Med Surg: Neurologic Nursing Care Flashcards Preview

Med Surg Test 7: Neuro/Muscular > Med Surg: Neurologic Nursing Care > Flashcards

Flashcards in Med Surg: Neurologic Nursing Care Deck (19)
Loading flashcards...

What are rapid neurologic assessments?

Glasgow coma scale: lowest score is 3 (eyes open, verbal and motor response), more cerebral cognition the higher the score with 15 highest

Response to painful stimuli: meaure interaction with environment, assess depth of unresponsivenedd, dont hurt patient



Pupil assessment



What are neuro lab and diagnostic tests?

blood cultures: meningitis, bacterial, viral, inflammation issues, abcess or encephalitis

Skill & spine x-ray: bony prominences, fragments of skull, depression of bone-rupture

Cerebral angiography: blood supply and flow

CT scan: tumors, other abnormalities


What is an electroencephalography?

Graphically records the electrical activity of the cerebral hemispheres

Sleep deprivation requirement

Anticonvulsants possibly withheld


What are clinical manifestations of neurological disease: Headaches?

Migraine headache

Often accompanied by a sensitive scalp, anorexia, photophobia, phonophobia, nausea

Aura often present

Three R's

- Recognize

- Respond

- Relieve


What is drug therapy for Migraine?

Abortive therapy: use auras or onset for best results

Aceaminophen or NSAIDS are usually effective for mild migraines

May need anti-nausea drugs


What is Migraine Preventative Therapy?

NSAID prescription: may take around click if not controlled well

Beta-adrenergic blocker: peripheral vasodialtion because migraines caused by constriction

Antidepressants and antiepiletptic drugs: migraine control


What are other interventions for migraines?

Yoga, meditation, massage, exercise, biofeedback, relaxation techniques



Avoidance of trigger events


What are cluster headaches?

Histamine headaches:

- uncommon

- cause unknown

- attributed to vasoreactivity and oxyhemoglobin desaturation

Unilateral, radiating to forehead, temple or check

Ipsilateral tearing of the eye, rhinorrhea, ptosis and miosis


What are interventions for cluster headaches?

same types of drugs used for migraines

clinet to wear sunglesses and avoid sunlight

oxygen via mask

avoidance of precipitating factors, such as anger, excitement: avoid oxygen desaturation, such as emtotional distress


What are the seizure types?





What is epilepsy?

Chronic disorder with recurrent, unprovoked seizures

Can occur after severe head trauma


What are seizure risk factors?

metabolic disorders

Acute alcohol withdrawal

electrolyte diturbances

Hypoxic states


What are seizure precautions?

oxygen and suctioning equipment

saline lock

place bed in lowest position: safety, protection, get to floor, pillow under head, on side/belly prevent aspiration

never insert padded tongue blades into clinets mouth during seizure


What is seizure management?

If simple partial seizure, observe clinet and document seizure

turn client on side during generalized tonic-clonic seizure

cyanosis usally is self-limiting

do not restrain


Drug therapy for a seizure?

Combination drugs

Take with or without food

Maintain therapeutic blood levels for maximal effectiveness


What is the client and family education for seizures?

Antiepileptic drugs may not be stopped, even is seizures stop

Refer limited-income clinets to social services

All states prohibit discrimination against people who have epilepsy

Alternative employment may be needed

Vocational rehab may be subsidized


What is status epilepticus?

prolonged seizures lasting more than 5 minutes or repeated seizures over 30 minutes

neurologic emergency that must be treated promptly and aggressively


What is status epilepticus treatment?

establish an airway

adminster oxygen as indicated

establish IV access for meds

for continuous monitoring, admit client to ICU

give IV diazepam, lorazepam, phentonin or general anesthesia