Neuro

Question 1

Autonomic dysreflexia patho

Answer 1

Caused by noxious stimuli below level of injury
Distended bladder - obstructed urinary cath, neurogenic bladder
Impacted rectum
Constricted clothing

Question 2

S+S of autonomic dysreflexia

Answer 2

Severe HTN
Severe HA, nasal stuffiness, and flushing
Bradycardia

Question 3

Tx of autonomic dysreflexia

Answer 3

Raise HOB
Loosen tight clothing
Check bladder distention or fecal impaction
Antihypertensive meds

Question 4

Bacterial meningitis S+S (early for neonates, peds, adults)

Answer 4

Neonates: poor feeding
Peds: fever, HA, vomiting
Adults: fever, HA, vomiting

Question 5

Bacterial meningitis (late cues for neonates, peds, adults)

Answer 5

Neonates: bulging fontanels
Peds: rash, neck stiffness
Adults: neck stiffness, Brudzinski, Kernig

Question 6

Brudzinski vs. Kernig

Answer 6

Brudzinski: Bend neck forward -> knee flex
Kernig: knee extension -> pain

Question 7

Labs of bacterial menigitis

Answer 7

Cloudy
High opening pressure
High WBC
High protein
Low glucose
Positive culture

Question 8

Frontal lobes

Answer 8

Voluntary mvt
Planning
Intellect
Problem solving
Abstract reasoning

Question 9

Temporal lobe

Answer 9

Hearing

Question 10

Parietal lobe

Answer 10

Touch perception
Mvt control
Manipulation

Question 11

Occipital lobe

Answer 11

Visual reception

Question 12

Cerebellum

Answer 12

Coordination
Balance

Question 13

Ischemic stroke risk factors (embolic)

Answer 13

Carotid artery dz
Atrial fibrillation
Abnormal cardiac values

Question 14

TIA

Answer 14

Angina of brain attack
Warning sign of stroke
Localized ischemic event -> resolves
Neuro deficits last only mins to hrs
Full fx recovery w/in 24 hrs

Question 15

Ischemic stroke S+S

Answer 15

BE FAST
Balance: ataxia and vertigo
Eyes: blurry vision, diplopia, visual field deficits
Face: weakness, drooping, numbness
Arms and legs: extremity numbness or weakness
Speech and swallowing: aphasia, dysarthria, dysphagia
Time: onset of symptoms

Question 16

Left hemi stroke

Answer 16

Language, reasoning, science, and thought

Question 17

Right hemi stroke

Answer 17

Spatial process, emotion, and visualization

Question 18

Nursing interventions of ischemic stroke

Answer 18

tPA
Monitor in ICU: bleeding precautions, neuro assessments, VS
Elevate HOB 15-30 degrees
Turn to unaffected side w/ head positioned midline

Question 19

tPA CI

Answer 19

Active bleeding
Recent brain/spinal surgery
Uncontrolled HTN (>185/110)
Low platelets or high PT/INR

Question 20

Hemianopsia pt teaching

Answer 20

Ask pt to move their head to scan full range of vision
Approach pt from unaffected side
Place pt’s personal objects w/in their visual field

Question 21

Ischemic stroke med management

Answer 21

Antiplatelet agents (aspirin)
Statins
ACE inhibitors

Question 22

Multiple sclerosis patho

Answer 22

Chronic autoimmune disorder
Brain and spinal cord are involved

Question 23

S+S of multiple sclerosis

Answer 23

Extreme fatigue
Eye symptoms
Lhermitte sign
Motor symptoms
Sensory symptoms
Bowel/bladder dysfx
Symptoms increase w/ heat exposure

Question 24

Tx of multiple sclerosis

Answer 24

Corticosteroids
Frequent rest

Question 25

Concussion (mild TBI)

Answer 25

Mild blow to head Brief or no loss of consciousness HA, dizziness, and amnesia No brain injury on brain scans Symptoms resolve w/in 3 days

Question 26

Contusion

Answer 26

Bruising of brain tissue Focal injury Symptoms depend on area of injury

Question 27

Diffuse axonal injury (cerebral edema)

Answer 27

High speed motor vehicle collision Shearing of white matter tracts Diffuse brain swelling Severe DAI -> coma

Question 28

Skull fracture

Answer 28

Linear, depressed, comminuted Underlying brain tissue injury Raccoon eyes Battle sign (bruising behind ear) Halo ring (CSF leakage)

Question 29

Basilar skull fractures are associated w/ what injury?

Answer 29

Intracranial injury

Question 30

Nursing interventions of TBI

Answer 30

Assume neck injury and stabilize cervical spine Oxygen IV access for 0.9% NaCl Endotracheal intubation for GCS score < 8 Pupillary assessment Check for rhinorrhea, ear drainage, scalp wounds HOB elevated 15-30 degrees

Question 30

Battle sign description?

Answer 30

Bruising behind ear

Question 31

Craniectomy interventions

Answer 31

Monitor for polyuria Manage pain w/ short-acting opioid analgesics Assess surgical site dressing for halos around drainage (clear-yellow ring = CSF leak) Place sign above sign indicating cranial bone flap or not

Question 32

Increased ICP S+S

Answer 32

Cushing triad: bradycardia, irregular respirations, widening pulse pressure Restlessness Unilateral pupil dilation (mydriasis) Flexed and pronated

Question 33

Cerebellum testing

Answer 33

Finger tapping Rapid alternating mvts Finger-to-nose Heel-to-shin

Question 34

Need for spinal immobilization

Answer 34

Neuro exam - numbness and decreased strength Significant trauma mechanism of injury Alertness (decreased) Distracting injury Spinal exam (NSAIDS)