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Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 | Registered Nurse (RN) School Study Aid

Types of Strokes

Transient Ischemic Attack (TIA)

Reversible Ischemic Neurologic Deficit (RIND)

Ischemic

Thrombotic

Atherosclerosis

Embolic

Atrial Fibrillation

Hemorrhagic

Severe Hypertension

3 mins

Level of Consciousness: Descriptive guide for Glasgow Coma Scale

Conscious

Confused

Delirious

Somnolent

Obtunded

Stuporous

Comatose

3 mins

Native American Culture

No Direct Eye Contact

No Organ Donation

No Blood Donation

Strong Handshakes Offensive

Tribal Shaman

Navajo Mother Massage Newborn

2 mins

Middle Cerebral Artery

Contralateral paralysis upper limb and face

Contralateral loss of sensation of upper limb and face

Affects Wernicke's area and Broca's area

Aphasia if Lesion in Dominant (Left) Hemisphere

Hemineglect if lesion in nondominant (right) hemisphere

1 min

Anterior Cerebral Artery

Contralateral paralysis of lower limb

Contralateral loss of sensation in lower limb

1 min

Right Hemisphere Stroke Assessment

Opposite Side Weakness (Hemiplegia)

Poor Proprioception

Disoriented to Person, Place, Time

Can't Recognize Faces (Prosopagnosia)

Loss of Judgement and Awareness

Impulsiveness

Personality Changes

Tonal Hearing Loss

2 mins

Left Hemisphere Stroke Assessment

Opposite Side Weakness (Hemiplegia)

Side to Side Discrimination

Aphasia

Agraphia

Slow Performance

Aware of Deficits

Anxiety

Depression

2 mins

CN V

Trigeminal Nerve

Sensory

Facial Sensation

Motor Function (Via Mandibular Nerve)

Mastication Muscles

1 min

CN VII

Facial Nerve

Lacrimation

Salivation

Sensory

Taste from Anterior 2/3 of Tongue

Motor

Facial Movement

Stapedius Muscle

Eyelid Closing

1 min

CN IX

Glossopharyngeal Nerve

Sensory

Taste from Posterior 1/3 of Tongue

Monitoring Carotid Body and Sinus

Motor

Stylopharyngeus

Swallowing

Salivation

1 min

CN X

Vagus Nerve

Sensory

Aortic Arch Chemoreceptors and Baroreceptors

Taste from Epiglottic Region

Motor

Swallowing

Palate Elevation

Talking

Coughing

Midline Uvula

1 min

CN XII

Hypoglossal Nerve

Motor

Tongue Movement

34 secs

Cranial Nerve Function

CN I

CN II

CN VIII

CN III

CN IV

CN VI

CN XI

CN XII

CN V

CN VII

CN IX

CN X

1 min

Alteplase

Tissue Plasminogen Activator

Thrombosis

Bleeding

Intracranial Hemorrhage

Internal Hemorrhaging

Minimize Bleeding

Monitor for Shock

Aminocaproic Acid

2 mins

Vital Signs - Adult

Temperature (96.8-100.4 Degrees F) (36-38 Degrees C)

Rectal

Tympanic

Oral

Axillary

Temporal

Respiration (12-20)

Oxygen Saturation (95%-100%)

Pulse (60-100)

Blood Pressure (<120/80)

Pain

2 mins

Increased Intracranial Pressure (ICP) Assessment

Change in LOC

Headache

Cushings Triad

Irregular Respirations

Widening Pulse Pressure

Bradycardia

Projectile Vomiting

Abnormal Pupils

Papilledema

Posturing

2 mins

Increased Intracranial Pressure (ICP) Interventions

Elevate Head Of Bed

Foley Catheter

Mannitol (Osmitrol)

High Dose Barbiturates

Passive Hyperventilation

Dexamethasone (Neoplasm or Infection)

Neuro Assessment

Maintain Normal Temperature

Avoid Activities That Increase ICP

Intracranial Monitoring System

2 mins

Hydrocephalus

Increased CSF in Ventricles of Brain

Signs of Increased ICP

High Pitched Cry

Irritability

Opisthotonus

Increased Head Circumference

Bulging Fontanel

Setting Sun Sign

Seizure Precautions

Elevate HOB

CSF Shunt

2 mins

Clopidogrel (Plavix)

ADP Receptor Antagonist

Prevent Platelet Aggregation

Acute Coronary Syndrome (ACS)

Prevention of Thrombotic Events

Bleeding

Thrombotic Thrombocytopenic Purpura (TTP)

Pancytopenia

Abdominal Pain

Withhold Before Surgery

2 mins

Warfarin (Coumadin)

Inhibits Clotting Factors

Atrial Fibrillation

Venous Thrombosis

Pulmonary Embolism

PT/INR Levels

Observe for Bleeding

Pregnancy

Vitamin K and Fresh Frozen Plasma

Prolonged Therapeutic Onset

Maintain Same Diet

2 mins

Aspirin (Acetylsalicylic Acid)

Inhibits Platelet Aggregation

NSAID

Thrombotic Event Prevention

General Pain

Inflammatory Conditions

Fever

Pancytopenia

GI Ulcers

Bleeding

Withhold Before Surgery 7-10 Days

Reye's Syndrome

2 mins

Depression Assessment

Anergia

Self Neglect

Decreased Libido

Vegetative Signs

Sad Affect

Worthlessness

Guilt

Anger and Irritability

Ineffective Problem Solving

Slowed Thinking

1 min

Types of Head Injuries

Open Head Injury

Linear Fracture

Comminuted Fracture

Depressed Fracture

Open Fracture

Basilar Skull Fracture

Closed Head Injury

Coup and Contrecoup

Brain Contusion

Concussion

2 mins

Hypoxia (Early Symptoms)

Diaphoresis

Restlessness

Tachypnea

Dyspnea on Exertion

Tachycardia

Hypertension

Arrhythmias

Decreased Urine Output

Unexplained Fatigue

1 min

Hypoxia (Late Symptoms)

Cyanosis

Cool, Clammy Skin

Use of Accessory Muscles

Retractions

Hypotension

Arrhythmias

2 mins

Traumatic Brain Injury Assessment

Change in LOC

Personality Changes

Amnesia

Increased Intracranial Pressure

Diplopia

Posturing

Basilar Skull Fracture

Halo or Ring Sign

Intracranial Bleeding

2 mins

CSF Lab Values: Normal

Pressure: < 20 cm H2O

Color/Appearance: Clear or Colorless

Proteins: < 40 mg/dL

Lactate Dehydrogenase: 10% of Serum Level

Cells: 0-5 Small Lymphocytes

Glucose: 40-70 mg/dL

2 mins

Eye

Sclera

Cornea

Iris

Lens

Ciliary Muscles

Optic Nerve

Rods

Cones

Retina

1 min

Magnetic Resonance Imaging (MRI)

Internal Body Images

Detects Variations of Soft Tissues

No Metal Objects

No Pacemakers

Contrast is Non-Iodine

Safe During Pregnancy

Long Procedure

Antianxiety Medications

2 mins

Mannitol (Osmitrol)

Osmotic Diuresis

Reducing Intracranial Pressure

Reducing Intraocular Pressure

Renal Failure Prophylaxis

Edema

Fluid and Electrolyte Imbalance

Avoid Use in Cardiac Patients

IV Administration

2 mins

Phenytoin (Dilantin)

Blocks Na+ Channels

Tonic-clonic Seizures

Ataxia

Nystagmus

Sedation

Gingival Hyperplasia

Purple Glove Syndrome

Hirsutism

Rash

Anemia

Individualized Dosing

2 mins

Hypernatremia

> 145 mEq/L Na+

Change in LOC

Extreme Thirst

Orthostatic Hypotension

Dry Flushed Skin

Muscle Twitching

Seizures

Treat and Prevent Dehydration

Hypotonic Solutions (0.225% or 0.45% NaCl)

Sodium Restriction

Diuretics

2 mins

Meningitis Assessment

Nausea and Vomiting

Fever

Nuchal Rigidity

Severe Headache

Purpura

Seizures

Photophobia

Opisthotonus Position

High-Pitched Cry

Bulging Fontanel

2 mins

Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)

Hypersecretion of ADH

Increased Sensitivity to ADH

Serum Hypoosmolality

Coma and Seizure

Dilutional Hyponatremia

Cramps and Tremors

Euvolemia

Change in LOC

2 mins

Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Pharmacologic Interventions

Diuretics

Hypertonic IV Fluids

Demeclocycline

Tolvaptan and Conivaptan

1 min

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