Stroke and Burn Injuries Quiz

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Questions and Answers

Which of the following is a unique symptom of a stroke in women?

  • Slow cognitive functions
  • Sudden hiccups (correct)
  • Persistent fatigue
  • Chronic headache

What is the purpose of blood tests in the diagnostic evaluation for stroke?

  • To assess neurological reflexes
  • To check for infections
  • To determine hypercholesterolemia (correct)
  • To measure brain activity

Which part of the brain, when affected by a stroke, is most likely to result in memory problems such as forgetting recent events?

  • Right half of the brain
  • Brain stem
  • Left half of the brain (correct)
  • Cerebellum

Which of the following is NOT considered an effect of stroke when it occurs in the right half of the brain?

<p>Difficulty understanding speech (C)</p> Signup and view all the answers

What type of stroke may lead to paralysis or inability to move on one or both sides of the body?

<p>Brain stem stroke (D)</p> Signup and view all the answers

What is a common behavior characteristic of a stroke survivor who has experienced a left hemisphere stroke?

<p>Slow and cautious behavior (D)</p> Signup and view all the answers

Which diagnostic tool is typically not used for detecting carotid stenosis?

<p>MRI scan (A)</p> Signup and view all the answers

What is the primary aim of the medical management for a stroke?

<p>To relieve the cause and prevent future strokes (D)</p> Signup and view all the answers

What is a potential systemic response to burn injuries that can lead to hypothermia?

<p>Loss of skin (A)</p> Signup and view all the answers

Which classification describes burns greater than 25% TBSA in adults?

<p>Major burn injury (D)</p> Signup and view all the answers

Which type of burn injury excludes patients with electrical or inhalation injuries?

<p>Minor burn injury (A), Moderate, uncomplicated burn injury (C)</p> Signup and view all the answers

Why are burns to the face considered more severe?

<p>They often result in corneal abrasions (C)</p> Signup and view all the answers

What percentage of TBSA defines a second degree burn as moderate in adults?

<p>15-25% (C)</p> Signup and view all the answers

Electrical burn injuries are classified as which category?

<p>Major burn injury (D)</p> Signup and view all the answers

What is the main mechanism behind a hemorrhagic stroke?

<p>Rupture of a cerebral blood vessel (C)</p> Signup and view all the answers

Which complication is specifically associated with burns on the ears?

<p>Auricular chondritis (C)</p> Signup and view all the answers

Which of the following is a controllable risk factor for cerebrovascular accidents (CVA)?

<p>Hypertension (A)</p> Signup and view all the answers

Chronic complications of electrical burns may include which conditions?

<p>Cataracts and glaucoma (B)</p> Signup and view all the answers

What is the most common clinical manifestation of a stroke?

<p>Sudden numbness or weakness of the face, arm, or leg (D)</p> Signup and view all the answers

What are the main components of the cerebrum?

<p>Frontal, parietal, temporal, occipital lobes (D)</p> Signup and view all the answers

Which structure is responsible for transmitting impulses away from the neuron's cell body?

<p>Axon (D)</p> Signup and view all the answers

Which statement correctly describes hypertension as a risk factor for CVA?

<p>It is a controllable risk factor. (C)</p> Signup and view all the answers

What is the role of myelin in the nervous system?

<p>To insulate axons and speed up impulse conduction (C)</p> Signup and view all the answers

Which group has a higher incidence of CVA?

<p>African Americans (C)</p> Signup and view all the answers

Which of the following conditions is NOT commonly associated with an increased risk of stroke?

<p>Regular exercise (C)</p> Signup and view all the answers

What are the nodes of Ranvier?

<p>Gaps between myelinated sections of axons (C)</p> Signup and view all the answers

What does sudden trouble seeing in one or both eyes indicate?

<p>Potential stroke symptoms (D)</p> Signup and view all the answers

Which part of the nervous system controls vegetative functions?

<p>Autonomic nervous system (B)</p> Signup and view all the answers

Which factor is a significant contributor to atherosclerosis that increases CVA risk?

<p>High blood cholesterol levels (C)</p> Signup and view all the answers

How are neurons classified based on their function?

<p>Sensory and motor (A)</p> Signup and view all the answers

What occurs during saltatory conduction?

<p>Impulses leap from one node of Ranvier to another (B)</p> Signup and view all the answers

Which part of the peripheral nervous system includes both cranial and spinal nerves?

<p>Peripheral nervous system (B)</p> Signup and view all the answers

What is one of the primary goals when caring for a burn injury patient?

<p>To maintain adequate tissue oxygenation (C)</p> Signup and view all the answers

Which nursing diagnosis is most closely associated with the risk of respiratory complications in burn patients?

<p>Ineffective airway clearance related to edema and effects of smoke inhalation (D)</p> Signup and view all the answers

What is a key consideration in the nutritional support of burn patients?

<p>Monitoring the adequacy of nutrients provided (A)</p> Signup and view all the answers

Which of the following is NOT a priority nursing intervention for burn injury patients?

<p>Encourage prolonged bed rest to prevent pain (C)</p> Signup and view all the answers

What is the first step in providing effective care for a burn injury patient?

<p>Assessing nutritional requirements (C)</p> Signup and view all the answers

What happens to fluid during the emergent phase of a burn injury?

<p>Fluid shifts into interstitial spaces. (B)</p> Signup and view all the answers

What primarily causes decreased urinary output in the emergent phase?

<p>Fluid loss and decreased renal blood flow. (C)</p> Signup and view all the answers

What is the effect of massive cellular trauma in the emergent phase?

<p>Release of K+ into extracellular fluid. (C)</p> Signup and view all the answers

Which of the following best describes hemoconcentration in the emergent phase?

<p>Increased liquid component loss to the extravascular space. (B)</p> Signup and view all the answers

What is a priority in the acute phase after a burn injury?

<p>Pain control and burn wound care. (C)</p> Signup and view all the answers

How does sodium concentration change during the emergent phase?

<p>Sodium loss occurs due to edema fluid and exudate. (C)</p> Signup and view all the answers

What is the impact of bicarbonate loss during the emergent phase?

<p>It causes metabolic acidosis. (D)</p> Signup and view all the answers

What should be frequently measured during the acute phase following a burn injury?

<p>Vital signs and fluid status. (C)</p> Signup and view all the answers

Flashcards

Cerebrum

The brain's outer layer, responsible for higher-level functions like thinking, language, and memory.

Lobes of the cerebrum

The frontal, parietal, temporal, and occipital lobes are all parts of the cerebrum.

Diencephalon

The thalamus and hypothalamus are the two main structures of the diencephalon, responsible for relaying sensory information and maintaining homeostasis.

Brain Stem

The midbrain, pons, and medulla oblongata are the three parts of the brainstem, responsible for vital functions like breathing, heart rate, and sleep-wake cycles.

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Central Nervous System (CNS)

The brain and spinal cord form the central nervous system, responsible for processing information and controlling bodily functions.

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Peripheral Nervous System (PNS)

Nerves that connect the CNS to the rest of the body, allowing for communication and control.

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Autonomic Nervous System

The autonomic nervous system is part of the PNS, controlling involuntary functions like heart rate, digestion, and breathing.

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Neuron

The basic unit of the nervous system, responsible for transmitting information throughout the body.

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Hemorrhagic Stroke

A type of stroke where a blood vessel in the brain ruptures, causing blood to leak into brain tissue. This increases pressure within the skull.

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Atrial Fibrillation

A condition where blood clots form in the heart's upper chambers and travel to the brain, blocking blood flow. It's a common risk factor for stroke.

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Hypertension

High blood pressure, a major risk factor for stroke. It damages blood vessels and increases the chance of clots.

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Hyperlipidemia

A condition with high blood cholesterol levels, contributing to atherosclerosis and stroke risk. It narrows blood vessels.

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Diabetes

Elevated blood sugar levels can increase the risk for stroke by contributing to blood vessel damage and clot formation.

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Transient Ischemic Attack (TIA)

A neurological event that occurs when the blood supply to part of the brain is blocked, causing damage. It's often a warning sign of an impending stroke.

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Vasoconstriction

A condition that restricts blood vessels, often due to smoking, increasing the risk of stroke. It reduces oxygen flow.

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Atherosclerosis

A narrowing of blood vessels due to plaque buildup, making them less flexible and increasing the risk of clots. It's a common underlying issue in stroke.

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Stroke (CVA)

A sudden onset of symptoms related to blood flow disruption in the brain. It involves a sudden loss of brain function, affecting movement, speech, and sensation.

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Stroke Symptoms in Women

Women may experience symptoms often overlooked or associated with other conditions, like migraines, anxiety, or digestive issues. Early recognition is crucial.

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Neurological Examination

This assessment involves observation and testing of a patient's physical and mental functions to identify potential stroke-related impairments.

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CT/MRI Scans and Angiogram

These advanced imaging techniques are used to visualize the brain and its blood vessels, helping doctors detect blood clots, hemorrhages, and other abnormalities.

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Blood Tests for Hypercholesterolemia

This blood test aims to determine if there are elevated cholesterol levels, a risk factor for both strokes and heart disease.

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Doppler Ultrasound and Arteriography

This medical procedure involves examining the carotid arteries in the neck to detect any narrowing or blockages that may increase stroke risk.

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Effects of Stroke

A major stroke can lead to significant brain damage and even death, while a milder stroke might cause temporary impairments.

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Medical Management for Stroke

Treatment aims to address the underlying cause of the stroke, if known, focus on rehabilitation to reduce long-term impairments, and prevent future strokes.

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Gastric Ischemia

Restricted blood flow to the stomach lining, potentially leading to ulcers and bleeding.

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Major Burn Injury

A burn covering more than 25% of an adult's body surface area.

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Minor Burn Injury

A burn covering less than 15% of an adult's body surface area.

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Special Care Area Burn

Burning of the eyes, face, hands, or genitals.

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Superficial Burn (First Degree)

A wound that damages the outermost layer of skin.

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Partial Thickness Burn (Second Degree)

A wound that damages the outer and inner layers of skin.

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Full Thickness Burn (Third Degree)

A wound that damages all layers of skin and potential underlying tissue

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Auricular Chondritis

Inflammation of cartilage, often seen in ear burns.

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Universal Precautions for Burn Patients

Wearing gloves, gowns, masks, and caps when caring for patients with open burns. This helps prevent healthcare workers from getting infected and spreading germs to other patients.

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Nutritional Support for Burn Patients

It's crucial during the acute phase of burn recovery to provide adequate nutrition to promote wound healing and reduce the risk of infections.

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Maintaining a Patent Airway in Burn Patients

Maintaining a patent airway and ensuring proper respiratory function are critical for burn patients, as they're susceptible to airway obstruction and lung complications from smoke inhalation.

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Hemodynamic Stability in Burn Patients

Maintaining a stable heart rate and blood pressure is crucial for burn patients due to fluid loss from burns and potential for shock. Restoring optimal fluid balance and blood circulation is essential.

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Pain Management for Burn Patients

Burn patients experience significant pain, and managing this pain effectively is paramount for their comfort and overall recovery. Different pain management strategies are implemented to achieve optimal pain relief.

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Emergent Phase of Burn Injury

The initial phase of burn injury, starting from the moment of injury until the completion of fluid resuscitation. Characterized by massive fluid shifts from blood vessels into the interstitial spaces due to increased capillary permeability, resulting in edema and decreased blood volume.

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Second Spacing

Second spacing refers to the accumulation of fluid in the interstitial space, outside of blood vessels, but still within the body's compartments. This can occur during the emergent phase of burn injury due to increased capillary permeability.

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Third Spacing

Third spacing refers to the accumulation of fluid in places where it doesn't normally exist, such as body cavities or within tissues. In burn injury, this can happen with the formation of blisters, where fluid leaks outside of the blood vessels and into the skin.

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Acute Phase of Burn Injury

The period following the emergent phase (48-72 hours after burn injury). Focus shifts to wound healing, pain management, and complications prevention. Hemodynamic monitoring remains crucial, with attention to respiratory and fluid status.

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Reduced Blood Volume in Burns

A decrease in blood volume caused by plasma leaking out of blood vessels during the emergent phase of burn injury. This contributes to a decrease in blood pressure and cardiac output.

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Sodium and Water Retention in Burns

The body's compensatory mechanism of retaining sodium and water in the kidneys during burn injury. It helps to maintain blood volume and pressure despite the fluid shifts.

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Decreased Urinary Output in Burns

A decrease in urine output due to fluid loss, reduced renal blood flow, and sodium/water retention during the emergent phase of burn injury.

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Potassium Excess in Burns

Increased potassium levels in the blood during burn injury. This happens because damaged cells release potassium into the bloodstream, where it's normally kept inside cells.

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Study Notes

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

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