NUR 240 Exam 4: Neuro Iggy Questions & Answers
What would be the cause of false high or low readings? - ANSWER:overinflation of the pulmonary artery
balloon
What is SVR (systemic vascular resistance)? - ANSWER:The resistance to flow that the aorta must
overcome in order to push blood through the circulatory system.
What are the effects of meds on SVR - ANSWER:vasodilators decrease SVR
Priority care for patients with a hemodynamic monitor - ANSWER:record CVP hourly
assess line to reduce infection
maintain pressure bag at 300 mm/Hg, neurovascular assessment
How is MAP calculated? - ANSWER:(SBP + 2DBP)/3
What does the dicrotic notch represent? - ANSWER:closure of the aortic valve
end of systole
Troubleshooting for over dampened waveform - ANSWER:catheter patency, air bubbles, blood/kinks
troubleshooting for under dampened waveform - ANSWER:excessive tubing length, multiple stopcocks
What meds are used to treat AWS? - ANSWER:Benzodiazepines, addition of a barbituate, infusions of
midazolam/versed, lorazepam/ativan, propofil/diprivan, dexmedetomidine/precedex. Phenobarbital is
an off label use for AWS. Haldol.
S/S of AWS - ANSWER:Two or more of the following: Psychomotor agitation, anxiety, autonomic
hyperactivity (tachycardia or sweating), increased hand tremor, insomnia, nausea or vomiting, transient
tactile, visual, or auditory, hallucinations, tonic-clonic seizure
What are the vitamin deficiencies associated with AWS? - ANSWER:Thiamine (B1) and Folic acid, B12
Thiamine (Vitamin B1) deficiency s/s - ANSWER:wernicke's encephalopathy: confusion, abnormal gait,
and paralysis of certain eye muscles
korsakoff's syndrome: selective memory disturbances, amnesia
Folic acid deficiency - ANSWER:Macrocytic, megaloblastic anemia; no neurologic Sx (as opposed to
vitamin B12 deficiency). Most common vitamin deficiency in the USA. Seen in alcoholism and pregnancy.
Vitamin B12 deficiency symptoms - ANSWER:smooth tongue, fatigue, anorexia, behavior changes
C in CAGE questionnaire - ANSWER:need to cut down on drinking?
A in CAGE questionnaire - ANSWER:Annoyed by criticism of drinking?
G in CAGE questionnaire - ANSWER:Guilty feelings about drinking?
E in CAGE questionnaire - ANSWER:Do you have an eye-opener first thing to steady your nerves?
, What is paracentesis? - ANSWER:removal of fluid from the abdominal cavity, either for assessment of
fluid or to relieve pressure
What are esophageal varices? - ANSWER:Dilated submucosal veins in the lower esophagus
What causes esophageal varices? - ANSWER:portal hypertension
What is portal hypertension? - ANSWER:Increased pressure in the portal venous system
Goals for treating esophageal varices - ANSWER:Maintain hemodynamic stability, identify the source,
implement interventions to stop bleeding, prevent recurrent bleeding.
Medications for treating esophageal varices - ANSWER:Somatostatin, octreotide, vasopressin.
Prophylactic antibiotic therapy
What are the causes of liver failure? - ANSWER:cirrhosis, chronic active hepatitis, liver cancer,
toxins/drugs, vascular shock
How do you treat an acetaminophen overdose? - ANSWER:N-acetylcysteine and mucomyst
What is cirrhosis? - ANSWER:scarring of the liver, a consequence of chronic liver disease, caused by
alcohol misuse and hepatitis
How is cirrhosis treated? - ANSWER:diuretics, beta blockers, lactulose, nonabsorbent antibiotics,
paracentesis, EVL, TIPS, surgical bypasss shunting procedures, liver transplant
endoscopic retrograde cholangiopancreatography (ERCP) description - ANSWER:Invasive, with contrast
Preparation: NPO
Flexible fibrotic endoscope is inserted into the esophagus, passed through the stomach and into the
duodenum to visualize the common bile duct, hepatic bile ducts, and pancreatic ducts. The common bile
duct and pancreatic duct are cannulated, a contrast medium is injected into the ducts, permitting
visualization and radiographic evaluation
endoscopic retrograde cholangiopancreatography (ERCP) indications - ANSWER:can detect extrahepatic
biliary obstruction, intrahepatic biliary obstruction caused by stones or tumor, and pancreatic disease,
such as chronic pancreatitis, pseudocysts, and tumors
Meds to treat liver failure - ANSWER:Furosemide and spironolactone
Albumin
Vasopressin (esophageal varices)
Beta blockers (prevent bleeding)
Lactulose (decrease ammonia levels)
Neomycin
Rifaximin
What would be the cause of false high or low readings? - ANSWER:overinflation of the pulmonary artery
balloon
What is SVR (systemic vascular resistance)? - ANSWER:The resistance to flow that the aorta must
overcome in order to push blood through the circulatory system.
What are the effects of meds on SVR - ANSWER:vasodilators decrease SVR
Priority care for patients with a hemodynamic monitor - ANSWER:record CVP hourly
assess line to reduce infection
maintain pressure bag at 300 mm/Hg, neurovascular assessment
How is MAP calculated? - ANSWER:(SBP + 2DBP)/3
What does the dicrotic notch represent? - ANSWER:closure of the aortic valve
end of systole
Troubleshooting for over dampened waveform - ANSWER:catheter patency, air bubbles, blood/kinks
troubleshooting for under dampened waveform - ANSWER:excessive tubing length, multiple stopcocks
What meds are used to treat AWS? - ANSWER:Benzodiazepines, addition of a barbituate, infusions of
midazolam/versed, lorazepam/ativan, propofil/diprivan, dexmedetomidine/precedex. Phenobarbital is
an off label use for AWS. Haldol.
S/S of AWS - ANSWER:Two or more of the following: Psychomotor agitation, anxiety, autonomic
hyperactivity (tachycardia or sweating), increased hand tremor, insomnia, nausea or vomiting, transient
tactile, visual, or auditory, hallucinations, tonic-clonic seizure
What are the vitamin deficiencies associated with AWS? - ANSWER:Thiamine (B1) and Folic acid, B12
Thiamine (Vitamin B1) deficiency s/s - ANSWER:wernicke's encephalopathy: confusion, abnormal gait,
and paralysis of certain eye muscles
korsakoff's syndrome: selective memory disturbances, amnesia
Folic acid deficiency - ANSWER:Macrocytic, megaloblastic anemia; no neurologic Sx (as opposed to
vitamin B12 deficiency). Most common vitamin deficiency in the USA. Seen in alcoholism and pregnancy.
Vitamin B12 deficiency symptoms - ANSWER:smooth tongue, fatigue, anorexia, behavior changes
C in CAGE questionnaire - ANSWER:need to cut down on drinking?
A in CAGE questionnaire - ANSWER:Annoyed by criticism of drinking?
G in CAGE questionnaire - ANSWER:Guilty feelings about drinking?
E in CAGE questionnaire - ANSWER:Do you have an eye-opener first thing to steady your nerves?
, What is paracentesis? - ANSWER:removal of fluid from the abdominal cavity, either for assessment of
fluid or to relieve pressure
What are esophageal varices? - ANSWER:Dilated submucosal veins in the lower esophagus
What causes esophageal varices? - ANSWER:portal hypertension
What is portal hypertension? - ANSWER:Increased pressure in the portal venous system
Goals for treating esophageal varices - ANSWER:Maintain hemodynamic stability, identify the source,
implement interventions to stop bleeding, prevent recurrent bleeding.
Medications for treating esophageal varices - ANSWER:Somatostatin, octreotide, vasopressin.
Prophylactic antibiotic therapy
What are the causes of liver failure? - ANSWER:cirrhosis, chronic active hepatitis, liver cancer,
toxins/drugs, vascular shock
How do you treat an acetaminophen overdose? - ANSWER:N-acetylcysteine and mucomyst
What is cirrhosis? - ANSWER:scarring of the liver, a consequence of chronic liver disease, caused by
alcohol misuse and hepatitis
How is cirrhosis treated? - ANSWER:diuretics, beta blockers, lactulose, nonabsorbent antibiotics,
paracentesis, EVL, TIPS, surgical bypasss shunting procedures, liver transplant
endoscopic retrograde cholangiopancreatography (ERCP) description - ANSWER:Invasive, with contrast
Preparation: NPO
Flexible fibrotic endoscope is inserted into the esophagus, passed through the stomach and into the
duodenum to visualize the common bile duct, hepatic bile ducts, and pancreatic ducts. The common bile
duct and pancreatic duct are cannulated, a contrast medium is injected into the ducts, permitting
visualization and radiographic evaluation
endoscopic retrograde cholangiopancreatography (ERCP) indications - ANSWER:can detect extrahepatic
biliary obstruction, intrahepatic biliary obstruction caused by stones or tumor, and pancreatic disease,
such as chronic pancreatitis, pseudocysts, and tumors
Meds to treat liver failure - ANSWER:Furosemide and spironolactone
Albumin
Vasopressin (esophageal varices)
Beta blockers (prevent bleeding)
Lactulose (decrease ammonia levels)
Neomycin
Rifaximin
