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NCLEX > Neuro > Flashcards

Neuro Flashcards

1
Q

What is ICP?

A

Increased cranial pressure is when vessels in the brain are compressed and causes compression on the brain stem which decreases hr and rr

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2
Q

What is the first sign of increased ICP?

A

Mental staus change

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2
Q

What type of vomiting occurs with increased ICP?

A

Vomiting without nausea

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3
Q

Late signs of ^ ICP

A

Cushing Triad:
-low hr and rr
- wide pulse pressure- systolic up, diastolic down
- HTN

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4
Q

Deadly signs of ^ ICP

A
  • pupils fixed, dilated, and unequal
    *8mm normal 2-6
  • doll eyes- brain stem is intact when eyes can move on their own
    *severe brainstem damage when they remain fixed and dilated
  • babinski reflex present- brain stem herniation
  • decorticate- arms flex inwards
  • decerebrate- arms flex out, worse
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5
Q

What test is done for brain injuries?

A

Ct scan

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6
Q

Normal ICP

A

5-15

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7
Q

Lumbar punctures (spinal taps)

A

Should she avoided with increased ICP

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8
Q

Interventions for Increased ICP

A
  • immobilize head
  • Log roll to turn pt
  • HOB Semi Fowlers 30-45*
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9
Q

What should you not allow for increased ICP patients

A

-No flexing or bending extremities
- No coughing, sneezing, blowing nose
- No valsalva maneuver
- No straining during bowel movement (give stool softener)

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10
Q

Glasgow coma scale

A

3-15
less than 8 intubate

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11
Q

Meds for increased ICP

A
  • steroids to decrease swelling
  • phenytoin- to prevent seizures
  • mannitol- decreases pressure
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12
Q

What causes seizures?

A

increased brain swelling
- stress
- sleep deprivation
- strobe lights
- low sugar
-low sodium

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13
Q

prodromal phase

A

warning phase before seizure

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14
Q

aura phase

A

visual, auditory, or swelling sensation clues before a big seizure
ex: burnt toast

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15
Q

ictal phase

A

active phase of seizure
(ignition phase)

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16
Q

postictal phase

A

after seizure when pt’s are confused and disoriented

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17
Q

Interventions for seizures

A
  1. Assist to the ground, turn to side
  2. prepare suction
    - never insert anything in mouth
    - don’t restrain
18
Q

Best drug for seizures

A

Benzodiazepines
- lorezapam
- diazepam

19
Q

Electroencephalogram

A

EEG assess electrical activity for seizures
no caffeine 12-24 hrs before
no seizure meds before
want them to be sleep deprived to increase activity
pt can eat

20
Q

Open TBI

A

basilar skull fracture with csf leaking from eyes, ears, nose
- test clear fluid for glucose to determine if csf

21
Q

Closed TBI

A

skull not fractured

22
Q

Coup Contrecoup

A

Closed TBI
- front to back of brain ex: whiplash
- Frontal lobe injury= expressive aphasia and memory problems
- Occipital lobe= vison problems

23
Q

Meningitis

A

inflammation in the brain caused by bacteria or virus

24
Q

s/s of meningitis

A

Headache and photophobia
hard stiff neck - nuchal rigidity
high temp

Peds: hight pitched cry, bulging fontanelle
Adults: altered loc first sign

25
Q

Meningitis tests

A

CT scan
lumbar puncture: viral- very clear
bacterial- cloudy

26
Q

Meningitis requires what type of precautions

A

Droplet

27
Q

Diagnostics for meningitis

A

Kernig sign: straightening leg is painful
Brudzinski sign: neck flex causes hip and knees to flex

28
Q

Parkinsons

A

Low dopamine and high acetylcholine
- permanent and no cure

29
Q

s/s of Parkinsons

A
  • shuffling gait with decreased arm swing
    -pill rolling
  • tremors at rest
30
Q

Meds for parkinsons

A

levodopa and carbidopa
avoid protein blocks absorption

31
Q

Multiple Sclerosis

A

autoimmune disease that attacks myelin sheath of muscles

32
Q

MS s/s

A

muscle spams
muscle stiffness

33
Q

Pts with MS need to

A

Mellow out and stay cool
- Avoid sun, hot tubs, hot baths, sauna, extreme heat
- smoking
- surgery
-stress
-sepsis

34
Q

Pharm for MS

A
  • IV IG
  • Cylcosporin- immunosupressant
35
Q

Myasthenia Gravis

A

autoimmune disorder
think * dry asthenia gravity
- present with dry body and muscle weakness, droopy eyelids
- avoid sun, stress, smoking, sickness

36
Q

Meds for Myasthenia Gravis

A

pyridostigmine give before meals
increases secretions to help swallow

37
Q

ALS

A
  • all organs in the body shut down, mind still intact
    entire body becomes paralyzed
    safety concern= dysphagia
    increased resp secretions kill pt as diaphragm becomes paralyzed= can’t breathe
38
Q

Guillian Barre Syndrome

A

rapidly ascending paralysis from ground up
- killed from resp failure- diaphragm becomes paralyzed

39
Q

worsening signs of Gillian barre syndrome

A

inability to cough
can’t lift eyebrows or head

40
Q

Cervical injury

A

causes quadriplegia
impaired breathing= deadly

41
Q

Thoracic injury

A

paraplegia- paralysis of the legs
Pelvic organs

42
Q

Lumbar injury

A

legs and leaky bladder

43
Q

Autonomic Dysreflexia

A

Spine cord injury t6 or higher
causes:
- Bladder issue: example would be a distended or urinary tract infection
Bowel issue: like hard stool that collects in the rectum leading to impaction
Break down of skin: due to any type of binding devices or clothing, pressure injury, burns, infection, cuts etc.
s/s: HTN, low hr, sweating, dilated pupils, flushing of face, cool and clammy below injury
Prevent: bladder distention or infection, prevent bowel impaction, asses for skin issues
Treat: position high fowlers with legs lower to lower bp
look for what is causing problem BBS
administer nitro

NCLEX (20 decks)

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