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NUR 333 Funds II > Neuro > Flashcards

Neuro Flashcards

(55 cards)

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1
Q

When beginning a neuro assessment what is most important to confirm?

A

Airway
Breathing
Circulation

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2
Q

Neuro assessment

A

general survey
LOC
orientation
subjective data
mental status
gait
reflexes
sensation
coordination
proprioception
GCS/EMV
pupils
visual fields
muscle strength
speech
swallowing
gag reflex

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3
Q

Who would need a focused neuro assessment?

A

bc of neuro disease
changes in neuro status
trauma
drug induced states
neuro complaints

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4
Q

4 Hs

A

hypoxia
hypoglycemia
hypotension
hypoventilation

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5
Q

Alert

A

awake
responsive
easily aroused
receptive and responsive

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6
Q

Lethargic

A

not fully alert
drifts off to sleep when not stimulated
drowsy
awakes to NAME
responds appropriately
slow to respond

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7
Q

Are lethargic patients airway ability intact?

A

yes

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8
Q

Obtunded

A

sleeps most of the time
doesn’t arouse to name
SHAKE to awake, LOUD shout
confused when aroused
mumbled speech, incoherent
requires constant stimulation

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9
Q

Are obtunded patients airway ability intact?

A

concerning, don’t feed for aspiration precautions

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10
Q

Stupor/Semi comatose

A

spontaneously unconscious
responds only to SHAKE or PAIN
groans, mumbles

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11
Q

Are stupor patients airway ability intact?

A

no, high concern

don’t feed, aspiration precautions

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12
Q

Comatose

A

completely unconscious
no meaningful stimuli
no motor response

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13
Q

GCS/EMV

A

graded 3-15
<7-9 comatose
objective assessment

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14
Q

What EMV score is the airway protection a concern?

A

7-9

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15
Q

What EMV score is unresponsive?

A

3

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16
Q

What is an exception to a low EMV score?

A

trach patients, who have no verbal ability

11T- appropriate and airway is protected

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17
Q

Proprioception

A

recognize where your limbs are in space

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18
Q

Coordination

A

rapid alternative movements

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19
Q

What is the goal for neuro patients?

A

protect status and maintain safety
assist patients in gaining independence

protect airway!

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20
Q

Skin care for neuro patients

A

monitor and assess skin
q2 turns
pressure distribution
mobility
elimination needs

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21
Q

Neuro Dx

A

x-ray
CT scan
contrast
MRI
EEG

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22
Q

What is the least invasive way to diagnose?

A

x ray

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23
Q

X ray

Study These Flashcards
A

skull
spinal

no NPO
keep c collar on
remove metal objects
painless

24
Q

CT scan

Study These Flashcards
A

3D images of organs, bones, tissues
detects hemorrhage, vascular abnormal, tumor, cysts
no NPO

identify allergies to iodine
NPO for some
claustrophobic

25
Contrast
PO, IV, rectal helps distinguish selected body parts from surrounding tissues *blood flow through brain can be iodine based-allergies
26
MRI
more detailed than CT no exposure to radiation expensive screen for metal-remove it! remove medicated patches
27
Who should you call if you are questioning if a MRI is safe for the patient?
radiology
28
Electroencephalogram EEG
monitors brain activity helps diagnose seizures confirms brain death electrodes places on skull with conduction paste
29
Factors influencing sensory function
age meaningful stimuli amount of stimuli social interaction enviromental factors cultural factors
30
Who is at risk for for sensory alterations?
farmers outdoor laborers night shift workers nuns, monks OA confined environments acutely ill
31
Common visual deficits
presbyopia cataracts computer vision syndrome dry eyes glaucoma DM retinopathy macular degeneration
32
Receptive aphasia
inability to understand written or spoken language trouble to UNDERSTAND
33
Expressive aphasia
inability to name common objects or express ideas in words or writing trouble to TALK can still understand
34
Care for visual deficits
announce self stay in visual field speak in warm, present tones explain care prior keep paths clear orient to room
35
What is the technique with ambulating a patient with visual deficits?
pace of patient 1/2 step in front of patient walk beside patient have them hold your arm
36
What size and color of text should you supply with visual deficit patients?
red and yellow large text
37
Care for hearing deficits
check for cerumen impaction amplify sounds add flashing lights for safety slow/normal tone short sentences communication boards face patient when speaking
38
Care with taste deficits
well seasoned food several textured food stimulate smell with aromas serve most appealing foods use plate as clock don’t bland or blend food
39
Care with smell deficits
smoke detector check food dates and appearance (teach) danger with cleaning chemicals no gas appliances
40
Care with tactile deficits
touch therapy turning, repositioning hyperesthesia, minimize irritation, avoid loose linens adapt with water temp, ice/heat, shoes
41
When are yes/no questions appropriate?
common communication deficits
42
Sensory deprivation causes
isolation loss/impairment of senses confinement emotional disorders brain injuries
43
Nursing care for sensory deprivation
slow opportunity for stimuli interaction tactile stimulation reorientation assistive devices **meaningful stimuli
44
For sensory deprived patients, is constant visitors or small 1-1 visits more appropriate?
small 1-1 visits
45
Care for community dwelling deprivation
encourage community agencies programs, rehab, OT clinic
46
Sensory overload
excessive stimuli often confused with mood swings
47
Causes of Sensory overload
pain lack of sleep ICU care visitors/ staff
48
Care for Sensory overload
orient control stimuli uninterrupted periods schedule visitor control
49
Migraine types
tension headache migraine headache cluster headache
50
Migraine
recurring headache characterized by unilateral throbbing pain
51
Who are migraines more common in?
women
52
Who are cluster headaches more common in?
men, 25-55 years
53
What are premature sx of migraines?
aura, hours to days before
54
Care for migraines
rule out intracranial or extracranial disease, meningitis meds-NSAIDS, tylenol, aspirin, excedrin, caffeine high flow O2 for cluster headache (no rebreather 6-8L/10 min)
55
CYP 450 pathway
substrates: 2nd drug Inducers: speed up, less absorbed, DECREASE effects Inhibitor: slows down, substrate stays in body longer, more toxic

NUR 333 Funds II (9 decks)

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