neuro part 1 (3)

Question 1

when in gestation does the neural tube begin to form?

Answer 1

4th week

Question 2

why is the brain and spinal cord at greater risk for injury in gestation?

Answer 2

they are formed really early on

Question 3

describe CNS at birth

Answer 3

complete but immature

Question 4

what cells enable receipt of nerve impulses

Answer 4

glial cells and dendrites

Question 5

why does head circumference increase in infants and toddlers

Answer 5

brain growth

Question 6

when does brain growth stop

Answer 6

12-15 years old

Question 7

what is associated with the presence of infant refelxes?
a) lack of myelination
b) hypoxia
c) structural defects
d) infections

Answer 7

a) lack of myelination

Question 8

what is the progressive covering of axons with layers of myelin or a lipid protein sheath is incomplete at birth

Answer 8

myelination

Question 9

what accounts for progressive acquisition of fine and gross motor skills , coordination, and loss of infant reflexes in early childhood

Answer 9

myelination

Question 10

what reflex has the baby extend the arms and fingers to form a C after being startled

Answer 10

moro

Question 11

when does moro reflex disappear

Answer 11

6 months

Question 12

which infant reflex is when you place a finger in the baby’s palm (not touching thumb). strong grip around finger

Answer 12

palmer grasp

Question 13

when does the palmer grasp go away

Answer 13

3 months

Question 14

What reflexes when you place a finger across the foot at the base of the toes, toes curl to grip the finger

Answer 14

plantar grasp

Question 15

when does plantar grasp disappear

Answer 15

8months

Question 16

What reflexes when you hold the infant erect and touch the top of one foot to the table or the chair, foot lifts as if to step onto the surface

Answer 16

placing reflex

Question 17

When does the placing reflex disappear

Answer 17

several times

Question 18

which reflexes when you hold the infant erect and touch the bottom of the foot on the surface, feet will lift in alternating pattern as if walking

Answer 18

stepping

Question 19

When does the stepping reflex disappear

Answer 19

4-8 weeks

Question 20

what reflexes when you place the infant supine and turn the head to one side, arm and leg on the face side extend an opposite arm and like flex, fencing position

Answer 20

tonic neck

Question 21

When does the tonic neck reflex appear and disappear?

Answer 21

Appears at two months, disappears four to six months

Question 22

what are spaces of connective tissue covering the brain at the junction of scroll bones which allow for brain growth

Answer 22

fontanels

Question 23

what happens if the fontanels close prematurely?

Answer 23

It will not allow proper head growth

Question 24

when does the posterior fontanelle close?

Answer 24

2-3 mo.

Question 25

When does the anterior fontanel close?

Answer 25

12-18 mo.

Question 26

Which fontanelle shows signs if there is increased intracranial pressure

Answer 26

anterior

Question 27

brain growth continues until what age?

Answer 27

12-15

Question 28

What is the most important indicator of neurologic dysfunction?

Answer 28

level of consciousness

Question 29

What is the responsiveness of the minds to censor stimuli

Answer 29

consciousness

Question 30

what are the two components of consciousness?

Answer 30

alertness cognitive power

Question 31

Which component of consciousness is the ability to react to stimuIi?

Answer 31

alertness

Question 32

Which component of consciousness is the ability to process the data and respond either verbally or physically?

Answer 32

cognitive power

Question 33

What can cause changes in level of consciousness? select all 1. inadequate folic acid 2. teratogens 3. infection 4. substance abuse 5. trauma 6. caffeine

Answer 33

2345

Question 34

T/F? Intracranial pressure is the force exerted by brain tissue, cerebrospinal fluid and blood within the cranial vault

Answer 34

true

Question 35

symptoms of a decline in LOC would include? Select all. 1. Slight disorientation to time and place 2. restless and fussy 3. will respond to soft verbal commands 4. Lethergy

Answer 35

124

Question 36

early clinical manifestations of increased intracranial pressure would include? Select all. 1. Headache 2. nausea and vomiting 3. Slight change in vital signs 4. peoples not as reactive or unequal 5. oriented to person, place and time and situation

Answer 36

1234

Question 37

What change in vital signs occur in the early stages of increased intracranial pressure?

Answer 37

tachycardia, Inc. temp with infection, increased in BP

Question 38

Late signs of intracranial pressure include which of the following? 1. Significant decrease in level of consciousness 2. Increased systolic blood pressure, wide pulse pressure 3. bradycardia 4. Irregular respirations 5. Fixed and dilated pupils 6. tachycardia 7. seizures

Answer 38

123457

Question 39

What are the symptoms of Cushing's triad related to increased intracranial pressure

Answer 39

1. increased systolic blood pressure, wide pulse pressure 2. bradycardia 3. irregular respirations

Question 40

which tool is used in the assessment of coma in infants and children, it enables future comparison of improvement or deterioration

Answer 40

Glasgow coma scale

Question 41

What diagnostic tests are done for alternative level of consciousness?

Answer 41

* CBC, electrolyte, blood culture * toxicology, blood, urine * lumbar puncture * EEG * CT * MRI

Question 42

Therapy for alter level of consciousness

Answer 42

find cause and treat

Question 43

nursing management for altered level of consciousness

Answer 43

* Maintain airway * assess/vitals * mouth care * integumentary * nutrition

Question 44

what are the immediate interventions for a jerking a seizure?

Answer 44

* airway assessment * assess safety * position on side * suction available * get help * monitor seizure activity * assess LOC * vitals/assess after * administer meds

Question 45

How long is the loss of consciousness from a tonic clonic seizure?

Answer 45

1-2 mins

Question 46

which tonic clinic phase Is where the body goes stiff and rigid due to muscle contraction

Answer 46

tonic

Question 47

which phase of tonic clinic is rhythmic jerking motion of muscles

Answer 47

clonic

Question 48

which seizure is a result of diffuse electrical activity that begins in both hemispheres of the brain simultaneously

Answer 48

tonic clonic

Question 49

What kind of seizure is a tonic clonic seizure

Answer 49

generalized

Question 50

what area of the brain does a tonic clinic seizure spread?

Answer 50

cortex/brainstem

Question 51

Describe facial appearance of tonic clonic seizures?

Answer 51

eyes roll upward or deviate to the side, pupils dilate, drooling or foaming at the mouth due to secretions

Question 52

describe airway, BMR, and urinary/bowel in tonic clonic seizures

Answer 52

* airway compromised * BMR rise (Inc oxygen demand) * urinary/bowel incontinence

Question 53

What are the two types of seizures

Answer 53

focal/partial, generalized

Question 54

what age do absence seizures occur?

Answer 54

4-10 years

Question 55

describe absence seizures?

Answer 55

Brief loss of consciousness, rarely longer than 30 seconds, usually five to 10 seconds

Question 56

How often do absence seizures occur?

Answer 56

can be 50-100/day or more

Question 57

What kind of seizures is where there is no loss of consciousness, lasts less than 30 seconds

Answer 57

simple partial

Question 58

What is another name for a simple partial seizure?

Answer 58

focal

Question 59

What kind of partial seizure is where consciousness is impaired for 30 seconds to five minutes?

Answer 59

complex partial

Question 60

What was the period following this season were a level of consciousness is decreased?

Answer 60

postictal phase

Question 61

What is a prolonged continuous seizure of 15 minutes or intermittent seizures lasted more than 15 minutes without a full recovery between them?

Answer 61

status epilepticus

Question 62

Which of the following is true about febrile seizures? Select all. 1. Rapid rising temperature 2. occurs between nine months and five years old 3. always needs treated long term 4. family history 5. increased risk of future febrile procedures if they have one

Answer 62

1245

Question 63

when are febrile seizures treated?

Answer 63

when they are repeated, use anticonvulsants, not treated if it only occurred once

Question 64

when can ibuprofen be used?

Answer 64

when older than 6 months

Question 65

What diagnostic testing for seizures?

Answer 65

* CBC, elec * urine/blood/lumbar puncture * lead level, urine/blood toxicology * inborn errors of metabolism * medication blood levels * EEG * MRI/CT

Question 66

what kind of drug therapy is preffered to treat seizures (decreases side effects)

Answer 66

mono-therapy (one drug)

Question 67

how effective is mono-therapy for seizures, and when would a second med be added?

Answer 67

effective for 50% of new onset seizures, second med added if poor control

Question 68

what classifies intractable seizures

Answer 68

continues to have seizures with 3+ meds

Question 69

what are options of therapy for intractable seizures (3)

Answer 69

1. surgery (resections) 2. vagal nerve stimulator (pulse generator, regulate seizures) 3. ketogenic diet (inc. fat, adequate protein, dec. carbs)

Question 70

when will someone on seizure medications go under med withdraw attempt?

Answer 70

after being seizure free for 2 years or longer

Question 71

what seizure med is teratogenic

Answer 71

valproic acid

Question 72

T/F? It is safe to place a tongue blade into a child's mouth to prevent them biting their tongue while they are having a seizure?

Answer 72

false

Question 73

what does oxygen need to be at during a seizure

Answer 73

>95%

Question 74

what meds are given during seizure

Answer 74

rectal diazepam