Neuro 2 LURN: Nervous System Diagnostic Tests

Question 1

Describe a Cerebral Angiogram.

Answer 1

• Allows for visualization of cerebral blood vessels
• Used to assess for blockages or abnormalities
• Catheter placed into an artery (usually the femoral) and threaded up to the blood vessels in the brain

Question 2

What is the pre-procedure nursing care for a cerebral angiogram?

Answer 2

• NPO 4-6hrs
• Check for allergy to contrast dye
• Assess kidney function
• Assess and mark distal pulses (to easily re-check them post op)

Question 3

What is the post-procedure nursing care for a cerebral angiogram?

Answer 3

• Check insertion site for bleeding
• Keep extremity straight and check for blood flow distal to the puncture site (pulses, capillary refill, temp, color)
• Encourage increased fluid intake

Question 4

Describe an EEG.

Answer 4

• Electroencephalography
• Used to identify seizures, sleep disorders and other conditions
• Electrodes placed on the scalp to record electrical activity in the brain

Question 5

What is the pre-procedure nursing care for the EEG?

Answer 5

• Instruct pt to wash hair prior to procedure
• Arrive sleep deprived
• Avoid stimulants or sedative medications prior to procedure
• No NPO required

Question 6

True or False

During an EEG, hyperventilation or strobe lights may be used to increase likelihood of seizure activity

Answer 6

True

Question 7

How do we precisely monitor ICP?

Answer 7

• A device will be inserted into the cranial cavity in the OR to measure pressure
• Huge risk of infection

Question 8

What are the indications for use of a ICP monitoring device?

Answer 8

• Comatose pt
• Glasco coma scale score of ≤8

Question 9

What is an early sign of increased ICP?

Answer 9

Irritability

Question 10

What are the general s/s of increased ICP?

Answer 10

• Restlessness
• HA
• Decreased LOC
• Pupil abnormalities
• Abnormal breathing (Cheyne Stokes, Biot’s)
• Abnormal posturing (decorticate, decerebrate)

Question 11

What are Cheyne Stokes respirations?

Answer 11

• Abnormal breathing pattern
• Involves a period of fast, shallow breathing followed by slow, heavier breathing and moments without any breath at all, called apneas

Question 12

What are Biot’s respirations?

Answer 12

• abnormal pattern of breathing
• characterized by groups of regular deep inspirations followed by regular or irregular periods of apnea

Question 13

Describe a lumbar puncture.

Answer 13

• CSF sample is taken from the spinal canal for analysis
• Used to diagnose meningitis, subarachnoid hemorrhage, neurological disorders
• Usually done between L3/L4 or L4/L5

Question 14

What is the pre-procedure nursing care for a lumbar puncture?

Answer 14

• Have patient empty bladder
• Position the patient on their side in a fetal position or stretched over a table while sitting so back is arched

Question 15

What is the post-procedure nursing care for a lumbar puncture?

Answer 15

• Instruct patient to lay flat for several hours and increase fluid intake
• Monitor for CSF leak, which can cause a severe HA (epidural blood patch may be necessary)
• Assess lower extremity sensation/motor function
• Monitor urinary OP