Stroke and Burn Injuries Quiz

Adult Nursing (2) Course Contents

• Unit I: Nursing management for patients with neurological alterations (6hrs)

  • Increased intracranial pressure management
  • Intracranial surgery (craniotomy) management
  • Stroke management
  • Seizure disorders management

• Unit II: Nursing management for patients with orthopedic alterations (9hrs)

  • Orthopedic trauma patient management
  • Fracture management
  • Methods of restriction movement
  • Traction
  • Cast
  • Methods of internal fixation
  • Orthopedic infection and acute osteomyelitis
  • Rheumatoid Arthritis

• Unit III: Nursing management of patients with urological alterations (9hr)

  • Caring for patients with urinary disorders
  • Urinary tract infection management
  • Cystitis
  • Obstructive disordered and urolithiasis
  • Renal failure
  • Acute renal failure
  • Chronic renal failure
  • Dialysis
  • Peritoneal dialysis
  • Hemodialysis

• Unit IV: Nursing management of patients with alterations in skin integrity (burns) (9hr)

  • Anatomy and physiology of the skin
  • Pathology of burns
  • First aid of burn
  • Emergent phase of burn
  • Acute phase of burn
  • Wound dressing
  • Hydrotherapy
  • Wound debridement
  • Infection control in burned patient
  • Nutritional support for burn patient
  • Skin graft
  • Rehabilitation phase of burn

The Nervous System (Learning Objectives)

• At the end of the lecture, the student should be able to discuss the anatomy and physiology of the nervous system, the position and function of cranial nerves, and identify lumbar puncture procedures.

The Nervous System (Anatomy & Physiology)

• The nervous system is divided into the central nervous system (CNS) and peripheral nervous system (PNS).
• CNS is divided into the brain and spinal cord.
• The brain is further divided into cerebrum, cerebellum and brainstem.
• Peripheral nervous system is divided into cranial nerves (12 pairs) and spinal nerves (31 pairs).
• The autonomic nervous system controls the body's many vegetative functions.
• Basic unit is the neuron. Neurons are sensory or motor, separated but work together. Signals travel from one neuron to another.

Increased Intracranial Pressure Management (Learning Objectives)

• Define intracranial pressure (ICP) and increased ICP.
• List causes of increased ICP.
• Identify signs and symptoms of increased ICP.
• Differentiate between the five grades of intracranial pressure.
• Identify diagnostic findings for increased ICP.
• List complications of increased ICP.
• Discuss nursing management and education for patients with increased ICP.

Increased Intracranial Pressure Management (Introduction & Definitions)

• Inside the cranium are brain tissue, blood, and cerebrospinal fluid (CSF).
• Intracranial pressure (ICP) is the measure of cerebrospinal fluid pressure within the cranium.
• Normal ICP ranges from 15-20 mmHg.
• Increased ICP is an increase in normal brain pressure due to increased cerebrospinal fluid pressure.

Stroke (Learning Objectives)

• Define stroke.
• List incidence of stroke.
• Identify types of stroke.
• Describe risk factors for stroke.
• Explain clinical manifestation of stroke.
• Identify diagnostic evaluation findings for stroke.
• Identify effects of stroke.
• Discuss medical and nursing management for patients with stroke.

Stroke (Definition & Incidence)

• A stroke is called a brain attack, or cerebrovascular accident (CVA).
• It occurs when prolonged interruption in blood flow to part of the brain occurs.
• Nerve cells die irreversibly if brain is deprived of oxygen for 3-7 minutes.
• In the US, stroke is the third leading cause of death. Approximately 780,000 Americans experience new or recurring strokes annually.

Stroke (Pathophysiology & Etiology)

• Ischemic strokes: Occur when an artery carrying blood to the brain is obstructed by a thrombus or embolus.
• Hemorrhagic strokes: Occur when a cerebral blood vessel ruptures and blood is released into brain tissue. Increased intracranial pressure (ICP) results from the accumulated blood.

Stroke (Risk Factors)

• Hypertension, Atrial fibrillation, Hyperlipidemia, Diabetes, Smoking, Obesity, Thrombogenic substances (e.g., some herbal products), Valvular disease or replacement (e.g., causing thrombi and emboli). Genetics and age are also factors.

Stroke (Clinical Manifestations)

General symptoms:

• Sudden numbness or weakness of the face, arm, or leg
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, or loss of balance
• Sudden confusion or trouble understanding speech
• Sudden severe headache with no known cause.

Symptoms unique to women:

• Sudden face and arm or leg pain (in women).

Symptoms specific to a stroke in the cerebellum:

• Abnormal reflexes of the head and upper body
• Balance problems.
• Dizziness, nausea and vomiting.

Symptoms specific to a brain stem stroke:

• Paralysis or loss of sensation in one or both sides of the body
• Difficulty in moving or feeling one or both sides of the body.

Seizure and Epilepsy (Learning Objectives)

• Define seizures and epilepsy.
• Differentiate between the three phases of grand mal seizure.
• Describe diagnosis, investigation for seizures and epilepsy.
• Illustrate a teaching plan for patient and the family.
• Develop nursing care during and after seizure.
• List complications during and after seizure.
• Discuss action patient before, during and after anticonvulsant therapy.

Craniotomy (Learning Objectives)

• Define craniotomy
• Mention indications for craniotomy
• Identify types of craniotomy
• Describe pre-operative and post-operative care
• List post-craniotomy complications

Craniotomy (Definition & Indications)

• A craniotomy is a temporary surgical opening of part of the cranium (skull) to access structures beneath the cranial bones.
• Possible Indications: Brain tumor removal, clot evacuation, biopsy, relieving pressure, repairing damaged tissue, etc.

Unconscious Patient Management (Learning Objectives)

• Define level of consciousness, altered level of consciousness, and unconscious patient.
• Identify causes of unconscious patient.
• List clinical manifestations of altered level of consciousness.
• Identify diagnostic evaluation for unconscious patient.
• Discuss appropriate nursing assessment of the unconscious patinet.
• Describe the multiple needs of the unconscious patient.
• Discuss nursing management for unconscious patient.

Urinary Tract Infection (Learning Objectives)

• Define urinary tract infection (UTI)
• List causes, classification, predisposing factors and risk factors for UTI.
• Describe routes of infection.
• Discuss pathophysiology.
• List clinical manifestations and complications for UTI.
• Discuss diagnostic tests and medical management for UTI.
• Discuss nursing process for the patient with UTI.
• Know examples of upper and lower urinary tract infections.

Kidney Stones (Learning Objectives)

• Define kidney stones.
• Discuss the pathophysiology of kidney stones.
• List types, causes, signs and symptoms, and risk factors of kidney stones.
• Discuss diagnostic evaluation of kidney stones.
• List complications and prevention of kidney stones.
• Discuss medical management and nursing management of kidney stones.

Renal Failure (Definition & Type)

• Renal failure is the inability of the kidneys to maintain fluid, electrolyte, and acid-base balances.
• Renal failure can be acute or chronic. Acute renal failure (ARF) is characterized by sudden and rapid decrease in renal function. CRF is characterized by progressive, irreversible damage to the nephrons.

Renal Failure (Causes)

• Pre-renal*
• hypovolemia, hemorrhage, burns
• decreased cardiac output (e.g., myocardial infarction or arrhythmia)
• vascular disorders (e.g., sepsis, anaphylaxis, severe acidosis)
• obstruction of renal blood vessels (e.g., renal artery stenosis, thrombosis)
• Intra-renal*
• acute tubular necrosis (ATN)
• glomerulonephritis
• polycystic kidney disease
• Post-renal*
• bilateral renal vein thrombosis
• ureteral calculi
• prostatic hypertrophy
• ureteral structure
• ureteral or bladder tumor