23 Pt's w/ brain disorders

Question 1

type of seizure affecting only one part of the brain leading to localized clinical symptoms

Answer 1

focal

Question 2

type of seizure involving both sides (bilateral) of the brain and usually the whole body if motor symptoms are present, no warning or aura

Answer 2

generalized

Question 3

absence
myoclonic
clonic
tonic
tonic-clonic
atonic seizures
infantile spasms (usually fever-induced)

Answer 3

generalized seizures

Question 4

-prologed partial or generalized seizure w/o recovery between attacks
-rapid, unrelenting series of convulsive seizures w/o intervening periods of consciousness, and an absence of respiration
-irreversible brain damage can occur if seizures are not controlled

Answer 4

status epilepticus

Question 5

diagnosing epilepsy

Answer 5

-Hx and actual signs and symptoms
-EEG, MRI
-electrolyte imbalances
-physical examination and tests

Question 6

epilepsy treatment

Answer 6

-control or eliminate cause
-antiepileptic drugs & pt teaching
-keto diet
-biofeedback
-surgery (implanted vagus nerve stimulator for pt’s w/ epilepsy and uncontrolled seizures)

Question 7

things to note during a seizure

Answer 7

-beginning and ending time
-what pt was doing just before
-where in the body seizure began; what parts of the body are involved
-which way the eyes are moving, whether they constrict or dilate, deviate to right or left or roll upward
-which side the head turns
-pt cry out or scream as it began
-evidence of repetitive movements: lip smacking, chewing, grimacing, tapping, or pill rolling
-movements are bilateral and symmetrical
-incontinence of urine or stool, vomiting, frothing at mouth, or bleeding
-pt become apneic or cyanotic
-changes in skin color or profuse perspiration

Question 8

postictal assessment- after a patent airway is ensured

Answer 8

-length of time before regaining awareness
-presence of lethargy or confusion
-presence of ha
-presence of speech impairment
-presence of muscle soreness
-aura before seizure began
-effects of seizure of pt’s vital signs

Question 9

patho of CVA

Answer 9

-cerebral thrombosis
-embolus
-intracerebral hemorrhage
-pressure on a blood vessel

Question 10

two ways a stroke can happen

Answer 10

hemorrhagic or ischemic

Question 11

congenital abnormality that is tangled mass of malformed, thin-walled, dilated vessels that form an abnormal communication between the arterial and venous system

Answer 11

arteriovenous malformation

Question 12

Area of the brain:
sensory discrimination, eyes to opposite side; body awareness; writing

Answer 12

parietal lobe

Question 13

Area of the brain:
motor activities (pyramidal)- leg, hip, trunk, arm, hand, neck, face
speech

Answer 13

frontal lobe

Question 14

Area of the brain:
reading
memory (short-term)
hearing, smell, taste

Answer 14

temporal

Question 15

diagnosis of this includes:
MRI or cerebral angiogram
EEG
brain scans
transcranial doppler flow studies
carotid artery doppler studies
testing for blood levels of glutamate
lumbar puncture

Answer 15

stroke

Question 16

stroke treatment

Answer 16

-maintain open airway
-fluid and antihypertensives
-temp control
-alteplase or systemic tissue plasminogen activator and other meds
-surgical procedures

Question 17

complications of stroke

Answer 17

-extension of hemorrhage or rebleed
-seizures
-hydrocephalus
-watch pt’s closely to detect deterioration of the pt’s condition for further bleeding and rise in ICP

Question 18

what phase:
-maintain adequate airway
-establish baseline vital signs, LOC, neuromuscular function, and neurologic status
-preserve joint and muscle function
-prevent complications that may interfere with rehab

Answer 18

Phase 1

Question 19

which side is the damage:
-slow and cautious in behavior
-speech problems, aphasia
-difficulty in following verbal commands
-apraxia
-difficulty in performing simple tasks
-right-sided hemiplegia

Answer 19

left-sided brain damage

Question 20

which side is the damage:
-quick and impulsive in behavior
-short attn span
-neglects left side
-easily distracted
-left-sided hemiplegia

Answer 20

right-sided brain damage

Question 21

brain tumor can begin in four places

Answer 21

-brain itself
-meninges
-cranial nerves
-pituitary gland

Question 22

nursing management of brain tumors

Answer 22

-routine neurologic assessment, including ADL’s
-pain assessment and control

Question 23

complications of brain tumors

Answer 23

-hydrocephalus (if blood has leaked into the ventricular system, it interferes with the resorption of CSF causing hydrocephalus)
-intercerebral hemorrhage

Question 24

bacterial meningitis etiology and patho

Answer 24

-inflammation of the membranes covering the brain and spinal cord caused by an infectious agent

Question 25

s/s of bacterial meningitis

Answer 25

-sudden onset of fever and severe and persistent ha greatly aggravated by moving the head
-nuchal rigidity
-Brudzinski sign
-Kernig sign

Question 26

viral meningitis most common viruses

Answer 26

enteroviruses, arboviruses, HIV, herpes simples

Question 27

most common types of viral encephalitis caused by

Answer 27

herpes simples virus 1, west nile virus, enteroviruses

Question 28

trigeminal neuralgia

Answer 28

-rare facial pain syndrome related to pressure on the nerve root
-rarely affects both sides
-extends from midline of the face across the cheek and jaw to the ear

Question 29

trigeminal neuralgia triggers

Answer 29

-exposure to drafts
-light touch or vibration
-washing the face

Question 30

numbness and partial or total paralysis of facial muscles
edema and ischemia of facial nerve, herpes simplex virus, stress, exposure to cold, and pregnancy

Answer 30

bells palsy

Question 31

Bells Palsy treatment

Answer 31

-patch over affected eye and artificial tears
-corticosteroids and acyclovir