Medsurg II- TEST 2

Medsurg II- TEST 2 - IICP 1 Earliest symptom is change in...

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IICP 1 Earliest symptom is change in LOC 1 Papilledema 1 Impaired eye movement 1 Decreased sensory/motor function 1 Vomiting 1 Headache 1 Pupillary changes 1 Changes in vital signs ***give Mannitol : osmotic diuretic; given IV; monitor for signs of improvement; sometimes given in conjunction with Lasix IICP vs. Shock IICP 1 Increased bp 1 Decreased pulse/respirations Shock 1 Decreased bp 1 Increased pulse/respirations Upper Motor Neuron Lesions 1 Loss of voluntary control 1 Increased muscle spasticity 1 No muscle atrophy 1 Hyperactive and abnormal reflexes Lower Motor Neuron Lesions 1 Loss of voluntary control 1 Decreased muscle tone (more flaccid) 1 Flaccid muscle paralysis 1 Muscle atrophy 1 Absent or decreased reflexes Non-Hemorrhagic : give anticoagulant, antiplatelet, tPA (must be administered within 3 hours of ischemic stroke and no antiplatelet or anticoagulant within 24 of tPA) 6 Thrombis: blood clot in vessel of brain or neck 6 Embolism: blood clot or other material from body 6 Ischemia: decreased blood flow Hemorrhage: 1 Epidural, Subdural, Subarachnoid, Intracranial Expressive Aphasia 2 Pt may know what they want to say but can not get it out, cannot express what they want 2 They understand everything that is said to them Receptive Aphasia
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1 Pt does not understand what is being said to them but he or she is able to express themselves. i.e.: pt can tell you that he or she is hungry or needs the bedpan but if you ask if they want juice or soda pt can’t tell you because they cant process what they are being asked Apraxia 2 Give pt a comb and tell them to comb hair, but they begin to brush their teeth Glasgow Coma Scale 1 Used to assess the degree of impaired consciousness 1 The 3 areas assessed are the inability of the patient to: o Speak o Obey commands o Open eyes when a verbal or painful stimulus is applied 1 Uses a numerical scale 1 The higher the number, the higher level of brain function 1 The highest GCS score is 15 for a fully alert person and the lowest possible score is 3 1 A score of 8 or less is indicative of a coma Guillian Barre 1 Acute and potentially fatal form of polyneuritis 1 It affects the peripheral nervous system and results in loss of myelin, edema and inflammation of the affected nerves causing a loss of neurotransmission to the periphery 1 More commonly seen in adults but is seen in all age groups 1 Etiology is unknown 1 Symptoms range from mild to severe 1 Usually develops 1 to 3 weeks after an URI or GI infection 1 Symmetric weakness of the lower extremities occurs over hours to days to weeks, usually peaking around the 14 th day 1 Distal muscles are more severely affected 1 Paralysis is ascending 1 Paresthesia (numbness and tingling) occurs first followed by paralysis in the extremities 1 Hypotonia (reduced muscle tone) and areflexia (lack of reflexes) are common persistent symptoms 1 Autonomic disturbances are usually seen in patients with sever muscle involvement and respiratory muscle paralysis o Most dangerous autonomic disturbances include:
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Medsurg II- TEST 2 - IICP 1 Earliest symptom is change in...

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