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If there is trauma to the cervical area what are the keys signs and symptoms?
What kind of shop will you go into with a spinal cord injury?
Neurogenic / spinal shock
What is the best position for a patient in shock?
Supine with the feet slightly elevated
What do you look for in a person with chest trauma?
Difficulty breathing, pneumothorax
If a client has a pneumothorax on the left side, what will you here on the left side?
Nothing. Very little air movement or no air movement at all.
What is a flail chest? What does this usually mean they have?
A flail chest is multiple broken ribs. This usually means they have a pneumothorax.
With abdominal trauma how would you know someone is bleeding into the peritoneal cavity?
The abdomen becomes very rigid. Peritonitis.
What is the treatment for orthopedic trauma?
Rice. Rest, ice, compression, and elevate.
What do you do for a chemical burn to the eye? Acid? Alkaline?
For acid you would flush for 5 to 10 minutes. For alkaline you will flush up to 20 minutes.
What are the nursing interventions for hypothermia?
Warm beverages, remove anything that is wet
For severe hypothermia how do you warm the body?
With mild to moderate hypothermia what type of re-warming will you administer?
Active external rewarming
With moderate to severe hypothermia what type of rewarming will you administer?
With frostbite what part of the cell is frozen?
The extracellular area
What would you teach the patient with frostbite?
Stay off the frost bitten area. Warm soaks only if it is continuously available otherwise keep area dry. Sterile gauze so there is no skin to skin cover and elevate to heart level
What are heat cramps?
These are the mildest form of hyperthermia. Painful muscle spasms in the legs. Typically occurs after strenuous exercise.
What do you do for suspected spinal or neck trauma?
Stabilize the neck. Client will need a supportive collar and backboard.
In emergency care what is a primary survey?
A systematic process of an initial assessment of the trauma patient. It looks at ABCs and disability.
What is the secondary survey?
It identifies areas that are not immediately noticed but may require treatment. Ache. Abdomen, chest, head and extremities.
What are the different types of shock?
Cardiogenic, distributive, obstructive, and hypovolemic.
What causes hypovolemic shock?
Severe loss of fluid
What causes cardiogenic shock?
Problems within the heart. Electrolyte imbalance, heart attack, heart failure
What causes obstructive shock?
Problem outside the heart that's keeping the heart from doing its job. For example pneumothorax, cardiac tamponade, pulmonary embolism.
What causes distributive shock?
Vascular bed becomes dilated not enough fluid in the space so blood pressure drops.
What are the three types of distributive shock?
Anaphylactic, neurogenic, septic
What are the keys signs and symptoms of shock?
Narrowing pulse pressure, rise in pulse, increase in respiration rate, oliguria, and cool clammy skin.
What are the signs and symptoms of neurogenic shock
CNS is not responding. Heart rate slows pulse pressure Narrows skin will be warm
What is surface trauma?
What is an abrasion?
What is an open wound?
Skin is actually broken may have to worry about infection.
What is a laceration?
What is a puncture wound?
What do you do for an impaled object?
Stabilize it and do not take it out
What is the treatment for anaphylaxis?
What are the complications of any open area of the skin?
Infection and check for vaccinations tetanus.
Tetanus should be done within the last blank years otherwise it will have to be blank.
If you have no open areas than your tetanus shot should be updated after blank years by your doctor.
How do you treat heat cramps?
Get out of the heat and drink fluids rest.
What type of shock do you get with heat exhaustion?
Hypovolemia because of excessive fluid loss they will have minor irritability which tells us it's affecting their loc. They will have a cool grey face body temperature may be slightly elevated
How do you treat heat exhaustion?
Fluids and get out of the heat
How do you treat heat stroke?
Get them out of the heat and call 9-1-1.
What are the signs and symptoms of heat stroke?
Irritability. Altered mental status they can no longer sweat core temperature will be up to 106
With heat stroke how will the lab values present?
What are general signs and symptoms of accidental poisoning?
Nausea vomiting abdominal pain change in loc
How do you treat inhalation poisoning?
Administer 100% oxygen
What are benign tumors?
Benign is a cluster of cells that is abnormal to the body but is non cancerous. Cells grow slowly and the same as surrounding tissue
What are malignant tumors?
Group of cells that grow out of control takes over function of the affected organ so poorly constructed or loosely formed
How do cancer cells spread or metastasize?
Blood and lymph
What increases your risk for cancer?
Viruses, radiation, exposure to sunlight, chemicals found in cigarettes or in food irritant
Why are the elderly at higher risk for cancer?
Their immune system is not functioning as well
Caution is the acronym 4 signs and symptoms of cancer.
Change in bowel movement. A sore that does not heal unusual bleeding or discharge. Thickening or lump in breast or other tissue. Indigestion or swallowing difficulties. Obvious change in a mole or wart. Nagging cough or hoarseness.
What are the general side effects of chemotherapy?
Hair loss, nausea and vomiting, CBC levels drop thrombocytopenia
What are general nursing interventions for clients receiving external radiation therapy?
Marking should never be washed off. No red meat may cause Dysgeusia. No powder pointment or lotion over the skin
What is the term for internal radiation therapy?
What are nursing interventions for a client receiving brachytherapy?
Private room. Nurses must wear dosimeter. Visitors may spend no more than 30 minutes they have to maintain 6 feet no one under 16 may enter the room
If the rain falls out of patient during brachytherapy how is it handled?
What is your number one concern with chemotherapy?
Bone marrow suppression WBC
What is an arthroscopy?
Surgical procedure where they go in and visualize a joint.
What is a strain?
Damage to muscle or tendon
What is a sprain?
Stretching or tearing of the ligament
How do you treat sprains and strains?
Rest, ice, compression, elevate. Rice.
What is a complete fracture?
Bone is broken into two separate pieces
What is a non displaced or incomplete fracture?
Not completely broken
What is a compound or open fracture?
Bone is broken into two pieces and has broken through the skin
What is a closed fracture?
It does not disrupt the skin
What are signs and symptoms of a fracture?
Pain. Area may look deformed decreased range of motion. Crepitation swelling ecchymosis
How do you treat a fracture?
Alignment reduction or a cast
What is an open reduction with external rotation
It was surgically put back together
What are nursing interventions for an external fixator?
Assess pin sites for infection
What is gout?
A buildup of uric acid in the joints most common in the great toe
Which lab values would you look at for gout?
What would you teach a client with gout about their diet?
What complication is a client with gout at risk for?
What are signs and symptoms of lupus?
What is the number one complication with total hip replacement?
How do you prevent subluxation?
What do you do for thromboembolic complications?
Ted hose STDs early ambulation exercises heparin or coumadin
Which lab value do you look at for heparin
Which lab value do you look at for coumadin?
PT and INR
What is the antidote for coumadin?
What is the antidote for heparin?
What are the signs and symptoms of a rise in intracranial pressure?
Change in loc changing pupils widening pulse pressure with bradycardia
Positioning for a client with ICP?
Semi Fowler's neutral midline position for the head
What do you do when someone's having a seizure?
Move things out of the way. Monitor them.
What do you do during the postictal phase of a seizure?
Client will be confused assist them to lay on their side
How do you protect a client at risk for seizures?
Pad side rails make sure they have their call light keep suctioning equipment in the room bed should be lowest of the floor
What is a subdural hematoma?
Venus in nature
What is an epidural hematoma?
Arterial in nature
Parkinson's disease is a problem with what neurochemical?
What are the signs and symptoms of Parkinson's disease?
Short shuffling gait
What are your nursing interventions for Parkinson's disease?
Assist with ambulation and ADLs
What are you nursing interventions for the patient with Alzheimer's disease?
Safety is your number one concern
What are T I A?
What is the underlying cause of a T I A?
What causes a hemorrhagic stroke?
What causes ischemic stroke
Thrombus or an embolus
What is your first priority when someone is having a stroke?
Maintain a painting airway
What is ALS
Lou Gehrig's disease
What is your number one concern in a client with Lou Gehrig's disease
What is Trigeminal neuralgia?
It affects the fifth cranial nerve
What are the signs and symptoms of trigeminal neuralgia?
Chewing causes intense pain on that side
Which cranial nerve does Bell's palsy affect?
7th cranial nerve
The Snellen chart is used to assess for what vision impairment?
What does 2200 mean?
Legally bind. The patient can see at 20 feet what the normal eye can see at 200 feet
What should you do for a client after a fluorescein stain?
Flush the eye
Signs and symptoms of retinal detachment?
Looking through a veil. Like a curtain has been lowered over eyesight patient should be in most dependent position
What are the signs and symptoms of closed angle glaucoma?
Unilateral rapid onset
What are the signs and symptoms of open angle glaucoma?
Bilateral gradual onset
What medications do you not give to the closed angle glaucoma patient?
What is the underlying sign or symptom for both closed and open glaucoma?
Loss of peripheral vision
What is conductive hearing loss?
Something is blocking the sound waves to the inside of the ear
What is sensory or neural hearing loss?
There's a problem with the nerve endings of the ear
What is a Titus media?
Infection of the middle ear
What are the signs and symptoms of a Titus media
What is Meniere's disease?
Inner ear infection watch for balance
How is hypertension diagnosed
Two separate readings on two separate days
What are signs and symptoms of hypertension
What is malignant hypertension
Diastolic blood pressure is typically high over 100 at very high risk for stroke
What causes malignant hypertension
Abruptly stopping medication
How we prevent thrombophlebitis?
Ted hose STDs exercise do not put pillows directly under knees
What does a positive Homans sign indicate
Thrombophlebitis is treated with what?
How do you take nitroglycerin?
Take one with chest pain, wait 5 minutes if they still have chest pain take another call 9-1-1. They can take up to 3
What does the nurse assess for when client is taking nitroglycerine?
Blood pressure pain level
What are the signs and symptoms of a myocardial infarction?
Chest pain / pressure nausea vomiting shortness of breath skin may be clammy
How do you treat a myocardial infarction?
Clot Busters within 6 hours
What lab values show the client is having a myocardial infarction
CK-MB and troponin
What position should the client having a myocardial infarction bn
How do you treat a client with a myocardial infarction?
Morphine for pain
In heart failure what symptoms come from the left?
In heart failure what symptoms come from the right side?
Edema weight gain JVD fatigue
What is the first sign or symptom you see with digoxin toxicity?
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