NR 341 Week 7 Exam Three Study Guide (Chapters 19, 20, 6, 17, 13, 21, 18), Exams of Nursing

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NR 341 Week 7 Exam Three Study Guide (Chapters 19, 20, 6, 17, 13, 21, 18)

Chapter 19 Trauma and Surgical Management  Introduction  Trauma demographics  Systems approach to trauma care o Trauma system  Levels of trauma care  Trauma continuum  Injury prevention  Trauma team concept  Prehospital care and transport  Trauma triage  Disaster and mass casualty management  Mechanism of injury o Blunt trauma o Penetrating trauma o Blast injuries  Emergency care phase o Initial patient assessment o Primary and secondary survey  Resuscitation phase o Establishing airway patency

o Maintaining effect breathing o Maintaining circulation o Diagnostic testing o Adequacy of resuscitation o Fluid resuscitation o Assessment of neurological disabilities o Exposure and environmental considerations  Assessment and management of specific organ injuries o Thoracic injuries  Cardiac tamponade  Cardiac contusion  Aortic disruption  Tension pneumothorax  Hemothorax  Open pneumothorax  Pulmonary contusion  Rib fractures and flail chest o Abdominal injuries o Musculoskeletal injuries  Complications  Compartment syndrome  Rhabdomyolysis  Venous thromboembolism

o Extent of injury  Physiological response to burn injury o Cardiovascular response o Host defense mechanisms o Pulmonary response o Renal response o Gastrointestinal response o Metabolic response  Phases of burn assessment and collaborative interventions o Resuscitative phase: prehospital  Primary survey  Stopping the burning process  Airway (with cervical spine precautions)breathing  Circulation  Secondary survey o Resuscitative phase: emergency department and critical care burn center  Transfer to a burn center  Primary survey  Airway  Breathing  Circulation o Fluid resuscitation o End point monitoring

o Peripheral circulation  Secondary survey  Cardiovascular system  Neurological status  Renal status  Gastrointestinal system  Integumentary system  Blood and electrolytes o Acute care phase: critical care burn center  Respiratory system  Cardiovascular system  Neurological status  Renal status  Gastrointestinal system  Integumentary system  Blood and electrolytes  Special considerations and areas of concern o Burns of the face o Burns of the ears o Burns of the eyes o Burns of the hands, feet, or major joints, burns of the genitalia and perineum o Electrical injury o Chemical injury

 Assessment of nutritional status  Overview of nutritional support o Enteral nutrition o Parenteral nutrition o Nutritional additives  Nutritional therapy goals  Practice guidelines o Enteral nutrition o Parenteral nutrition o Drug-nutrient interactions  Monitoring nutritional status and complications of nutritional support o Monitoring and evaluating the nutrition care plan Chapter 17 Gastrointestinal Alterations  Introduction  Review of anatomy and physiology o Gastrointestinal tract  Gut wall  Mucosa o Gastric mucosal barrier  Submucosa  Oropharyngeal cavity  Mouth

 Salivary glands  Pharynx  Esophagus  Stomach  Small intestine  Large intestine o Accessory organs  Pancreas  Liver  Vascular functions o Blood storage o Blood filtration  Secretory functions o Bile production o Bilirubin metabolism  Metabolic functions o Carbohydrate metabolism o Fat metabolism o Protein metabolism o Production and removal of blood clotting factors o Detoxification o Storage, synthesis, and transport of vitamins and minerals  Gallbladder

 Medical assessment  Laboratory studies  Endoscopy and barium study o Nursing diagnoses o Collaborative management: nursing and medical considerations  Hemodynamic stabilization  Gastric lavage  Pharmacological therapy  Antibiotics  Endoscopic therapy  Surgical therapy  Nursing diagnoses  Recognition of potential complications o Treatment of variceal bleeding  Somatostatin or octreotide  Vasopressin  Endoscopic procedures  Transjugular intrahepatic portosystemic shunt  Esophagogastric tamponade  Surgical interventions o Patient outcomes  Acute pancreatitis o Pathophysiology

o Assessment  History and physical examination  Diagnostic tests  Predicting the severity of acute pancreatitis o Nursing diagnoses o Medical and nursing interventions  Fluid replacement  New modalities  Electrolyte replacement  Nutrition support  Comfort management  Pharmacological intervention  Treatment of systemic complications  Surgical therapy o Patient outcomes  Hepatic failure o Pathophysiology  Hepatitis  Assessment  Nursing diagnoses  Medical and nursing interventions  Cirrhosis  Fatty liver

o Cerebral Metabolism o Blood-Brain Barrier System o Ventricular System and Cerebrospinal Fluid  Functional and Structural Divisions of the Central Nervous System o Meninges o Brain (Encephalon) o Cerebrum  Brainstem  Cerebellum  Specialized Systems Within the Central Nervous System o Spinal Cord o Peripheral Nervous System o Effects of Aging o Assessment  Mental Status  Language  Memory  Cranial Nerve Function  Motor Function  Reflexes  Sensory Function  Respiratory Assessment  Hourly Assessment

 Increased Intracranial pressure o Pathophysiology o Causes of Increased Intracranial Pressure  Increased Brain Volume  Increased Cerebral Blood Volume  Increased Cerebrospinal Fluid o Assessment  Monitoring Techniques  Intracranial Pressure Monitoring  Cerebral Oxygenation Monitoring o Diagnostic Testing o Nursing Diagnoses o Management  Medical and Nursing Interventions (Nonsurgical)  Nursing Actions to Manage Intracranial Pressure  Medical Management  Adequate Oxygenation  Management of Carbon Dioxide  Diuretics  Optimal Fluid Administration  Blood Pressure Management  Reducing Metabolic Demands o Temperature Control

o Assessment  Nursing Diagnoses o Management  Medical (Nonsurgical) Interventions  Surgical Interventions  Acute Stroke o Pathophysiology  Ischemic Stroke  Large Artery Atherosclerosis  Cardioembolic Stroke  Lacunar Stroke  Cryptogenic Stroke  Hemorrhagic Stroke  Intraparenchymal Hemorrhage  Ruptured Cerebral Aneurysm with Subarachnoid Hemorrhage  Arteriovenous Malformation o Assessment o Diagnostic Tests o Management  Nursing Diagnoses  Ischemic Stroke  Thrombolytic Candidates  Nonthrombolytic Candidates

 Other Ischemic Events  Transient Ischemic Attacks  Hemorrhagic Stroke  Intraparenchymal Stroke  Subarachnoid Hemorrhage  Arteriovenous Malformation o Postoperative Neurosurgical Care  Seizures and Status Epilepticus o Pathophysiology of Status Epilepticus o Assessment o Diagnostic Tests o Management  Nursing Diagnoses  Nursing and Medical Interventions  Central Nervous System Infections o Bacterial Meningitis  Pathophysiology  Assessment  Diagnostics Tests  Management  Nursing Diagnoses  Nursing and Medical Management  Spinal Cord Injury

 malignancies  transplant immunology: immunosuppression and rejection o immunosuppression o rejection  lung transplantation o indications o candidate criteria o donor criteria o postoperative management  complications  rejection  kidney transplantation o indications o candidate criteria o donor criteria o postoperative management  complications  rejection  heart transplantation o indications o candidate criteria o donor criteria o postoperative management

 complications  rejection  liver transplantation o indications o candidate criteria o donor criteria o postoperative management  complications  rejection Chapter 18 Endocrine Alterations  Introduction o Changes in the endocrine system in critical illness o Disease states of the endocrine system  Hyperglycemia in the critically ill patient o Achieving optimal glycemic control o Hypoglycemia as a preventable adverse effect of glucose management o Hyperglycemia in the critically ill patient  Pancreatic endocrine emergencies o Review of physiology o Effects of aging o Hyperglycemic crises  Pathogenesis