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ICP Flashcards

1
Q

If a client has a hemorrhagic stroke in the parietal lobe, which function will be affected?

A

Understanding language

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2
Q

Which of the follow causes a ischemia stroke?

a. ) Trauma
b. ) Aneurysm
c. ) Blockage
d. ) Malformation

A

Blockage

The others are causes of the hemorrhagic stroke

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3
Q

When a client present with signs of a stroke what is the priority?

A

Obtain a CT scan

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4
Q

When a client is having a seizure, what is the priority?

a. ) keep client safe
b. ) hold client down
c. ) insert an oral airway
d. ) obtain VS

A

A - Keep client safe

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5
Q

What med would the nurse expect to admin for the acute onset of seizure?

a. ) Pheyntoin
b. ) Narcan
c. ) Daizepam
d. ) Oxcarbazapine

A

C - Daizepam is priority

Pheyntoin & Oxcarbazapine are maintenece

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6
Q

What diagnostic test helps to diagnose seizure activity in the brain?

a. ) EEG
b. ) MRI
c. ) CT
d. ) Vagal nerve stimulator

A

EEG
MRI & CT r/o other conditions
Vagal nerve stimulator is a surgical insert that interrupts seizure activity

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7
Q

What is the diagnostic for meningitis?

A

Lumbar puncture

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8
Q

Which of these explains severe extension of the head with arching of the back?

a. ) Nuchal rigidity
b. ) Kernig’s sign
c. ) Brudinski’s signs
d. ) Opisthotonos

A

D - Opisthotonos

Indicates meningitis

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9
Q

True/False: Parkinson’s disease is curable

A

False

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10
Q

True/False: Clients with MS has tingling and burning in their extremities

A

True

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11
Q

Which assess finding would indicate that a client with meningitis is worsening?

a. ) Purpura lesions on the body
b. ) Pain to the neck with turning
c. ) Complaints of lights hurting eyes
d. ) Nucal rigidity

A

A - Indicate DIC, body shutting down

Other normal findings of meningitis

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12
Q

Which of the following is a finding associated with MS

a. ) Hypertension
b. ) Steady gait
c. ) Ancle clonus
d. ) Blurred vision

A

D - Blurred vision

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13
Q

What med can the nurse administer to help a hemorrhagic stroke pt. with vasospasm

A

Nimodipine - Ca+ channel blockers

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14
Q

Pt. has a stroke in their frontal lobe. What can the nurse expect to be abnormal due to the location of the stroke?

A

Personality changes
Problem solving problems
Creative changes

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15
Q

Pt. has a stroke in their temporal lobe. What can the nurse expect to be abnormal due to the location of the stroke?

A

Memory problems

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16
Q

Pt. has a stroke in their Brain stem. What can the nurse expect to be abnormal due to the location of the stroke?

A

Basic life functions- autonomic system

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17
Q

Pt. has a stroke in their Parietal lobe. What can the nurse expect to be abnormal due to the location of the stroke

A

Visual changes
Understanding language
Reading probs

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18
Q

Pt. has a stroke in their occipital lobe. What can the nurse expect to be abnormal due to the location of the stroke

A

visual changes

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19
Q

Pt. has a stroke in their cerrebellum. What can the nurse expect to be abnormal due to the location of the stroke

A

Balance probs
Coordination probs
Motor function changes

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20
Q

Cranial nerve 3

A

Oculomotor - eye movement up, down, lateral, opening of eyelid, pupil constriction

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21
Q

Cranial nerve 4

A

Trochlear - Medial and downward medial eye movement

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22
Q

Cranial nerve 6

A

Abducens - Lateral eye movement

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23
Q

When the nurse is assessing cranial nerve 3, 4, 6 what condition does the nurse suspect?

A

Meningitis

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24
Q

Homonymous Hemianopia

A

only see left or right side of vision field can be clinical manifestation of stroke

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25
Homonymous Hemianopia is a manifestation of what condition?
Stroke
26
What scale assesses for stroke?
National Institute of Health Stroke Scale (NIHSS)
27
If a pt. has a 42 on the NIHSS. How is the pt. doing?
This is the highest a pt. can score on the scale. This means the pt. is not doing good at all. The higher the number the worse they are
28
Normal ICP level
< 20
29
Broca's Area
responsible for production of speech
30
Wernicke's area
Responsible for interpreting speech
31
Priority intervention for a pt. comes into ER with symptoms of a stroke
CT scan! | To determine if it is hemorrhagic or ischemic stroke
32
Symptoms of Left side brain damage
Slow, cautious behavior Dysphagia Broca and Wernicke's area Paralyzed right side
33
Symptoms of Right side brain damage
Quick, impulsive behavior Spatial/ perceptual deficits Memory deficit Paralyzed left side
34
Patient came into the ER with signs of stroke 7 hours ago. The nurse gets a CT and it is determined that the pt. has a ischemic stroke. The HCP order TPA to defuse the clot. What is the nurse's action?
Question the order. TPA can only be given within 3-4 hours of the pt. showing signs of stroke.
35
What can contraindicate a pt. from receiving TPA
``` Hemorrhagic stroke Hx Diabetes or prior stroke Any surgery w/i 3 months Severe HTN Internal bleeding NIHSS score > 25** Age > 80 Take anticoagulants regardless of INR Head trauma ```
36
You assessed your pt. at 0700 he was norm. At 1200 you assess and he shows signs of stroke. It is determined that it is ischemic. What must the nurse determine before admin TPA?
When the symptoms started. If neither the pt. or nurse don't know when the symptoms started, the nurse cannot admin TPA
37
Because the nurse is hydrating a ischemic stroke pt. what complication can occur and what electrolyte imbalance should the nurse watch?
The hydration can cause SIADH and the nurse should watch for hyponatremia
38
Permissive hypertension
Will allow BP to be high in ischemic stroke pt. for blood to reach the area of ischemia
39
Complications of ischemic stroke
Cytotoxic edema | Hemorrhage
40
Diagnosis tool for seizures
EEG
41
Priority intervention during ictal phase of seizures
Airway management
42
Therapeutic range for phenytoin
10-20 mg/mL
43
What is priority assessment during ictal phase of a seizure
Time and length and what type of seizure
44
Vagal nerve stimulator increase what neurotransmitter in the brain?
GABA
45
What meds can be given for acute seizure activity
Benzos
46
What meds are for maintenance of chronic seizures?
Phenytoin | Phenobarbital
47
Main clinical manifestations of Meningitis
``` Nucal rigidity Opisthotonos Brundzinki's Sign Kernig's Sign Petechia rash > lead to DIC ```
48
Nucal rigidity
Touch chin to chest and causes pain in neck occurs in meningitis
49
Opisthotonos
Spasms of the muscles of the neck that causes back to arch
50
Brundzinki's Sign
Involuntary flexion of the hip when the pt. is lay supine and when neck is flexed
51
Kernig's Sign
Pain in the hamstring when the leg is flexed
52
Diagnosis tool for meningitis
Lumbar puncture
53
Meningitis is a ___ ___!
Meningitis is a MEDICAL EMERGENCY!
54
What meds are ordered for a pt. with meningitis
Broad spectrum antibiotics - able to cross blood brain barrier Corticosteroids Pain meds
55
What non pharm intervention can decrease ICP?
Increase HOB to above 30 degrees
56
Signs of sepsis
``` Low BP Low O2 High HR High RR high temp High BS High WBC High Lactic Acid Low platelets DIC ```
57
The nurse's pt. has meningitis. What precautions can the nurse expect the pt. to be in?
Droplet precautions
58
How can the nurse assess increased ICP
Assess LOC
59
What labs will the nurse expect in a pt. with meningitis?
Increase WBC | Increased proteins
60
What lab assessment must the nurse perform before and after lumbar puncture?
BS
61
SE of Pramiprexole and Levadopa/Carbadopa
Orthostatic Hypotension | Urinary Frequency
62
Why is a pt. with Parkinson's prescribed anticholinergics and how does the nurse manage these meds?
Suppress tremors and drooling | Nurse admin stool softeners and fluids to manage SE
63
Anticholinergic for Parkinson's
Benzotropine
64
Meds for Multiple Scerolsis
Beta Interferons Immunosuppressants Corticosteroids Muscle relaxers - Baclofen
65
True/False: There is a cure for MS
False, no cure
66
Primary assessments for a pt. with MS
Neuromuscular | Skin integrity
67
Risk factors for MS
High temperatures Exercise Increased stressors
68
Pt. presents with weakness, tremors, partial vision loss, bladder dysfunction, and slurring of words. What can the nurse suspect will be the diagnosis?
MS
69
True/False: MRI is the gold standard for diagnosing MS
False, there is no specific test that is gold standard. MRI looks at plaques on the brain.
70
What is the goal of Tx for a pt. with MS
Recovering form attacks and managing lifestyle and symptoms
71
Teachings for pt. with MS
``` They are at increased risk for infection (immunosuppressant) Increase risk for falls Stay cool Rest Eat healthy Physical therapy - stay mobile ```
72
What is the priority intervention for a pt. with MS?
Maintaining airway
73
What electrolyte imbalance can cause seizures?
``` Hyponatremia Hypophosphatemia Hypomagnesemia Hyperphosphetemia Hypernatremia ```
74
First line meds for seizures?
Benzos

Med Surg (22 decks)

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