Intro to Intracranial Regulation Flashcards
(21 cards)
What are examples of excitation neurotransmitters ?
Epinephrine & Norepinephrine
What are examples of inhibitory neurotransmitters ?
Serotonin, GABA, dopamine
What is the neuro assessments for a conscious pt ?
- assess LOC
- talk with pt and avoid yes or no questions
- identify S&S like HA, nausea, visual disturbances, slow/unequal pupil reaction
- identify if pt is a reliable source of info (may need to ask caregiver)
- establish onset and progression
- meds can alter someone’s mental acuity
What is the neuro assessment for a altered LOC pt ?
- assess for response in normal, loud & light touch, central pain
- glascow coma scale
- assess for unequal pupil reactions
- lack of response to pain can be local nerve damage, spinal cord or brain damage
- differentiate between higher functional awareness (moving away from pain)
- purposeful movement and obeying commands vs posturing
- decorticate or decerebrate posturing
What are some S&S of increased intracranial pressure ?
- change in LOC
- cushing’s triad (increased BP, decreased HR and RR)
- ocular signs: dilation, or nonresponsive (EMERGENCY)
- decrease in motor function
- HA and vomiting
- posturing
What are signs of Rt sided brain damage ?
- paralyzed left side
- left-sided neglect
- denies or minimizes problems
- short attention span
- impulsivity
- impaired judgement
- impaired time concepts
What are S&S of Lt sided brain damage ?
- paralyzed on right side
- impaired speech/language aphasias
- impaired Rt/Lt discrimination
- slow performance, cautious
- aware of deficits: depression, anxiety
- impaired comprehension of math or language
What are some functions of glial cells ?
provides:
- support
- protection
- nourishment
What is epilepsy ?
disease marked by a continuing predisposition to seizures
- with neurologic, cognitive, psychologic and social consequences
What is a seizure ?
transient, uncontrolled electrical discharge of neurons in the brain that interrupts normal function
- accompany a disorder
- occur spontaneuosly
What are the 2 major classifications of seizures ?
- generalized
- focal
What are the phases of a seizure ?
- prodromal
- aural
- ictal
- postictal
What is a generalized seizure ?
involves both sides of the brain with bilateral synchronous epileptic discharge
- tonic- clonic
- typical absence seizure: simple vs, complex
- atypical absence seizure
- others: mycoclonic, atonic, tonic, clonic
What is a focal seizure ?
(aka partial or partial focal) begins in 1 hemisphere of the brain in a specific region of the cortex
- produces sensory, motor, cognitive, or emotional manifestions
- simple focal or complex focal
What are some complications of a seizure ?
Physical:
- status epilepticus: seizure > 5 mins
- permanent brain damage
- death
- severe injury
Psychosocial:
- ineffective coping
- depression
- social stigma
What are some diagnostic studies for seizures ?
- seizure description
- health history
- EEG/ magnetoencephalography
- serum and urine labs
- CT, MRI, PET
- diagnostic criteria
What is the purpose of vagal nerve stimulators with seizures ?
interrupts the synchronization of epileptic brain wave activity
- surgically implanted electrode in neck programmed to deliver electrical impulses to vagus nerve
- pt or caregiver can activate with magnet if sense a seizure imminent to stop or shorten seizure
What are the meds for status epilepticus ?
diazepam & lorazepam (IV)
What are the meds for tonic-clonic and focal seizures ?
- phenytoin
- carbamazepine
- valproic acid
- phenobarbital
What is RN care during a seizure ?
- protect pt from injury
- turn pt to the side to decrease aspiration
- loosen restrictive clothing
- do not restrain pt
- do not place anything in mouth
- observe and document episode before, during and after seizure
What is some RN care after a seizure ?
- maintain in side-lying to prevent aspiration and drain secretions
- check VS
- assess for injuries
- perform neurological checks
- allow pt to rest
- reorient and calm pt
