LPN exit class Final, (Answered)

LPN exit class Final, (Answered) Cranial Nerve I Olfactory -smell Cranial Nerve II Optic -vision Cranial Nerve III Oculomotor -most eye muscles *test by following finger Cranial Nerve IV Trochlear -superior oblique *test by looking down at nose Cranial Nerve V Trigeminal -facial sensation -muscles of mastication (chewing) Cranial Nerve VI Abducens -lateral rectus *look to the side to test Cranial Nerve VII Facial -facial expressions -taste *test by smile, raise the eyebrows, sugar or salt Cranial Nerve VIII Vestibulocochlear -hearing -balance *test with a tuning fork, look for vertigo Cranial Nerve IX Glossopharyngeal -pharynx sensation *test with gag reflex Cranial Nerve X Vagus -Muscles of larynx and pharynx, parasympathetic *check for hoarseness, open wide and say "AH" Cranial Nerve XI Accessory -Trapezius and sternocleidomastoid *test shoulder raise or turning the head Cranial Nerve XII Hypoglossal -tongue muscles *test by having patient stick out tongue three stages of shock compensatory - body tries to recover progressive - body is loosing the battle irreversible - when we cant turn things around IV fluids administered in shock -replace fluids in a 3:1 ratio (300 ml for every 100 ml fluid loss) oxygen therapy in shock administer oxygen via nonrebreather mask at 12 to 15 L/min goals of shock treatment (ABCDE) -Airway -control work of breathing -optimize circulation -assure adequate oxygen delivery -achieve end points of resusitation different types of shock -hypovolemic shock -anaphylactic shock -septic shock -neurogenic shock (container) -cardiogenic shock (pump) hypovolemic shock Shock caused by fluid or blood loss. hypovolemic shock (diagnostic tests) -BUN -electrolytes -hematocrit -hemoglobin -orthostatic vitals -24 hr. I&O -albumin -total protein (help hold fluid in intravascular space) hypovolemic shock (medications) -fluids -oxygen -zofran (if vomiting) -Imodium (if diarrhea) hypovolemic shock (risk factors) -dehydration *V&D *burns -hemorrhage -GI loss -Diabetes insipidus *increases urine output -Diuresis *from diuretics hypovolemic shock (teaching) educate about the use of diuretics anaphylactic shock Severe shock caused by an allergic reaction. anaphylactic shock (diagnostic test) -increased eosinophils *WBC anaphylactic shock (risk factors) allergies -food -med anaphylactic shock (medications) -epinephrine -antihistamines *benadryl *zantac -steroids -oxygen anaphylactic shock (teaching) -allergy tests -keep food log *try to figure out what pt. is allergic to -With contrast dyes ask for *iodine or shellfish allergy anaphylactic shock (subjective and objective assessment) subjective: throat closing objective: sweating, SOB, rash septic shock caused by severe infection, usually a bacterial infection. septic shock (diagnostic tests) -blood culture (before antibiotic) -CBC *white count -urinalysis & culture -sputum culture septic shock (medications) -antibiotics -fluids Septic shock (subjective & objective assessment) subjective: warm & flushed objective: fever (up to 105-106 sometimes), cloudy urine septic shock (teaching) -hand washing -oral hygiene -healthy lifestyle -vaccines *influenza and pertussis neurogenic shock Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation -seen in patients with spinal cord injuries. neurogenic shock (assessment) -bradycardia -decreased cardiac output -decreased BP neurogenic shock (interventions/meds) -fluids -atropine *increases HR -epinephrine *vasoconstrictor to help increase BP -raise legs *get blood flow back to heart *Trendelenburg neurogenic shock (risk factors) -spinal cord injury above T5 -spinal anesthesia -severe pain -hypoglycemia Prevention of neurogenic shock fluid bolus before anesthesia cardiogenic shock results when an inefficient heart cannot sustain adequate circulation cardiogenic shock (risk factors) -heart failure -MI (heart attack) -arrhythmias -structural problems *regurgitation -A fib *decreased preload crystalloids substances in a solution that diffuse through a semipermeable membrane -NS & LR colloids substances such as large protein molecules that do not readily dissolve into true solutions -albumin 5% or 25%, plasma protein fraction, dextran 40 or 70, hetastarch vasopressors act to increase blood pressure -Dopamine. -Phenylephrine. -Dobutamine. diuretics medications administered to increase urine secretion in order to rid the body of excess water and salt -lasix loop diuretic side effect - ears antidhysrhythmics -flecainide (Tambocor) -amiodarone (Cordarone) side effects: Your arrthymia gets worse. Your heartbeat gets faster or slower. Your chest hurts. You get dizzy, lightheaded, or faint. Your vision gets blurry. Your feet or legs swell. antihistamines inhibit allergic reactions of inflammation, redness, and itching caused by the release of histamine -side effects: Dry mouth. Drowsiness. Dizziness. Nausea and vomiting. corticosteroids anti-inflammatory agents side effects: osteoporosis (fragile bones), hypertension (high blood pressure), diabetes, weight gain, increased vulnerability to infection, bruising albuterol Bronchodilator side effects: Nervousness. Headache. N/V Cough. Irritation in the throat. Muscle, bone, or back pain. aminophylline Bronchodilator side effects: Stomach pain/cramping N/V diarrhea loss of appetite headache trouble sleeping, irritability, restlessness, nervousness, shaking (tremors) flushing increased urination ABCDEFGH's of Trauma care Airway/cervical spine stabilization Breathing Circulation Disability Exposure/Environment