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From Flashcardlet > Neuro Assessment Part 1 > Flashcards

Neuro Assessment Part 1 Flashcards

1
Q

What types of changes need to be assessment with neuro?

A

everything, especially subtle

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2
Q

What is the most metabolic organ of the body?

A

brain

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3
Q

If the brain doesn’t get continuous O2 and glucose, what will happen?

A

neuro changes

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4
Q

How much of glucose consumption is in the brain?

A

10%

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5
Q

How much of the body caloric needs are in the brain?

A

20%

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6
Q

What are the 7 components of a neuro assessment?

A 
Patient History
Level of Consciousness (LOC)
Mentation
Cranial Nerve Assessment
Pupils
Sensorimotor Function
Vital Signs
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7
Q

When obtaining a patient history, what is important to know about timing?

A

the onset of the mental status change

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8
Q

What is sudden onset of MSC due to?

A

trauma, medication, bleeding

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9
Q

What is gradual onset of MSC due to?

A

metabolic things, fall several days ago that has subderal hematoma, slow growing tumor

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10
Q

What is the single most important sign in a neuro assessment?

A

level of consciousness

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11
Q

Which LOC is AAO x3m comprehend spoken and written words, and expresses ideas verbally and/ or written?

A

Full consciousness

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12
Q

Which LOC is disoriented to time, place, or person, shortened attention span, memory difficulty, possible hallucinations, may be agitated or restless?

A

Confusion

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13
Q

Are people disoriented to person, place, or time first?

A

time, then place, then person

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14
Q

When is confusion typically worse?

A

At night, sundowning

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15
Q

Which LOC is oriented x3 but slow and sluggish in speech, mental process, cognition, and motor activities?

A

Lethargy

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16
Q

Which LOC is readily arousable if stimulated, able to respond verbally in word or two and follow simple commands but is otherwise very drowsy?

A

obtundation

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17
Q

Which LOC lies quietly with minimal spontaneous movement and is generally unresponsive except to vigorous and repeated stimuli?

A

Stupor

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18
Q

With stupor, what will repeated stimuli do?

A

make them make incomprehensible sounds or eye openings

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19
Q

Do people in stupor respond appropriately to pain?

A

yes

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20
Q

Which LOC appears in a sleep-like state, doesn’t respond to body or environmental stimuli, makes no verbal sounds?

A

Coma

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21
Q

Are eyes open or closed with Coma?

A

closed

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22
Q

Which coma is unarousable and has no spontaneous movement, but will withdraw purposefully to painful stimuli?

A

light

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23
Q

Are brainstem reflexes intact with Light Coma?

A

yes, so they should have gag/corneal/pupil reflexes

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24
Q

Which coma is unarousable and withdraws non-purposefully to pain?

A

Coma (middle)

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25
Q

Are brainstem reflexes intact with coma coma?

A

may or may not be

26
Q

Are they posturing in coma coma

A

may or may not be posturing

27
Q

Which coma is unarousable, unresponsive to pain with no brainstem reflexes and posturing?

A

deep

28
Q

What posture are they normally in with deep coma?

A

decerebrate

29
Q

What is another term for chronic coma or irreversible coma?

A

persistent vegetative state

30
Q

What are you in when your eyes are typically open and you are in a state of permanent unconsciousness?

A

persistent vegetative state

31
Q

Do you have a sleep cycle with persistent vegetative state?

A

yes

32
Q

Are you aware of the environment or yourself in persistent vegetative state?

A

no

33
Q

What is a state of paralysis that involves voluntary muscles despite full consciousness and intact cognitive functions?

A

Locked-In Syndrome

34
Q

What movement can you make with locked-in syndrome?

A

blink and move eyes

35
Q

What happens when people who are physically locked into a body that doesn’t work, but their brain is fine?

A

locked-in syndrome

36
Q

What is an irreversible loss of both cortical and brain stem activity?

A

brain death

37
Q

Is there any brain stem reflex or cortical activity with brain death?

A

no

38
Q

Is brain death reversible?

A

no

39
Q

What is a universally recognized, accepted tool for evaluation and determination of levels of consciousness?

A

Glasgow Coma Scale

40
Q

Is glasgow coma scale a neuro assessment?

A

no, it is a determination of the LOC

41
Q

Can glasgow coma scale be a indicator for intracranial pressure?

A

yes, but it is not an assessment of it

42
Q

What are the 3 categories for glasgow?

A

eye, verbal and motor

43
Q

What score does a fully alert patient get?

A

15

44
Q

What type of injury would 13-14 indicate?

A

mild head injury

45
Q

What type of injury would 9-12 indicate?

A

moderate

46
Q

What type of injury would less than 7 indicate?

A

severe and probable coma

47
Q

What is the lowest score for glasgow?

A

3

48
Q

What are the 4 parts of the eye portion of glasgow?

A

Spontaneous (4)
To verbal command (3)
To pain (2)
None (1)

49
Q

What are the 5 parts of the verbal portion of glasgow?

A 
Oriented (5)
Disoriented (4)
Inappropriate words (3)
Incomprehensible sounds (2)
No response (1)
50
Q

When does glasgow become inaccurate?

A

in verbal portion if ET tube is in (chart 1T)

51
Q

What are the 6 parts of the motor portion of glasgow?

A 
Obeys verbal command (6)
Localizes painful stimulus (5)
Withdraws from pain or posturing in a decorticate fashion (4)
Flexion or decerebrate (3)
Fully extended (2)
No Response – flaccid (1)
52
Q

What does localizes painful stimulus mean?

A

Attempt to move and also attempt to remove the stimulus

53
Q

What do you assess when look at mentation for neuro assessment?

A 
general appearance
mood and affect
cognitive function
attention and concentration
short-term memory
recent memory
abstract reasoning
insight and judgement
54
Q

When would assessing general appearance be most appropriate?

A

in ER, in ICU they stay however we make them

55
Q

What tells us a lot about a persons mental state, unless medicated?

A

mood and affect

56
Q

How do you assess attention and concentration?

A

have them count backwards by three

57
Q

How do you assess short term memory?

A

tell them 3 words and ask them to repeat them 5 min later

58
Q

How can you assess recent memory

A

ask who brought them to the hospital or what they ordered for lunch

59
Q

How do you assess abstract reasoning?

A

have them interpret a proverb

60
Q

How do you assess insight and judgement?

A

give them a situation they need to judge what to do. Like what would you do if there was a a fire in the trash can?

From Flashcardlet (107 decks)

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