Riding Out the Storm: Sympathetic Storming After Traumatic Brain Injury

~ Exam ~

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1. Symptoms common to sympathetic storming include:
  a. tachycardia, hypothermia, dysarthria, hypertension and diaphoresis.

  b. tachycardia, hyperthermia, dystonia, hypotension, and diaphoresis.

  c. bradycardia, hypothermia, atonia, hypertension and diaphoresis.

  d. tachycardia, hyperthermia, dystonia with posturing, hypertension and diaphoresis.

2. Symptoms related to sympathetic storming usually occur:
  a. in the aftermath of intracerebral hypertension.

  b. preceding uncal herniation.

  c. spontaneously and unprovoked.

  d. after aggressive stimulation.

3. Medications are utilized to:
  a. provide sympathetic tone.

  b. inhibit stress response.

  c. stimulate cortical activity.

  d. eliminate adrenocortical release.

4. A common nursing intervention that is aimed at decreasing the intensity and duration of the storming episode is:
  a. maintaining temperature within normal range.

  b. maintaining adequate hydration.

  c. intermittent bladder irrigation.

  d. passive range of motion.

5. Triggers are activities that:
  a. have shown to decrease length of episodes.

  b. decrease dystonia and hyperthermia.

  c. induce an episode.

  d. stimulate parasympathetic release.

6. A common injury associated with sympathetic storming is:
  a. hydrocephalus.

  b. subarachnoid hemorrhage.

  c. diffuse axonal injury.

  d. brain stem hemorrhage.

7. Family education should be geared toward:
  a. pathophysiology of symptoms and anticipated rehabilitation treatments.

  b. pathophysiology of symptoms, rationale of treatment, and methods to assist in preventing and controlling episodes.

  c. expected duration of symptoms, guardianship process, and discharge planning.

  d. variation in symptoms, rehabilitation potential, and discharge planning.

8. Prolonged affects of sympathetic overactivity include:
  a. dehydration, focal myocardial damage, protein wasting and skin breakdown.

  b. worsening effects of secondary injury, hypoglycemia, deep vein thrombosis, respiratory insufficiency.

  c. neurogenic pulmonary edema, cerebral salt wasting, hypoglycemia, and pulmonary emboli.

  d. hypernatremia, arterial fibrillation, hypoglycemia, and aspiration pneumonia.

9. Cardiac irregularities associated with sympathetic storming include:
  a. arrhythmias, decreased ST interval, supraventricular tachycardia, T wave inversion.

  b. biphasic T waves, T wave inversion, ST depression and bradycardia.

  c. tachycardia, arrhythmias, decreased T wave amplitudes and ST depression.

  d. tachycardia, hypotension, widening pulse pressure and elevated pulmonary wedge.

10. Three commonly used medications include:
  a. verapamil (Isoptin®), propranolol (Inderal®), and morphine sulfate.
  b. propanolol (Inderal®), oxycodone, and bromocriptine (Parlodel®).

  c. chlorpromazine (Thorazine®), mannitol (Osmitrol®), and morphine sulfate.
  d. dantrolene (Dantrium®), midazolam (Versed®) and mannitol (Osmitrol®).