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Med Surg II > Neuro Conditions > Flashcards

Neuro Conditions Flashcards

1
Q

inflammatory conditions of the brain

A

brain abscesses, meningitis, encephalitis

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2
Q

bacterial meningitis

A

acute inflammation of meningeal tissue surrounding brain and spinal cord

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3
Q

when does bacterial meningitis occur

A

fall, winter, or early spring

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4
Q

what is bacterial meningitis typically r/t

A

a viral respiratory disease

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5
Q

what are the leading causes of bacterial meningitis

A

streptococcus pneumonial, neisseria, meningitis

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6
Q

pathophysiology of bacterial meningitis

A

organisms enter CNS through upper respiratory tract/bloodstream; may enter through skull wounds/fractures

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7
Q

inflammatory response of bacterial meningitis

A

increased cerebrospinal fluid production; purulent secretions spread to other areas of brain through CSF; cerebral edema and increased ICP becomes problematic (if extends to parenchyma)

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8
Q

key signs of bacterial meningitis

A

fever, severe headache, nausea, vomiting, nuchal rigidity

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9
Q

2 ways to check for bacterial meningitis

A

tuck chin in, light sensitivity, and fever

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10
Q

when would a coma be associated with a poor prognosis

A

photophobia; decreased level of consciousness

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11
Q

signs of increased intracranial pressure

A

seizure occurs in 1/3 cases; headache worsens; vomiting and irritability

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12
Q

complications of bacterial meningitis

A

increased ICP; residual neurologic function; optic nerve (CN II) compressed by increased ICP; ocular movements affected with irritation to CN III, IV, VI; CN V irritation; inflammation of CN VII; irritation of CN VIII; hemiparesis, dysphagia, hemianopsia; cerebral abscess, subdural empyema, subdural effusion, or persistent meningitis occurs if everything doesn’t happen

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13
Q

increased ICP s/s

A

major cause in change in mental status

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14
Q

residual neurologic function s/s

A

cranial nerves II, III, IV,V, VI, VII, VIII can become dysfunctional

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15
Q

optic nerve (CN II) compressed by increased ICP s/s

A

papilledema with possible blindness

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16
Q

ocular movements affected with irritation to CN III, IV, and VI s/s

A

ptosis, unequal pupils, diplopia

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17
Q

CN V irritation s/s

A

sensory loss and loss of corneal reflex

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18
Q

inflammation of CN VII s/s

A

facial paresis

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19
Q

irritation of CN VIII s/s

A

tinnitus, vertigo, deafness; hearing loss may be permanent

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20
Q

what might acute cerebral edema cause

A

seizures, CN II palsy, bradycardia, hypertensive coma, death

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21
Q

diagnostic studies for neuro condition

A

blood culture; CT scan; neutrophils are predominant WBC in CSF; x-rays of the skull; MRI

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22
Q

how can the diagnosis of bacterial meningitis be verified

A

lumbar puncture; analysis of CSF; specimen of secretions are cultured to identify causative; gram-stain to detect bacteria

23
Q

interprofessional care for bacterial meningitis

A

rapid diagnosis is crucial; this is a medical emergency

24
Q

what is started before diagnosis is confirmed for bacterial meningitis

A

broad spectrum antibiotics

25
Q

what should the initial assessment should include for bacterial meningitis

A

vital signs; neurological assessment; I&Os; evaluation of lungs and skin

26
Q

nursing diagnoses of bacterial meningitis

A

decreased intracranial adaptive capacity; ineffective tissue perfusion; hyperthermia; acute pain

27
Q

overall nursing goals for bacterial meningitis

A

return to maximum neurological functioning; resolve the infection; control pain and discomfort

28
Q

health promotion (implementation) for meningitis

A

vaccinations for pneumonia and influenza; meningococcal vaccines; early, vigorous treatment of respiratory infections; prophylactic antibiotics for anyone exposed to bacterial meningitis

29
Q

acute care (implementation) bacterial meningitis

A

close observation and assessment; provide relief for head and neck pain; position for comfort; darkened room and cool cloth over eyes for photophobia; minimize environmental stimulus (delirium and hallucinations may occur); provide safety

30
Q

observe and record seizures (implementation) bacterial meningitis

A

prevent injury; give anti-seizure drugs as ordered

31
Q

vigorously mange fever (implementation) bacterial meningitis

A

fever increases cerebral edema and risk of seizures; neurologic damage may result from high, prolonged fever

32
Q

ambulatory care (implementation) bacterial meningitis

A

provide for several weeks of recovery; increased activity as tolerated (stress adequate nutrition and encourage adequate rest/sleep); progressive ROM exercises and warm baths for muscle rigidity; ongoing assessment for recovery of vision, hearing, cognitive skills, motor, and sensory abilities; be aware of anxiety and stress felt by family and caregivers

33
Q

other nursing implementations for bacterial meningitis

A

assess for dehydration; follow designed antibiotic schedule to maintain therapeutic blood levels; respiratory isolation until cultures are negative

34
Q

nursing evaluations for bacterial meningitis

A

patient will: have appropriate cognitive function; AAOx3; maintain body temp within normal range; report satisfaction with pain control

35
Q

viral meningitis

A

treat with antibiotics after obtaining diagnostic sample but while awaiting test results

36
Q

what are the most common causes for viral meningitis

A

enterovirus, arbovirus, HIV, and HSV

37
Q

how is viral meningitis spread

A

direct contact with respiratory secretions

38
Q

how does viral meningitis present

A

headache, fever, photophobia, and stiff neck

39
Q

transient ischemic attack

A

a transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia, but without acute infraction of brain

40
Q

brain tumor

A

occur in any part of brain, benign and malignant, primary vs. secondary

41
Q

what does the brain tumor do

A

apply pressure to surrounding brain tissue causing decreased overflow of CSF resulting in increased ICP, cerebral edema, neurodeficits

42
Q

clinical manifestations of a brain tumor

A

dysarthria, dysphagia, positive romberg and babinski sign, vertigo, hemiparesis, loss of gag reflex

43
Q

manifestations of supratentorial tumors

A

severe headache, visual changes, seizures, loss of movement, cognitive function, paralysis

44
Q

manifestations of infratentorial tumors

A

hearing loss, facial drooping, dysphagia, hemiparesis, and ataxia

45
Q

diagnostics for brain tumors

A

CBC, x-ray, LP, cerebral biopsy, CT, MRI, renal, endocrine, lab work, and electrolyte status

46
Q

nursing management for brain tumors

A

maintain airway, safety and seizure precautions; administer O2; monitor lung sounds, neurological status

47
Q

medications for brain tumors

A

analgesics, steriods, anticonvulsants, antiemetic, H2 antagonists

48
Q

other treatment options for brain tumors

A

chemo, radiation, craniotomy

49
Q

complications

A

SIADH

50
Q

SIADH

A

fluid retained due to overproduction of vasopressin or antidiuretic hormone; hypothalamus is damaged

51
Q

s/s of complications

A

disorientation, headache, vomiting, muscle weakness, decreased LOC, irritability, weight fain, seizures, coma

52
Q

treatment for complication

A

fluid restriction; treat hypnotremia

53
Q

CSW

A

complication of CNS disease; causes hypnotremia and hypovolemia; monitor electrolytes, I&O, weight, fluid balance, hydration

Med Surg II (9 decks)

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