Nurs 5463 Module 7 test questions with
|\ |\ |\ |\ |\ |\ |\
answers
delirium
an acutely disturbed state of mind that occurs in fever,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
intoxication, and other disorders and is characterized by
|\ |\ |\ |\ |\ |\ |\ |\
restlessness, illusions, and incoherence of thought and speech.
|\ |\ |\ |\ |\ |\ |\
Dementia
a slowly progressive decline in mental abilities, including
|\ |\ |\ |\ |\ |\ |\ |\
memory, thinking, and judgment, that is often accompanied by
|\ |\ |\ |\ |\ |\ |\ |\ |\
personality changes |\
RASS
Richmond Agitation Sedation Scale |\ |\ |\
CAM ICU test |\ |\
-4 questions and a command
|\ |\ |\ |\
-Only tool validated for use on vent patients to diagnose delirium
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
,Risk factors for ICU delirium. 3 categories
|\ |\ |\ |\ |\ |\
1) acute illness
|\ |\
2) age/chronic health problems
|\ |\ |\
3) environmental/iatrogenic
|\
Leading iatrogenic risk factors for delirium?
|\ |\ |\ |\ |\
psychoactive medications |\
Management of delirium |\ |\
- mobilize early
|\ |\
- improve sleep cycle
|\ |\ |\
- no haldol or atypical antipsychotics to prevent dilirium, or is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
prolonged QT, Torsades, or when taking meds that prolongs QT
|\ |\ |\ |\ |\ |\ |\ |\ |\
-Use Precedex rather than benzos when require sedation
|\ |\ |\ |\ |\ |\ |\
-Benzos and delirium in alcohol or benzo withdrawal
|\ |\ |\ |\ |\ |\ |\
Transient Ischemic Attack (TIA) |\ |\ |\
- transient episode of neurologic dysfunction caused by focal
|\ |\ |\ |\ |\ |\ |\ |\ |\
brain, spinal cord, or retinal ischemia, without acute infarction
|\ |\ |\ |\ |\ |\ |\ |\
-highest risk for stroke after a TIA is within 48hr
|\ |\ |\ |\ |\ |\ |\ |\ |\
-15% of TIA precede stroke
|\ |\ |\ |\
-early intervention of TIA reduce risk for stroke-80%
|\ |\ |\ |\ |\ |\ |\
,TIA common and uncommon causes.
|\ |\ |\ |\
common: atherosclerosis of large vessels, cardioembolism and a-
|\ |\ |\ |\ |\ |\ |\
fib
uncommon: hypercoaguable states, aortic dissection, |\ |\ |\ |\ |\
hyperlipidemia, smoking, obesity and DM |\ |\ |\ |\
ABCD2 Risk Stratification Score |\ |\ |\
-used by clinicians to determine risk of stroke in the first 7 days
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
following a TIA |\ |\
-5 parameters: age, BP, clinical features, duration of TIA, DM
|\ |\ |\ |\ |\ |\ |\ |\ |\
-Score range 0-7 |\ |\
Management of TIA |\ |\
Use ABCD score to determine risk of CVA. If 3 or greater, should
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
be admitted
|\
-Age (>60) |\
-Blood pressure (>140/90) |\ |\
-Clinical symptoms |\
-Duration (>60 minutes) |\ |\
-Diabetes
, Treatment of TIA |\ |\
-tPA initiated if symptoms do not resolve and r/o bleed
|\ |\ |\ |\ |\ |\ |\ |\ |\
-prophylactic antiplatelet therapy (if TIA is NOT caridogenic); ASA,
|\ |\ |\ |\ |\ |\ |\ |\
ticlopidine (ticlid), clopidogrel (Plavix), dipyridamole
|\ |\ |\ |\ |\
-cardiogenic TIA requires anticoagulation |\ |\ |\
-IV heparin and then warfarin longterm
|\ |\ |\ |\ |\
-carotid endarterectomy indicated in pts with ant circulation TIA
|\ |\ |\ |\ |\ |\ |\ |\ |\
and moderate-to-high grade carotid stenosis (70-90%)
|\ |\ |\ |\ |\
-control BP, (treat 220/120 or map >110) with CCB Nicardipine;
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
mixed a1/b1,2 blocker Labetalol (it decreases PVR w/o significant
|\ |\ |\ |\ |\ |\ |\ |\ |\
decrease in HR or CO |\ |\ |\ |\
-serum cholesterol, glucose, afib, stop smoking, avoid excessive
|\ |\ |\ |\ |\ |\ |\ |\
alcohol, lose weight |\ |\
Modifiable risk factors for stroke |\ |\ |\ |\
*Hypertension-most significant |\
Hypercholesterolemia
Atherosclerosis
Atrial fibrillation
|\
Obesity
Drugs and alcohol |\ |\
Diabetes, sickle cell anemia |\ |\ |\
TIA's
|\ |\ |\ |\ |\ |\ |\
answers
delirium
an acutely disturbed state of mind that occurs in fever,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
intoxication, and other disorders and is characterized by
|\ |\ |\ |\ |\ |\ |\ |\
restlessness, illusions, and incoherence of thought and speech.
|\ |\ |\ |\ |\ |\ |\
Dementia
a slowly progressive decline in mental abilities, including
|\ |\ |\ |\ |\ |\ |\ |\
memory, thinking, and judgment, that is often accompanied by
|\ |\ |\ |\ |\ |\ |\ |\ |\
personality changes |\
RASS
Richmond Agitation Sedation Scale |\ |\ |\
CAM ICU test |\ |\
-4 questions and a command
|\ |\ |\ |\
-Only tool validated for use on vent patients to diagnose delirium
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
,Risk factors for ICU delirium. 3 categories
|\ |\ |\ |\ |\ |\
1) acute illness
|\ |\
2) age/chronic health problems
|\ |\ |\
3) environmental/iatrogenic
|\
Leading iatrogenic risk factors for delirium?
|\ |\ |\ |\ |\
psychoactive medications |\
Management of delirium |\ |\
- mobilize early
|\ |\
- improve sleep cycle
|\ |\ |\
- no haldol or atypical antipsychotics to prevent dilirium, or is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
prolonged QT, Torsades, or when taking meds that prolongs QT
|\ |\ |\ |\ |\ |\ |\ |\ |\
-Use Precedex rather than benzos when require sedation
|\ |\ |\ |\ |\ |\ |\
-Benzos and delirium in alcohol or benzo withdrawal
|\ |\ |\ |\ |\ |\ |\
Transient Ischemic Attack (TIA) |\ |\ |\
- transient episode of neurologic dysfunction caused by focal
|\ |\ |\ |\ |\ |\ |\ |\ |\
brain, spinal cord, or retinal ischemia, without acute infarction
|\ |\ |\ |\ |\ |\ |\ |\
-highest risk for stroke after a TIA is within 48hr
|\ |\ |\ |\ |\ |\ |\ |\ |\
-15% of TIA precede stroke
|\ |\ |\ |\
-early intervention of TIA reduce risk for stroke-80%
|\ |\ |\ |\ |\ |\ |\
,TIA common and uncommon causes.
|\ |\ |\ |\
common: atherosclerosis of large vessels, cardioembolism and a-
|\ |\ |\ |\ |\ |\ |\
fib
uncommon: hypercoaguable states, aortic dissection, |\ |\ |\ |\ |\
hyperlipidemia, smoking, obesity and DM |\ |\ |\ |\
ABCD2 Risk Stratification Score |\ |\ |\
-used by clinicians to determine risk of stroke in the first 7 days
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
following a TIA |\ |\
-5 parameters: age, BP, clinical features, duration of TIA, DM
|\ |\ |\ |\ |\ |\ |\ |\ |\
-Score range 0-7 |\ |\
Management of TIA |\ |\
Use ABCD score to determine risk of CVA. If 3 or greater, should
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
be admitted
|\
-Age (>60) |\
-Blood pressure (>140/90) |\ |\
-Clinical symptoms |\
-Duration (>60 minutes) |\ |\
-Diabetes
, Treatment of TIA |\ |\
-tPA initiated if symptoms do not resolve and r/o bleed
|\ |\ |\ |\ |\ |\ |\ |\ |\
-prophylactic antiplatelet therapy (if TIA is NOT caridogenic); ASA,
|\ |\ |\ |\ |\ |\ |\ |\
ticlopidine (ticlid), clopidogrel (Plavix), dipyridamole
|\ |\ |\ |\ |\
-cardiogenic TIA requires anticoagulation |\ |\ |\
-IV heparin and then warfarin longterm
|\ |\ |\ |\ |\
-carotid endarterectomy indicated in pts with ant circulation TIA
|\ |\ |\ |\ |\ |\ |\ |\ |\
and moderate-to-high grade carotid stenosis (70-90%)
|\ |\ |\ |\ |\
-control BP, (treat 220/120 or map >110) with CCB Nicardipine;
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
mixed a1/b1,2 blocker Labetalol (it decreases PVR w/o significant
|\ |\ |\ |\ |\ |\ |\ |\ |\
decrease in HR or CO |\ |\ |\ |\
-serum cholesterol, glucose, afib, stop smoking, avoid excessive
|\ |\ |\ |\ |\ |\ |\ |\
alcohol, lose weight |\ |\
Modifiable risk factors for stroke |\ |\ |\ |\
*Hypertension-most significant |\
Hypercholesterolemia
Atherosclerosis
Atrial fibrillation
|\
Obesity
Drugs and alcohol |\ |\
Diabetes, sickle cell anemia |\ |\ |\
TIA's
