neuro Flashcards
(116 cards)
1
Q
what causes a stroke
A
stroke is caused by a narrowing or blocking of view.
ischemic and hemo stroke and tia
2
Q
ischemic
A
ischemic
embolic stroke: afib blood clot that travels the blood vessels
thrombotic: HTN/hyperlipidemia: in the circulatory sys
3
Q
where do the blood flow come from
A
carotid or vertebral arteries
4
Q
apraxia
A
you cant use objects properly or carry our commands/movements
5
Q
agonsia
A
cant recognize objects
loss of comprehension of visual, auditory through sensory sphere
6
Q
dysphagia
A
cant swallow
7
Q
dysphasia
A
cant comprehend or speak
8
Q
dysarthria
A
difficulty speaking because of tongue muscles
9
Q
hemiplegia
A
paralysis on one half of the body
10
Q
paraplegic
A
lower body
11
Q
quadplegic
A
4 extremities
12
Q
hemiparesis
A
mild or partial weakness/loss of strength on one side of the body
13
Q
subjective
A
- PMH
- Meds?
- ask them if they had any surgerys
- developmental delays
14
Q
objective
A
- assess their appearance
- behavior
- cognition: time place person situation
- mooood aand affect.
- cranial nerves
- motor system
- sensory: touch
- reflexes
15
Q
glasgow coma scale
A
3-15
higher the better
eyes
mouth
moving
16
Q
less than 8 glasglow
A
intubate
17
Q
NIH stroke scale
A
15
0-15
0 is normal
18
Q
CSF
CSF Analysis-lumbar puncture
- is there a signed consent?
- what position should the patient be?
- what should the patient do after the procedure?
- what should the nurse encourage/advise the patient to do?
- nursing intervention
A
- yes. invasive and its aspects
- lateral recumbent position
- lay for an hour
- encourage fluids
- take vital signs and neuro status for headache
19
Q
Cerebral Angiography
prep op
- is patient on NPO
post op
- how frequent are VS
- is patient ambulating or bedrest
A
- yes because its dye
- 15-30 mins for 2 hours, 1 for 6 hours, 2 for 24 hours
- bedrest
20
Q
CT scan neuro with dye
A
assess for allergeis
IV in case allergies
patient is still
give IV fluids
21
Q
MRI
MRI with angiography
A
metallic (tattoo)?
pacemaker)
may need xanny for claustrrophobia
takes one hour
22
Q
SPECT
A
IVs
no sedatives
empty bladder
glucose monitor
23
Q
myelogram
A
dye is injected into the spinal cord
empty bladder
SEDATE THE PATIENT
REMAIN FLAT
24
Q
EEG
A
hold anti seizure meds because we want to see the seizures for one day
25
seizure
uncontrolled electrical discharge of neurons
26
seizures metabolic disturbances
* acidosis
* electrolyte imbalances
* hypoglycemia
* alc or barb withdrawal
* too much water too little water
27
extracrancial disorders
sepsis
lupus
HTN
DM
heart lung kidney liver
28
risk factors for seizures
low ses
AA
male
heredity
60 yrs old
29
when is the sensory warning phase
aural
30
tonic-clonic
LOC
stiffening(tonic)
jerking (clonic)
**could have tongue or cheek biting or incontinence**
post itcal: muscle soreness, no memory, fatigue
31
abscene seizure
* happens in children
* daydreaming spell
* can be mis dx as ADHD
* child is hyperventilation and flashing lights
32
what can patients do in the prodromal stage
take their shirt off
33
what can patients do during the aural phase
smell things
hallucinate
34
atypical absence seizure
staring pell
lip smacking and eye twitching
35
myoclonic
excessive jerking
atonic: drop attack they will gain con after drop
36
tonic
increased muscle tone
37
clonic
LOC
loss of muscle tone while jerking
and it could be ASSYMETRIC
38
partial seizures
stays on one side but can spread to other side to turn into generralized
39
partial seizures only include
simple and complex
40
simple seizure
patient is **conscious**
has weird feelings of emotions like happy and sad
starts to hallucinate and see smell taste things that are not there
41
complex focal seizures
change or LOC: dream like
automatic behavior: repetitive movement
does not remember activity before the seizure
lasts a few sec
42
psychogenic seizures
physical manifestation of a psych disturbance
43
how long does status epi last
more than 5 mins back to back
44
why is SE an emergency
patient can go into respiratory or cardiac arrest
45
which seizure for SE is the worst
tonic clonic
46
what can happen from SE
permanent brain damage or even death or severe injurry
47
SE is more common in what gender
male
48
what meds do you give for SE
IV lorazepam and diazepam
49
what drugs do you give for generealized tonic clonic
pheny
carb
phenobarb
depakote
50
what do the meds do for patients with seizures
stabilize nerve cell membrane and prevent spread of epileptic discharge
51
what drug is contraindicated for liver disease
phenytoin
52
absence and myoclonic meds
clozepam
depakote
53
what are other therapies for seizures
- keto
- vagal nerve stimulation
- anterior temporal lobe resection
54
Nursing Assessment Subjective and Objective for seizures
what were you doing before? auras? where was it? also the time of it?
what the the post itcal phase? LOC/VS/ Muscle soreness and weakness
55
1 number NANDA for seizures
ineffective breathing pattern
56
can you leave the seizure patient alone
NO
57
what should you do if the patient is having a seizure
place them on the side, loosening clothes, ease to the floor
PATENT AIRWAY
do not restrain patient
observe the movements and location
DO NOT POSITION, SUCTION, OR GIVE OXYGEN
58
how can we prevent injury for seizures
wear helmet
padded bed rails
59
what is TIA
transient episode of neuro dysfunction caused by focal brain, spinal cord, retinal ischemia
60
how long can a TIA last
less than 1 hour
61
what are carotid system symptoms?
numbness
hemiparesis
loss of sensation and vision
can't speak
62
what are vertebrobasilar systems
tinnitus
vertigo
blurred vision
ataxia
63
what is the most common stroke
thrombotic
⅔ of the cases is because HTN and DM
64
what is the main symptoms of intracerebral hemorrhage
HA
N
V
decreased LOC
65
what causes intracerebral hemorrhage
HTN
66
what causes subarachnoid hemorrhage
coke, aneurysm rupture, trauma
67
what are signs and symptoms of subarachnoid
LOC
N
V
SEIZURES
STIFF NECK
68
what is the right sided stroke
* **left-sided neglect ONLY WITH THE RIGHT SIDED STROKE**
* spatial and perceptual deficits
* impulsive
* short attention span
*
69
what is the left sided stroke
* math
* speech
* writting
* slow and cautious
70
aphasia
total loss of comprehending and using lang
71
expressive aphasia
patient can understand but can't speak brocas
72
receptive aphasia
patient cant understand whats writtten
wernecks
73
dysphasia
impaired ability to understand or use the spoken word
74
expressive dysphasia
they can't put words together to make a meaning
75
receptive dysphasia
difficult in comprehending. speak slowly so the patient can understand
76
right side spatial and perceptual
agnosia
apraxia
incorrect perception of themselves
77
what is the most important for stroke dx
non-contrast CT scan
MRI
78
how can we prevent strokes
-healthy diet
weight control
regular exercise
no smoking
limit alc
control BP
79
how can we prevent thrombus/emobolus
ASA and Plavis
80
anticoag with a fib and TIAA
rda ans and warfarin
81
what surgical interventions can we do for TIAA
* carotid endartectomy
* transluminal angioplasty
* stenting
82
carotid endarterectomy
move fatty plaques from BV
83
transluminal angioplasty
balloon to crack it up
84
stent
put a stent that holds up the blood vessel especially when its weakneded
85
hemorrhage stroke surgical therapy
resection
clip the aneurysm
get rid of the hematomas
86
tpa should be
administered within:
rule out:
prior to admin:
after admin:
3 hours
hem. stroke, GI bleeds, BP over 190, stroke, head trauma, major surgery in last 14 days
prior to admin: foley, IV sites, NG tube
after admin: monitor for bleedings, neuro EVERY 30 mins, BP control.
87
what drugs are contraindicated in hem. strokes
anti coags and platelets
88
for hem. strokes how can we manage HTN
IV metoprolol
make sure the BP is less than 160
89
for hem. strokes how can we manage HTN
IV metoprolol
make sure the BP is less than 160
MANAGE SEIZURES
90
how can we management ICP for hem strokes
dopamine(vasoconstrict)
mannitol
drain the fluid(ventriculostomy)
91
SEIZURES CAN HAPPEN WITH WHAT STROKE
Hem Stroke
92
what are the goals for stroke
preserve life
no furture brain damange
reduce disability
93
emergency care for stroke: nurse should
airways: get rid of dentures
IV
CT scan non contrast for I stroke or H stroke
Elevate patient
Seizure precautions
NPO BECAUSE RISK OF ASPIRATION!
94
who assessing the the gag reflex
speech therapist
95
priority for stroke patients
risk for aspiration pneumonia if patient has dysphagia
96
vital signs for stroke
assess for lung sounds because remember patient got mannitol
BP
bleeding
VTE assessment in case the clot travels or forms
97
range of motion for stroke
early mobility
hand cones for contractures(hardening of muscles and this can stiffen their joints)
trochanter roll at hip
DO NOT pull the patient
use splints
98
left-sided stroke communication
nonverbal cues and can't comprehend
99
Multiple Sclerosis is CPD
chronic
progressive
degenerative
demylination of nerrve fibers
100
risk factors for multiple sclersosis
* gender and age: women between age of 20-40
* climate: temperate climites
101
what triggers MS
bacterial
viral
102
MS death occurs because of
infection
103
lifespan for MS
more than 25 years after dx
104
what are the first symptoms of MS
visual distubrances
105
motor MS signs and symptoms
* weakness
* spanning speech: long pauses
* spasticity of muscles
106
sensory
* flaccid/spastic bladder(incontience)
* lhermittes
* numbness/tingling
* tinnitus
107
cerebellar
dysphagia
dysarthria
108
DX for MS
MRI: plaques
CSF: oliogbands
109
how to diagnosis MS
evidence at least 2 lesions at two different locations within CNS
damange occuring usually one month part
eveything else has to be rule out
110
what should you give if the MS is being exacerbations
corticos
111
MS nutrition
Vitamin B12 and C
low fat, gluten free diet
high protein
112
MS
Impaired physical mobility
113
can ms patients have dysphagia
mid
114
a male client is having a tonic clonic seizures what should you do first
take measures to prevent injury. dont elevate bed you have to lower it.
115
can you give patients thin liquids if they have strokes
no
116
does generalized have an aura
NO
