Systolic > 180, Diastolic > 105
Neosynephrine is a medication indicated to treat hypotension after this.
Adequate fluid resuscitation
Nicardipine is a ______________ used to treat _____________
Calcium channel blocker
Hypertension
How often do you perform neuro checks on patients for the first 6 hours s/p carotid endarterectomy?
Q 15 minutes
How often do you perform VS and neuro checks 6 hours after tPA administration?
Q 30 minutes
Name four nursing considerations related to the care of a patient on vasopressors.
Continuous cardiac monitoring
Frequent VS
Titration per parameters
Strict I&O
Extravasation precautions
Extravasation is treated by
Warm compresses
Terbutaline