NURS 424 Exam 3 Questions With Complete Solutions
what drug do we avoid with SCIs
methylprednisone (steroids)
midodrine (SCI)
regulate BP
*watch for bradycardia
gabapentin/pregabalin (SCI)
neuropathic pain
baclofen & valium (SCI)
skeletal muscle relaxants
SSRI (SCI)
antidepressant
* life is completely different and will affect them
stool softener & suppository (SCI)
bowel function
* no longer have sensation
oxybutynin (SCI)
bladder antispasmodic
enoxaparin (lovenox) (SCI)
blood thinner
* patient is not ambulating increasing their risk for DVT
, autonomic dysreflexia
EMERGENCY
- starts at T6
- patients experience dizziness, flushed, sweating
- can be caused by small things: full bladder
- closely monitor patient
- reversal is to catch and treat causing agent
CPP
- MAP minus ICP
- needs to be greater than 60
treatment for low CPP
pressors (levo)
monroe kelly doctrine
- brain, blood and CSF
- if problem evolves and doesn't get resolved: swelling goes
down to spinal cord goes patient to be brain dead
- if there is swelling in the brain, decrease blood, fluids or both
- if not caught early, patient can herniate
neurologic changes w/ opioids
- lethargic
- GCS can be 3
- pupils constrict to pinpoints and nonreactive to light
concussions
symptoms can last up to 16 wks (3 months)
what drug do we avoid with SCIs
methylprednisone (steroids)
midodrine (SCI)
regulate BP
*watch for bradycardia
gabapentin/pregabalin (SCI)
neuropathic pain
baclofen & valium (SCI)
skeletal muscle relaxants
SSRI (SCI)
antidepressant
* life is completely different and will affect them
stool softener & suppository (SCI)
bowel function
* no longer have sensation
oxybutynin (SCI)
bladder antispasmodic
enoxaparin (lovenox) (SCI)
blood thinner
* patient is not ambulating increasing their risk for DVT
, autonomic dysreflexia
EMERGENCY
- starts at T6
- patients experience dizziness, flushed, sweating
- can be caused by small things: full bladder
- closely monitor patient
- reversal is to catch and treat causing agent
CPP
- MAP minus ICP
- needs to be greater than 60
treatment for low CPP
pressors (levo)
monroe kelly doctrine
- brain, blood and CSF
- if problem evolves and doesn't get resolved: swelling goes
down to spinal cord goes patient to be brain dead
- if there is swelling in the brain, decrease blood, fluids or both
- if not caught early, patient can herniate
neurologic changes w/ opioids
- lethargic
- GCS can be 3
- pupils constrict to pinpoints and nonreactive to light
concussions
symptoms can last up to 16 wks (3 months)
