Exam 1 Review: Chapter 47-52

unme Chp E . * Have a pt that . 47 48 49 , 50 51 52 , , , , comes in , they have severe What test its back pain , when might youthink the moving worse lower . HCP will order ? Myelogram - * know parts of Spine ; Female pt She is paralyzed at Pg 975 . C4 . everything below is not okay ! Know . * When arm repositioning ; Male make , a sure male/female moving scrotum is not stuck blow the farapthatcomes *Babinski reflex in , we are every 2hrs . Female . legs and they are bedriden Has some type . moving breast out way of injury make sure the feet , and are positioned correctly positioned properly . so its not under the Foot drop) Ned Bigtoe and other toes flare out > - know reflexes *About what age does the babinski 2y . retex stop ? 0 * Apt that's having trouble eating after CvA etc... we way about nutrition What will we do to help them get more nutrients ? . * Sit , . High protein dief/High caloric upright *Small frequent meals Stay with pt * . * Encephalitis : If someone comes in the ER and they have its that look like encephalitis Gathering subjective and objective data and they went hiking/camping in the mountains What should consider ? (Louisiana , out find West nile virus ↓Seizures partial : - * Status Eplilectus : Want . . room one (mosquitoes/ticks) side ; generalized-both hemispheres Seizures prepared in ICU ! * Important you time we last 30 mins or langer ; Emergent Situation ; Meds : valuum/Ativan seizures # Stages of Alzheimers ; Stage 2 They start to wonder , we * Encephalopathy : Mental status changes - Late stage Seizures/lethargy : ↑** * When they get to late stage how much interaction Not much ; No participation # Have a pt with . of what ? provide safety , , , ↓ * stroke on left side - so - know 9 hour cranial surgery tumor/mass : you will see problems with suspect stroke how long do a ; or difference expressive and receptive put their stuff on the left side * Come in ER and we , . Have Increased cranial pressure , we are gonna make sure Ho elevated Stroke > Dysphasia A - (smacking of lips chewing (dreamlike state) type of head injury some they have with you ? can , Important to document when they . rightside ! diagnose it and make have to we aphasia saw sure its not a hemanhagic ? them last #TPA-tissue plasminogen activator >thin blood (3-4 Shrs) - . * Someone to comes do with her ? Call in , they have unilateral peralisis , aphasia and the inability to follow directions What would . , we expect the ER does stroke team (c, labs , X-ray EKG) i , *Someone comes in at 2 am 3-4 Shrs . , and has symptoms of stroke a How . long do we have ? . * What is the worst kind of stroke/brain bleed , has highest rate of not doing well ? Subarachnoid hemorrhage *Someone had - a stroke some type of "brain" incident , . Lough and cry inappropriatly , what is this called ? Psuedobulbar affect from stroke and their eating * Have someone that's . We are present and they Going to give them time and not rush them recovering might choke they pocket food in their cheek Who might we call ? . , - Speech therapy . , . * Multiple scrosis - Mydlin sheath is demyelinating what test can we do that determines it ? * Myasthenia Gravis - Surround their activities in the morning ; #What Tensilan test (muscle strength improves dramatically) is usually their demise at the end ? Respiratory can't swall * Guillain-Barre Sund : Remember both sides of the body ; Ascending so worried about respiratory , caused/triggerd by virus or certain vaccines * Amyotrophic Lateral Sclerosis (ALS) : "Lou kills them : Gehrig"; What do we . 3 stages usually see ? Respiratory *Plasmapheresis : plasma exchange therapy Remares plasma from whole blood and replace it with fresh plasma antibodies suppressing immune response and inflammation llabs) , . * What would - HsH we , ? patients pl count and clotting studies check on these CBC , * One of the diseases thats treatable that removes the thymus (thymectomy) , - is ? Myasthenia Gravis * Electronystagmogram : If they have what implanted in them ,thistest is contraindicated ? Pacemaker * Know Romberg test : Fallingtest * Caloric test : Warm and cold water in * Whisper voice test: whisper in * When they opposite ear get older what colors do they See : * ear Red , yellau , Not orange ; Going to test for Intraocular pressure , see (Gross hearing and not see anymore? see : Blue , green , purple etc . we are assisting.Would you go get a what ? Tonometer *Pinnia (outer eart someone comes in and their entire yes ! ear is off, can they still hear ? . Goal to remove * Cataract surgery , what part of the eye are they messing with ? Lens * What would we be usingFluorescein angiography for ? * Diabetic retinopathy" retinal vascular disease Looking for taking vessels * What would we Apply do with our pressure to finger if we are giving eyedrops ? punctafor 2 mins /punctal occlusion) the * What is it called when you check the pupils and look at the other eye? Consensual response * What do older adults get with their eyes ? Presbyopia /can't see upclose) decreased elasticity * Working orthopedic floor patient has a fractured femur and taking them to for what the HCP has ordered surgery ;your looking pre-op He wants to give them morphine and atropine What are you going to do if they have "Angle-closed glacma"? , . . Call HCP and not give it , request order for something else * Macular degeneration what part of the vision did they , Central vision *Otosckrosis , what type of - surgery can be done ? Stapedectomy Surgery not want these patients * What do lose? ear I mustbe up doing ?their nose,shiff fly in airplane Scuba dive usually get if they have something going on with the inner ? Sneezing with mouth closed blowing , earplugs , , , * Nauseated ? Give them an antiemetic - * Meniere disease e salt restricted dief Imbalance of fluid) * Labyrinthitis - , what do Dizziness , we vertigo , nu zar exensise , lift , heavy objects or use * Someone has DM high glucose levels - * You have * In , do a on them and , you they have what are we worried about ? history The eyes (diabetic non-poliferative/politerative know difference and which , , or * We have multiple surgery's that comes in cover both can DM is mostly associated with ? Nonproliferative , be done for retinal detachment Know how each . eyes (stop movement care . What should you be thinking ? HOB should be elevated , no stimuli with B/P if ICP is in there and see all kinds of stuff, what yousee systolics going up and diastolic remain the same might * you get - - done and pt . , * CushingTriad > is do? and they fell on apen and it's in the eye What are you ganna Assisting the RN and yourgiving - one low pitch ast ? , * ICP : ↓RR , Bradycardia , increasing ? Arterial hypertension * Nuchal rigidity > Pain/stiffness when neck is moved - * knau difference : decorciate/decebrate ; worse? decebrate #If they havenuchal rigidity ,what might they have ? - * In a diabetic person with these High pitch (speak in low tone slowly and faceto face) - - . retinopathy) Age do they lose their high pitched * Someone multiple episodes of hyperglycemia Menegifis eunder encephalopathy HavePwith highpbradycardia and diaphoretic What d theaa , . Autonomic Dysreflexia (bladder distention) * Continuous Seizures are called what ? Status epilectus * After head injury and their in - you and Diabetic Inspidus they have polyuria and polydipsia? What do they have ? . teaching * Why would we - give heparin ? Anticoagulant ; thinning blood *Plarix , dopigel : what classification? Antiplatelet - * Have a pt that . your ganna * What happens in - GBS ? TPA , same as thrombolitic Happeningto the Myelin sheath ? Demyelinating *Symptom in pt s . - with ALS ? Fasciculation (twitching) * What's mystagmus ? *Posis ? Drooping of Involuntary cyclical rapid movement of eyes . , , eyelid * Inflammation or infection of inner *TIA-transient Ischemic attack * If the (issue plasminogen activator) do we want a hemarhagic stroke ? No , looking for Ischemic stroke - ear ? Labrynthitis temporary symptoms last just long enough forthem to have - attack and its not permanent, would it be , a cua or TA ? TA *it has heart attack , post m and . - an experiencing A-fib . What are they high risk for ? Ischemic Stroke/embolic * Goin pt s room the next day after stroke and it was Ischemic , repaired it ,TPA was given You go in and they're just staring ? What . would you - do ? More around to see if , . they fallow you ; Not moving somethings wrong ! * looking for tracking