What is the basis for PaCO2 control in a patient with a traumatic brain injury?
What will be an ideal response?
Suggested response: Carbon dioxide is the most potent agent that controls cerebral blood flow. Increases in PaCO2 levels will cause vasodilation of cerebral blood vessels, which will increase the cerebral blood flow. This in turn can lead to raised ICP. Conversely, a fall in PaCO2 will result in vasoconstriction of the cerebral blood vessels leading to decreased cerebral blood flow and therefore decreasing ICP. In someone with a traumatic brain injury, the challenge is to control ICP while ensuring adequate blood flow to the brain. Research has shown significantly poorer 3- and 6-month outcomes in patients who received prophylactic hyperventilation, i.e. PaCO2 <25 mmHg. Because of this, the Brain Trauma Foundation recommends that: • Hyperventilation is recommended as a temporizing measure for the reduction of elevated ICP. • Hyperventilation should be avoided during the first 24 hours after injury when cerebral blood flow is often critically reduced.
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A nurse working with a dying patient would expect to add interventions to the care plan to address which needs? (Select all that apply.)
a. Pain b. Dyspnea c. Delirium d. Dementia e. Restlessness
The nurse is caring for a 5-year-old child. The child is taking a drug that has a known therapeutic range in adults, and the nurse checks that the ordered dose is correct and notes that the child's serum drug level is within normal limits
The child complains of a headache, which is a common sign of toxicity for this drug. Which action will the nurse take? a. Administer the drug since the drug levels are normal. b. Attribute the headache to non-drug causes. c. Hold the next dose and contact the provider. d. Request an order for an analgesic medication.
A nurse assists a victim of intimate partner abuse to create a plan for escape if it becomes necessary. Which components should the plan include? Select all that apply
a. Keep a cell phone fully charged. b. Hide money with which to buy new clothes. c. Have the phone number for the nearest shelter. d. Take enough toys to amuse the children for 2 days. e. Secure a supply of current medications for self and children. f. Assemble birth certificates, Social Security cards, and licenses. g. Determine a code word to signal children when it is time to leave.
Describe the major disorders of the eye for which medications are given.
What will be an ideal response?