Acronym for early stroke awareness
FUN
FACE
FAST
RACE
What does the 'F' in FAST stand for?
Face
Fast Response
False
Finish a sentence
Movement of arms like a 'C' inward toward spinal cord is called:
decerebrate
'C'eizure
decorticate
muscle spasms
A transient ischemic attack or 'TIA' usually
lasts 2-3 hours
has permanent effects
lasts less than 1 hour
due to hemorrhage
Hemiplegia describes paralysis involving
unilateral side of body
lower extremeties
all four extremeties
muscles of the mouth
Clinical manifestations of CVA include:
HTN, dysphagia, arm drift, facial droop
burning in throat, epigastric pain
polyuria, polydipsia, polyphagia
chest pain and SOB
Types of ischemic stroke are:
thrombotic
hemorrhagic
transient
embolic
Cells involved in clearing blood debris of a hemorrhagic stroke include:
RBCs
lymphokines
astrocytes
macrophages
What are clinical manifestations of hemorrhagic stroke?
headache that develops in seconds, decreased LOC
urinary and bowel incontinence
aphasia, apraxia
increased hunger
Decerebrate posturing is described as:
extensor posturing
arms like an 'X'
arms like a 'C'
stiff neck
Neurological symptoms of a stroke appear as:
symmetrical
opposite side of injury
gradual onset
hypotension
Pt is exhibiting signs of right brain stroke, which side of the body will you see s/s?
left side
right side
both sides
neither side
Documenting a pt as lethargic means
easy arousal
no verbal response
minimal verbal response
disorientation to time
Pt only opens eyes w/ vigorous and repeated stimulation
coma
obtundation
lethargy
stupor
Increased intracranial pressure causes decrease in cerebral perfusion
The most common cause of osteomyelitis is:
hematogenous spread of infection
rheumatoid disease
direct contamination of an open wound
deficiency of calcium.
deficiency of vitamin D
The pathogenesis of osteoporosis involves:
inadequate mineralization
impaired synthesis of bone organic matrix
alteration in the OPG/RANKL/RANK system
formation of sclerotic bone
none of these
RA begins with:
destruction of the synovial membrane and subsynovial tissue
inflammation of ligaments
destruction of the articular cartilage
softening of the articular cartilage
destruction of the joint capsule
The causes of OA include which of the following? (More than one answer may be correct.)
enzymatic breakdown
proteoglycan destruction
rheumatoid factor
circulating immune complexes
infections
Ankylosing spondylitis: (More than one answer may be correct.)
is a systemic immune inflammatory disease
is characterized by stiffening or fusion of the spine.
causes instability of synovial joints
begins with inflammation of fibrocartilage
is manifested early by low back pain and stiffness
In gout:
the pathogenesis is formation of monosodium urate crystals in joints and tissues.
purine metabolism is altered.
affected individuals likely have an inherited enzyme defect.
the hyperuricemia can be the result of acquired chronic disease or a drug
all of these
A muscle contracture is:
muscle shortening possibly because of CNS injury
often helped by relaxation training and biofeedback
a consequence of reduced muscle protein synthesis
Sprains:
articular cartilages lose contact entirely
articular cartilages are partially separated
complete separation of a tendon or a ligament
a ligament tear
osteo-
pertaining to the bone
pertaining to the cartilage
muscle
pertaining to the joing
condro-
pertaining to the joint
Rhabdo-
literally means 'rod' or 'rod-like'
muscle weakness
myo-
tumors of the connective tissue
artho-
muscle diagnosis in which there is muscle weakness due to dysfunction of muscle fiber
fibromyalgia
myopathy
neuropathy
sprain
A sarcoma is a group of tumors arising from connective tissue
Arthritis is an inflammatory joint disease characterized by damage or destruction in the _____ or _____ and by systematic signs of inflammation (select all that apply)
connective tissue
synovial membrane
articular cartilage
nerve fibers
Non-inflammatory disease caused by a progression of loss in cartilage
osteoarthritis
RA
osteomyelitis
Non-infectious disease caused by an autoimmune reaction
Sclerosis of bone underneath the cartilage and formation of bone spurs is possible with _____
_____ has a higher incidence in the elderly and is primarily idiopathic
Chronic condition caused by deterioration of cartilage (damaging chondrocytes). Cartilage becomes thin, flaky, then absent. Bone surfaces become less protected and therefore pt experiences pain upon weight bearing and mobilization
Risk factors for _____ include: advancing age, joint trauma, long-term mechanical stress, drugs, obesity, and endocrine DOs
Clinical manifestations of _____ include: deformity/nodules at ends of digits, worsening pain with activity, and asymmetrical symptoms
Pain worsens with activity
AM pain/stiffness diminishes in about 30 minutes after getting out of bed
Diagnosis of _____ can be done with an x-ray
An inflammatory autoimmune joint disease, primarily involving damage to the connective tissue in the synovial membrane. Cause is unknown, but multifactorial contributors and genetic predisposition have been noted
Neutrophils and other cells in synovial fluid become activated and thicken becoming inflammatory exudate. Joint become swollen and inflamed. Inflammation causes small venules to become occluded w/ cells --> decrease in vascular flow to the joint. Inflammatory cytokines induce enzymatic breakdown of cartilage and bone.
Pannus, which is associated with _____, grows over the articular surface and causes destruction
Pain worsens w/ rest
Morning pain/stiffness lasts 1+ hours after getting out of bed
Clinical manifestations of _____ include: fever, fatigue, weakness, anorexia, weight loss, joint pain/stiffness/tenderness, joints warm to touch, deformity (swan hands). and decreased ROM. Symptoms occur symmetrically
Starts in fingers and wrists w/ later involvement in weight bearing joints (ankles & feet).
Complications of _____ include: systemic effects including skin, cardiac valves, pericardium, pleura, lung parenchyma, and spleen; formation of nodules w/ central tissue necrosis and proliferation of connective tissue
Blood tests are used to diagnose _____
Osteomyelitis is most commonly caused by a _____ infection.
candidal
staph
strep
_____ osteomyelitis may originate from an open wound, open fracture, penetrating wound, or surgical procedure
exogenous
endogenous
_____ osteomyelitis may originate from pathogens carried in the blood from sites of infection elsewhere in the body
Clinical manifestations of _____ include: acute or chronic inflammation, fever, pain, and necrotic bone.
As you age, the amount of cartilage in your body starts to build up
Fibrous connective tissue that attaches skeletal muscle to bone
tendon
ligament
band of fibrous connective tissue that connects bones where they meet in a joint
tearing or stretching of a muscle or tendon is commonly known as a:
strain
Ligament tears are commonly known as:
sprains
strains
What makes up the CNS
brain
spinal cord
cranial nerves
spinal nerves
What makes up the PNS
The sympathetic and parasympathetic systems are components of the _____ nervous system
autonomic
somatic
What are the types of pain?
visceral
referred
In promoting health maintenance for prevention of strokes, the nurse understands that the highest risk for the most common type of CVA is seen in
African Americans with hypertension and diabetes.
Women who smoke
People w/ DM
Those who are obese with high dietary fat-intake.
the name given to a collection of language disorders caused by damage to the brain. loss of ability to understand or express speech, caused by brain damage
aphasia
apraxia
agnosia
the name given to a collection of language disorders caused by damage to the brain. loss of ability to understand or express speech, caused by brain damage. With speech, the messages from the brain to the mouth are disrupted, and the person cannot move his or her lips or tongue
is the inability to process sensory information. Often there is a loss of ability to recognize objects, persons, sounds, shapes, or smells while the specific
means 'weakness'
-plegia
-paresis
means paralysis or no movement at all
Which is not a neuromodulator of pain?
prostaglandins
5-hydroxytryptamine
norepinephrine
heparin
An individual shows flexion in upper extremities and extension in lower extremities. This is:
decorticate posturing
decerebrate posturing.
excitation posturing
caloric posturing
Alzheimer disease:
can be caused by increased cerebral levels of acetylcholine
is most prevalent as a late-onset dementia
manifests as nerve cell tangles
manifests as neuron senile plaques.
Dystonia is:
abnormal posture maintained by muscular contractions
flexed posture
stooped, hyperflexed posture.
a spastic gait
Confusion:
orientation to person, time, and place
slow vocalization, decreased oculomotor activity
inability to think clearly
vocalization in response to pain stimuli
no arousal
Coma:
TIAs are:
unilateral neurologic deficits that slowly resolve.
generalized neurologic deficits that occur a few seconds every hour
focal neurologic deficits that develop suddenly, last more than an hour, and clear without evidence of infarction
neurologic deficits that slowly evolve or develop.
Which is a risk factor for the development of CVAs?
polycythemia vera
HTN
DM
hyperhomocysteinemi
Which most typically characterizes the victims of a cerebral embolic stroke
individuals older than 65 years with a history of hypertension
individuals with a long history of TIA
middle-aged individuals with a history of heart disease
individuals with gradually occurring symptoms that then rapidly disappear
Ruptured aneurysms are most likely in which of the following cerebrovascular accidents.
TIA
Pain is a compensatory mechanism to stabalize the environment and maintain homeostasis
Not all pain involves tissue injury, release of chemical (inflammatory), mediators, and sensitization of spinal cord neurons
The _____ Theory asserts that non-painful input 'closes' the gates to painful input, which prevents pain sensation from traveling to the CNS.
Gate Control
Specificity of Pain
Intensity of Pain
Pattern of Pain
These fibers are associated w/ 'fast' pain
A-delta
C
These fibers are associated w/ 'slow' pain
Nociceptors are free nerve ending in the _____ PNS
afferent
efferent
_____ are widespread in the superficial layers of the skin, periosteum, arterial walls, and joint surfaces
nociceptors
neurons
neuromodulators
axons
_____ are myelinated
_____ fibers are associated with mechanical or thermal stimulation (needle stick, knife cut, acute burn) and are transmitted in less than 0.1 seconds
associated with acute pain
_____ fibers are stimulated by chemicals, mechanically, or thermally. Some examples include aches, throbbing, and nauseous pain
_____ fibers transmit signals at a rate of over 1 second
Associated w/ chronic pain
Neuromodulators are messengers released from a neuron in the _____, or in the periphery that affects groups of neurons or effector cells that have the appropriate receptors.
CNS
PNS
_____ trigger responsiveness
Choose the following tissue injury neuromodulators
bradykinin
substance P
histamine
glutamate
somatostatin
Choose the following excitatory neuromodulators
_____ pain is a protective mechanism against immediate harm. It is the response of excessive adrenergic (sympathetic) activity
acute
chronic
Somatic, visceral, referred, and neuropathic pain are types of _____ pain
pain in the body framework (skin, bones, muscle)
neuropathic
pain in the organs of the body (chest pain, abdominal pain)
pain felt in remote areas away from the original point of pain generation
The disruption of nerves or hypersensitization of nerves.
_____ pain occurs in ppl w/ DM
_____ pain may be treated (off-label) w/ tricyclic antidepressants, anticonvulsants, or antiarrhythmics
_____ pain lasts as little as a few seconds to as much as 3 months. There is a temporary or minor disruption in normal ADL's and lifestyle
_____ pain persists more than 3 months. It imposes severe emotional, physical, economic, and social stresses on pts and their family
Acute pain is a very costly health care problem. Is is usually caused from a complex underlying DO
_____ pain affect employment, finances, family structure, social relationships
Personality changes are apparent with chronic pain
Negative health consequences of _____ pain include increased stress, decreased GI motility and appetite, increased blood clotting, delayed healing, decreased immune system, interference with sleep, and hormonal imbalances
In the PQRST approach to pain assessment, which letter/factor involves what increases or decreases the pain level
P-provocative/palliative
Q-quality
R-region
S-severity
T-temporal characteristics
In the PQRST approach to pain assessment, which letter/factor involves a description of what the pain feels like (sharp, dull, hot, stinging, ect)
T-Temporal characteristics
In the PQRST approach to pain assessment, which letter/factor involves where the pain is (localized, referred)
T-temporal charachteristics
In the PQRST approach to pain assessment, which letter/factor involves rating the pain on a scale of 1-10
In the PQRST approach to pain assessment, which letter/factor involves how long the pain has been present (acute, chronic)
The _____ nervous system has motor and sensory pathways regulating voluntary motor control of skeletal muscle
The somatic nervous system regulates _____ motor control
voluntary
involuntary
The _____ nervous system has motor and sensory pathways regulating the body's internal environment thru involuntary control of organ systems
The _____ nervous system controls the body's fight or flight response
sympathetic
parasympathetic
The _____ nervous system conserves the body's energy
The _____ pathway is ascending and messages go from the body to the brain
The _____ pathway is descending and messages travel from the brain to the body
_____ neurons transmit impulses from sensory receptors to the CNS
sensory
motor
associational/inter
_____ neurons transmit impulses from the CNS to an effector organ
_____ neurons transmit impulses from neuron to neuron
A pts pain _____ is the lowest intensity of pain that a person can recognize
threshold
tolerance
A pt's pain _____ is the greatest intensity of pain that a person can endure
_____ is a respiratory rate of less than 12 breathes a minute and is associated w/ neurological conditions, electrolyte disturbances, narcotic or barbituate OD, or is seen postanesthesia
bradypnea
tachypnea
Biot's respirations
Cheyne-Stokes respirations
Kussumal respirations
_____ results in a persistent respiratory rate of more than 20 breathes per minute and is associated with trauma, injury, stress, pain; respiratory, cardiac, or liver disease
Kussmaul respirations
_____ is a cyclic breathing pattern characterized by shallow breathing alternating w/ periods of apnea. They are associated with neurologic problems, head trauma, brain abscess, and heatstroke
_____ is a cyclic breathing pattern characterized by periods of respirations of increased rate and depth alternating w/ periods of apnea. They are associated w/ CHF, drug OD, increased intracranial pressure, and impending death
_____ are respirations of increased rate and depth and are associated w/ metabolic acidosis, DKA, and renal failure
Kummmaul respirations
Which of the following shows the stages of altered consciousness
confusion, disorientation, lethargy, obtundation, stupor, coma
disorientation, confusion, obtundation, lethargy, coma, stupor
confusion, disorientation, stupor, lethargy, obtundation, coma
obtundation, disorientation, confusion, lethargy, stupor, coma
loss of ability to think, impaired judgement and decision making
confusion
disorientation
beginning loss of consciousness, unable to tell name, place, or time
limited spontaneous movement or speech; easy arousal w/ normal speech or touch; may or may not be oriented to time, place, and person
lethargic
mild to moderate reduction in arousal w/ limited response to environment; fall asleep unless stimulated verbally or tactilely; answer questions w/ minimal responses
condition of deep sleep or unresponsiveness; opens eyes only w/ vigorous and repeated stimulation
no verbal response to external environment or to any stimuli
_____ posturing include flexing and the arms are like 'C's' and move in toward the spinal cord
_____ posturing involves extension and the arms are like 'e's'