238 Neuro

Question 1

What is a myelography?

Answer 1

Test to see the subaranchnoid space, spinal cord, and vertebrae after injection of dye by LP

Question 2

What is a contraindication to LP?

Answer 2

Increased ICP

Question 3

What is specific of “neurogenic” or “central” DI?

Answer 3

It is caused by a lesion in the brain; it is the most common type

Question 4

What is specific about “primary” DI?

Answer 4

It’s also called “psychogenic”, because it is caused by excessive water intake. Could be caused by a structural lesion in the thirst center or psych issues

Question 5

What is “nephrogenic” DI?

Answer 5

It is when there is enough ADH in circulation, but decreased kidney response

Question 6

What is one of the most common causes of Nephrogenic DI?

Answer 6

Lithium

Question 7

How is central DI treated?

Answer 7

Desmopressin acetate is drug of choice; some form of vasopressin is used to replace missing ADH

Question 8

How is Nephrogenic DI treated?

Answer 8

Low sodium diet and thiazide diuretics

Question 9

What would be the clinical presentation of a patient with SIADH?

Answer 9

Hypobatremia; muscle cramping, weakness, dyspnea on exertion. As it get more severe: vomiting, abdominal cramps, muscle twitching and seizures

Question 10

What is the treatment for SIADH?

Answer 10

Fluid restriction, duiretics (Lasix) and hypertonic saline.

Question 11

What is Declomycin given for?

Answer 11

Treatment of SIADH; blocks the effects of ADH on the renal tubules (allowing a more dilute urine)

Question 12

What is Samsca and Vaprisol given for?

Answer 12

They are vasopressin receptor antagonists (lessen the effect of AHD on the kidneys)

Question 13

What disease results from a decrease in Acetylcholine-secreting neurons?

Answer 13

Alzheimer’s

Question 14

What disease results from a reduction in acetylcholine receptors?

Answer 14

Myasthenia Gravis

Question 15

What disease is due to destruction of dopamine-secreting neurons?

Answer 15

Parkinson’s

Question 16

What does dopamine control?

Answer 16

Emotions, moods and regulation of motor control

Question 17

What does Serotonin control?

Answer 17

Moods, emotions and sleep

Question 18

What is normal ICP?

Answer 18

5-15

Question 19

What is the brain’s use of glucose and oxygen?

Answer 19

20% of oxygen and 25% of glucose

Question 20

What is normal CPP (cerebral perfusion pressure)?

Answer 20

60-100

Question 21

What CPP indicates cerebral ischemia?

Answer 21

<50

Question 22

What GCS score indicates a coma?

Answer 22

<8

Question 23

What CSF lab value indicates infection?

Answer 23

> 5

Question 24

The myelin sheath of CNS nerve fibers are composed of what?

Answer 24

Oligodendrocytes

Question 25

The extrapyramidal carries impulses concerned with what?

Answer 25

Voluntary movement

Question 26

What is the earliest sign of increased ICP?

Answer 26

Altered LOC

Question 27

What is Cushing's Triad?

Answer 27

Increasing systolic BP (with widening pulse pressure), bradycardia and irregular breathing

Question 28

What is normal ICP?

Answer 28

5-15

Question 29

What is normal CPP?

Answer 29

60-100

Question 30

What CPP indicates ischemia?

Answer 30

<50

Question 31

How is CPP calculated?

Answer 31

CPP= MAP - ICP

Question 32

How can MAP be calculated?

Answer 32

MAP = SBP + 2(DBP) divided by 3

Question 33

What is Trigeminal Neuralgia?

Answer 33

Recurrent episodes of sharp, stabbing pain that last seconds to 2-3 minutes

Question 34

What is the etiology of TN?

Answer 34

It is not fully understood

Question 35

What are risk factors for TN?

Answer 35

MS, HTN, herpesvirus, tooth/jaw infection and brainstem infarct

Question 36

What drugs are "1st line therapy" for TN?

Answer 36

Tegretol and Trileptal

Question 37

What is the "cardinal sign" of Bell's Palsy?

Answer 37

An eye that will not blink

Question 38

What is meant by the "primary" spinal cord injury?

Answer 38

The initial injury to the spinal cory

Question 39

What is meant by the "secondary" spinal cord injury?

Answer 39

Ongoing progressive injury that occurs after the initial injury

Question 40

What is "spinal shock"?

Answer 40

Decreased reflexes, loss of sensation and flaccid paralysis below the level of spinal injury

Question 41

What is "neurogenic shock" (as contrasted with spinal shock)?

Answer 41

Loss of vasomotor tone -- characterized by hypotension and bradycardia

Question 42

How are spinal cord injuries classified?

Answer 42

By: - Mechanism of injury - Level of injury - Degree of injury

Question 43

What is tetrapelgia?

Answer 43

Injury is T1 or above; all 4 extremities involved

Question 44

What is Paraplegia?

Answer 44

Injury is below T1; lower extremities affected

Question 45

Cervical injury above C4 means that what is required?

Answer 45

Mechanical ventilation

Question 46

Cervical injury below C4 results in what type of breathing?

Answer 46

Diaphragmatic with hypoventilation because of use of intercostals

Question 47

What difficulties will a patient with an injury below C4 have?

Answer 47

Ineffective or absent cough; artificial airway possibly leading to atelectasis and/or pneumonia (bronchial and oral hygiene is very important)

Question 48

Spinal cord injury above which level reduces the sympathetic nervous system and causes bradycardia?

Answer 48

T6

Question 49

What is the drug of choice to increase HR in a pt with injury above T6?

Answer 49

Atropine

Question 50

Pt may have paralytic ileus and gastric distention after a cord injury at what level?

Answer 50

Above T5

Question 51

Excessive HCL in the stomach puts a pt at risk for what?

Answer 51

Stress ulcers

Question 52

What meds would a pt be given to reduce risk of stress ulcers?

Answer 52

H2 receptor blockers (Zantac, Pepcid) and Proton Pump Inhibitors (Protonix, Prevacid and Prilosec)

Question 53

Neurogenic bowel occurs when spinal shock or injury is at what level?

Answer 53

T12 or below

Question 54

What is Pikilothermism?

Answer 54

Adjustment of body temperature to room temperature

Question 55

Tetanus causes what type of muscle response?

Answer 55

Spacicity

Question 56

What is trismus?

Answer 56

"lockjaw"; spasms and stiffness of jaw

Question 57

How often do adults need the Tetanus/diptheria toxoid booster?

Answer 57

Every 10 years

Question 58

If you have an injury, you will be reimmunized if you haven't had a booster in how many years?

Answer 58

5

Question 59

NG suctioning may lead to what state?

Answer 59

Metabolic Alkalosis

Question 60

Decreased tissue perfusion may lead to what state?

Answer 60

Acidosis

Question 61

Autonomic dysreflexia only occurs with injuries above?

Answer 61

T6

Question 62

What triggers autonomic dysreflexia?

Answer 62

Irritation, or discomfort; most common cause is distended bladder or bowel

Question 63

What are manifestations of Autonomic Dysreflexia?

Answer 63

Hypertension, Blurred vision, throbbing headache, marked diaphoresis, flushing of skin above injury, nasal congestion, anxiety, nausea and hair standing on end

Question 64

What are nursing interventions for autonomic dysreflexia?

Answer 64

Elevate HOB, notify MD, assess cause, loosen tight clothing, monitor VS q15, assess for bladder distention and cath if distended