Graded A+
Chapter 1 & 2:
• Medications: amiodarone, lidocaine, magnesium, procainamide, and
vasopressin these are antiarrhythmic used in life threatening cardiac
problems
Alpha 1- cause skin and mucous membranes to vasoconstrict
Beta 1- stimulate the heart (you have 1 heart)
Beta 2- affects heart and lungs (you have 2 lungs) bronchodilation in lungs, and
uterine smooth muscle to relax.
Dopamine- causes renal blood vessels to dilate
Epinephrine- triggers alpha 1, and beta 1 and 2 receptors. Vasoconstriction,
increased HR, and bronchodilation SE: Hypertensive crisis, dysrhythmias, angina,
Dopamine- triggers dopamine receptors, beta 1 receptors, useful for shock and heart
failure
Dobutamine- triggers beta 1 receptors (heart rate increased, and used for heart
failure)
CH. 3 Neurologic diagnostic procedures
Cerebral angiogram: catheter inserted in groin or neck. Contrast dye is used so be
aware of pregnancies, shellfish and iodine allergies, check for patient’s renal
function (BUN, creatnine). Check is patient is on anticoagulant because bleed risk.
NPO 4-6 hrs before procedure. After procedure, check distal pulses and bleeding at
site.
EEG: Used to detect seizures, but can also check for sleep disorders and behavioral
changes. Wash hair prior to hair, and be sleep deprived, don’t have to fast for this.
This stress can trigger seizures or abnormal brain activities.
Glasgow Coma scale: how we determine level of consciousness. Highest score is 15;
anything less then 8 is severe head injury and coma. 4 are eyes opening.
,Intracranial pressure & monitoring: If someone has a low Glasgow scale more
monitoring needs to be done. High infection risk with the machine that is taking
pressure.
Symptoms in increase ICP: irritability, headache, decreasing LOC, no pupil response,
alterations in breathing, decorticate posturing. Normal intracranial pressure should
be between 10-15.
Lumbar puncture: Used to withdrawal small amt of CSF to treat for diseases. Lay in
cannonball position, have patient lay flat for an hour. If clotting doesn’t occur
afterwards, CSF may leak and they’ll get a really bad cranial headache.
, MRI: Remove jewelry, check for claustrophobia (might need sedation), check for
implants containing metal.
Ch. 4: Pain management
Acute pain: temporary, protective and usually resolves with tissue healing
Chronic pain: goes past 6 months and includes depression, fatigue
Nociceptive pain: damage or inflammation of tissue. Localized. Described as
throbbing or aching
-Somatic: Bones, joints, muscles
-Visceral: internal organs
-Cutaneous: in the skin or subQ tissue
Check on aggravating vs. Relieving symptoms- what makes it worse/what makes it
better.
Non-pharmacological and pharmacological methods of managing pain
Non-pharmacological: imagery, acupuncture, relaxation, TRANS, application of heat
and cold, therapeutic touch/massage
Pharmacological: Percocet (be away there is Tylenol in this), Tylenol, tinnitus or
vertigo is a side effect associated with aspirin (salicylates), gastric ulcers are side
effects for NSAID’s.
Opioids are go to for moderate to severe pain.
Opioid SE: constipation, urinary retention, orthostatic hypotension, n/v, sedation,
respiratory depression. Have order for narcan on hand incase respirations get too
low.
Ch 5: Meningitis
What is it? Inflammation of the meninges. These are the membranes that surround
the brain and spiral cord. Can either be viral or bacterial. Viral is more common and
will self-resolve. Bacterial meningitis is very worse and requires antibiotics. Key
vaccines= HIV vaccine, and then MCV4 vaccine.