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Exam 2 - Block 2 > Neuro 1 > Flashcards

Neuro 1 Flashcards

(108 cards)

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1
Q

Which is the earliest sign of increasing intracranial pressure?

A

Change in level of consciousness

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2
Q

What are the symptoms associated with Cushing’s triad?

A

Bradycardia
Bradypnea
Hypertension (Pulse widening of 40 mmHg)

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3
Q

Extension and external rotation of the arms and wrists and plantar flexion of the feet is what form of posturing?

A

Decerebrate

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4
Q

The cranial vault contains brain tissue, blood, and cerebrospinal fluid; an increase in any of the components causes a change in the volume of the others. This hypothesis is called what?

A

Monro-Kellie

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5
Q

What is the priority concern for a patient with a change of level of consciousness?

A

Maintaining airway clearance

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6
Q

When a PT has an uncontrolled fever along with ICP, what would require immediate intervention?

A

Shivering

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7
Q

When assessing the pupils, what reaction would confirm increasing intracranial pressure?

A

Unequal response

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8
Q

Flexion of the elbows and wrists inwards, plantar flexion of the feet is what form of posturing?

A

Decorticate

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9
Q

What is the normal range of ICP?

A

0-15 mmHG / anything under 20 mmHg

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10
Q

Why is cerebral perfusion pressure needed?

A

To maintain adequate oxygen, blood, and nutrient to the brain

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11
Q

What is the normal range of cerebral perfusion pressure?

A

70-100 mmHg

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12
Q

How is cerebral perfusion pressure calculated?

A

CPP = MAP - ICP

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13
Q

If you need to increase cerebral perfusion pressure what 2 things could be done?

A

Reduce ICP
Support MAP via administering IV fluids or Vasodilators (Dopamine/Dobutamine)

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14
Q

How do you measure ICP?

A

Via Ventriculostomy

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15
Q

What is Ventriculostomy used for?

A

Draining CSF and lowering ICP while maintaining perfusion

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16
Q

What diagnostics are done when ICP is suspected?

A

CT scan and using the Glasgow Coma Scale

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17
Q

What signs and symptoms are monitored for ICP severity?

A

LOC
Glasgow coma scale (8 or lower?)
Pupils (sluggish, unilateral dilation, ptosis etc.)
Decreasing motor function
Posturing (Decorticate or Decerebrate)

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18
Q

What position do we place someone in that has ICP?

A

High fowlers with the head of the bed a 30 degrees

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19
Q

What treatments can be seen in Hospital for a ICP patient?

A

IV mannitol
Steroids (decrease inflammation)
Anticonvulsants (prevent seizures)
Antipyretics (prevent shivering and manage temp.)
Sedatives (relieve anxiety)
Analgesics (pain management)
Stool Softeners

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20
Q

What are our Nursing goals for a patient with ICP?

A

Decreasing of ICP
No infections
Education of: f/u appointments, important s/s to look out for, medication usage

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21
Q

What assessments are done for a patient with an altered level of consciousness?

A

Verbal responses present
Level of alertness
Motor response with or without posturing
Respiratory status
Pupils
Reflexes present

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22
Q

A CPP of less than 50 mmHg means what?

A

Permanent neurological damage

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23
Q

Focal seizures originate where?

A

On one hemisphere of the brain

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24
Q

Generalized seizures originate where?

A

Bilaterally in the brain

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25
"Provoked" seizures are related to what?
Acute and possibly reversible conditions due to things like electrolyte imbalances
26
What is agnosia?
The inability to interpret objects and sensation due to brain damage
27
What are risk factors for Stroke?
HTN, Diabetes, Oral contraceptives, CV disease, High cholesterol, Obesity
28
Strokes are also called?
Brain attacks
29
What are the 2 types of strokes?
Ischemic and Hemorrhagic
30
What occurs with Ischemic strokes?
Decreased blood supply and oxygen supply that causes tissue death
31
What are the types of Ischemic strokes?
Large artery Small penetrating artery thrombosis (Deep in brain) Cardiogenic embolism (A-fib caused) Cryptogenic (unknown cause)
32
What are the manifestations of an Ischemic stroke?
Numbness/Weakness/Total paralysis Change in mental status and confusion Dizziness/Loss of balance Sudden severe HA Perceptual/Vision disturbances
33
What is Hemiplegia?
Paralysis on one side of the body
34
What is Hemiparesis?
Weakness on one side of the body
35
What is Dysarthria?
Slurred speech/ trouble swallowing r/t muscle damage
36
What is Hemianopsia?
Blindness over 1/2 of the visual field
37
What is a Transient Ischemic Attack (TIA)?
Temporary neurological deficit that is the warning of an oncoming stroke
38
What is done to diagnosis a Hemorrhagic stroke?
CT scan
39
What management is done for a Hemorrhagic stroke?
Bed rest with sedation Treatment of: Vasospasm, increased ICP, HTN, Potential seizures and prevention of further bleeding
40
What medications are used for prevention of secondary TIA's?
Antihypertensives (ACE, ARBs, Beta blockers, Calcium channel blockers) Statin's Anticoagulant therapy (ASA, Clopidogrel)
41
What is the surgical treatment for prevention of secondary TIA's and Strokes?
Carotid endarterectomy for carotid stenosis (open the vessel to remove plaque)
42
What medical management is done for Acute Phase of Stroke?
Assessment of stroke with NIHSS tool Thrombolytic therapy Elevation of HOB Maintaining airway and ventilation Continuous hemodynamic monitoring
43
What is the cause of a Hemorrhagic stroke?
Bleeding into the brain tissue, the ventricles or subarachnoid space causing compression of the brain and ischemia
44
How do Hemorrhagic strokes present?
Severe HA Early/sudden changes to LOC Projectile vomiting Similar to Ischemic strokes
45
What nursing management is done for the acute phase of an Ischemic stroke?
Frequent monitoring of systems and vitals Monitoring: LOC, Motor symptoms, Pupil changes, I&O, Oxygen saturation
46
What assessments are done for a patient recovering from an Ischemic stroke?
Sensation/Perception Motor control Swallowing ability Nutritional/hydration status Skin integrity Activity tolerance Bowel and bladder function
47
What are the complications for one recovering from an Ischemic stroke?
PNA DVT's Inadequate O2 delivery to brain Decreased cerebral blood flow
48
What nursing interventions are done for one recovering from an Ischemic stroke?
Prevention of joint deformities Prevention of shoulder abduction Changing positions q2hr Prevention of shoulder pain Consults for speech therapy, OT, and PT Prevention of constipation
49
What are Nursing diagnoses for patients with Hemorrhagic strokes?
Risk for ineffective tissue perfusion R/T bleeding and vasospasm Anxiety R/T illness/medically imposed restrictions
50
What are the complications for a patient with a Hemorrhagic stroke?
Vasospasm (#1 cause death in subarachnoid pt's) Seizures Hydrocephalus (R/T impaired circulation) Rebleeding Hyponatremia (admin 3% IV and monitor)
51
What are nursing goals for a patient with Hemorrhagic stroke?
Improved cerebral tissue perfusion Relief of anxiety Absence of complications
52
What nursing interventions are done for one recovering from an Hemorrhagic stroke?
Relief of anxiety Re-orientation Seizure precaution Non-stimulating environment Visitor restriction HOB at 30 degrees with bedrest
53
What are the Infectious neurological disorders?
Meningitis Brain abscesses
54
What is Meningitis?
Inflammation of the meninges covering the brain and spinal cord
55
What are the 2 types of Meningitis?
Bacterial and Viral
56
How is bacterial Meningitis transmitted?
Secretions and Aerosol contamination
57
How does Meningitis present?
HA Fever Changes in LOC Nuchal rigidity Similar to the Flu
58
Who is eligible for the Meningococcal vaccine?
Youth 11-12 y/o
59
What is the medical management of bacterial Meningitis?
Dexamethasone (decreases brain swelling) High doses of broad-spectrum ABX Appropriate ABX
60
What are the concerns with Meningitis?
Dehydration Shock Seizurres
61
What is the Nursing management of Meningitis?
Pain and fever management Protection from injury R/T falls and seizures Frequent assessments of VS and LOC Monitoring daily weight, electrolytes, urine vol.
62
What is a positive Kernig sign?
The inability to fully extend one leg when the other is flexed upwards
63
What is a positive Brudzinski sign?
when the patients neck is flexed a instinctive flexion of the knees and hips occurs
64
How do brain abscesses form?
Via collection of infectious material from an uncontrolled infection
65
How do you prevent brain accesses?
Treating Otitis media and rhinosinusitis
66
How do brain abscesses present?
HA that is worse in the AM Fever Vomiting Neurological deficits S/S ICP
67
What diagnostics are done for a brain abscess?
MRI or CT CT-guided aspiration to identify pathogen
68
What are the nursing managements of brain abscesses?
Control ICP Drain abscess Administer ABX and corticosteroids
69
What is Encephalitis?
An acute, inflammatory process of the brain tissue
70
What causes Encephalitis?
Viral infections (Herpes) Vector-borne infections
71
How does Encephalitis present?
HA Fever Confusion Hallucinations
72
How does Vector-borne Encephalitis present?
Rash Flaccid paralysis Parkinson-like movements
73
What medication is used for HSV Encephalitis infections?
Acyclovir
74
What is the nursing management of Encephalitis?
Supportive care for symptoms
75
Which subtype of stroke is due to atrial fibrillation?
Cardio embolic
76
Which term refers to the inability to perform previously learned purposeful motor acts on a voluntary basis?
Apraxia
77
What is akathisia?
Restless, a need to move around and agitation
78
What is bradykinesia?
Slow movements and speech, seen in Parkinson's
79
What is dyskinesia?
Impaired, uncontrolled involuntary movements
80
What is parasthesia?
The sensation of numbness, tingling or pins and needles
81
Where are Gliomas located?
In the brain/spinal cord
82
How do Meningioma's present?
Encapsulated (usually benign)
83
What do Acoustic neuromas affect?
The 8th CN causing issues with hearing and balance
84
Who do Pituitary adenomas occur in most?
Childbearing age women
85
What are Angiomas?
Masses of abnormal blood vessels
86
Where do Astrocytoma's occur?
The brain stem
87
What diagnostics are done for Brain Tumors?
Neurological exams CT scans MRI (best diagnostic) PET scan EEG Study of cerebrospinal fluid Biopsy
88
What are the types of medical management for Brain tumors?
Surgery Radiation therapy Chemotherapy Pharmacologic therapy
89
Medical management for brain tumors depends on what?
The type, location, and accessibility of it
90
Intramedullary tumors occur where?
Within the spinal cord
91
Extramedullary tumors occur where?
Intradural, within or under the spinal dura
92
Extramedullary-Extradural tumors occur where?
Outside the dural membrane
93
What treatment is done to relieve compression on Spinal cord tumors?
Dexamethasone with radiation
94
What assessments are done for Brain tumors?
Baseline neurologic exams (looking for deficits) Pain checks Respiration monitoring Bowel and bladder function check
95
Parkinsons is caused by what?
A decrease in Dopamine in the substansia nigra
96
What are the cardinal manifestations of Parkinson's?
Tremor Rigidity Bradykinesia
97
What is Bradykinesia?
The slowing of voluntary movement
98
What is Akathisia?
Restless, urgent needs to move around and agitation
99
ALS is defined as what?
The loss of motor neurons in the anterior horn of he spinal cord
100
How does ALS present?
Atrophy of muscles Cramps Twitching Lack of coordination
101
How does Muscular Dystrophy present?
Muscle weakening and wasting
102
How does Degenerative Disc Disease present?
Low back pain
103
What is Radiculopathy?
Pain related to the compression of spinal nerves
104
How does post-polio syndrome present?
Musculoskeletal weakness & pain Fatigue
105
What 2 medications are used in Parkinson's?
Levodopa and Benztropine mesylate
106
What assessment is done for Cervical Discectomy?
Determining location, onset and pain radiation Assessing for paresthesias, ROM Assessing if is bilateral
107
What are complications with Cervical Discectomy?
Hematoma Spinal cord compression Persistant pain post SX
108
What is a Cervical Discectomy?
Surgery to remove a herniated or degenerative disc in the neck

Exam 2 - Block 2 (2 decks)

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