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EXAM 1: PNR MED > CH 47- Neurologic System > Flashcards

CH 47- Neurologic System Flashcards

1
Q

What does a basic neurological assessment include?

A 
LOC
Vital signs (BP, P, RR)
Pupil response to light
Extremity strength/movement
Sensation (touch, pain)
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2
Q

What is dysphagia?

A

difficultly swallowing/ eating

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3
Q

Neurologic assessment times

A

q 15 mins
q 8 hrs
q 24 hrs

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4
Q

What should a health history include?

A 
Symptoms
Medications
Past surgeries 
Family History
Lifestyle
WHATS UP?
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5
Q

The Glasgow Coma Scale assesses…

A

Eye opening
Verbal response
Motor response (abnormal posture)

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6
Q

Glasgow Coma Scores:

A

range from 3-15

under 7=comatose pt

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7
Q

A physical examination includes:

A 
LOC 
Mental examination
Pupil response
Muscle function
Cranial Nerve Function
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8
Q

2 types of abnormal postures, assessed for in Glasgow coma scale include:

A

Decorticate

Decerebrate

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9
Q

Decorticate, abnormal posture, can be described as:

A 
Feet plantar flexed
-Legs internally rotated
-Elbows flexed
Wrists and fingers flexed
Arms ADDucted
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10
Q

Decerebrate, abnormal posture, can be described as:

A 
Feet plantar flexed
-Forearms pronated
-Elbows extended
Wrists and fingers flexed
Arms ADDucted
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11
Q

Decorticate can indicate

A

impairment of cerebral functioning
(FLEXED)
*cerebral cortex

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12
Q

Decerebrate can indicate

A

brainstem damage
(EXTENSION)
*cerebrum

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13
Q

PERRLA stands for

A

Puplis equal, round, reactive to light, reactive to accommodation

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14
Q

What is anisocoria?

A

pupils unequal in size

Causes: congenital
cataract surgery
*** if even become uneven, medical emergency

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15
Q

What is nystagmus?

A

involuntary movement of the eyes

Causes: Dilantin toxicity
brainstem injury

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16
Q

Laboratory tests that may be ordered to R/O underlying cause

A 
Thyroid
Vit B12
CBC
Electrolytes
CK -Creatine kinase
VDRL- (test for Syphilis)
Liver/Renal function
ESR/WBC= Infection (MENINGITIS)
Prolactin/cortisol= dysfunction of pituitary gland                 ( Brain tumor)
Anticholinerterase testing/ antibody titer=MG
17
Q

Why would a Lumbar puncture be performed?

A

to obtain Cerebrospinal fluid

-Assessing for: increased glucose, protein, bacteria, WBC, immunoglobin, antibodies, culture and sensitivity

18
Q

Where is the Lumbar puncture needle usually placed on an adult?

A

L3-4, L4-5

19
Q

Before a LUMBAR puncture, a nurse will

A 
obtain informed consent
assist in positioning
 -side lying
 -knees flexed to chest
 -may lean over bedside table
20
Q

After a lumbar puncture, a nurse will aid in

A

maintaining flat bedrest 6-8 hrs
increase oral intake of fluids
Assess site for: swelling, drainage, movement of lower extremities, q 4 hrs, headache

21
Q

Before a CT scan, a nurse will

A

administer contrast dye if ordered
-check BUN, creatinine
-allergies to iodine, shellfish
Teach: may feel a sensation of warmth

22
Q

For an Allergic reaction to contrast dye, what symptoms should be assessed for?

A

Nausea
Diaphoresis
itching
difficulty breathing

23
Q

After a CT scan, a nurse will

A

encourage fluids if dye used

24
Q

With an MRI, a nurse must

A

make sure there are no pacemakers or metal on pt
administer sed
teach relaxation

25
Q

Why would a CT scan be performed?

A

diagnosis of neurological disorders of brain and spine

26
Q

Why would a MRI be performed?

A

Diagnosis of degenerative diseases

27
Q

Why would an Angiogram be performed?

A

abnormality of cerebral or spinal blood vessels

blood supply to tumor

28
Q

Before an Angiogram, What will the nurse do?

A 
Informed consent
Pt clear liquid diet
IV site/ fluids
Check BUN, creatinine, PT, PTT
Sedation
29
Q

After an Angiogram, What will the nurse do?

A 
Maintain pressure to site
keep bed flat for 6-8 hrs
Keep affected leg straight
Assess: vitals, pulses, site
    -q 15 mins for 1 hr, q 2 hrs for 4 hrs
Increase oral fluids
30
Q

When will a Myelogram be performed?

A

after a lumbar puncture

contrast material is injected

31
Q

What nursing considerations should be implemented after a myelogram?

A

Seizure history/precautions
Informed consent
Bed rest, HOB 30 degrees

32
Q

What are contractures?

A

permanent muscle contractions occur because lack of use

33
Q

What is dysarthria?

A

difficulty speaking

34
Q

What is EXPRESSIVE aphasia?

A

difficulty or inability to verbal communicate with others

35
Q

What is RECEPTIVE aphasia?

A

patients inability to understand spoken language

36
Q

What is agnosia?

A

inability to interpret or recognize familiar objects

EXAM 1: PNR MED (6 decks)

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