Emergency Medical Management Quiz

Questions and Answers

What is a key intervention to promote adequate cerebral perfusion in ischemic stroke management?

Immediate surgical intervention

Administering high doses of anticoagulants

Maintaining blood pressure within prescribed parameters (correct)

Increasing fluid intake to hypervolemic levels

Which of the following is NOT a management strategy for ischemic strokes?

Providing DVT prophylaxis

Inducing hyperthermia to improve outcomes (correct)

Maintaining normal blood glucose levels

Using thrombolytic treatment

In managing hemorrhagic stroke, what is the primary focus of nursing assessment?

Ensuring neurological status and stability (correct)

Administering pain relief medications

Monitoring for signs of dehydration

Assessing renal function to evaluate fluid balance

What is the importance of maintaining normothermia in stroke management?

Associated with improved outcomes and reduced mortality Signup and view all the answers

Which diagnostic method is used for noninvasive evaluation of cerebrovascular structures?

MRA or CT angiogram Signup and view all the answers

What is the primary reason for intubating a patient with a Glasgow Coma Scale (GCS) of less than 8?

To prevent aspiration accidents Signup and view all the answers

Which intervention is crucial in preventing hypotension in a critically ill patient?

Employ vasopressors and provide albumin Signup and view all the answers

What should be monitored to effectively manage hyponatremia in a patient?

Daily fluid status and appropriateness of oral salt intake Signup and view all the answers

Which complication can arise as a result of open skull fractures or penetrating wounds?

Systemic infections Signup and view all the answers

What is a common pharmacological approach for seizure prophylaxis in patients following severe neurological events?

Phenytoin (Dilantin) Signup and view all the answers

What does increased intracranial pressure (ICP) potentially lead to if not managed correctly?

Brain herniation Signup and view all the answers

Which of the following is a recommended nursing management strategy for a patient with suspected meningitis?

Monitor vital signs and neurological status frequently Signup and view all the answers

What is the primary goal of nursing management for a patient with increased intracranial pressure (ICP)?

Maintain normal ICP levels Signup and view all the answers

Which intervention is most critical to prevent complications in a patient with altered level of consciousness?

Ensuring proper airway management Signup and view all the answers

According to the Monro-Kellie hypothesis, what is a primary compensatory mechanism for increased ICP?

Decrease in blood volume Signup and view all the answers

Increased intracranial pressure beyond which level is considered abnormal?

15 mmHg Signup and view all the answers

What is an essential nursing intervention for managing a patient with meningitis?

Strict isolation precautions Signup and view all the answers

For a patient suffering from seizures, what is a primary nursing responsibility during and after a seizure activity?

Maintain the patient's airway and monitor vital signs Signup and view all the answers

What is the rationale behind limiting fluid intake in patients with increased ICP?

To reduce cerebrospinal fluid production Signup and view all the answers

What is an indication of increased intracranial pressure that a nurse should monitor for?

Altered level of consciousness Signup and view all the answers

Which condition is considered a potential complication of untreated increased intracranial pressure?

Cerebral herniation Signup and view all the answers

Which nursing intervention is critical for ensuring proper cerebral perfusion following a craniotomy?

Monitoring fluid and electrolyte balance Signup and view all the answers

What is the primary focus of nursing management for a patient at risk for ineffective thermoregulation post-craniotomy?

Maintaining a controlled ambient environment and monitoring temperature regularly Signup and view all the answers

In the context of nursing care following a craniotomy, which of the following complications would require immediate intervention?

Sudden weakness or loss of sensation in the limbs Signup and view all the answers

Which nursing action is most effective in supporting psychological adaptation for a patient with body image disturbance after surgery?

Facilitating conversations that express the patient's feelings and concerns Signup and view all the answers

What essential nursing consideration should be prioritized for a patient post-craniotomy to prevent disturbed sensory perception?

Assessment of the patient's neurological status and sensory function frequently Signup and view all the answers

Which nursing intervention should be prioritized to prevent complications associated with increased intracranial pressure?

Maintain NPO status until consciousness is regained Signup and view all the answers

What is an important consideration when managing a patient with a decreased level of consciousness who is at risk for injury?

Padding and securing bed rails to maintain safety Signup and view all the answers

Which action should a nurse take to support optimal ventilation in a patient with increased intracranial pressure?

Auscultate breath sounds and monitor oxygenation status regularly Signup and view all the answers

What is a key nursing responsibility when managing a patient with impaired oral mucosa?

Providing frequent mouth care to maintain oral hygiene Signup and view all the answers

In the context of nursing management for a patient at risk for skin integrity issues, which approach is appropriate?

Implementing passive range of motion (ROM) exercises every 2 hours Signup and view all the answers

Study Notes

Objectives of Adult Nursing II

Discuss conditions related to the nervous system, including altered consciousness, intracranial pressure, head injury, meningitis, encephalitis, brain abscess, stroke/CVA, and seizure disorders.

Increased Intracranial Pressure (ICP)

The cranial vault consists of brain tissue (80%, approximately 1,400 g), blood (10%, about 75 mL), and cerebrospinal fluid (CSF) (10%, about 75 mL).
Normal ICP ranges from 10 to 15 mmHg; values above 15 mmHg indicate abnormal levels.
ICP is critical as increased pressure can lead to severe complications and potential life threats.

Monro-Kellie Hypothesis

Suggests that within the rigid skull, an increase in any one intracranial component leads to compensatory decreases in others to maintain equilibrium.
Compensation mechanisms include displacing CSF, enhancing absorption of CSF, or reducing cerebral blood volume.

Diagnostic Evaluations

CT and MRI scans identify stroke-related damages like ischemic areas.
Cerebral angiography assesses cerebrovascular insufficiency and structural abnormalities in blood vessels.
Electroencephalogram (EEG) monitors electrical activities of the brain, especially post-injury.

Management of Ischemic Stroke

Prioritize airway, breathing, circulation, and patients' neurological assessment.
Fluid replacement and keeping blood pressure within target parameters (e.g., SBP ≥ 100 mmHg).
Administer thrombolytic therapy and maintain normoglycemia and normothermia.

Management of Hemorrhagic Stroke

Similar initial steps: secure airway, monitor neurological status, administer IV fluids.
Blood pressure should be managed to prevent complications and promote perfusion.

Nursing Management Post-Craniectomy

Maintain patient's airway, monitoring fluids and nutrition, preventing injury, and offering cognitive support.
Regular assessments for neurological changes, including LOC, pupil reactions, and sensory/motor functions.

Complications Associated with Nervous System Conditions

Potential for infections, increased ICP, hydrocephalus, and brain herniation.
Risk of neurologic deficits, seizure disorders, and behavioral changes such as impulsivity or aggression.

Meningitis

Inflammation of the protective membranes (meninges) surrounding the brain and spinal cord.
Symptoms may present through signs in the CSF collected from the subarachnoid space.

Neurological Assessment

Conduct health history focused on symptoms like pain, seizures, dizziness, motor weakness, and vision changes.
Vital assessments include monitoring LOC, pupil reactions, vital signs, cranial nerves, reflexes, and sensory function.

Medical Management Considerations

Recognize and treat hypoxia and acid-base imbalances promptly.
Manage ICP via medications or surgical interventions such as burr holes or craniotomies as necessary.

Nursing Diagnoses

Common diagnoses may involve ineffective airway clearance, risk for injury, fluid volume deficits, impaired skin integrity, and disturbed sensory perception.

Important Parameters Affecting ICP

Cerebral Perfusion Pressure (CPP) calculation: CPP = Mean Arterial Pressure (MAP) - ICP; critical for assessing brain oxygenation and glucose supply.
Any increases in Cerebral Blood Volume (CBV) relate directly to shifts in Cerebral Blood Flow (CBF) influenced by CPP dynamics.

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Description

Test your knowledge on emergency medical management protocols, focusing on airway, breathing, and circulation considerations. This quiz covers critical aspects of patient care, especially for intubated patients. Evaluate your understanding of proper interventions to ensure patient stability.