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HEALTHSTREAM ICU knowledge Exam –77 Questions and Answers
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HEALTHSTREAM ICU knowledgeExam –77 Questions and Answers
Intracranial hemorrhage's goal for treatment? - -Stop bleeding. Decrease
icp.
-Subdural hematoma? - -bleeding between covering of brain (dura) and
surface of brain. Compress brain tissue , leadin to brain dead. Most pt do not
recover.
-Epidural hematoma? - -covering of the brain (dura) peel away from skull
(from skull fracture). Wake up and die. Changes in vital signs are late signs.
-SubArachnoid hemorrhage (SAH)? - -aneurysm of artery in brain, causing
rupture. This is a type of hemorhagic stroke. Risk for repeated bleeding is
35% within. First 14 days post first bleed. Vasospasm is a common
complication of SAH. Cerebral angiogram can dx cerebral aneurysm. A
ruptured aneurysm has a risk for death of 40% , 08% disable after rupture.
-Normal ICP for adult? - -less than 15mmHg. When treating high ICP, the
goal is to be 20 mmHg ICP.
-What is cushing's triad? - -three symptoms that indicate brian damage
from high ICP. BRADYCARDIA, RESP DEPRESSION, HYPERTENSION.
-What factors increase ICP? - -suction, any stimulations.
-Glascow score of 5 indicate? - -
-Cerebral angiogram? - -visualize cerebral blood flow and blood vessels. Can
remove clot in bv at time of process. Insertion of dye through femoral artery.
Pt lies flat. Indicated for: atherosclerosis, dissection, tumor, aneurysm, av
malformation, stroke. Not for kidney failure, bleeding issue, allergic to dye
(iodine& shellfish). Cerebral angiogram can dx cerebral aneurysm. A
ruptured aneurysm has a risk for death of 40% , 08% disable after rupture.
-Av malformation? - -l connection between artery and vein without capillary
bed between in brain blood vessels. Leading to high pressure in veins (as
vein is receiving blood too quick!-> weaken bv-> risk aneurysm.
-WHY IS AVM BAD? - -1 risk of aneurysm rupture. 2 enlarged avm will put
pressure on surrounding brain. 3 cells that only gets oxy from capillary bed
will die.
, -Types of AV MALFORMATION? - -dural fistula, venous malformation,
cavernoma, capillary telangiectasia.
-two locations of AVM? - -BRAIN & SPINE.
-treatment for avm? - -embolization - deliver glue/ obstructive materials into
avm, thus, blood cant flow into avm to cause rupture.
-what test is used to locate what part of the brain is damaged by seizure or
stroke. this test combines both neuroimaging anf neuropsychological tests? -
-wada test- inject barbiturate into carotid artery to shut down one brian
hemisphere and evaluate the opposite hemisphere..
-How to know if a person will be allergic to angiogram dye? - -allergic to
iodine and shellfish.
-A pt with cerebral aneurysm is dx. What can the medical team do to secure
it in preventing rupture of the aneurysm? - -clipping , endovascular coiling.
-What is the procedure of opening the skull? - -craniotomy.
-What is clipping? - -clip at the neck of aneurysm to block normal blood floe
from entering; thus, stop it from stretching further and eventually rupture.
-What is endovascular coiling? - -fill aneurysm with spiral coil to stop blood
from filling the aneurysm; thus, prevent high blood pressure from rupturing.
Post coiling : extremity straight, neuro check, watch for stroke.
-Carotid stenting? - -place a stent to keep carotid artery open.
Complications: increase risk for stroke by 10%. , Mi 5%, bleeding, formation
of clots in stent.
-What cause vasospasm post cerebral stenting? - -breakdown of
hemoglobin in the subarachnoid space, creating inflammatory response,
impairing autoregulation. Causing ischemic and infarction. S/S: decrease
LOC. Focal/local deficit (ex: speech, vision, hearing probs).
-Transcranial doppler (TCD)? - -ultrasound that measures velocity of blood
flow in brain.
-Perfusion CT? - -IMAGING THAT SHOWS PERFUSION AREAS OF BRAIN.
-WHAT IS IN A NEURO ASSESSMENT? - -Pupil size, shape, equality and
reactivity, Level of consciousness, orientation and appropriateness, sensory
and motor function, visual changes, cranial nerve function, intracranial and
cerebral perfusion pressures, ventriculostomy drainage. neurological status
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