Exam (elaborations)
Final Exam NR 325 (1)
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Final Exam NR 325 (1)
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Final Exam NR 325Conscious, locked in syndrome, persistent vegetative state (no cognition, have sleep/wake
cycles), akinetic mute syndrome (no purposeful movements, eyes open and close refexively),
Coma - ANS-Levels of consciousness
40 mmHg - ANS-Intracranial pressure must be less than ______ to still have adequate
perfusion to brain
50 and 150 - ANS-Systolic must be between _____ and ________ to have adequate perfusion
to the brain
Cushing's Reflex - ANS-If the body has increased ICP _______ will be triggered
High BP, low HR, decreased LOC, and possibly decreased RR - ANS-What are the cardinal
signs of Cushing's Reflex?
A patent airway - ANS-What is the first concern when a patient becomes unconscious?
decrease metabolic demand on brain. May use hypothermic environment. Reduce fever
because of a fever's ability to increase metabolic demand - ANS-When a patient goes
unconscious with increased ICP we want to ______ metabolic demand
Mannitol is a sugar that will increase the osmotic gradient thereby pulling fluid into the vessels
and will be discarded through urination - ANS-How would mannitol be used with patients with
increased ICP?
bruising of the brain with tissue injury. Often happens with an acceleration/ decelleration event -
ANS-Contusion
Temporary loss of neurological function. No structural damage or bruising to the brain. Typically
no residual effects as long as enough healing time is allowed and the concussions are not
reoccurent - ANS-Concussion
Usually a direct blow. Requires some type of intervention which due to its accessibility is more
easily treated - ANS-Epidural hemorrhage
Usually a result of trauma, can be result of aneurysm, can be acute and chronic. -
ANS-Subdural hemorrhage
Most complicated, usually inoperable, related to intracerebral aneurysm or cancer. Cannot be
fixed well - ANS-Intracerebral
, Promote rest, little stimulation, elevate head of bed to decrease intracranial pressure, give O2
(CO2 is a vasodilator), report presence of CSF from nose or ears, provide calm environment,
monitor fluid and electrolytes, provide adequate fluids to perfuse brain, maintain safety and
seizure precautions - ANS-Management of head injuries
Drug of choice for seizure prophylaxis. - ANS-Dilantin
Benzos may help but will also alter LOC and therefore it will be hard to tell what interventions
are helping and if the patient is having a change of status - ANS-Why not give benzodyazapines
to patient with head injury
Dilantin for seizure prophylaxis. Stool softner so they are not bearing down and increases ICP.
Diuretic to reduce ICP. Antihypertensives. Diprovan used to slow the activity of the CNS and
relax a patient. Often used during anesthesia to relax the pt. - ANS-Medications to give
someone with a head injury
Fever in children, hyperthermia, tumors, malformaties, hypertension, injury, drug and alcohol
withdrawl, allergies, electrolyte imbalances - ANS-Causes of seizures
Involves both cerebral hemispheres Tonic-clonic seizure, tonic seizure, clonic seizure, myoclonic
seizure, atonic or akinetic seizure - ANS-Generalized seizures
Involves only one cerebral hemisphere. Complex partial seizure, simple partial seizure -
ANS-Partial or focal/local seizure
Begins for only a few second with a tonic episode (stiffening of the muscles) and loss of
consciousness. - ANS-Tonic-clonic seizure
Clients suddenly lose consciousness and experience sudden and increased muscle tone, loss
of consciousness, and autonomic manifestations (arrhythmia, apnea, vomiting, incontinence,
salvation). - ANS-Tonic seizure
Muscles contract and relax - ANS-Clonic seizure
Characterized by a few seconds in which muscle tone is lost. Frequently results in falling -
ANS-Atonic or akinetic seizure
Can cause a loss of consciousness or blackout for several minutes. Associated with behaviors
that the client is unaware of such as lip smacking or picking at clothing. - ANS-Complex partial
seizure
Consciousness is maintained throughout. - ANS-Simple partial seizure
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