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nclex > neurological system > Flashcards

neurological system Flashcards

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1
Q

functions of cerebellum

A

voluntary movement and balance

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2
Q

how to test voluntary movement

A

touch finger to nose

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3
Q

how to test balance

A

can walk straight

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4
Q

PERRLA

A

equal, round, reactive to light, and accommodates

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5
Q

accomodation

A

accommodates to close and far objects

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6
Q

normal size for pupils

A

3-5 mm

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7
Q

s/s of basilar skull fracture (BSF)

A

Battle’s sign: bruise behind ear, periorbital hematoma/raccoon eyes, CSF leakage from nose or ear

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8
Q

nursing priority for BSF

A

monitor neuro, immobilize C spine

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9
Q

decorticate

A

problems with cortex

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10
Q

decerebrate

A

problems in brainstem

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11
Q

tonic clonic seizures

A

tonic: loss of conscious
clonic: jerking of arms and legs only

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12
Q

absence seizures

A

freezing of body

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13
Q

myoclonic seizures

A

whole body jerking

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14
Q

atonic seizures

A

pt collapses

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15
Q

status epilepticus

A

repeat seizures, not conscious

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16
Q

epilepsy

A

chronic seizures

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17
Q

nursing for seizures

A

position pt on side to maintain airway, loosen clothing, O2, time + record time and duration of seizure, never stop antiseizure meds, suction after seizure

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18
Q

Cushing’s triad

A

sign of increased ICP

high BP, high HR, high pulse pressure

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19
Q

nursing for increased ICP

A

elevate HOB to 30 degrees for good cerebral perfusion, stool softeners to prevent straining, no stress, ensure warm as cold temps increase ICP,

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20
Q

CSF assessment

A

normal: colourless, nothing in it (e.g. WBC), normal pressure of 60-150,, normal volume (125-150)

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21
Q

ischemic stroke

A

block in blood flow

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22
Q

s/s of ischemic stroke

A

hypertension

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23
Q

nursing for ischemic stroke

A

give TPA 3-4 hours from onset of s/s

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24
Q

when is TPA contraindicated

A

thrombocytopenia/low levels of platelets, trauma to head, surgery

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25
hemorrhagic stroke
bleed in brain that can cause seizure
26
nursing for hemorrhagic stroke
NPO, neuro assessment, stool softeners, elevate HOB to 30 degrees for good cerebral perfusion, no anticoagulants
27
cranial nerve tests
olfactory: smell test optic: Snellen chart, oculomotor: pupil constriction trochlear: eye movement trigeminal: clench teeth abducens: can move arms facial: can move face acoustic: hearing, Romberg's test/ proprioception, glossopharyngeal: gag reflux vagus: able to say "ahhh" spinal accessory: can turn head, lift shoulders hypoglossal: can stick out tongue
28
s/s of autonomic dysreflexia
flushing, ++++ BP, sweating
29
parts of cerebral cortex/brain
frontal (decision-making, Broca's area: speech production parietal: senses (e.g. taste, touch) temporal: hearing, Wernicke's area: speech understanding) occipital: visual
30
Wernicke’s encephalopathy
altered mental status due to low thiamine
31
causes of Wernicke’s encephalopathy
alcoholism
32
meningitis
inflammation of brain
33
causes of meningitis
bacterial, viral
34
s/s of meningitis
photophobia, stiff neck, Brudzinski’s sign: neck movement causes movement in hip and knee, Kernig's sign: hard to straighten out leg CSF is cloudy and presence of protein, WBC
35
nursing for meningitis
droplet/contact (*DROPLET PRECAUTIONS NOT NEEDED FOR VIRAL), elevate HOB 30-45 degrees, seizure precautions, prepare for lumbar puncture
36
contusion
bruising to brain
37
types of skull factures
linear: break in bone but stays in place depressed: bone becomes depressed into skull compound: bone is elevated from skull comminuted: broken pieces of bone
38
epidural hematoma
due to bleed in artery
39
s/s of epidural hematoma
LOC --> lucid interval where pt feels feels --> decline in function
40
subdural hematoma
due to bleed in vein, slow bleed
41
intracerebral hemorrhage
blood vessel in brain ruptures causing blood to leak into brain
42
C1-C8 spinal cord injury
quadriplegia: shoulders down paralyzed
43
T1-L4 spinal cord injury
paraplegia/ legs paralyzed
44
C4 or above spinal cord injury
respiratory difficulty
45
nursing for spinal cord injury
immobilize spine
46
cerebral aneryusm
vision changes, tinnitus, headache
47
nursing for cerebral aneryusm
no stress
48
MS
demyelination of neurons
49
Parkinson’s disease
low dopamine levels leading to shuffling and uncontrollable shaking
50
nursing for Parkinson’s disease
avoid foods high in B6 as works against meds
51
Bell's palsy
problems in CN 7 leading to facial paralysis
52
s/s of Bell's palsy
facial muscle exercises, keeps eyes lubricated, oral care, chew on unaffected side
53
Guillain Barré syndrome
immune system attacks own nerves
54
s/s of Guillain Barré syndrome
respiratory failure, weakness
55
nursing for Guillain Barré syndrome
monitor breathing
56
amyotrophic lateral sclerosis
loss of muscle control, no cure
57
s/s of amyotrophic lateral sclerosis
respiratory failure, weakness
58
myasthenia gravis
problems in voluntary muscles due to not enough of ACh
59
nursing for myasthenia gravis
DB&C, suction, elevate HOB 30-45 degrees for eating and pills, meds (AChE)
60
myasthenia crisis
myasthenia gravis gets bad
61
nursing for myasthenia crisis
increase meds (AChE)
62
cholinergic crisis
too much ACh
63
s/s of cholinergic crisis
twitching
64
nursing for cholinergic crisis
hold AChE meds and give antidote of atropine sulfate
65
Edrophonium test
to diagnose myasthenia gravis and tell myasthenia crisis and cholinergic crisis IF muscle control improves = MC; give AChE IF muscle control does not improve = CC; hold AChE meds and give antidote of atropine sulfate
66
what risk during Edrophonium test
pt can go into vfib
67
GCS
``` eye opening response: 4 = spontaneous 3 = only to verbal stimuli 2 = pain 1 = none ``` verbal response: 5 = oriented 4 = confused (wrong answers e.g. 1998 instead of 2021 is the year) 3 = inappropriate words (not even answering question e.g. is the sky blue? when asked about the year) 2 = incoherent 1 = none ``` motor response: 6 = obeys commands 5 = localizes to pain 4 = withdraws from pain 3 = flexion to pain (decorticate) 2 = extension to pain (decerebrate) 1 = none ```

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