Placing the client flat in bed may increase ICP and promote pulmonary aspiration. Nothing is inserted into the ears or nose of a client with a skull fracture because of the risk of infection. Question 17 Explanation:. Garbled speech is known as dysarthria. Warning symptoms or auras typically occur before seizures.
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Question 18 Explanation:. Question 19 Explanation:. Spinal shock descends from the injury, and respiratory difficulties occur at C4 and above. Question 20 Explanation:. Noxious stimuli, such as a full bladder, fecal impaction, or a decub ulcer, may cause autonomic dysreflexia. A headache is a symptom of autonomic dysreflexia, not a cause.
Autonomic dysreflexia is most commonly seen with injuries at T10 or above. Question 21 Explanation:. Question 22 Explanation:. Hypervolemia is indicated by rapid and bounding pulse and edema. Autonomic dysreflexia occurs after neurogenic shock abates.
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Signs of sepsis would include elevated temperature, increased heart rate, and increased respiratory rate. Which of the following conditions would the nurse anticipate during the acute phase? Movement of only the right or left half of the body. Question 23 Explanation:. Absent corneal reflexes, decerebrate posturing, and hemiplegia occur with brain injuries, not spinal cord injuries. Question 24 Explanation:. Hypertension, bradycardia, anxiety, blurred vision, and flushing above the lesion occur with autonomic dysreflexia due to uninhibited sympathetic nervous system discharge.
A year-old paraplegic must perform intermittent catheterization of the bladder. Which of the following instructions should be given? Question 25 Explanation:.
The meatus is always cleaned from front to back in a woman, or in expanding circles working outward from the meatus in a man. When discharging him to the care of his mother, the nurse gives which of the following instructions? Question 26 Explanation:. Changes in LOC may indicate expanding lesions such as subdural hematoma; orientation and LOC are assessed frequently for 24 hours. A keyhole pupil is found after iridectomy.
Profuse or projectile vomiting is a symptom of increased ICP and should be reported immediately. A slight headache may last for several days after concussion; severe or worsening headaches should be reported. Which neurotransmitter is responsible for may of the functions of the frontal lobe?
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Question 27 Explanation:. Question 28 Explanation:.
An EEG measures the electrical activity of the brain. Percent of functional brain tissue would be determined by a series of tests. Question 29 Explanation:. An epidural hematoma occurs when blood collects between the skull and the dura mater. In a subdural hematoma, venous blood collects between the dura mater and the arachnoid mater. In a subarachnoid hemorrhage, blood collects between the pia mater and arachnoid membrane. Quadriplegia and loss of respiratory function. Question 30 Explanation:. Injury levels C1 to C4 leads to quadriplegia with total loss of respiratory function.
Paraplegia with intercostal muscle loss occurs with injuries at T1 to L2. Injuries below L2 cause paraplegia and loss of bowel and bladder control.
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Question 31 Explanation:. If the tongue or relaxed throat muscles are obstructing the airway, a nasopharyngeal or oropharyngeal airway can be inserted; however, the client must have spontaneous respirations when the airway is open. The head-tilt, chin-lift maneuver requires neck hyperextension, which can worsen the cervical spine injury. Assess for bladder distention and bowel impaction. Question 32 Explanation:. Question 33 Explanation:.
A complication of a head injury is diabetes insipidus, which can occur with insult to the hypothalamus, the antidiuretic storage vesicles, or the posterior pituitary gland. Dexamethasone, a glucocorticoid, is administered to treat cerebral edema.
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This medication may be ordered for the head injured patient. Ethacrynic acid and mannitol are diuretics, which would be contraindicated.
Question 34 Explanation:. Hematest positive nasogastric tube drainage. Question 35 Explanation:. After spinal cord injury, the client can develop paralytic ileus, which is characterized by the absence of bowel sounds and abdominal distention. A history of diarrhea is irrelevant.
Strict adherence to a bowel retraining program. Limiting bladder catheterization to once every 12 hours. Keeping the linen wrinkle-free under the client. Question 36 Explanation:. Straight catherization should be done every 4 to 6 hours, and Foley catheters should be checked frequently to prevent kinks in the tubing. Constipation and fecal impaction are other causes, so maintaining bowel regularity is important. Other causes include stimulation of the skin from tactile, thermal, or painful stimuli. The nurse administers care to minimize risk in these areas. Monitoring vital signs before and during position changes.
Using vasopressor medications as prescribed. Question 37 Explanation:.