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nclex > neurological system > Flashcards

neurological system Flashcards

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
Q

hemorrhagic stroke

A

bleed in brain that can cause seizure

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26
Q

nursing for hemorrhagic stroke

A

NPO, neuro assessment, stool softeners, elevate HOB to 30 degrees for good cerebral perfusion, no anticoagulants

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27
Q

cranial nerve tests

A

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
Q

s/s of autonomic dysreflexia

A

flushing, ++++ BP, sweating

29
Q

parts of cerebral cortex/brain

A

frontal (decision-making, Broca’s area: speech production

parietal: senses (e.g. taste, touch)
temporal: hearing, Wernicke’s area: speech understanding)
occipital: visual

30
Q

Wernicke’s encephalopathy

A

altered mental status due to low thiamine

31
Q

causes of Wernicke’s encephalopathy

A

alcoholism

32
Q

meningitis

A

inflammation of brain

33
Q

causes of meningitis

A

bacterial, viral

34
Q

s/s of meningitis

A

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
Q

nursing for meningitis

A

droplet/contact (*DROPLET PRECAUTIONS NOT NEEDED FOR VIRAL), elevate HOB 30-45 degrees, seizure precautions, prepare for lumbar puncture

36
Q

contusion

A

bruising to brain

37
Q

types of skull factures

A

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
Q

epidural hematoma

A

due to bleed in artery

39
Q

s/s of epidural hematoma

A

LOC –> lucid interval where pt feels feels –> decline in function

40
Q

subdural hematoma

A

due to bleed in vein, slow bleed

41
Q

intracerebral hemorrhage

A

blood vessel in brain ruptures causing blood to leak into brain

42
Q

C1-C8 spinal cord injury

A

quadriplegia: shoulders down paralyzed

43
Q

T1-L4 spinal cord injury

A

paraplegia/ legs paralyzed

44
Q

C4 or above spinal cord injury

A

respiratory difficulty

45
Q

nursing for spinal cord injury

A

immobilize spine

46
Q

cerebral aneryusm

A

vision changes, tinnitus, headache

47
Q

nursing for cerebral aneryusm

A

no stress

48
Q

MS

A

demyelination of neurons

49
Q

Parkinson’s disease

A

low dopamine levels leading to shuffling and uncontrollable shaking

50
Q

nursing for Parkinson’s disease

A

avoid foods high in B6 as works against meds

51
Q

Bell’s palsy

A

problems in CN 7 leading to facial paralysis

52
Q

s/s of Bell’s palsy

A

facial muscle exercises, keeps eyes lubricated, oral care, chew on unaffected side

53
Q

Guillain Barré syndrome

A

immune system attacks own nerves

54
Q

s/s of Guillain Barré syndrome

A

respiratory failure, weakness

55
Q

nursing for Guillain Barré syndrome

A

monitor breathing

56
Q

amyotrophic lateral sclerosis

A

loss of muscle control, no cure

57
Q

s/s of amyotrophic lateral sclerosis

A

respiratory failure, weakness

58
Q

myasthenia gravis

A

problems in voluntary muscles due to not enough of ACh

59
Q

nursing for myasthenia gravis

A

DB&C, suction, elevate HOB 30-45 degrees for eating and pills, meds (AChE)

60
Q

myasthenia crisis

A

myasthenia gravis gets bad

61
Q

nursing for myasthenia crisis

A

increase meds (AChE)

62
Q

cholinergic crisis

A

too much ACh

63
Q

s/s of cholinergic crisis

A

twitching

64
Q

nursing for cholinergic crisis

A

hold AChE meds and give antidote of atropine sulfate

65
Q

Edrophonium test

A

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
Q

what risk during Edrophonium test

A

pt can go into vfib

67
Q

GCS

A 
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

nclex (17 decks)

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