Neurologic Flashcards
(106 cards)
1
Q
What does the central nervous system include?
A
Brain and spinal cord
2
Q
What does the peripheral nervous system include?
A
- Cranial and spinal nerves
- Autonomic and somatic systems
3
Q
What is the basic function unit of the nervous system?
A
neuron
4
Q
What is assessed for neurologic function?
A
- Pain
- Seizures
- Dizziness or Vertigo
- Visual Disturbances
- Weakness
- Abnormal sensations
- Past health/family/social hx
5
Q
What are the some of the causes of neurological dysfunction?
A
- 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.
6
Q
What are 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.
7
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.
8
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.
9
Q
What is akinetic mutism?
A
Unresponsiveness to the environment, maskes no movement or sound but sometimes opens eyes
10
Q
What is locked-in syndrome?
A
Inability to move or respond excempt for eye movements due to a lesion affecting the pons
11
Q
What is persistent vegetative state?
A
Devoid of cognitive function but has sleep-wake cycles
12
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.
13
Q
What are the types of cerebrovascular accidents?
A
- Ischemic stroke
- Hemorrhagic stroke
- Transient ischemic attack (TIA)
Each type has distinct causes and clinical manifestations.
14
Q
What are the potential complications of altered level of consciousness?
A
- Respiratory distress/failure
- Pneumonia
- Aspiration
- Pressure ulcers
- Deep vein thrombosis (DVT)
- Contractures
These complications arise from lack of mobility and impaired responsiveness.
15
Q
What are some of the goals when caring for a patient with altered level of consciousness?
A
- Maintenance of a clear airway (primary goal)
- Skin integrity
- Fluid volume balance
- Thermoregulation
This is essential to prevent respiratory complications.
16
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.
17
Q
How is fluid balance maintained in patients with altered level of consciousness?
A
- Assess turgor and mucosa, I&O
- Tube feeding, IVF
18
Q
How is body temperature maintained in patients with altered level of consciousness?
A
Adjust environment and cover patient appropriately
19
Q
How does a patient present when arousing from coma?
A
May experience period of agitation; minimize sensory stimulation
20
Q
How does decorticate posturing present?
A
Arms are bent at the elbows and wrists with the hands clenched into fists and held towards the chest and legs are extended and turned inward
21
Q
How does decerebrate posturing present?
A
Extending and rigidly holding the arms and legs straight out with the toes pointed downward and the head and neck arched back
22
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.
23
Q
What are nonmodifiable risk factors for delirium?
A
- Age
- Dementia
- Prior coma
- Recent trauma
24
Q
What is the most common type of dementia?
A
Alzheimer’s disease.
It accounts for up to 75% of older adults with dementia.
25
What nursing actions should be taken during a seizure?
Ensure patient safety by:
* Padding bed rails
* Placing the patient on their side
* Speaking calmly during recovery
## Footnote
These actions help prevent complications such as aspiration.
26
What are some common anticonvulsants used in the management of seizures?
* Carbamazepine
* Clonazepam
* Phenobarbital
* Phenytoin
* Topiramate
* Levetiracetam
* Gabapentin
* Lamotrigine
## Footnote
Each medication has specific indications and potential side effects.
27
What is a common side effect of almost every seizure medication?
Dizziness or drowsiness
28
What are the key elements to include in family education for a patient who has had a stroke?
* Care requirements
* Signs of complications
* Rehabilitation process
* Resources for support
## Footnote
Educating families can enhance patient outcomes and support.
29
What is the primary cerebrovascular disorder and fifth leading cause of death in the United States?
Stroke
30
What is a transient ischemic attack (TIA)?
Temporary neurologic deficit resulting from temporary impairment of blood flow
31
What are nonmodifiable risk factors for stroke?
* Age
* Gender
* Ethnicity
32
What are modifiable risk factors for stroke?
* Hypertension (primary)
* Cardiovascular disease
* Elevated cholesterol or hematocrit
* Obesity
* Diabetes
* Oral contraceptives
* Smoking, drug, alcohol use
33
What are the two main types of stroke?
* Ischemic
* Hemorrhagic
34
What causes an ischemic stroke?
Disruption of blood supply caused by an obstruction, usually a thrombus or embolism
35
What are the types of ischemic stroke?
* Large artery thrombus
* Small penetrating artery thrombus
* Cardiogenic embolism
* Cryptogenic
* Other
36
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
37
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)
38
What are preventative treatments for TIA or stroke?
* Carotid endarterectomy for carotid stenosis
* Anticoagulants (A-fib)
* Antiplatelets
* Statins
* Antihypertensives
39
What is a hemorrhagic stroke caused by?
Bleeding into brain tissue, the ventricles, or subarachnoid space
40
What are potential complications of a hemorrhagic stroke?
* Vasospasm
* Seizure
* Hydrocephalus
* Rebleeding
* Hyponatremia
41
What are clinical manifestations of a hemorrhagic stroke?
* Similar to ischemic
** Severe headache (sudden)
* LOC
* Vomiting
* Bleeding
42
What is the NIHSS assessment tool used for?
Assessment of stroke
43
What are the goals for nursing management of acute ischemic stroke?
* Return to baseline
* Rehab to improve mobility
* Independent ADLs
44
What are nursing interventions for patients that have had an ischemic stroke?
* Mobility
* Preventing shoulder pain
* Assist w/ nutrition
* Bladder/Bowel control
* Communication
45
What is the medical management of hemorrhagic stroke focused on?
Supportive care
46
What is meningitis?
Inflammation of the meninges, which cover and protect the brain and spinal cord
47
What are the two main types of meningitis?
* Bacterial
* Viral
48
What are common manifestations of meningitis?
* Headache
* Fever
* Changes in LOC
* Behavioral changes
* Nuchal rigidity
* Positive Kernig sign
* Positive Brudzinski sign
* Photophobia
49
When is meningococcal vaccine given?
* Youth 11-12, then booster at 16
* First-year college students
* Members of the military
50
What is the treatment for bacterial meningitis?
Early administration of high doses of appropriate IV antibiotics; Dexamethasone
51
What is a positive Kernig's sign
Demonstrated when pain or resistance is experienced when the knee is passively extended beyond 135 degrees, while the hip is flexed at a 90-degree angle; bilaterally when meningeal irritation is suspected
52
What is a positive Brudzinski sign?
When the patient’s neck is flexed it produces flexion of the knees and hips OR when the lower extremity of one side is passively flexed, a similar movement is seen in the opposite extremity; a more sensitive indicator of meningeal irritation
53
What is a brain abscess?
Collection of infectious material within brain tissue
54
What is the most common causative organism of a brain abscess?
Bacteria
55
What are common symptoms of a brain abscess?
* Headache (worse in the morning)
* Fever
* Vomiting
* Neurologic deficits
* Signs of increased ICP
56
What is the medical management for a brain abscess?
* Control ICP
* Drain abscess
* Administer appropriate antibiotic therapy
* Corticosterioids may be used for cerebral edema
57
What are the neurologic deficits associated with increased ICP?
headache, vomiting, visual disturbances, seizures, and altered consciousness
## Footnote
Increased intracranial pressure (ICP) can lead to serious complications if not managed promptly.
58
What is encephalitis?
An acute, inflammatory process of the brain tissue
## Footnote
It can be caused by various infections, including viral and fungal.
59
What are common causes of encephalitis?
* Viral infections (e.g., Herpes Simplex)
* Vector-borne viral infections (e.g., West Nile, St. Louis)
* Fungal infections
60
What symptoms may manifest in a patient with encephalitis?
* Headache
* Fever
* Confusion
* Hallucinations
* Rash
* Flaccid paralysis
* Parkinson-like movements
61
What is Multiple Sclerosis (MS)?
A progressive immune-related demyelination (damage to myelin sheath protecting nerve fibers) disease of the CNS
## Footnote
It affects the central nervous system and has varying clinical manifestations.
62
What are the clinical manifestations of Multiple Sclerosis?
* Fatigue
* Weakness
* Numbness
* Difficulty in coordination
* Loss of balance
* Pain
* Visual disturbances
63
What disease-modifying therapies are used to manage Muliple Sclerosis?
* Interferon B-1A
* Interferon B-1B
* Glatiramer Acetate
* IV methylprednisolone
64
What are the major goals in the planning for a patient with Multiple Sclerosis?
* Physical mobility
* Avoidance of injury
* Bowel/bladder continence
* Speech and swallowing mechanisms
* Improvement in cognitive function
* Development of coping strengths
65
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
66
What is Myasthenia Gravis?
An autoimmune disorder affecting the myoneural junction; antibodies directed at acetylcholine at the myonerual junction impair transmission of impulses
## Footnote
It is characterized by impaired transmission of impulses due to antibodies directed at acetylcholine.
67
What are the initial symptoms of Myasthenia Gravis?
* Ocular muscle weakness
* Diplopia (double vision)
* Ptosis (droopy eyelid)
* Weakness of facial muscles
* Swallowing and voice impairment (dysphonia)
68
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.
69
What is a Cholinergic crisis?
Caused by overmedication with cholinesterase inhibitors
## Footnote
It presents with severe muscle weakness and may lead to respiratory compromise.
70
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.
71
What are the manifestations of Guillain–Barré Syndrome?
* Weakness
* Paralysis
* Paresthesia
* Pain
* Diminished or absent reflexes
* Bulbar weakness
* Cranial nerve symptoms
* Autonomic dysfunction
72
What are assessment considerations for Guillain–Barré Syndrome?
* Monitor for life-threatening complications such as respiratory failure, cardiac dysrhythmias, DVT
* Changes in vital capacity and negative inspiratory force
73
What are some potential complications of Guillain–Barré Syndrome?
* Respiratory failure
* Cardiac dysrhythmias
* DVT
* Autonomic dysfunction
* Pulmonary embolism
* Urinary retention
74
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.
75
What are the manifestations of Bell's Palsy?
* Unilateral facial muscle weakness or paralysis
* Facial distortion
* Increased lacrimation (tears)
* Painful sensations in the face
* Difficulty with speech or eating
76
What is the management approach for Bell's Palsy?
* Corticosteroid therapy to reduce inflammation
* Protection of the eye
* Facial exercises and massage
77
What are the types of primary brain tumors?
* Gliomas
* Meningiomas
* Acoustic neuromas
* Pituitary adenomas
* Angiomas (masses of blood vessels)
* Metastatic tumors
78
What are common symptoms of brain tumors?
* Localized or generalized neurologic symptoms
* Symptoms of increased ICP
* Headache
* Vomiting
* Visual disturbances
* Seizures
* Hormonal effects
79
What diagnostic evaluations are used for brain tumors?
* Neurologic examination
* CT scan
* MRI
* PET scan
* EEG
* Cytologic study of cerebrospinal fluid
* Biopsy
80
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.
81
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.
82
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.
83
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.
84
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.
85
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.
86
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.
87
What are the cardinal manifestations of Parkinson's disease?
* Tremor
* Rigidity
* Bradykinesia/akinesia
* Postural instability
* Dysphagia
* Psychiatric changes
## Footnote
These symptoms are key indicators of the disease.
88
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.
89
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.
90
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.
91
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.
92
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.
93
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.
94
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.
95
What is the pathophysiology of Huntington's disease?
Premature death of cells in the striatum of the basal ganglia (control of movement) and the cortex (think, memory, perception, judgement)
96
What is Amyotrophic Lateral Sclerosis (ALS) also known as?
Lou Gehrig disease
## Footnote
ALS involves the loss of motor neurons leading to significant disability.
97
What is Amyotrophic Lateral Sclerosis (ALS)?
Loss of motor neurons in the anterior horn of the spinal cord and loss of motor nuclei of the lower brainstem
98
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.
99
What are muscular dystrophies characterized by?
Progressive weakening and wasting of skeletal and voluntary muscles
## Footnote
Most muscular dystrophies are inherited disorders.
100
What is the most common type of muscular dystrophy?
Duchenne muscular dystrophy
## Footnote
It is inherited as a sex-linked trait.
101
What is a significant public health disorder related to back pain?
Degenerative disc disease
## Footnote
It has significant economic and social costs.
102
What are common treatment options for degenerative disc disease?
* Rest
* Medications
* Surgery may be required
## Footnote
Treatment is often conservative initially.
103
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.
104
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.
105
What surgical procedures are used for lumbar disc disorders?
* Lumbar laminectomy/discectomy
* Microdiscectomy
## Footnote
These surgeries are performed to relieve nerve compression.
106
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.
