EXAM 3 NURC 424 QUESTIONS WITH
COMPLETE SOLUTIONS.
1 of 108
Term
During the assessment of a patient with a head injury from a fall, the
patient reports a sudden severe headache, nausea and vomiting. The
nurse notes right sided weakness, slurred speech and a right facial
droop. For which collaborative care procedure would the nurse
expect to prepare the patient?
Give this one a try later!
*Mannitol
Burr holes *Hypertonic Saline
, reposition the patient by
normal oculocephalic reflex elevating the head of the bed
Don't know?
2 of 108
Definition
Mannitol-osmotic diuretic-may be contraindicated in patient with
renal disease.
Hypertonic SALINE
ANTiseizure drugs (pheny toin)
Corticosteroids-
dexamethasone-controls vasogenic edema, for brain tumors and
bacterial meningitis
Histmaine (H2)- receptor antagonist (cimetidine)
0r PPI (pantroprazole to prevent GI ulcers and bleeding)
Hyperventilation therapy
Hypertonic saline given to reduce ICP
Give this one a try later!
Monitoring ICP and
Cerebral Oxygenation::::>>>
drug therapy for ICP
, Indications for Intracranial Pressure
Monitoring
CBF cerebral edema
Don't know?
3 of 108
Term
what are nursing diagnoses for patient with increased ICP?
Give this one a try later!
fibrinogen and factor VIII
Cryoprecipitate replaces factor VIII and fibrinogen and is given if the fibrinogen
level is below 100 mg/dL (1 g/L).
pupillary assessment:
pressure on the cranial nerves causes fixed pupils in patient with increased ICP.
Brisk pupil constriction is normal finding and is not expected with increased ICP.
decreased intracranial adaptive
capacity ineffective tissue perfusion
risk for injury
!) open the eyes when a verbal or painful stimulus is applied
2)speak and
3) obey commands
, Don't know?
4 of 108
Term
A nurse is caring for a patient with increased ICP due to a subdural
hematoma. Upon assessment, the nurse notes one pupil is 3mm and
the other is 7mm. Which action should the nurse take next?
Give this one a try later!
evaluate the patient's assess the cranial nerves for
respiratory function abnormalities
monitor the patient's heart rate check the patient's peripheral
and rhythm reflexes
Don't know?
5 of 108
Term
When is FFP indicated?
Give this one a try later!
-for severe coagulopathy (INR
> 6) with active bleeding tumors, injury, EDEMA, bleeds, CSF
accumulation (hydrocephalus)
COMPLETE SOLUTIONS.
1 of 108
Term
During the assessment of a patient with a head injury from a fall, the
patient reports a sudden severe headache, nausea and vomiting. The
nurse notes right sided weakness, slurred speech and a right facial
droop. For which collaborative care procedure would the nurse
expect to prepare the patient?
Give this one a try later!
*Mannitol
Burr holes *Hypertonic Saline
, reposition the patient by
normal oculocephalic reflex elevating the head of the bed
Don't know?
2 of 108
Definition
Mannitol-osmotic diuretic-may be contraindicated in patient with
renal disease.
Hypertonic SALINE
ANTiseizure drugs (pheny toin)
Corticosteroids-
dexamethasone-controls vasogenic edema, for brain tumors and
bacterial meningitis
Histmaine (H2)- receptor antagonist (cimetidine)
0r PPI (pantroprazole to prevent GI ulcers and bleeding)
Hyperventilation therapy
Hypertonic saline given to reduce ICP
Give this one a try later!
Monitoring ICP and
Cerebral Oxygenation::::>>>
drug therapy for ICP
, Indications for Intracranial Pressure
Monitoring
CBF cerebral edema
Don't know?
3 of 108
Term
what are nursing diagnoses for patient with increased ICP?
Give this one a try later!
fibrinogen and factor VIII
Cryoprecipitate replaces factor VIII and fibrinogen and is given if the fibrinogen
level is below 100 mg/dL (1 g/L).
pupillary assessment:
pressure on the cranial nerves causes fixed pupils in patient with increased ICP.
Brisk pupil constriction is normal finding and is not expected with increased ICP.
decreased intracranial adaptive
capacity ineffective tissue perfusion
risk for injury
!) open the eyes when a verbal or painful stimulus is applied
2)speak and
3) obey commands
, Don't know?
4 of 108
Term
A nurse is caring for a patient with increased ICP due to a subdural
hematoma. Upon assessment, the nurse notes one pupil is 3mm and
the other is 7mm. Which action should the nurse take next?
Give this one a try later!
evaluate the patient's assess the cranial nerves for
respiratory function abnormalities
monitor the patient's heart rate check the patient's peripheral
and rhythm reflexes
Don't know?
5 of 108
Term
When is FFP indicated?
Give this one a try later!
-for severe coagulopathy (INR
> 6) with active bleeding tumors, injury, EDEMA, bleeds, CSF
accumulation (hydrocephalus)
