Nursing

Warning Signs After Head Injury

* Changes in LOC * Seizures * Bleeding or water drainage from nose or ears * Pupils slow to react or unequal * Visual Problems * Loss of sensation to any extremity * Slurred speech * Projectile Vomiting

Serum Lipase and Amylase * What causes elevation? * How long to rise? * How long stays elevated? * Normal levels

* Lipase and Amylase are released by pancreas in response to injury or inflammation. * Rise within 2-12 hours. * Amylase return to normal within 3 days. * Lipase stays elevated for 7-10 days Amylase - 1-130 U/L Lipase - 0-160 U/L

Portal System Encephalopathy * symptoms * Tx * what makes it worse?

* increased ammonia * changes in LOC * neuromuscular disturbances * Tx: decrease protein in diet, give lactolose and Neomycin * Worse: increased dietary protein, infection, GI bleed, hypovolemia, hypokalemia

Parkinson's Disease

* pill rolling tremors * gradual onset after 50 * stooped posture * shuffling gait * bradykinesia * Muscle rigidity

Right CVA

* right brain damage, left sided weakness * spacial-perceptual deficits * short term attention span * visual field deficits * Impulsive * Impaired judgement * Impaired time concept

Peritonitis * Dx * Symptoms * Tx

Dx: CBC, xray, peritoneal lavage, history Symptoms: hot belly, round tenderness, abd distention and rigidity, fever, anorexia, N/V, inc BP and HR, dec bowel sounds, dehydration TX: abx, ID cause, IV fluids, dec abd distention, sx close to perforation

Pulmonary Emboli * Define * How dx?

Dx: pulmonary angiogram, MRI V/Q Scan

Stroke Mnemonic

F - Face weakness A - Arm weakness S - Speech difficulty T - Time to Call 911

MI

Morphine Oxygen Nitroglycerin Aspirin

Overdose * symptomatic vs asymptomatic

Symptomatic: respiratory, cardiac and IV support, urinary catheter I and O, gastric lavage, antidotes Asymptomatic: continue to asses

Respiratory sounds

normal or advantageous. Advantageous sounds such as wheeze (indicated airflow obstruction), squawk ( ), rhonchi, stridor, crackles.

Aminoglycoside Toxicity

ringing in the ears, nephrotoxicity