CCRN-Adult Exam Dumps : CCRN (Adult) - Direct Care Eligibility Pathway

Epidural hematoma

An epidural hematoma is a collection of blood that forms between the skull and the dura mater, the outermost layer of the meninges that cover the brain. The most common cause of an epidural hematoma is a head injury that fractures the temporal bone and tears the middle meningeal artery, which runs along the inner surface of the skull. Arterial bleeding is under high pressure and can rapidly expand the hematoma, compressing the brain and causing neurological deterioration. A typical symptom of an epidural hematoma is a brief loss of consciousness followed by a lucid interval and then a rapid decline in consciousness and brain function. This condition requires urgent surgical evacuation of the hematoma to prevent brain damage or death12. Venous bleeding, clot formation, and intracranial aneurysm are not the main factors associated with the deterioration of the patient’s condition in this case.

Beta-agonists are the first-line drugs for acute asthma exacerbations because they rapidly reverse bronchoconstriction and improve airflow. They act by stimulating beta-2 receptors in the smooth muscle of the airways, causing relaxation and dilation. Beta-agonists can be administered by inhalation, nebulization, or injection. Examples of beta-agonists include albuterol, levalbuterol, and terbutaline.

References:

• Management of Acute Asthma Exacerbations | AAFP: This article states that “Quick-relief medicines include: Albuterol (ProAir HFA, Proventil-HFA, Ventolin HFA, others). Levalbuterol (Xopenex, Xopenex HFA).”
• Asthma attack - Diagnosis and treatment - Mayo Clinic: This article states that “If you’re in the yellow zone, the plan will tell you how many puffs of your quick-relief medicine to take and how often you can repeat the dose. Young children or people who have difficulty with an inhaler use a device called a nebulizer to inhale the medicine in a mist. Quick-relief medicines include: Albuterol (ProAir HFA, Proventil-HFA, Ventolin HFA, others). Levalbuterol (Xopenex, Xopenex HFA).”

An increase in intracranial pressure (ICP) above 25 mm Hg often results in changes in the waveform morphology observed in the monitoring of intracranial pressure. Specifically, the amplitude of P2 becomes greater than P1, which is indicative of decreased intracranial compliance. This pattern is known as the "pathological waveform," suggesting increased intracranial pressure and decreased ability of the brain to accommodate the pressure changes. References: CCRN Exam Handbook, AACN, page 23, section on Neurological.