Complex Medical-surgical Neuro And Gastrointestinal Exam

left sided strokes affect language including speech and writing. Remember the 3 "R's"

Motor Vehicle Accidents (MVA's) are the most common cause of Spinal Cord Injuries. This is because during car accidents, the force and impact can cause severe trauma to the spinal cord, leading to injuries. The sudden jolt or impact can result in fractures or dislocations of the vertebrae, which can damage the spinal cord. The high speed and force involved in MVA's make them a major cause of spinal cord injuries. Falls, acts of violence, and sports-related injuries can also cause spinal cord injuries, but MVA's are the most common cause.

TPN (Total Parenteral Nutrition) is a specialized form of nutrition support that provides all nutrients intravenously. It is given through a dedicated line called a TPN line, which is specifically designed for TPN administration. TPN lines are not meant for administering medications, as they are solely used for delivering nutrition. Therefore, it is not appropriate to administer IV medications through a TPN line.

Hepatitis A is spread via oral-fecal route and is common in preschools and restraunts where employees do not wash their hands.

Blood in the stool is a common symptom of colorectal cancer. Colorectal cancer refers to cancer that starts in the colon or rectum. The presence of blood in the stool can be caused by the growth of tumors in the colon or rectum, which can bleed and result in blood being visible in the stool. This symptom should not be ignored and should prompt further medical investigation to determine the cause and appropriate treatment.

thrombolytic strokes occur due to atherosclerosis of the carotid and vertebral arteries. If a pt already has CAD they probably also have plaques in their other arteries as well

unilateral neglect only occurs with right sided strokes; the pt neglects their left side of the body an can only see 1/2 of the normal visual field

Impaired swallowing could lead to aspiration which blocks the airway: ABC's

Remember: door to CT in 30 minutes

The given statement suggests that the person has thoroughly examined the Pain and Coma Worksheets and is now fully prepared to respond to any question related to them. Therefore, the correct answer is true, indicating that the person is confident in their knowledge and understanding of the Pain and Coma Worksheets.

Most pancreatic cancer is detected only after it has advanced and cannot be resected. Prognosis is poor.

TPN is high in glucose so blood sugar levels need to be watched as the pancrease adjusts insulin coverage during the period of TPN administration

Headache is the most frequent symptom of a brain tumor. This is because as the tumor grows, it can put pressure on the surrounding tissues, blood vessels, and nerves in the brain, causing pain and discomfort. Headaches caused by brain tumors are often persistent and worsen over time. Other symptoms such as nausea and vomiting, visual disturbances, and seizures can also occur, but headache is the most common and often the first symptom experienced by patients with a brain tumor.

The patient undergoes surgery for esophageal cancer, where the diseased part of the esophagus is removed. To replace this section, a portion of the jejunum is used. The jejunum is a part of the small intestine that is located between the duodenum and the ileum. This surgical procedure is known as esophageal reconstruction or esophageal replacement. By using a section of the jejunum, the surgeon can create a new pathway for food and liquids to pass through, allowing the patient to continue eating and drinking normally after the surgery.

A common TIA usually lasts about 1 hour. This is because a transient ischemic attack (TIA) is a temporary interruption of blood flow to the brain, which can cause stroke-like symptoms. However, the symptoms typically resolve within a short period of time, usually lasting around 1 hour. It is important to seek medical attention immediately if experiencing symptoms of a TIA, as it can be a warning sign of an impending stroke.

Hypertension, also known as high blood pressure, is the greatest risk factor for all types of stroke. Hypertension can lead to the weakening and narrowing of blood vessels, increasing the likelihood of blood clots or ruptures that can cause a stroke. It puts strain on the heart and damages the blood vessels, making them more prone to blockages. Managing and controlling hypertension through lifestyle changes and medication can significantly reduce the risk of stroke. Atherosclerosis, the buildup of plaque in the arteries, and DVTs (deep vein thrombosis) are also risk factors for stroke, but hypertension is the most significant one.

when fluid leaks into the paritoneal cavity in ascites it takes clotting factors with it from the blood. This reduction in clotting factors causes DIC whose s/s are bleeding from injection sites, the skin or cavities of the body

Normal ICP is 0-10 mmHg

right side affects visual/spacial awareness, orientation and causes a pt to be impulsive and have poor judgment

head-on is hyperflexion and rear-ended is hyperextension. I remember the difference by thinking I would extend my neck to turn around and look behind me.

The diagnostic tool of choice for a diagnosis of gastric cancer is EGD (esophagealgogastoduodenoscopy). This procedure allows the doctor to visually examine the lining of the esophagus, stomach, and upper small intestine using a flexible tube with a camera on the end. It can also be used to take tissue samples for further testing. MRI and CAT scans can provide detailed images of the stomach, but they are not as effective in detecting small abnormalities or taking tissue samples. Endoscopy offers a direct and accurate visualization of the stomach, making it the preferred choice for diagnosing gastric cancer.

blood clots can form from uncirculated blood in the heart, break off and travel to the brain causing this type of stroke

hemorrhagic stroke are associated with adults > 60 yo and with activity while ischemic strokes usually happen at night while pt is resting.

Although rare, these are s/s of neurogenic shock: The spinal cord is in initial shock from trauma causing injury to the sympathetic pathways in the SC. S/S- bradycardia, hypothermia and hypovolemia leading to hypotension

In hepatitis, inflammation leadsto injury of cells but not cell death

all are important but rest is the primary intervention b/c it decreases the liver's metabolic demands and increases the liver's blood supply allowing regeneration of cells

The primary cause of death related to cirrhosis is hepato-renal syndrome, which is kidney failure caused by liver dysfunction. In cirrhosis, the liver becomes severely damaged and is unable to perform its normal functions, leading to a buildup of toxins in the body. These toxins can damage the kidneys and impair their ability to filter waste products from the blood. As a result, kidney failure can occur, leading to a cascade of complications that can ultimately be fatal.

chronic pancratitis damages the liver to the extent where it cannot make insulin any longer causing DM and insulin dependency

Diverticulitis is a condition characterized by inflammation or infection of small pouches called diverticula that form in the walls of the colon. These diverticula are most commonly found in the sigmoid colon, which is the S-shaped portion of the large intestine located just before the rectum. The sigmoid colon is a common site for diverticula formation due to increased pressure and muscle contractions in this area. Therefore, diverticulitis is typically diagnosed when these pouches become inflamed or infected in the sigmoid colon.

A RIND, or reversible ischemic neurological deficit, refers to a temporary episode of neurological symptoms caused by a temporary disruption of blood flow to a specific part of the brain. The symptoms are similar to a stroke but resolve completely within a relatively short period of time. The correct answer, "24 hours to a week," indicates that a RIND can last anywhere from a day to a week before the symptoms completely disappear. This time frame distinguishes a RIND from a transient ischemic attack (TIA), which typically lasts for less than 24 hours.

remember: scissors at the bedside in case of this type of emergency!

UC affects the whole colon from the rectum to the cecum preventing fluid absorption from the stool causing it to be liquified

The TIPS procedure, or Transjugular Intrahepatic Portosystemic Shunt, is a minimally invasive procedure used to treat portal hypertension. Portal hypertension is a condition where there is increased blood pressure in the portal vein, which carries blood from the digestive organs to the liver. This can lead to complications such as esophageal varices, which are enlarged veins in the esophagus, and ascites, which is the accumulation of fluid in the abdomen. The TIPS procedure involves creating a shunt between the portal vein and the hepatic vein to relieve the pressure and improve blood flow. It is not used to treat coagulation defects.

The ascendin colon is the beginning of the colon right after the terminal ilium- stool is still liquid at this point.

increased ICP puts pressure on the pituitary gland which can cause it to increase or decrease production of ADH. In this case, increased UO and increased sodium are symptomatic of DI. If UO decreased and Na was low, it would be SIADH

SCI patients are put on methylprednisolone IV for the first 24 hour after trauma to reduce swelling around the spinal cord

avoid clustering to decrease stress and give more frequent rest periods; do not flex head or hips

even though these vitals are WNL, the increase in BP with the decrease in Pulse and onset of HA could signify Autonomic Dysreflexia. The primary cause of this in SCI patients is overfilled bladder so the foley should be checked first.

tachycardi can sometimes be stopped by performing the vagal manuver- bearing down or coughing

The only way to know for sure if the stroke is ischemic or hemorrhagic from the above choices is a CAT scan- do not give thrombolytics to a pt with a hemorrhagic stroke

inflammation in the ilium occur prior to the colon so stools still have water extracted from them preventing liquid consitency

Smeltzer reccomends 1/4-1/3 full to prevent the weight of the effluent from pulling the bad down and breaking the seal

the liver produces sugars through glucogenesis; when part of it is removed it produces less glucose causing hypoglycemia

sedation is first- the rest go in the order of interventions

for cirrhosis,all lab levels increase EXCEPT protein and albumin

epidual bleeds are more common with falls/trauma; their is usually a brief LOC followed by lucidity and then s/s withing 2 hours of injury. An subdural bleed usually takes days to weeks to see any s/s. Subdurals are more common with MVA's

NPO is not necessary d/t no conscious sedation; heparin therapy is contra-indicated because high risk of bleeding due to vascularity of liver.

The Darvocet is the only regimen that exceeds 4000mg of acetaminophen in a 24 hour period

Irrigating an ostomy involves flushing the stoma with water to remove waste and promote regular bowel movements. It is generally recommended to irrigate once a day after a meal. This timing helps to ensure that the bowel is relatively empty and the irrigation process is more effective. Irrigating after a meal also allows for better control of bowel movements throughout the day, reducing the risk of accidents or discomfort.

all are correct