Critical Care
HESI Remediation
Critical Care HESI Remediation
Basilar skull fracture: A halo-sign which is blood surrounded by a yellow colored
... [Show More] stain, is
likely to appear on the gauze if the client experienced a CSF leak as a result of a basilar
skull fracture.
o Other signs of a basilar skull fracture: hemorrhage from the nose, pharynx, ears,
or blood under the conjunctiva, Battle sign (bruising over the mastoid process)
may be seen after 24 hours
o CSF leak: when cerebrospinal fluid escapes from the ear or nose and the halo
sign is visible on bed linens or head dressing, it is a blood stain surrounded by a
yellowish stain
o CSF leak is a serious problem because organisms can access the cranial contents
through the nose, ear, sinus, or tear in the dura and create problems such as
meningitis, abscess formation, or osteomyelitis
Dopamine drip-POC: Dopamine is used as a first choice vasopressor for a client who is
hypotensive because it increases systemic vascular resistance and MAP, which
determines renal blood flow, GFR, and urine production. Urine output must be
monitored at least hourly to evaluate systemic pressure and renal perfusion.
o Dopamine is a Vasopressor (causes vasoconstriction). When a person is
hypotensive they have low systemic vascular resistance, low cardiac output, and
reduced perfusion. Therefore we need to constrict the vessels to raise vascular
resistance and ultimately cardiac output, perfusion, and MAP.
o It would only make sense that if the patient having trouble with perfusion due to
low blood pressure then renal blood flow, GFR, and urine production would slow
along with it. Therefore after the administration of dopamine, which is
attempting to fix these problems we should monitor urine output for the
effectiveness of the drug.
o Some reasons why the patient may be hypotensive include shock, trauma, or
sepsis.
Hypertensive crisis: Nitropress is a potent vasodilator that acts directly on smooth
muscle, and is the drug of choice for immediate reduction of the blood pressure during a
hypertensive crisis.
o Although nitroprusside is the drug of choice it [Show Less]