T3 U8 NEURO

Question 1

what is the #1 sign of ICP?

Answer 1

change in LOC

Question 2

manifestations of ICP in infants?

Answer 2

High pitch screech cry
Bulging fontanels
Sun setting eyes/pupils face down

Question 3

late s/sx of ICP

Answer 3

Cushings Triad
HTN, BradyC & Irregular/shallow breath

Question 4

how often to monitor V/S with ICP?

Answer 4

Q1hr
GCS with every set of vitals

Question 5

how should a ICP pt be positioned in bed?

Answer 5

HOB 15-30 degrees
Head/neck midline

Question 6

What interventions should be avoided with ICP pt?

Answer 6

Suctioning (vigorous)
Hypotonic IV solution

Question 7

what should be preformed on an ICP pt in bed?

Answer 7

Passive ROM Q 2 hr

Question 8

medication given for ICP

Answer 8

Mannitol (Osmitrol)

Question 9

When to not use Mannitol?

Answer 9

In active bleed
Anuria
Don’t add blood products

Question 10

side effects of mannitol?

Answer 10

HA
Blurred vision
HyperK
HyperNa

Question 11

what is the criteria for I&O for mannitol

Answer 11

must be @ least 30-50mL/Hr

Question 12

what is the action of barbituates in ICP?

Answer 12

VasoC in brain but VasoD in rest of body

Question 13

monitor ______ when using barbs w/ ICP?

Answer 13

BP
Volume status

Question 14

when is IPM (intracranial pressure monitoring) used?

Answer 14

GCS <8
Increased ICP or post op neuro surg

Question 15

when is ICP considered elevated in children

Answer 15

greater than 15mmHg

Question 16

what is the most common 1st time seizure in children?

Answer 16

Febrile
Last less than 15 min
Tend to “grow out of it”

Question 17

an EEG monitors what

Answer 17

electrical activity in brain

Question 18

what Hx questions should be asked r/t seizures?

Answer 18

Videogames/visuals
exercise
dehydration
What they were doing pre-seizure

Question 19

what is the theraputic level for phenytoin?

Answer 19

10-20mg

Question 20

for a child w/ Gen ton/clon seizures - what should be done immediately?

Answer 20

Time the seizure & note sequence of events

Question 21

what statement about physical activites & seizures precautions is wrong?

Answer 21

the child can participate in sport/physical activities

Question 22

what manifestations present with absence seizures?

Answer 22

Rapid eye blinking/staring into space

Question 23

what is the initial drug of choice for treating staus epilepticus?

Answer 23

IV diazepam

Question 24

what early sign of ICP would present in a TBI

Answer 24

slurred speech

Question 25

a GCS level of 8 would indicate what LOC

Answer 25

severe impairment

Question 26

what is the priority assessment for a PT with a TBI in acute phase?

Answer 26

monitor ICP

Question 27

what should a seizure precaution client avoid in their diet?

Answer 27

excessive caffeine

Question 28

which finding indicates immediate action by nurse in a post seizure pt? &why

Answer 28

postical N/V @ risk for aspiration --> L Lat positoin

Question 29

what should be the priority intervention for a PT with suspected encephalitis?

Answer 29

admin antiviral meds

Question 30

what finding would a nurse associate with encephalitis?

Answer 30

Positive Kernig's sign Knee & hip flexed @ 90 degree= pain on extension

Question 31

common vector/transmission of encephalitis?

Answer 31

Mosquitos

Question 32

How to promote mobility/prevent contractures with cerebral palsy?

Answer 32

rom

Question 33

what would present with spastic cerebral palsy?

Answer 33

hyperflexia

Question 34

what can the nurse do to help a cerebral palsy PT thats having difficulty swallowing?

Answer 34

Offer thickened liquids & pureed foods

Question 35

what is priority for the nurse to assess with a CP pt thats prescribed baclofen (Liorseal)?

Answer 35

s/sx of respiratory distress

Question 36

what is the most common cause of bacterial meningitis?

Answer 36

S.Pneumoniae

Question 37

s/sx of meningitis

Answer 37

fever HA Stiff neck LOC changes photophobia

Question 38

s/sx of meningitis in INFANTS

Answer 38

bulging fontanelle increased head circumference High pitched cry

Question 39

priority intervention for meningitis

Answer 39

IV & ABX

Question 40

neuro status checks for meningitis occur how often?

Answer 40

Q2hr

Question 41

new onset of seizures can be indicative of what neuro condition?

Answer 41

encephalitis

Question 42

important to assess for encephalitis diagnosis

Answer 42

skin for lesions - mosquito bites camping recently - exposure brain biopsy is defintive

Question 43

what is a complication of encephalitis the nurse should monitor for?

Answer 43

SIADH water retention & low Na levels

Question 44

prevention/help prevent encephalitis?

Answer 44

bugspray with deet in it

Question 45

prenatal care for spina bifida?

Answer 45

400 mg folic acid

Question 46

what does Meningocele SB include

Answer 46

meninges/CSF neuro function normally isnt affected

Question 47

Myelomeningocele involves what?

Answer 47

meninges protrude thru defect & contain spinal cord elements most SB form

Question 48

what other issues can myelomeningocele cause?

Answer 48

hip/joint deformities impaired bowel/bladder function

Question 49

how can you diagnose spinda bifida

Answer 49

ultrasounds at 12-14 wk of preg serum testing of A feroprotein

Question 50

prevention of spina bifida edu for mom

Answer 50

avoid sauna/hot tubs closely monitor diabetes

Question 51

priority nursing concern with spina bifida babies?

Answer 51

preventing infection/injury cover defect with sterile non adhesive dressing

Question 52

how should myelomeningocele (SB) be laid/taken care of

Answer 52

on stomach no diaper (or not near the defect)

Question 53

children with SB also often have what allergy

Answer 53

latex --> kiwi/banana

Question 54

4 types of cerebral palsy

Answer 54

spastic ataxic athetoid/dyskinetic mixed

Question 55

how does spastic cerebral palsy present?

Answer 55

very tight can't pull arms down contractures

Question 56

how would Ataxic CP present?

Answer 56

messed up gait

Question 57

how would A/D CP present

Answer 57

can't make hands work the way they want to

Question 58

manifestations of CP?

Answer 58

muscle rigidity muscle spasticity poor posture control ataxia vision/sensory impairments

Question 59

edu for CP

Answer 59

encourage school enrollment freq rest periods to reduce spasms assistive devices non traditional growth

Question 60

meds for CP

Answer 60

Dantrolene to decrease spasms Baclofen to relax muscles

Question 61

how to maintain O2 with a TBI

Answer 61

oxygen with bag valve mask

Question 62

after observation, what would the nurse assess next for TBI?

Answer 62

Palpate for fractures

Question 63

s/sx of Basal skull fracture

Answer 63

CSF from nose/ears hemotypanum (blood in ears) mastoid ecchymosis periorbital ecchymosis

Question 64

what intervention is contraindicated with TBI? & why?

Answer 64

NG tube/suction Run risk of aggitating undiscovered fractures

Question 65

what is a hallmark sign of abusive head trauma

Answer 65

retinal hemorrhage