Notes for Med surg They might not make since now but study them they will

on the test!!!! Things to know it might be confusing because its notes from two different people 1. CNS- brain and spinal cord 2. Spinal cord extends from c1 to L2 3. Age related changes nerve cells decrease brain weight is reduced and ventricle increased in size 4. Neurological findings 80 yrs. Old patient has dizziness and vertigo although common are abnormal 5. Patient has extreme stress- indicator is constriction of pupil 6. Most reliable indicator Neurological status / level of consciousness ability to respond to person place or time 7. Babinsky- downward curling of the toes 8. Stuporous semicomatosis/ not alert but responds to painful stimuli page 422 in book 9. You cannot do a MRI on a patient with a pacemaker 10. If your withdrawing fluid from a spinal tap to prevent headache keep patient lying flat and wait for body to build fluid back up 11. A patient with a seizure- protect the head, cradle the head and time the seizure 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. Before angiogram check to see if they have an allergy to shrimp shellfish Nurse caring for a 90 pt with closed head injury report blood pressure changes from low to high Post craniotomy- elevate the head of the bed 30 degrees Appropiate gift for a patient with Parkinson disease(choose best answer) best answer is satin sheets Asses vital signs and neurological status frequently for patients with meningitis Paralytic ileus- use stool softeners and monitor bowel status Know the plateu phase and the recovery phase Suctioning patient with gullianbarre- increase pulse rate and advitation breath sounds and respiratory rate Parkinsons disease (st johns wart) herbal remedies can interfere with the effectiveness of the Parkinson drug Patient says Drugs no longer controlling symptoms patient respond -other drugs combined with aldopamine Patient with MS- encourage patient to take break in between activities Parkinson thicken liquids Trigeminal nerve (5th cranial nerve Dilantin take with meals can cause gum hyper platia 7th cranial nerve bells palsy Post cva symptoms on right left side Greatest risk cva African American 65 hypertension

29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47.

Pttia Coumadin warfin therapeutic -1.5-2.0 x normal INR =2-3 (35 sec INR-2 is the answer) Nurse updates teaching plan- aspirin Coumadin prevents formation of clots CVA- well oxygenated TPa nurse response thrombolytic drugs must be given three hours onset Lumbar puncture stroke patient - hemorrhagic or embolitic Patient with hemmo..stroke is to be given 60 mg of calcium channel blocker . answer :pulse is 82 give the calcium channel blocker (full dose as prescribed )/ <pulse less than 60 don t give Acute cva phase patient at risk for falling / keep bed rails up according to agency policy Prevention of pneumonia- answer contraindicated ( encourage forceful coughing to stimulate deep breathing Excess fluid volume assesses advitation breath sounds Heparin math problem: 400 u heparin / 5000 u per 100ml/ divide 5000by 100 +50u /400/50=8ml/hr Bowel elimination: daily stool softener Rehabilitation caring: patient knocks over plate nurse responds learning new skills is hard lets see what is causing the problem Altered sensation in the cva patient teaching / make frequent assessment pressure or injuries Patient or you cross your arms right hand to right or left to left/ do not have muscular dystrophy Dysrhythmia/inability to speak clearly Family ask what can you do to support patient after stroke/ nurse response support joint &funct alignment Read the red on all slides from slideshow