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Neuro 1 - Exam 4 > Clinical Manifestations - Lecture 14 > Flashcards

Clinical Manifestations - Lecture 14 Flashcards

1
Q

measures of arousal, cognition and memory

A

orientation

glasgow coma scale

rancho los amigos level of cognitive fxning scale

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2
Q

testing orientation

A

A+O *4

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3
Q

A+O*4

A

alert and oriented

self

location

date

situational awareness

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4
Q

glasgow coma scale (GCS)

A

defines severity of TBI w/in 48-72 hrs

simple, reliable, correlates well with outcomes

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5
Q

what can the outcome of a pt be associated w/

A

best response in their first 24 hrs after injury

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6
Q

grading

A

GCS 3-8

GCS 9-12

GCS 13-15

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7
Q

GCS 3-8

A

severe injury

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8
Q

GCS 9-12

A

moderate injury

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9
Q

GCS 13-15

A

minor injury

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10
Q

what is the critical score

A

8

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11
Q

GCS score 8

A

90% of pts less than or equal to 8 are in a coma

50% die at 6 hrs

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12
Q

pts with greater than or equal to 9

A

typically not in a coma

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13
Q

pts with higher levels

A

better outcomes at 6 hrs

eye opening = 1 in 5 chance of good recovery

w/o eye opening = 1 in 10 chance

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14
Q

no motor response

A

3% chance of good recovery

show flexion = better than 15% chance

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15
Q

no noise

A

8% chance of recovery

groan = 30% chance

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16
Q

GCS =

A

highest score for correct prediction of outcome

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17
Q

Rancho los amigos scale

A

defines the severity of deficit in cognitive fxning

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18
Q

how many levels does ranchos los amigos have

A

10

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19
Q

level 1

A

no response

total assistance

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20
Q

level 1 details

A

complete absence of observable change in behavior when presented visual, auditory, tactile, proprioceptive, vestibular or painful stimuli

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21
Q

level 2

A

generalized response

total assistance

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22
Q

level 2 response to painful stimulus

A

generalized reflex response

inconsistent and non-purposeful

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23
Q

responses may be –> level 2

A

the same regardless of type and location of stimuli

significantly delayed

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24
Q

level 3

A

localized response

total assistance

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25
Q

level 3 details

A

localized withdrawal or vocalization (inconsistently) to stimuli (pain, simple commands)

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26
Q

level 4

A

confused/agitated

maximal assist

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27
Q

level 4 –> state of activity

A

alert and heightened

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28
Q

what does a level 4 pt exhibit

A

agitation and aggressive behavior

mood swings

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29
Q

attention span of a lvl 4 pt

A

brief

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30
Q

short term memory of a lvl 4 pt

A

absent

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31
Q

level 4 pts also have

A

confabulation

confused, with incoherent/inappropriate verbalizations

32
Q

level 5

A

confused, inappropriate non-agitated

maximal assist

33
Q

level 5 pts are

A

alert and confused

but not oriented

34
Q

what do level 5 pts respond to

A

simple commands

fairly consistently

35
Q

when may level 5 pts become agitated

A

in response to external stimulation or lack of structure

36
Q

attention of a lvl 5 pt

A

gross attention to environment

highly distractible

37
Q

memory of a lvl 5 pt

A

severely impaired recent memory

38
Q

other details of a level 5 pt

A

absent goal-directed, problem solving, self-monitoring behavior

inappropriate use of objects

unable to learn new info

39
Q

level 6

A

confused, appropriate

mod assist

40
Q

level 6 orientation

A

inconsistently oriented

consistently follows simple commands

41
Q

what can level 6 pts do

A

attend to highly familiar tasks in non-distracting environment for 30 min with moderate redirection

42
Q

level 6 behavior

A

goal directed

but depending on external direction

43
Q

level 6 pts carry over

A

relearned tasks

but not new tasks

44
Q

what do level 6 pts use

A

assistive memory aide with max assist

45
Q

level 6 pts verbal expressions

A

appropriate in highly familiar and structured situations

46
Q

level 7

A

automatic, appropriate

min assist

47
Q

how are level 7 pts oriented

A

consistently except to time

48
Q

what do level 7 pts attend to

A

highly familiar tasks for over 30 min w/ min assist to complete tasks

49
Q

level 7 supervision

A

minimal

carryover of new learning

minimal supervision for safety in routine activities

50
Q

level 7 recall

A

shallow

superficial awareness of his/her condition

51
Q

what are level 7 pts unable to do

A

think about consequences of a decision or action

they overestimate their abilities

unable to recognize inappropriate social interaction behavior

52
Q

what are level 7 pts unaware of

A

others needs and feelings

53
Q

level 8

A

purposeful, appropriate

stand by assist

54
Q

level 8 pts are consistently

A

A&O*3

1 hour attention in distracting environments

55
Q

level 8 pts can complete

A

familiar routines with stand-by assist

56
Q

level 8 pts can also

A

recall and integrate past/recent events

carryover of new learning

57
Q

level 8 pts use

A

assistive memory devices with stand by assist

58
Q

level 8 pts require no

A

assistance once new tasks or activities are learned

59
Q

level 8 pts are aware of

A

impairments but require stand by assist to correct

60
Q

what do level 8 pts think about

A

consequences of a decision with min assist

61
Q

level 8 pts acknowledge

A

others needs/feelings and response appropriately with min assist

62
Q

what do level 8 pts recognize

A

inappropriate social interaction and corrects w/ min assist

63
Q

level 9

A

purposeful, appropriate

stand by assist on request

64
Q

level 9 pts are able to

A

shift attn and sustain it for more than 2 consecutive hours

65
Q

level 9 pts are aware of

A

impairments and takes appropriate corrective action

requires standby by assist to anticipate a problem before it occurs and takes action to avoid it

66
Q

level 9 thinks about

A

consequences of decisions w/ assist when requested

67
Q

what can lvl 9 pts accurately estimate

A

abilities but requires stand-by assist to adjust to task demands

68
Q

level 9 pts acnkowledge

A

others needs and feelings

responds appropriately with stand-by assist

69
Q

what may continue in level 9

A

depression and irritability/ low frustration

70
Q

level 9 self monitors

A

appropriateness of social interaction with stand-by assist

71
Q

level 10

A

purposeful, appropriate

mod 1

72
Q

what can lvl 10 pts handle

A

multiple tasks simultaneously

73
Q

level 10 pts can independently

A

create/maintain own assistive memory devices

complete familiar and unfamiliar tasks
–> but may require extra time and/or compensator strategies

74
Q

what do lvl 10 pts anticipate

A

impact of impairments and avoid problems before they occur

may require extra time and or compensatory strategies

75
Q

what do lvl 10 pts independently think about

A

consequences of decisions

–> may require extra time and or compensatory strategies to select appropriate action

76
Q

level 10 pts may have

A

periodic depression and irritability when sick, fatigue and or under emotional stress

77
Q

level 10 social interaction

A

consistently appropriate

Neuro 1 - Exam 4 (12 decks)

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