patient care final

• What are the 4 levels of consciousness? Fully Alert, Drowsy, Unconscious but Responsive, Comatose(unresponsive)
• last sense to go is?

  Hearing
• what scale measures levels of consciousness?

  Glasgow Scale
• on Glasgow Scale what is the best response? and the unresponsive?

  15 & 3
• What are the different levels of trauma?

  1-4
• Level one-24 hour coverage by general surgeons, and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, plastic surgery, oral and maxillofacial, pediatric and critical care.
• Level two- 24 hour coverage by general surgeons, as well as coverage by the specialties of orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology and critical care
• Level three- 24 hour coverage by emergency medicine physicians and the prompt availability of general surgeons and anesthesiologists.
• Level four- Basic emergency department facilities to implement ATLS protocols and 24-hour laboratory coverage. Available trauma nurse(s) and physicians available upon patient arrival.
• Fainting  = Syncope
• Hypovolemic (low blood volume due to blood loss) is?

  Hypovolemic , most common in ER
• Failure of circulatory system to profuse vital body functions is?

  shock
• Poor cardiac output is?

  Cardiogenic
• dizziness. Sudden or temporary change in the balance structure of the inner ear or change to the balance systems of the brain. *Have patient lay down to feel centered on floor?

  vertigo
• fainting. Lack of blood to the brain, rapid onset *Lay patient down in Trendelenburg w/o pillow or sit them down with head between knees or as close. Cool cloth on forehead. Causes- Sitting up too fast, hunger, temperature, trauma, hunger, fatigue, heart disease, psychological shock?


  syncope
• feeling dizzy when sitting up or standing up too quickly. Blood flow (low BP) didn’t get to brain quick as they sat up…..*Tell patient to slowly sit up and wait a minute and then continue to stand?

  Postural hypotension or orthostatic hypotension
• nosebleed * lean forward pinch nostrils , if doesn’t stop after 10 minutes call doctor… Er.. could be brain vessel problems (too high a BP, or other issues)?

  Epistaxis
• Myocardial Infarction- diminished blood supply to an area of the heart muscles not getting profusion- could lead to hart muscle dying or worse.. patient death?

  Heart Attack-MI
• Levels of consciousness

  • Fully Alert
  • Drowsy
  • Unconscious but Responsive
  • Comatose(unresponsive)
• Last sense to go is hearing
• Levels of trauma

  • Level one
  • Level two
  • Level three
  • Level four
• CPR


  CardioPulmonary Resuscitation - technique for reviving someone whose heart has stopped beating- by imitating electrically stimulating the heart. Correct order: CAB - Circulation, Airway, Breathing & D - Defibrillation
• Stroke

  CVA - Cerebral Vascular Accident - occlusion of blood supply to brain or rupture, altered blood supply to brain, results in hemorrhage directly into brain tissue or surrounding areas
• Warning Signs of a Stroke

  • Face drooping
  • Arm weakness
  • Speech slurring
  • Time - the faster the better to get medical help
• TIA

  Trans-Ischemic Attack - mini stroke - a warning
• Hypoglycemia

  Low glucose-sugar, excessive insulin. Symptoms: rapid onset, blurred vision, nervousness, irritability, sweaty, clammy skin. Needs carbs - sugar
• Hyperglycemia

  Excessive glucose-sugar, insufficient insulin. Symptoms: slow onset, flushed skin, fruity, smelling breath, air hunger, excessive thirst or urination. Needs insulin
• Seizure


  Nursing care: Keep patient safe from injuring themselves if thrashing all around. Record time/duration of seizure and what side of body/location where it occurred. Do not put anything in their mouth
• Types of seizures

  • Partial (focal)
  • Petit mal(absence) febrile seizure
  • Grand mal(tonic/clonic)
• Partial (focal) seizure


  1. 4 minutes, appear alert but can't talk, starts at hand or foot and works it ways up, confused for a few minutes after
• Petit mal(absence) febrile seizure

  No warning, happens with children with high fever, abruptly stops all activity, eye flutters, lip smacking, mild body movement, may appear unaware of anything happening (10-30 sec)
• Grand mal(tonic/clonic) seizure

  Preceded by aura (heightened sense of smells, flashing lights, spots, dizziness, etc), 2-5 minutes, muscle spasms
• Types of asepsis

  • Medical - clean technique
  • Surgical - sterile technique
• Medical asepsis

  Prevent the spread of infectious microorganisms, reduce/eliminating the number of microorganisms. Clean always from cleanest to dirtiest area, clean tech/dirty tech to make sure to keep patient/tech safe from contamination
• Surgical asepsis

  Kill/ complete removal of microorganisms for surgical procedures. Must use sterilization for equipment - different types of sterilization. Sterile consciousness, sterile field, sterile corridor and what is considered sterile in a surgical room
• Hospital acquired infection

  HAI or Nosocomial infection. Occur in 2 million patients per year, approximately 5% of patients
• Physician acquired infection

  Iatrogenic nosocomial
• Cycle of Infection

  • Infectious agent
  • Reservoir
  • Portal exit
  • Mode of transmission
  • Portal of entry
  • Susceptible host
• Modes of Transmission

  • Contact either direct contact with infected host or indirect contact with a contaminated object
  • Vector borne
  • Air borne
  • Droplet
• Use PPE's for protection against modes of transmission