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NCLEX > neuro > Flashcards

neuro Flashcards

1
Q

define glasgow coma scale

A

a scale that measures the degree or level on consciousness.

used to assess the level of consciousness or has the potential of altered consciousness.

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2
Q

three responses of the glasgow coma scale

A
  1. eye opening
  2. motor response
  3. verbal response
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3
Q

we like to have a number ranging from ___ for the glasgow coma scale.

A

13-15. 15 is the best score

never will be 0. at least 3

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4
Q

what is included in a neuro assessment?

A

glasgow coma scale
pupillary changes (normal pupil size 2-6) PERRLA
hand grips/lift legs/ pushing strenght of feet
reflex assessment (babinski reflex)

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5
Q

___ is always the #1 with neuro assessment.

A

LOC

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6
Q

babinski reflex

A

normal in a child up to 1 yr.
abnormal in an adult!
the adult or child greater then one year should have a planter reflex or curling or the toes when the bottom of the foot is stroked.

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7
Q

what does it mean if the adult has a present babinski reflex or faning on the toes when you stroke the bottom on the foot?

A

a severe problem in the central nervous system. (tumor or lesion on the brain or spinal cord, MS, lou gehrig’s disease)

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8
Q

a normal reflex response would be documented as ___.

A

2+/4+

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9
Q

will you need the client to sign a consent form prior to the test when using dye? (CT scan)

A

YES

CT takes pictures in slices(layers), head still, no talking.

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10
Q

MRI:

is dye used?

A

mri is better than ct. mri picks up on a problem earlier.

NO DYE. no radiation. a magnet is used.

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11
Q

cerebral angiography:

will a consent form be needed? why?

A

xray of cerebral circulation through the femoral artery.

yes signed consent because they are using dye

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12
Q

when cerebral angiography , what should you tell the patients?

A

they will have a warmth in the face and a metallic taste.

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13
Q

post procedure for cerebral angiography?

A

bed rest 4-6 hrs.
watch for bleeding at the femoral artery
embolus (embolus will go to brain bc of this… changes in loc, one sided weakness, paralysis, motor/sensory deficits)

***baseline neuro assessment before they go for procedure.

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14
Q

EEG helps to diagnose…

A

seizure disorders and evaluate the types of seizures occuring.

evaluates loss of consciousness and dementia

screening procedure for coma

indicator of brain death

used to diagnose sleep disorders

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15
Q

whats the one test we dont want client to be NPO

A

EEG

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16
Q

pre procedure of eeg

A

hold sedatives (decrease electricity in brain), no caffeine, not NPO (drops blood sugar)

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17
Q

how should a client be positioned with lumbar puncture?

A

back arched up!!

leaning on table or side lying fetal position

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18
Q

post procedure for lumbar puncture?

A

lie flat or prone for 2-3 hours
increase fluid to replace lost spinal fluid
HA most common complication

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19
Q

life threatening complication of lumbar punction?

A

brain herniation (with known increased ICP, a lumbar puncture is contraindicated)

meningitis

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20
Q

normal lab value for icp

A

0-15mmHG

21
Q

early sign of increased icp

A 
earliest sign? change in loc
speech slurred and slow
delayed in response to verbal 
increasing drowsiness
restless with no apparent reason
cofusion
22
Q

late signs of increased icp

A

marked changes in loc progressing to stupor, then coma!!
vital signs changes (cushing traid)
posturing

23
Q

cushing’s traid

A
  1. systolic hypertenson with a widening pulse pressure
  2. slow, full, and bounding pulse
  3. irregular respirations
24
Q

decorticate posturing

A

arms flexed inward and bent in towards the body and the legs are extended

25
Q

decerebrate posturing

A

all 4 extremities in rigid extension; WORST

26
Q

complications of increased ICP

A

brain herniation :this herniation obstructs the blood flow to the brain leading to anoxia and then brain death

DI and SIADH: can either so you must assess for both

27
Q

with increased icp, you should keep the temperature below ___.

they should be getting ___ saline and ____agents

A

100.4

isotonic and inotropic (to prevent hypotension)

28
Q

if the glasgow come scale is below 8, think ___

A

intubate

29
Q

meningitis

A

inflammation of the spinal cord or brain

can be either viral or bacterial. bacterial is transmitted throught the respiratory system

30
Q

s/s of meningitis

A
  • chills and fever
  • severe HA
  • N/V
  • nuchal rigidity (stiff neck)
  • photophobia
31
Q

tx meningitis

A

steriod
antibiotics if bacterial
analgescis
drop precautions for BACTERIAL meningitis

32
Q

bacterial meningitis is very contagious, medical emergency. it has a high mortality and _____ is recommended for college-aged students.

viral meningitis is transmitted by feces and requires ___ precautions . most commonly seen in infants and children.

A

immunizations

DROPLET PRECATIONS

contact precautions!

33
Q

partial seizure

A

is limited to a specific local area of the brain

an aura may be the only manifestation

called focal seizure

symptoms can range from simple to complex

34
Q

aura

A

things before seizure, bright light etc.

35
Q

simple symptoms

A

means without loss of consciousness; will see numbness, tingling, prickling or pain

36
Q

complex symptoms

A

means that they have impaired consciousness and may be confused and unable to respond

37
Q

generalized seizures

A

involves the entire brain

called non-focal seizure

loss of consciousness is the initial manifestations

38
Q

____ formerly known as grand mal
___sudden, brief contractions of a muscle or group of muscles
____ formerly called petit mal and characterized by a brief loss of consciousness.

A

tonic -clonic
myoclonic
absence

39
Q

a continuous seizure without returning to consciousness between seizures

A

status epilepticus

40
Q

anticonvulsants: can be long or short term therapy.

rapid acting are_____.
long acting are _____.

A

lorazepam and diazepam

phenytoin and phenobarbital

41
Q

battle’s sign

A

bruising over mastoid

42
Q

with basal skull fracture, where do you see bleeding

A

EENT

43
Q

how do we tell CSF from other drainage?

A

positive for glucose and the halo test (bloody spot on pillow then it will form a halo)

44
Q

non-depressed skull fractures usually ______; depressed fracture ___ surgery.

A

do not require surgery

do require

45
Q

what should you be watching for with a client with a concussion?

concussion is a temporary loss of neurologic function with complete recovery!

A

watch for increased ICP!

46
Q

epidural hematoma

is this an emergency?

A

rupture of the middle meningeal artery. fast bleeder under high pressure

injury—loss of consciousness–recovery period—cant compensate any longer—neuro changes

tx-burr holes and remove the clot; control the icp

YES THIS IS AN EMERGENCY

47
Q

subdural hematoma

A

usually a venous bleed.
can be acute (fast), subacute (medium), chronic (slow)

tx- chronic imitates other conditions. bleeding and compensating. neuro changes= maxed out (cant compensate anymore!!)

acute or chronic- immediate craniotomy and remove clot and control ICP

48
Q

autonomic dysreflexia

A

with upper spinal cord injury (above t6)!

sudden onset. medical emergency. hypertensive stroke could occur.

distended bladder, constipation, and painful stimuli can cause this

NCLEX (14 decks)

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