CONCEPTS OF MEDICAL SURGICAL NURSING
EXAM 3 | CORRECLTY ANSWERED AND
GRADED A+ | GALEN
what IV solution would you never give with a brain injury
- Correct Answer - Hypertonic solutions any D5% AND up that is in
anything but water
What GCS score indicates a severe head injury
- Correct Answer - 8 or less
What GCS score indicates that the patient could be brain dead
- Correct Answer - 5 or less
what assessment can confirm that a patient is brain dead
- Correct Answer - absents of two or more autonomic reflexes S/A - gag,
blinking, swallowing, movement of eyes
what is the first sign of meningitis
- Correct Answer - nuchal rigidity
,what is the brudzinski sign
- Correct Answer - involuntary movements of the hip and knees when the
neck is passively flexed - indication of meningitis
What are the types of spinal cord injury
- Correct Answer - Flexion, hyperextension, compression
how would a client receive a flexion spinal injury
- Correct Answer - when a head hits a steering wheel or windshield
causing hyperflexion, It ruptures the posterior ligaments
how would a client receive a hyperextension spinal injury
- Correct Answer - a fall which chin hits an object and the head is thrown
back, rupturing the anterior ligaments
how would a client receive a compression spinal injury
- Correct Answer - often caused by falls or jumps which the person lands
on head sacrum or feet, the force of impact actually fractures vertebrae
most injury occur at which section and vertebrae
- Correct Answer - The mobile segments which are C1, C2, C4,C6, C5,
T11, T12
,The initial manifestation of acute SCI occur
- Correct Answer - At the level of injury, below is what is lost
what is the biggest concern with a C6 or above fracture
- Correct Answer - Airway, loss of diaphragm movements.
A client with a C7 injury is still able to
- Correct Answer - Lift the shoulders
Why do blood pressure and temperature drop with a early SCI
- Correct Answer - spinal shock
Clinical Manifestation of early complete transection of SCI
- Correct Answer - immediate paralysis below the level of injury,
hypotension, loss of temperature control
A good client teaching for a C6 or above injury is too
- Correct Answer - deep breath to retrain the diaphragm
what might a client with a C6 or above injury need to use at bedtime to
maintain Normal breathing patterns - Correct Answer - CPAP
, What are some clinical syndromes causing partial paralysis - Correct
Answer - central cord, anterior cord, brown- sequard
When intubating a C-spine fracture for mechanical breathing, NEVER -
Correct Answer - Arch the neck
What are manifestations of central cord syndrome - Correct Answer -
more weakness in upper extremities/ caused by edema and hemorrhage
in central SC
what injuries can cause central cord syndrome - Correct Answer - diving,
spinal stenosis, falling forward
Manifestations of anterior cord syndrome - Correct Answer - Complete
motor function loss and decrease pain and temperature sensation from
anterior spinal artery lesion and infarction of SC
What is usually preserved with anterior cord syndrome - Correct Answer
- position, vibration, and touch senses
Manifestation of brown- sequard syndrome - Correct Answer - lateral
hemisection of cord - same side motor paralysis, opposite side loss of
pain and temperature sensation