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Neurologic Flashcards

1
Q

What does the central nervous system include?

A

Brain and spinal cord

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2
Q
A
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3
Q

What is the significance of physical assessment in diagnosing neurologic dysfunction?

A

It is crucial for identifying and diagnosing various neurological conditions.

Physical assessment helps in recognizing symptoms and determining the severity of neurologic issues.

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4
Q

What are the causes of neurological dysfunction?

A

They include:
* Cerebrovascular disease
* Hypoxemia
* Fever (childhood)
* Head injury
* Hypertension
* CNS infections
* Metabolic and toxic conditions
* Brain tumor
* Drug and alcohol withdrawal
* Allergies

These causes can lead to seizures and other neurological disorders.

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5
Q

Define seizures.

A

Episodes of abnormal motor, sensory, autonomic, or psychic activity caused by a sudden excessive discharge from cerebral neurons.

Seizures can involve either a localized area of the brain or the entire brain.

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6
Q

What is epilepsy?

A

Defined as ‘more than one unprovoked seizure’ by the International League Against Epilepsy.

Epilepsy can manifest in various forms, including focal onset, generalized onset, and unknown onset.

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7
Q

What is the Glasgow Coma Scale used for?

A

To assess the level of consciousness in patients.

It evaluates verbal response, alertness, motor response, and other criteria.

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8
Q

What are the types of cerebrovascular disorders?

A

They include:
* Ischemic stroke
* Hemorrhagic stroke
* Transient ischemic attack (TIA)

Each type has distinct causes and clinical manifestations.

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9
Q

What is a common complication of patients with altered level of consciousness?

A

Respiratory distress or failure due to inability to maintain airway.

This can lead to pneumonia or aspiration if not properly managed.

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10
Q

Fill in the blank: The basic functional unit of the nervous system is the _______.

A

[neuron]

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11
Q

What are the potential complications of altered level of consciousness?

A

They include:
* Pneumonia
* Aspiration
* Pressure ulcers
* Deep vein thrombosis (DVT)
* Contractures

These complications arise from lack of mobility and impaired responsiveness.

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12
Q

What is the primary goal when caring for a patient with altered level of consciousness?

A

Maintenance of a clear airway.

This is essential to prevent respiratory complications.

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13
Q

What must be assessed frequently to maintain tissue integrity in patients with altered level of consciousness?

A

Skin condition, particularly areas at high risk for breakdown.

Regular turning and proper positioning are critical interventions.

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14
Q

What is status epilepticus?

A

Acute prolonged seizure activity lasting 5 minutes or longer or serial seizures without full recovery of consciousness.

It is a medical emergency that requires immediate intervention.

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15
Q

What are modifiable risk factors for delirium?

A

Use of benzodiazepines and blood transfusions.

Addressing these factors can help reduce the incidence of delirium.

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16
Q

What is the most common type of dementia?

A

Alzheimer’s disease.

It accounts for up to 75% of older adults with dementia.

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17
Q

What nursing actions should be taken during a seizure?

A

Ensure patient safety by:
* Padding bed rails
* Placing the patient on their side
* Speaking calmly during recovery

These actions help prevent complications such as aspiration.

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18
Q

What are some common anticonvulsants used in the management of seizures?

A

They include:
* Carbamazepine
* Clonazepam
* Phenobarbital
* Phenytoin
* Topiramate
* Levetiracetam
* Gabapentin
* Lamotrigine

Each medication has specific indications and potential side effects.

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19
Q

What are the key elements to include in family education for a patient who has had a stroke?

A

Topics should cover:
* Care requirements
* Signs of complications
* Rehabilitation process
* Resources for support

Educating families can enhance patient outcomes and support.

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20
Q

What is altered level of consciousness (LOC)?

A

A continuum from normal alertness and full cognition to coma.

LOC may indicate underlying pathology rather than being a disorder itself.

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21
Q

What is a common side effect of almost every medication?

A

Dizziness or drowsiness

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22
Q

What is the primary cerebrovascular disorder?

A

Stroke

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23
Q

What is the fifth leading cause of death in the United States?

A

Stroke

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24
Q

What is a transient ischemic attack (TIA)?

A

Temporary neurologic deficit resulting from temporary impairment of blood flow

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25
What are the two categories of risk factors for stroke?
Nonmodifiable and modifiable risk factors
26
List three nonmodifiable risk factors for stroke.
* Age * Gender * Ethnicity
27
What is the primary modifiable risk factor for stroke?
Hypertension
28
What are the two main types of stroke?
* Ischemic * Hemorrhagic
29
What causes an ischemic stroke?
Disruption of blood supply caused by an obstruction, usually a thrombus or embolism
30
What are the types of ischemic stroke?
* Large artery thrombus * Small penetrating artery thrombus * Cardiogenic embolism * Cryptogenic * Other
31
What are common symptoms of an ischemic stroke?
* Numbness or weakness of face, arm, or leg, especially on one side * Confusion or change in mental status * Trouble speaking or understanding speech * Difficulty in walking, dizziness, or loss of balance or coordination * Sudden onset severe headache
32
What lifestyle changes can help in the primary prevention of ischemic stroke?
* No smoking * Physical activity at least 40 minutes a day, 3-4 days a week * Maintain healthy weight * Specific diets (DASH diet, Mediterranean diet)
33
What is the purpose of carotid endarterectomy?
For carotid stenosis
34
What is a hemorrhagic stroke caused by?
Bleeding into brain tissue, the ventricles, or subarachnoid space
35
What are potential complications of a hemorrhagic stroke?
* Vasospasm * Seizure * Hydrocephalus * Rebleeding * Hyponatremia
36
What is the NIHSS assessment tool used for?
Assessment of stroke
37
What is the goal for nursing management of acute ischemic stroke?
Best return to baseline
38
What interventions can help improve mobility in stroke patients?
* Positioning * Ambulation
39
What is the medical management of hemorrhagic stroke focused on?
Supportive care
40
What is meningitis?
Inflammation of the meninges, which cover and protect the brain and spinal cord
41
What are the two main types of meningitis?
* Bacterial * Viral
42
What are common manifestations of meningitis?
* Headache * Fever * Changes in LOC * Behavioral changes * Nuchal rigidity * Positive Kernig sign * Positive Brudzinski sign * Photophobia
43
What is the treatment for bacterial meningitis?
Early administration of high doses of appropriate IV antibiotics
44
What is a brain abscess?
Collection of infectious material within brain tissue
45
What is the most common causative organism of a brain abscess?
Bacteria
46
What are common symptoms of a brain abscess?
* Headache (worse in the morning) * Fever * Vomiting * Neurologic deficits * Signs of increased ICP
47
What is the medical management for a brain abscess?
* Control ICP * Drain abscess * Administer appropriate antibiotic therapy
48
What are the neurologic deficits associated with increased ICP?
Signs and symptoms may include headache, vomiting, visual disturbances, seizures, and altered consciousness ## Footnote Increased intracranial pressure (ICP) can lead to serious complications if not managed promptly.
49
What imaging techniques are used for diagnosis of brain conditions?
MRI or CT ## Footnote These imaging techniques help visualize abnormalities in the brain.
50
What is the purpose of CT-guided aspiration?
To identify causative organisms ## Footnote This procedure is often used in cases of brain abscesses.
51
What are the key components of medical management for a brain abscess?
* Control ICP * Drain abscess * Administer appropriate antibiotic therapy * Corticosteroids may be used to treat cerebral edema
52
What is encephalitis?
An acute, inflammatory process of the brain tissue ## Footnote It can be caused by various infections, including viral and fungal.
53
What are common causes of encephalitis?
* Viral infections (e.g., Herpes Simplex) * Vector-borne viral infections (e.g., West Nile, St. Louis) * Fungal infections
54
What symptoms may manifest in a patient with encephalitis?
* Headache * Fever * Confusion * Hallucinations * Rash * Flaccid paralysis * Parkinson-like movements
55
What is Multiple Sclerosis (MS)?
A progressive immune-related demyelination disease of the CNS ## Footnote It affects the central nervous system and has varying clinical manifestations.
56
What are the clinical manifestations of Multiple Sclerosis?
* Fatigue * Weakness * Numbness * Difficulty in coordination * Loss of balance * Pain * Visual disturbances
57
What is the primary goal of medical management for Multiple Sclerosis?
Disease-modifying therapies ## Footnote Includes medications such as Interferon β-1A and IV Methylprednisolone.
58
What are the major goals in the planning for a patient with Multiple Sclerosis?
* Promotion of physical mobility * Avoidance of injury * Achievement of bowel and bladder continence * Promotion of speech and swallowing mechanisms * Improvement in cognitive function * Development of coping strengths
59
What are some nursing interventions for the patient with Multiple Sclerosis?
* Coordinate referrals to health care services * Implement a program of activity and daily exercise * Provide bowel and bladder control training * Encourage cognitive function enhancement strategies
60
What is Myasthenia Gravis?
An autoimmune disorder affecting the myoneural junction ## Footnote It is characterized by impaired transmission of impulses due to antibodies directed at acetylcholine.
61
What are the initial symptoms of Myasthenia Gravis?
* Ocular muscle weakness * Diplopia * Ptosis * Weakness of facial muscles * Swallowing and voice impairment (dysphonia)
62
What is a Myasthenic crisis?
A result of disease exacerbation or precipitating event, commonly a respiratory infection ## Footnote It leads to severe generalized muscle weakness with respiratory and bulbar weakness.
63
What is a Cholinergic crisis?
Caused by overmedication with cholinesterase inhibitors ## Footnote It presents with severe muscle weakness and may lead to respiratory compromise.
64
What is Guillain–Barré Syndrome?
An autoimmune disorder with acute attack of peripheral nerve myelin ## Footnote It often follows a viral infection and can lead to rapid demyelination.
65
What are the manifestations of Guillain–Barré Syndrome?
* Weakness * Paralysis * Paresthesia * Pain * Diminished or absent reflexes * Bulbar weakness * Autonomic dysfunction
66
What are some potential complications of Guillain–Barré Syndrome?
* Respiratory failure * Autonomic dysfunction * DVT * Pulmonary embolism * Urinary retention
67
What is Bell’s Palsy?
Facial paralysis caused by unilateral inflammation of the seventh cranial nerve ## Footnote Most patients recover completely within 3 to 5 weeks.
68
What are the manifestations of Bell's Palsy?
* Unilateral facial muscle weakness or paralysis * Facial distortion * Increased lacrimation * Painful sensations in the face
69
What is the management approach for Bell's Palsy?
* Corticosteroid therapy to reduce inflammation * Protection of the eye * Facial exercises and massage
70
What are the types of primary brain tumors?
* Gliomas * Meningiomas * Acoustic neuromas * Pituitary adenomas * Angiomas
71
What are common symptoms of brain tumors?
* Localized or generalized neurologic symptoms * Symptoms of increased ICP * Headache * Vomiting * Visual disturbances * Seizures
72
What diagnostic evaluations are used for brain tumors?
* Neurologic examination * CT scan * MRI * PET scan * EEG * Cytologic study of cerebrospinal fluid * Biopsy
73
What is the goal of medical management for brain tumors?
Removal of tumor without increasing neurologic symptoms or relieving symptoms by decompression ## Footnote This may involve surgery, radiation therapy, and pharmacologic therapy.
74
What are the main surgical procedures for brain tumors?
Craniotomy, transsphenoidal surgery, stereotactic procedures ## Footnote These procedures are often used to access and remove brain tumors.
75
What is the cornerstone of treatment for many brain tumors?
Radiation therapy ## Footnote Radiation therapy is a key component in the management of brain tumors.
76
What are the major goals for a patient with nervous system metastases or primary brain tumor?
* Compensating for self-care deficits * Improving nutrition * Reducing anxiety * Enhancing family coping skills * Absence of complications ## Footnote These goals focus on improving the quality of life for patients.
77
What nursing interventions are encouraged for patients with nervous system metastases or primary brain tumors?
* Encourage independence * Improve cognitive function * Allow patient participation in decision making * Allow expression of fears and concerns * Provide presence of family and health care personnel ## Footnote Supportive interventions are crucial for patient care.
78
What measures can improve nutrition for patients with nervous system tumors?
* Oral hygiene before meals * Plan meals when patient is comfortable * Make mealtimes pleasant * Offer preferred foods * Dietary supplements * Daily weight monitoring * Record dietary intake ## Footnote Nutrition is vital for recovery and well-being.
79
Define Parkinson's disease.
A slow, progressive neurological movement disorder associated with decreased levels of dopamine ## Footnote Parkinson's disease affects movement and can lead to various complications.
80
What are the cardinal manifestations of Parkinson's disease?
* Tremor * Rigidity * Bradykinesia/akinesia * Postural instability ## Footnote These symptoms are key indicators of the disease.
81
What are some autonomic manifestations of Parkinson's disease?
* Sweating * Drooling * Flushing * Orthostatic hypotension * Gastric and urinary retention ## Footnote Autonomic symptoms can significantly impact daily life.
82
What is the primary focus during the assessment of a patient with Parkinson's disease?
Degree of disability and functional changes throughout the day ## Footnote Assessment helps tailor treatment and interventions.
83
What is the most effective pharmacologic treatment for Parkinson's disease?
Levodopa-Carbidopa ## Footnote This combination helps manage symptoms by converting to dopamine in the brain.
84
What is dyskinesia in the context of Parkinson's disease?
Involuntary movements such as facial grimacing, rhythmic jerking movements of hands, and head bobbing ## Footnote Dyskinesia often develops after long-term treatment with levodopa.
85
What are the major goals for a patient with Parkinson's disease?
* Improving functional mobility * Maintaining independence in ADLs * Achieving adequate bowel elimination * Attaining acceptable nutritional status * Achieving effective communication * Developing positive coping skills ## Footnote These goals help enhance quality of life.
86
What are some nursing interventions to improve mobility in Parkinson's disease patients?
* Progressive daily exercise program * Stretching and ROM exercises * Postural exercises * Consultation with physical therapy * Walking techniques for safety and balance * Frequent rest periods * Proper shoes * Use of assistive devices ## Footnote Mobility is crucial for independence.
87
What characterizes Huntington's disease?
A chronic progressive hereditary disease resulting in choreiform movement and dementia ## Footnote It is transmitted as an autosomal dominant trait.
88
What is Amyotrophic Lateral Sclerosis (ALS) also known as?
Lou Gehrig disease ## Footnote ALS involves the loss of motor neurons leading to significant disability.
89
What are common manifestations of ALS?
* Progressive weakness and atrophy of muscles * Cramps and twitching * Lack of coordination * Difficulty speaking, swallowing, and breathing ## Footnote These symptoms can severely impact daily functioning.
90
What are muscular dystrophies characterized by?
Progressive weakening and wasting of skeletal and voluntary muscles ## Footnote Most muscular dystrophies are inherited disorders.
91
What is the most common type of muscular dystrophy?
Duchenne muscular dystrophy ## Footnote It is inherited as a sex-linked trait.
92
What is a significant public health disorder related to back pain?
Degenerative disc disease ## Footnote It has significant economic and social costs.
93
What are common treatment options for degenerative disc disease?
* Rest * Medications * Surgery may be required ## Footnote Treatment is often conservative initially.
94
What should be assessed in a patient undergoing a cervical discectomy?
* Onset, location, and radiation of pain * Paresthesia * Limited movement * Diminished function of neck and shoulders * Bilateral symptoms ## Footnote This assessment helps in planning care.
95
What are common diagnostics for lumbar disc herniation?
* History and physical findings * Imaging (CT, MRI, myelography) ## Footnote Accurate diagnostics are essential for effective management.
96
What are the goals of medical management for lumbar disc disease?
* Pain relief * Muscle relaxants * NSAIDs * Systemic corticosteroids * Slow disease progression * Increase functional ability * Weight reduction * Physical therapy/exercise ## Footnote A comprehensive approach is necessary for optimal recovery.
97
What surgical procedures are used for lumbar disc disorders?
* Lumbar laminectomy/discectomy * Microdiscectomy ## Footnote These surgeries are performed to relieve nerve compression.
98
What is included in nursing management for patients with lumbar disc disorder?
* Pre- and post-operative care * Neurologic and pain assessments * Positioning * Education on self-care management ## Footnote Education is crucial for recovery and prevention of complications.

MedSurg (16 decks)

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