Nurs 5463 Module 7 test questions with answers

Nurs 5463 Module 7 test questions with
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answers

delirium
an acutely disturbed state of mind that occurs in fever,
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intoxication, and other disorders and is characterized by
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restlessness, illusions, and incoherence of thought and speech.
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Dementia
a slowly progressive decline in mental abilities, including
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memory, thinking, and judgment, that is often accompanied by
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personality changes |\




RASS
Richmond Agitation Sedation Scale |\ |\ |\




CAM ICU test |\ |\




-4 questions and a command
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-Only tool validated for use on vent patients to diagnose delirium
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,Risk factors for ICU delirium. 3 categories
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1) acute illness
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2) age/chronic health problems
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3) environmental/iatrogenic
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Leading iatrogenic risk factors for delirium?
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psychoactive medications |\




Management of delirium |\ |\




- mobilize early
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- improve sleep cycle
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- no haldol or atypical antipsychotics to prevent dilirium, or is
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prolonged QT, Torsades, or when taking meds that prolongs QT
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-Use Precedex rather than benzos when require sedation
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-Benzos and delirium in alcohol or benzo withdrawal
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Transient Ischemic Attack (TIA) |\ |\ |\




- transient episode of neurologic dysfunction caused by focal
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brain, spinal cord, or retinal ischemia, without acute infarction
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-highest risk for stroke after a TIA is within 48hr
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-15% of TIA precede stroke
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-early intervention of TIA reduce risk for stroke-80%
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,TIA common and uncommon causes.
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common: atherosclerosis of large vessels, cardioembolism and a-
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fib
uncommon: hypercoaguable states, aortic dissection, |\ |\ |\ |\ |\


hyperlipidemia, smoking, obesity and DM |\ |\ |\ |\




ABCD2 Risk Stratification Score |\ |\ |\




-used by clinicians to determine risk of stroke in the first 7 days
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following a TIA |\ |\




-5 parameters: age, BP, clinical features, duration of TIA, DM
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-Score range 0-7 |\ |\




Management of TIA |\ |\




Use ABCD score to determine risk of CVA. If 3 or greater, should
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be admitted
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-Age (>60) |\




-Blood pressure (>140/90) |\ |\




-Clinical symptoms |\




-Duration (>60 minutes) |\ |\




-Diabetes

, Treatment of TIA |\ |\




-tPA initiated if symptoms do not resolve and r/o bleed
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-prophylactic antiplatelet therapy (if TIA is NOT caridogenic); ASA,
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ticlopidine (ticlid), clopidogrel (Plavix), dipyridamole
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-cardiogenic TIA requires anticoagulation |\ |\ |\




-IV heparin and then warfarin longterm
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-carotid endarterectomy indicated in pts with ant circulation TIA
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and moderate-to-high grade carotid stenosis (70-90%)
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-control BP, (treat 220/120 or map >110) with CCB Nicardipine;
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mixed a1/b1,2 blocker Labetalol (it decreases PVR w/o significant
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decrease in HR or CO |\ |\ |\ |\




-serum cholesterol, glucose, afib, stop smoking, avoid excessive
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alcohol, lose weight |\ |\




Modifiable risk factors for stroke |\ |\ |\ |\




*Hypertension-most significant |\




Hypercholesterolemia
Atherosclerosis
Atrial fibrillation
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Obesity
Drugs and alcohol |\ |\




Diabetes, sickle cell anemia |\ |\ |\




TIA's