NSG 520 Exam 2 Study Guide Latest Update

NSG 520 Exam 2 Study Guide Latest Update

• Questions and 100%

Verified Correct Answers Guaranteed A+ Approved by the Professor

Articulate secondary conditions associated with the various types of strokes -

CORRECT ANSWER: Cerebral edema (ischemic)

-Secondary effect of ischemic event regardless of location -Intravascular fluids diffuse into neural tissues, passing blood-brain barrier = inflammation -~2-3 days after stoke, brain cannot expand bc skull, compresses tissues → can cause herniation and death

Classify a burn according to the extent and degree of injury - CORRECT ANSWER: - Burns are a product of thermal, chemical, or electrical damage to the skin

As a result of sever damage to the skin, produces systemic derangements with the body's ability to enact an effective immune response

Following a burn, mortality is most often a product of secondary pneumonia and other infections processes

Burns are classified by the extent of the tissue involvement and degree of burn

The amount of skin involved with a burn is most-often described by the rule of 9's, which breaks the body into 12 sections, 11 of which equal 9% of the body, and 1 equaling 1% (representing the groin)→the more skin involved, the more chance of an infection

A first-degree burn: is superficial and involves only the epidermis. This produces temporary changes in pigmentation and cause some degree of pain with the involved skin peeling off approximately 5 - 10 days after the burn. This is most often the product 1 / 4

of a sunburn. No medical treatment is needed; however, 1st degree burns should be avoided, as changes in the epidermis can lead to an increased risk of developing skin cancer

Second degree burn: involves the full depth of the epidermis and some amount of

underlying dermal tissues. Blistering occurs with these types of injuries, with minimal complications from burns with limited dermal involvement. Deeper dermal burns will result in scarring and have a risk of infection. When infections occur, damage can progress the burn to full-thickness 3rd degree burn.

Third Degree Burn: those that advance into tissues underlying the dermis. As all dermal tissues are destroyed, these burns will lack sensation and protective functions of the skin. Risk of infection is significant; and all involved areas will be replaced with scar tissue.

Classify a traumatic brain injury in accordance with the primary classifications for injury

(i.e., mechanism, hemorrhage, lesions, and severity) - CORRECT ANSWER: Open

-Allows entry of environmental contaminants into cranial vault -Fragment of bone may directly damage neural tissue, meninges may have CSF leak -Penetrating, most often related to violence ---Missile - bullet or explosive fragmentation ---Non-missile - i.e knife -Antibiotics to decrease chance of meningitis or abscess formation

Closed -Hematoma (EDH, SDH, SDH) -Epidural Hematoma (2% of TBI): occur due to rupture of the smaller arteries between the bony tissues of the skull and dura mater. Since these vessels are small they have a higher arterial pressure. These injuries may appear lucid and free of symptoms they can be insidiously fatal. It is because the hematoma will expand under high pressure and build up until the collapse of the dura mater; causing a high velocity indentation which can cause comatose status or instant fatality and 1/3 only goes to fatal.

• / 4

o Subdural Hematoma (15% of occurrences and more common): Primarily due to

venous vessels within subdural space so blood collects under low pressure.▪ Most common in elderly because cerebral atrophy will cause vessels to stretch to bridge the gap formed between the dura and the arachnoid mater. Therefore these vessels are prone to sheering from something mild like a fall at home.▪ Being significant enough to lead to brain herniation, to mild enough to produce no neurological clinical effect. Because blood will collect under conditions of low pressure, symptoms may not develop for 2-3 weeks after a mild injury

Contusion -Bruise of brain, formed of hemorrhage, infarcted and necrotic tissue -Coup injury - contusion at site of direct trauma -Contercoup - contusion at opposite site of direct trauma because of RECOIL

Diffuse axonal injury -Whiplash -Damage to axons throughout CNS due to traumatic acceleration then deceleration -Axon may be completely severed;

Compare and contrast the physiological impact of various types of strokes, including TIA, ischemic, and hemorrhagic - CORRECT ANSWER: Transient ischemic attack (TIA) -Ischemic event where symptoms resolve rapidly -24 hours is a commonly used boundary between TIA and stroke

Ischemic- 80% -Blockage due to a thrombosis or embolus; deprives cells of glucose and oxygen ---Ischemic death of brain tissue -Hypoperfusion due to reduced circulation or small vessel disease -Loss of function coordinates with location of lesion

• / 4

Hypoxic ischemia -Severe hypotension or strangulation -Blood flow is inadequate to meet metabolic requirements of brain -Portions of cerebrum with least vascularization are first to experiences ischemia ---Anterior - frontal and parietal ---Posterior - occipital; contralateral blindness ---Subcortical - proximal arm and face weakness

Hemorrhagic -Rupture of an aneurysm or vessel within brain tissue or surrounding space

Compare and contrast the various clinical presentations for the types of traumatic

hemorrhagic events (i.e., SDH, EDH, and SAH) - CORRECT ANSWER: Both EDH and

SDH may cause mass effect severe enough to cause brain herniation

Epidural hematoma (EDH) -Rupture of arterial blood supply dissecting the dura

Subdural hematoma (SDH) -Rupture of venous supply bridging the dural space

Subarachnoid hemorrhage -Rupture of subarachnoid vessels -Cerebral dysfunction occurs bc increased intracranial pressure and from toxic effects of subarachnoid blood on brain tissue and cerebral vessels -Can cause secondary strokes

Compare the functional impact and potential for prosthesis utilization for various levels of limb amputation - CORRECT ANSWER: Amputation: surgical procedure to remove all or part of a limb, either due to a traumatic event or non-traumatic disease process

• / 4