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Critical Care NSG > Neuro > Flashcards

Neuro Flashcards

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1
Q

Drugs, drops, and damages to the pons cause what?

A

Pinpoint pupils

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2
Q

Fear, seizures, cocaine, crack, and phencyclidine can cause what?

A

Dilated pupils

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3
Q

bruising over the mastoid areas suggestive of a basilar skull fracture

A

Battle Sign

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4
Q

Periorbital edema and bruising suggestive of a frontobasilar fracture

A

Racoon eye

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5
Q

Drainage of CSF from the nose suggests fracture of the cribriform plate with herniation fragments of the dura and arachnoid through the fracture

A

Rhinorrhea

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6
Q

Drainage of CSF from the ear is usually associated with a fracture of the petrous portion of the temporal bone

A

CSF otorrhea

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7
Q

Includes nuchal rigidity (pain and resistance of the neck flexion), fever, headache, and photophobia are signs of

A

Meningeal irritation

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8
Q

Decreased LOC, Restlessness, confusion, combativeness are S/s

A

early signs of increased ICP

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9
Q

Changes in VS in increased ICP is considered what?

A

Late sign

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10
Q

Vitals
late sign of increased icp
bradycardia
wide pulse pressure
changes in respiratory patters (Cheyne-stokes)

A

Cushing triad

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11
Q

Benzos are usually avoided in patients with ICP unless needed for what?

A

Seizures

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12
Q

why is analgesics and sedative intervention used during increased ICP

A

It reduced O2 needs, agitation, pain, and or discomfort that can lead to an increase in ICP

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13
Q

Most common anesthetics used during increased ICP

A

Propfol

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14
Q

Why are NBA paralytics used

A

to decreased CO2 and O2 needs, its usually a last resort

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15
Q

Used for htn in those with increased ICP

A

Nicardipine

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16
Q

With brain bleeds you want to avoid a map of

A

greater than 110

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17
Q

first line with neurp patients to decrease systemic bp

A

Ace and beta

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18
Q

Avoided during IICP due to cerebral edema

A

Calcium channel blockers

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19
Q

nursing managements for IICP

A

BP management, A line, Seizure precaution, low stimulation,

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20
Q

removing portion of the skull to allow for more room to swell after swelling improves, it is replaced

A

decompressive craniotomy

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21
Q

Managements of brain tumors include

A

corticosteroids, h2 receptor blockers, seizure medications, surgical managements, radiation therapy, chemotherapy.

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22
Q

management of aneurysm includes

A

clipping, wrapping, coiling, and pipelin

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23
Q

Manangment of brain tumors should take place within

A

24-48hrs

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24
Q

a tubing of nickel-cobalt chromium

A

pipeline

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25
Treatment of vasospasms
triple H therapy, Nimodipine, balloon angio, intra-arterial vasodilator
26
late signs of IICP
cushings abnormal posturing VFIB dolls eyes
27
what happens if CPP is greater than 100
It indicates hyperperfusion and IICP
28
what does less than 60 CPP mean
decreased blood supply and hypoxia
29
what does it mean if MAP=ICP
indicates no cerebral BF
30
what CPP level is maintained for critically ill patients
70
31
normal ICP
0-15
32
to maintain functional autoregulation what needs to be present
Normal PaCo2, Cpp >60 and MAP <160
33
fluid filled catheter inserted into the lateral ventricles via a burr hole. Allows CSF drainage and bedside monitoring
Vebtriculostomy
34
hollow, threaded screw is placed in the subarachnoid space. Connected by fluid-filled tubing to a transducer level with lateral ventricles.
subarachnoid screw
35
fiber-optic sensor inserted into the epidural space. Measures the changes in light reflected from a pressure-sensitive diaphragm in the catheter tip. Noninvasive and measures ICP.
Epidural or subdural sensor
36
Hypercapnua causes what?
Vasodilation
37
why is hyperventilation a tempory treatment for IICP
is causes a decrease in Co2 and vasoconstriction
38
what is contraindiciated in a patient with a TBI for the first 24hrs
Hyperventilation
39
ischemic stokes can be reversed with fibrinolytic therapy using what?
tPA
40
Can you use the same IV for other medications that was used for tPA?
No.
41
clinicals manifestations of stoke
weakness, numbness, visual changes, dysarthria, dysphagia, aphasia
42
Mycotic aneurysm is caused by what?
Infections
43
what is triple H therapy?
treat hypertension, hemodilution and hypervolemia that is causing Vasospasms
44
medications used to treat vasospasms
dopamin and levophed
45
a tangle of vessels, usually congenital and may enlarge with age
AVM
46
managements of ischemic stroke
tPa within 3-4 hrs of symptoms iv interventional therapy to remove clots within 8 hrs anticoagulation therapy BP control
47
management of hemorrhagic stroke
treat underlining condition such a hypertension, AVM, diagnose with CT
48
ensure what medication is available if the patient starts to have bleeding issues during code stroke
aminocaproic acid
49
Central technique of stimulation
Trapeziues pinch, sternal rub
50
arms are in full flexion on chest
decorticate
51
arms are stiffly extended, extension of legs -Hands are C
decerebrate
52
which pupil sign goes with brain stem injury
Dolls eyes
53
Signs of IICP and meningeal irritation
nucha rigidity, kernigs sign, fever, headache, and photophobia
54
Osmotic diuretic used to treat cerebral hypertension
Mannitol 0.25-2gm/ kg IV Filter needle target osmolality 320
55
How should you suction a patient and for how long
Limit passes 1-2 no more than 5-10 seconds.
56
Hypertonic NS 3% is an intervention for what?
Treat IICP.
57
positoning for a patient with iicp
HOB raised, head facing straight, neck neutral.
58
Accelerations injuries (head on collision) is what type of SCI
Hyperflexion
59
backward snap of spine by rear end collision, downward fall onto chin is what?
Hyperextension
60
caused by landing on feet from a height
axal loading/ compression
61
trauma of C4 and above the patient is at risk for what?
Impaired ventalation
62
priority intervention for SCI
Cervical spine stabilization
63
with SCI, you should always assesse for what
tracheal deviation
64
occurs with sci above T6 leading to vasoconstriction reflex
Autonomic dysreflexia
65
managements of autonomic dysreflexia
1- sit upright to decrease BP, administer nitrates and hydralazine
66
occures immediately or within hours of sci
spinal shock
67
flaccid paralysis, loss of reflexes below level of injury and paralytic ileus is s/s of
spinal shock
68
Can occur within 24 hrs of a SCI Hypotension, bradycardia, dependent edema, abrupt fever Tx with vasopressors, atropine, and IVF
neurogenic shock
69
you provide traction; immobilize spinal column
halo fixation
70
three cardinal findings of brain death
coma or unresponsiveness, absence of brainstem reflexes, apnea
71
test for brain death
motor testing pupillary repsponse oculocephalic refelx (dolls eys)
72
explain normal, abnormal and absent findings with a caloric water test
normal-eyes move abnormal- eyes do not move absent- eyes stay neutral
73
near temporal bone is associated with the epidural bleed/hematoma
Linear skull fracture
74
can be because they extend to brain matter at times. often results in a communication between the external and interbal environment (Risk for infection) but can allow movement of swelling with the brain
depressive
75
around the anterior, middle or posterior fossa
basilar
76
between the skill and dura, near the middle meneigeal artery.
Epidural hematoma
77
in the arachnoid matter,
subdural hematoma
78
aneurysms and avams are usually the cause. They can have surgery to stop the bleeding or balloon angioplasty.
subarachnoid hematoma
79
covers the actual brain. When people bleed here it is true intracranial bleeding.
pia matter
80
you should give patients with a brain bleed other things to treat fever besides what and why?
tylenol becuase it does not work with neurogenic fevers
81
management for intracranial bleeds
euvolemic protocol, monitor ecg changes, seizure precatuions, neuro assessment.
82
GSC score of 13-15 , lOC, amnesia for 5-60 seconds, no abnormal ct
mild head injury
83
gsc 9-12, LOC amnesia up to 24hrs.
moderate
84
gsc score 3-6 LOC. long term amnesia, cerebral contusuion, lascerations or hematoma
severe
85
therapeutic hypothermia can help what
ICP
86
seizures and fever are considered what
hyper metabolic situations
87
another way to treat ICP bu placement of this drain
EVD

Critical Care NSG (1 decks)

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