06.04 Differentiating Ectopy and Aberrancy for CCRN Review
Nursing Points General Ectopy & Aberrancy Aberrancy Supraventricular arrhythmia that starts in the atrium Arriving from atrium to “tired” bundle Right Bundle branch block viewed/seen as a little mountain pattern, this is a little problem Left bundle branch block All complexes are wide Narrow R wave Ectopy Ventricular arrhythmia Preventricle Contractions (PVCs) Right ventricle Rare […]
06.05 Wide Complex Tachycardia for CCRN Review
Nursing Points General Wide complex Tachycardia Known as an “unknown type” Goal is to preserve cardiac function Treatment To preserve cardiac function Cardioversion Amiodarone Procainamide Used specifically for low ejection fraction Contraindicated Lidocaine Verapamil Adenosine
07.01 CVA (Cerebrovascular Accident/Stroke) for CCRN Review
Nursing Points General Cerebralvascular Accident (CVA) Types Ischemic Caused by a blockage in an artery supplying brain Damage or death to cells because they do not get the needed blood flow Hemorrhagic Ruptured vessel–> causes bleeding on the brain Results of ishemic and hemorrhagic CVAs/strokes TIA = Transient Ischemic Attack Temporary blockage causes a “mini-stroke” […]
07.02 Neuro Anatomy for CCRN Review
Nursing Points General Neuro Anatomy Cortex Brainstem Midbrain Pons Medulla Tentorial notch = Anterior opening Foramen magnum Large opening at the base of the skull Pyramidal tracts Begin on one side of head and cross over to other side of the body Assist with movements If injury occurs on tracts it is seen […]
07.03 Uncal Herniation for CCRN Review
Nursing Points General Uncal herniation Lateral shift of brain in the skull Caused from arterial bleed, which causes an increased intracranial pressure Symptoms A change in pupil NOT in level of consciousness (LOC) Mannitol for treatment is contraindicated Does not work on edematous cells
07.04 Supratentorial Herniation and Glasgow Coma Scale for CCRN Review
Nursing Points General Supratentorial herniation Brain shifts down within the skull Symptoms include a change in LOC Assessed with the Glasgow Coma Scale Score based on level of response Max score is 15, minimum score is 3 Eye Opening Spontaneous (4) To verbal (3) To pain (2) None (1) Verbal Response Oriented (5) Confused (4) […]
07.05 Supratentorial Herniation: Cushings Triad for CCRN Review
Nursing Points General Cushing’s Triad (Not the same as Cushing’s Syndrome) Result of increased intracranial pressure (ICP) Increased systolic pressure Widening pulse pressure Decreased heart and respiratory rate Treatment Mannitol –> Only if there are good cells left (Mannitol doesn’t treat edematous cells) 3% Sodium Chloride –> Run it wide open
07.06 Increased Intracranial Pressure (ICP) for CCRN Review
Nursing Points General Increased Intracranial Pressure (ICP) Increased Intracranial Pressure Causes Acidosis Hypotonic Solution Hyerextension Flexion Decreased protein uptake Write restraints Symptoms Headache Altered level of conciousness (LOC) Pupil changes Bradycardia Bradypnea Widening pulse pressure
07.07 Cerebral Perfusion Pressure for CCRN Review
Nursing Points General Cerebral Perfusion Pressure Pressure delivering oxygen to brain If it is too low = Can cause ischemia because not enough blood and oxygen are getting to the brain If it is too high=Can raise intracranial pressure because more blood flow is delivered into the brain Normal range is 70-95mmHg but can range […]
07.08 Basilar Skull Fracture for CCRN Review
Nursing Points General Basilar Skull fracture A broken bone in the base of the skull Symptoms Raccoon eyes = black eyes Battle sign- black and blue on the mastoid Bleeding behind eardrum Otorrhea – Cerebral Spinal Fluid leak from the ear Rhinorrhea – CSF leak from the nose Lose cranial nerve 1 = olfactory nerve