MT2

Question 1

What is the SIRS criteria?

Answer 1

• 2 or more:
  
  • temp >38.5C or <35C
  • HR >90
  • RR>20 or PaCO2 <32
  • WBC >12000, <4000, or >10% Bands

Question 2

What is an alarming creatinine change?

Answer 2

increase of 0.5 or more

Question 3

What do you monitor if patient is on Heparin? What is antidote?

Answer 3

PTT

Protamine Sulfate

Question 4

What do you monitor if pt is on Coumadin?

Answer 4

PT/INR

Vita K

Question 5

What does metformin do?

Answer 5

• controls glucose level
• can cause diarrhea, abdominal discomfort

Question 6

What do beta-blockers do?

Answer 6

• reduces heart work and cardiac output
• lowers BP
• reduces demand for O2
• treats HTN/chest pain

Question 7

What is the antidote for Benzo?

Answer 7

• Flumazainyl

Question 8

Antidote for Norco?

Answer 8

Norcan

Question 9

What does advair do?

Answer 9

• Fluitcasone & Salumetrol
• brochodilator and coritcosteriod

Question 10

What is glipizide?

Answer 10

controls BG levels by helping pancrease produce insulin

Question 11

What does quinapril do?

Answer 11

• Treats HTN/ Heart failure
• ACE inhibitor
• may cause light-headedness, little to no voiding
  
  • monitor BP/HR

Question 12

What does lipitor do?

Answer 12

Decreases LDL and triglycerides in blood

Question 13

What does Reglan do?

Answer 13

• speeds up rate stomach empties into intestines
• treats heartburn and helps with N/V

Question 14

What side of brain is responsible for speech?

Answer 14

Left

Question 15

Why do we monitor BS when a pt comes in for suspected stroke?

Answer 15

Hypoxemia can mimic stroke

Question 16

What are the warning signs of a Stroke?

Answer 16

• Aphagia (speech problems)
• Vision problems
• ataxia or problems w/ certain side of the body

Question 17

What is the scale for eye opening category of the GCS?

Answer 17

1. none
2. pain
3. speech
4. spontaneous

Question 18

What is the scale for the GCS speech category?

Answer 18

1. none
2. incomprehensible sounds
3. inappropriate words
4. confused
5. oriented

Question 19

What is the scale for the GCS motor response category?

Answer 19

1. flaccid
2. abnormal extension (decerebrate)
3. abnormal felxion (decorticate)
4. flexion withdrawal (pull away from pain)
5. localizes pain
6. obeys command in ANY extremity

Question 20

When do you notify the physician when observing the GCS?

Answer 20

If there has been a change in 2 points

Question 21

What is the time frame for interventions with stroke?

Answer 21

3 hours

Question 22

When do you treat a PT w/ a stroke that has a high BP?

Answer 22

• Ischemic
  
  • Giving TPA
    
    • Must treat BP >185/110
  • If not giving TPA
    
    • treat >200/100
• Hemorrhagic
  
  • Treat BP if it is >160/90

Question 23

Whats the criteria for TPA qualifaction?

Answer 23

• 3 hour since onset
• no recent trauma or surgery
• no recent homorrhage or coag therapy (warfarin INR >1.7, plts <100000)
• no HTN (>185/110)
• no seizures

Question 24

What is the TPA dosage?

Answer 24

• .9mg/kg
• give 10% bolus followed by 90% infusion
• max 90mg

Question 25

How often do you assess during and after TPA infusion?

Answer 25

* During: q15 mins * Post * q 15 for 2 hrs * q 30 mins for 6 hrs * q 1 hour for 16 hrs

Question 26

What are the clinical presentations of a middle CEREBRAL artery stroke?

Answer 26

* Contralateral * Hemiparesis/-plegia * Hemisensory loss * visual field loss * Dominant hemisphere - aphasia * Non-dominant - neglect, flat affect

Question 27

What are the clinical manifestations of an anterior CEREBRAL artery stroke?

Answer 27

* Contralateral hemiparesis in distal areas (legs) * numbness, tingling, loss of sensation * aphasia * Contralateral blurring or indistinct in one side of field of vision in both eyes * ipsilateral monocular blindness

Question 28

What are the symptoms of CEREBELLAR stroke?

Answer 28

* Truncal and gait ataxia * ipsilateral * limb ataxia * facial weakness and sensory loss * gaze paresis * small reactive pupils

Question 29

What are the clinical manifestations of a brainstem stroke?

Answer 29

* Quadriparesis or contralateral hemiparesis * coma * horizontal gaze paresis * hyperthermia, hyperventilation

Question 30

Why would you want sodium levels above normal?

Answer 30

* low sodium can cause seizure * BP can increase and pull edema from brain into vessels

Question 31

What meds can alter neuro?

Answer 31

* BP meds * Insulin * Narcotics * Benzodiazipines

Question 32

If a patient is aphasic, where is the site of injury most likely?

Answer 32

* damage in left temporal lobe near Wornicke's area or Broca's area

Question 33

What two drugs should you avoid in the elderly that can affect their neuro?

Answer 33

Adavan and pepcid

Question 34

What is dopamine responsible for?

Answer 34

* movement * balance * walking

Question 35

What are ways to medically manage parkinson's?

Answer 35

* Providing dope to basal ganglia * Sinemet (levodopa +carbidopa) * Block acetylcholine release * thalamotomy * deep brain stimulation

Question 36

How do you compute CO?

Answer 36

CO=SV x HR

Question 37

What Calcium Channel Blockers are most widely used for HTN treatment?

Answer 37

Amlodipine and Cardiezem

Question 38

What is the Frank Starling Mechanism?

Answer 38

Increase stretch of Cardiac muscle = Increase force of contraction

Question 39

Normal Cl value?

Answer 39

95-110

Question 40

Normal serum CO2

Answer 40

24-32

Question 41

Normal Ca level?

Answer 41

8.6-10.5

Question 42

Normal triglyceride level

Answer 42

35-160

Question 43

Normal WBC level?

Answer 43

4.5-11

Question 44

Normal HGB level?

Answer 44

13-16

Question 45

Normal HCT level?

Answer 45

37-49

Question 46

Normal PLT level?

Answer 46

130-400

Question 47

Normal PTT?

Answer 47

23-33.5

Question 48

Normal PT?

Answer 48

11-12.5

Question 49

Normal HCO3

Answer 49

22-28