NR 341
NR 341 Week 7 Exam Three Study Guide (Chapters 19, 20, 6, 17, 13, 21, 18)
NR 341 Week 7 Exam Three Study Guide
NR 341 Week 7 Exam 3
NR 341
... [Show More] Week 7
NR 341 Week 7 Exam Three Study Guide (Chapters 19, 20, 6, 17, 13, 21, 18)
Chapter 19 Trauma and Surgical Management
• Introduction
• Trauma demographics
• Systems approach to trauma care
o Trauma system
Levels of trauma care
Trauma continuum
Injury prevention
Trauma team concept
Prehospital care and transport
Trauma triage
Disaster and mass casualty management
• Mechanism of injury
o Blunt trauma
o Penetrating trauma
o Blast injuries
• Emergency care phase
o Initial patient assessment
o Primary and secondary survey
• Resuscitation phase
o Establishing airway patency
o Maintaining effect breathing
o Maintaining circulation
o Diagnostic testing
o Adequacy of resuscitation
o Fluid resuscitation
o Assessment of neurological disabilities
o Exposure and environmental considerations
• Assessment and management of specific organ injuries
o Thoracic injuries
Cardiac tamponade
Cardiac contusion
Aortic disruption
Tension pneumothorax
Hemothorax
Open pneumothorax
Pulmonary contusion
Rib fractures and flail chest
o Abdominal injuries
o Musculoskeletal injuries
Complications
• Compartment syndrome
• Rhabdomyolysis
• Venous thromboembolism
• Fat embolism syndrome
• Critical care phase
o Damage-control surgery
o Postoperative management
• Special considerations and populations
o Alcohol and drug abuse
o Family and patient coping
• Rehabilitation
Chapter 20 Burns
• Introduction
• Review of anatomy and physiology of the skin
o Effects of aging
• Mechanisms of injury
o Thermal injury
o Chemical injury
o Electrical injury
o Inhalation injury
Carbon monoxide and cyanide poisoning
Injury above the glottis
Injury below the glottis
• Burn classification and severity
o Depth of injury
o Extent of injury
• Physiological response to burn injury
o Cardiovascular response
o Host defense mechanisms
o Pulmonary response
o Renal response
o Gastrointestinal response
o Metabolic response
• Phases of burn assessment and collaborative interventions
o Resuscitative phase: prehospital
Primary survey
• Stopping the burning process
• Airway (with cervical spine precautions)breathing
• Circulation
Secondary survey
o Resuscitative phase: emergency department and critical care burn center
Transfer to a burn center
Primary survey
• Airway
• Breathing
• Circulation
o Fluid resuscitation
o End point monitoring
o Peripheral circulation
Secondary survey
• Cardiovascular system
• Neurological status
• Renal status
• Gastrointestinal system
• Integumentary system
• Blood and electrolytes
o Acute care phase: critical care burn center
Respiratory system
Cardiovascular system
Neurological status
Renal status
Gastrointestinal system
Integumentary system
Blood and electrolytes
• Special considerations and areas of concern
o Burns of the face
o Burns of the ears
o Burns of the eyes
o Burns of the hands, feet, or major joints, burns of the genitalia and perineum
o Electrical injury
o Chemical injury
o Abuse and neglect
• Pain control
• Infection control
• Wound management
o Wound care
o Topical agents and dressings
o Surgical excision and grafting
• Nutritional considerations
• Psychosocial considerations
• Geriatric concerns
• Nonburn injury
o Severe exfoliative disorders
Toxic epidermal necrolysis, stevens-johnson syndrome, erythema multiforme
Staphylococcal scalded skin syndrome
o Necrotizing soft tissue infections
• Discharge planning
• Burn prevention
Chapter 6 Nutritional Support
• Introduction
• Gastrointestinal tract
• Utilization of nutrients
• Assessment of nutritional status
• Overview of nutritional support
o Enteral nutrition
o Parenteral nutrition
o Nutritional additives
• Nutritional therapy goals
• Practice guidelines
o Enteral nutrition
o Parenteral nutrition
o Drug-nutrient interactions
• Monitoring nutritional status and complications of nutritional support
o Monitoring and evaluating the nutrition care plan
Chapter 17 Gastrointestinal Alterations
• Introduction
• Review of anatomy and physiology
o Gastrointestinal tract
Gut wall
• Mucosa
o Gastric mucosal barrier
• Submucosa
Oropharyngeal cavity
• Mouth
• Salivary glands
• Pharynx
Esophagus
Stomach
Small intestine
Large intestine
o Accessory organs
Pancreas
Liver
• Vascular functions
o Blood storage
o Blood filtration
• Secretory functions
o Bile production
o Bilirubin metabolism
• Metabolic functions
o Carbohydrate metabolism
o Fat metabolism
o Protein metabolism
o Production and removal of blood clotting factors
o Detoxification
o Storage, synthesis, and transport of vitamins and minerals
Gallbladder
o Neural innervation of the gastrointestinal system
o Hormonal control of the gastrointestinal system
o Blood supply of the gastrointestinal system
o Geriatric considerations
• General assessment of the gastrointestinal system
o History
o Inspection
Skin color and texture
Symmetry and contour of abdomen
Masses and pulsations
Peristalsis and movement
o Auscultation
o Percussion
o Palpation
• Acute gastrointestinal bleeding
o Pathophysiology
Peptic ulcer disease
Stress ulcers
Mallory-Weiss Tear
Esophageal varices
o Assessment
Clinical presentation
Nursing assessment
Medical assessment
• Laboratory studies
• Endoscopy and barium study
o Nursing diagnoses
o Collaborative management: nursing and medical considerations
Hemodynamic stabilization
Gastric lavage
Pharmacological therapy
• Antibiotics
Endoscopic therapy
Surgical therapy
Nursing diagnoses
Recognition of potential complications
o Treatment of variceal bleeding
Somatostatin or octreotide
Vasopressin
Endoscopic procedures
Transjugular intrahepatic portosystemic shunt
Esophagogastric tamponade
Surgical interventions
o Patient outcomes
• Acute pancreatitis
o Pathophysiology
o Assessment
History and physical examination
Diagnostic tests
Predicting the severity of acute pancreatitis
o Nursing diagnoses
o Medical and nursing interventions
Fluid replacement
New modalities
Electrolyte replacement
Nutrition support
Comfort management
Pharmacological intervention
Treatment of systemic complications
Surgical therapy
o Patient outcomes
• Hepatic failure
o Pathophysiology
Hepatitis
• Assessment
• Nursing diagnoses
• Medical and nursing interventions
Cirrhosis
Fatty liver
o Assessment of hepatic failure
Presenting clinical signs
• Portal hypertension
• Impaired metabolic processes
• Impaired bile formation and flow
o Nursing diagnoses
o Medical and nursing interventions
Diagnostic tests
Supportive therapy
Support for the failing liver
Treatment of complications
• Ascites
• Portal systemic encephalopathy
• Hepatorenal syndrome
• Hepatopulmonary syndrome
o Patient outcomes
• Bariatric surgery
Chapter 13: Nervous System Alterations
• Introduction
• Anatomy and Physiology of the Nervous System
o Cells of the Nervous System
o Cerebral Circulation
o Cerebral Metabolism
o Blood-Brain Barrier System
o Ventricular System and Cerebrospinal Fluid
• Functional and Structural Divisions of the Central Nervous System
o Meninges
o Brain (Encephalon)
o Cerebrum
Brainstem
Cerebellum
Specialized Systems Within the Central Nervous System
o Spinal Cord
o Peripheral Nervous System
o Effects of Aging
o Assessment
Mental Status
Language
Memory
Cranial Nerve Function
Motor Function
Reflexes
Sensory Function
Respiratory Assessment
Hourly Assessment
• Increased Intracranial pressure
o Pathophysiology
o Causes of Increased Intracranial Pressure
Increased Brain Volume
Increased Cerebral Blood Volume
Increased Cerebrospinal Fluid
o Assessment
Monitoring Techniques
• Intracranial Pressure Monitoring
• Cerebral Oxygenation Monitoring
o Diagnostic Testing
o Nursing Diagnoses
o Management
Medical and Nursing Interventions (Nonsurgical)
• Nursing Actions to Manage Intracranial Pressure
• Medical Management
• Adequate Oxygenation
• Management of Carbon Dioxide
• Diuretics
• Optimal Fluid Administration
• Blood Pressure Management
• Reducing Metabolic Demands
o Temperature Control
o Sedation
o Seizure prophylaxis
o Neuromuscular Blockade and Barbiturate Therapy
Surgical Interventions
Psychosocial Support
• Traumatic Brain Injury (TBI)
o Pathophysiology
Scalp Lacerations
Skull Fractures
• Linear Skull Fracture
• Depressed Skull Fracture
• Comminuted Skull Fracture
Brain injury
• Primary Brain Injury
• Concussion
• Contusion
• Diffuse Axonal injury
• Penetrating Injury
• Hematoma
o Epidural Hematoma
o Subdural Hematoma
o Intracerebral Hematoma
• Secondary Brain Injury
o Assessment
Nursing Diagnoses
o Management
Medical (Nonsurgical) Interventions
Surgical Interventions
• Acute Stroke
o Pathophysiology
Ischemic Stroke
• Large Artery Atherosclerosis
• Cardioembolic Stroke
• Lacunar Stroke
• Cryptogenic Stroke
Hemorrhagic Stroke
• Intraparenchymal Hemorrhage
• Ruptured Cerebral Aneurysm with Subarachnoid Hemorrhage
• Arteriovenous Malformation
o Assessment
o Diagnostic Tests
o Management
Nursing Diagnoses
Ischemic Stroke
• Thrombolytic Candidates
• Nonthrombolytic Candidates
Other Ischemic Events
• Transient Ischemic Attacks
Hemorrhagic Stroke
• Intraparenchymal Stroke
Subarachnoid Hemorrhage
Arteriovenous Malformation
o Postoperative Neurosurgical Care
• Seizures and Status Epilepticus
o Pathophysiology of Status Epilepticus
o Assessment
o Diagnostic Tests
o Management
Nursing Diagnoses
Nursing and Medical Interventions
• Central Nervous System Infections
o Bacterial Meningitis
Pathophysiology
Assessment
Diagnostics Tests
Management
• Nursing Diagnoses
• Nursing and Medical Management
• Spinal Cord Injury
o Pathophysiology
o Assessment
Airway and Respiratory Assessment
Neurological Assessment
Bowel and Bladder Function
Skin Assessment
Psychological Assessment
o Diagnostic Studies
o Management
Nursing Interventions
Nursing and Medical Interventions
Surgical Intervention
Chapter 21 Solid Organ Transplantation
• Introduction
o Organ donation
o Donor management
Organ recovery
o selection of candidates for transplantation
o posttransplant management
infection
recipient-derived infections
viral infections
malignancies
• transplant immunology: immunosuppression and rejection
o immunosuppression
o rejection
• lung transplantation
o indications
o candidate criteria
o donor criteria
o postoperative management
complications
rejection
• kidney transplantation
o indications
o candidate criteria
o donor criteria
o postoperative management
complications
rejection
• heart transplantation
o indications
o candidate criteria
o donor criteria
o postoperative management
complications
rejection
• liver transplantation
o indications
o candidate criteria
o donor criteria
o postoperative management
complications
rejection
Chapter 18 Endocrine Alterations
• Introduction
o Changes in the endocrine system in critical illness
o Disease states of the endocrine system
• Hyperglycemia in the critically ill patient
o Achieving optimal glycemic control
o Hypoglycemia as a preventable adverse effect of glucose management
o Hyperglycemia in the critically ill patient
• Pancreatic endocrine emergencies
o Review of physiology
o Effects of aging
o Hyperglycemic crises
Pathogenesis
• Etiology of diabetic ketoacidosis
• Etiology of hyperosmolar hyperglycemic state
Pathophysiology of diabetic ketoacidosis
Pathophysiology of hyperosmotic hyperglycemic state
Assessment
• Clinical presentation
• Laboratory evaluation
Nursing and medical interventions
• Respiratory support
• Fluid replacement
• Insulin therapy
• Electrolyte management
• Treatment of acidosis
• Patient and family education
Patient outcomes
o Hypoglycemia
Pathophysiology
Etiology
Assessment
• Clinical presentation
• Laboratory evaluation
Nursing diagnoses
Nursing and medical interventions
Patient outcomes
• Acute and relative adrenal insufficiency
o Etiology
o Review of physiology
o Pathophysiology
o Assessment
Clinical presentation
• Cardiovascular system
• Neurological system
• Gastrointestinal system
• Genitourinary system
Laboratory evaluation
o Nursing diagnoses
o Nursing and medical interventions
Fluid and electrolyte replacement
Hormone replacement
Patient and family education
• Thyroid gland in critical care
o Review of physiology
o Effects of aging
o Thyroid function in the critically ill
• Thyroid crisis
o Etiology
o Thyrotoxic crisis (thyroid story)
Pathophysiology
Assessment
• Clinical presentation
o Thermoregulation disturbances
o Neurological disturbances
o Cardiovascular disturbances
o Pulmonary disturbances
o Gastrointestinal disturbances
o Musculoskeletal disturbances
• Laboratory evaluation
Nursing diagnoses
Nursing and medical interventions
• Antagonism of peripheral effects of thyroid hormones
• Inhibition of thyroid hormone biosynthesis
• Blockage of thyroid hormone release
• Supportive care
• Patient and family education
Patient outcomes
o Myxedema coma
Pathophysiology
Etiology
Assessment
• Clinical presentation
o Cardiovascular disturbances
o Pulmonary disturbances
o Neurological disturbances
o Skeletal muscle disturbances
• Laboratory evaluation
Nursing diagnoses
Nursing and medical interventions
• Thyroid replacement
• Fluid and electrolyte restoration
• Supportive care
• Patient and family education
Patient outcomes
• Antidiuretic hormone disorders
o Review of physiology
o Diabetes insipidus
Etiology
Pathophysiology
Assessment
• Clinical presentation
• Laboratory evaluation
Nursing diagnoses
Nursing and medical interventions
• Volume replacement
• Hormone replacement
• Nephrogenic diabetes insipidus
• Patient and family education
Patient outcomes
o Syndrome of inappropriate antidiuretic hormone
Etiology
Pathophysiology
Assessment
• Clinical presentation
o Central nervous system
o Gastrointestinal system
o Cardiovascular system
o Pulmonary system
• Laboratory evaluation
Nursing diagnoses
Nursing and medical interventions
• Fluid balance
• Nursing
• Patient and family education
Patient outcomes
o Cerebral salt wasting
Etiology
Pathophysiology
Assessment
Clinical presentation
• Laboratory evaluation
Nursing diagnoses
Nursing and medical interventions
Patient outcomes [Show Less]