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Adult ll > Acute Intracranial Problems > Flashcards

Acute Intracranial Problems Flashcards

1
Q

3 Compartments of total volume of ICP

A

brain tissue, blood, cerebrospinal fluid (CSF)

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2
Q

Increased ICP clinical manifestations

A

changes in level of consciousness

vital signs - HTN, bradycardia, full bounding pulse, irregular respirations

Ocular Signs - pupil dilation

Motor Function - hemiparesis or hemiplagia

headache/vomiting

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3
Q

Spontaneous abnormal motor function

A

occurs without regard to external stimuli and may not occur by request

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4
Q

Localization abnormal motor function

A

occurs when the extremity opposite the extremity receiving pain crosses middling of the body in an attempt to remove the noxious stimulus from the affected limb

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5
Q

withdrawal abnormal motor function

A

occurs when the extremity receiving the painful stimulus flexes normally in an attempt to avoid the noxious stimulus

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6
Q

Decortication abnormal motor function

A

abnormal flexion response that may occur spontaneously or in response to noxious stimuli

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7
Q

Flaccid abnormal motor function

A

no response to painful stimuli

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8
Q

Decerebrate posture

A

results from damage to the upper brain stem

the arms are adducted and extended with the wrists pronated and the fingers flexed. The legs are stiffly extended with plantar flexion of the feet

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9
Q

Decorticate posture

A

Results from damage to 1 or both corticospinal tracts

the arms are adducted and flexed, with the writs and fingers flexed on the chest. The legs are stiffly extended and internally rotated, with plantar flexion of the feet

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10
Q

Increased ICP dx studies

A

MRI, CT scan, cerebral angiography, EEG, ICP measurement

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11
Q

Increased ICP - nursing intervention

A

respiratory function - maintain airway

Fluid/electrolyte balance - daily weights, monitor BS, Na, K, Mg

Monitoring ICP - early s/s of intracranial HTN

Body position - HOB elevated

Protection from injury - confusion, agitation, possible seizures

Psychological considerations

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12
Q

Primary brain tumors

A

benign or malignant

gliomas - most common (astrocytoma, Glioblastoma multiforme)

More than half are malignant

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13
Q

Secondary brain tumors

A

metastasis from a malignant neoplasm (tumor)

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14
Q

brain tumor clinical manifestations

A

headache - common
seizures (common in gliomas and brain metastasis)
N/V
cognitive dysfunction (including memory problems and mood or personality changes)
Muscle weakness
Sensory Loss
Aphasia

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15
Q

Brain tumor complications

A 
cerebral edema/inflammation
increased ICP
neurological deficiets
hydrocephalus
pituitary dysfunction
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16
Q

brain tumor dx studies

A

MRI, PET scan, CT scan

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17
Q

brain tumor collaborative tx

A

identifying the tumor type and location

removing or decreasing tumor mass

preventing or managing ICP

Surgical tx - preferred
Radiation/Chemo
Shunt

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18
Q

Stereotactic surgery

A

used with greater frequency to perform a biopsy and remove small brain tumors

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19
Q

bacterial meningitis

A

acute inflammation of the pia mater and arachnoid membrane surrounding the brain and spinal cord

Leading causes: Streptococcus pneumoniae and Neisseria meningitidis

20
Q

bacterial meningitis clinical manifestations

A 
fever, severe headache,
N/V, nuchal rigidity
photophobia, decreased LOC,
s/s of increased ICP may be present
Seizures in 1/3 of cases
21
Q

Kernig’s Sign

A

physical symptom of meningitis

severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed at 90 degrees

22
Q

Brudzinski’s Sign

A

physical symptom of meningitis

Severe neck stiffness causes a patient’s hip and knees to flex when the neck is flexed

23
Q

Bacterial Meningitis Complications

A

Increased ICP - most common
meningoccemia
disseminated intravascular coagulation (DIC)

Residual neurological dysfunction: hemiparesis, dysphasia, hemianopais

cranial nerve dysfunction: CN lll, CN lV, CN Vl, CN Vll, CN Vlll

24
Q

Cranial Nerve lll

A

oculomotor

25
Q

Cranial Nerve lV

A

trochlear

26
Q

Cranial Nerve Vl

A

Abducens

27
Q

Cranial Nerve Vll

A

Facial

28
Q

Cranial Nerve Vlll

A

vestibulocochlear

29
Q

Hemianopsia

A

blindness in half of the visual field

30
Q

Bacterial Meningitis Dx studies

A

blood culture, CT scan, lumbar puncture, CBC, sputum/throat/nasal culture
Skull x-rays

31
Q

bacterial meningitis collaborative care

A

IV fluids, codeine, acetaminophen, Dexamethasone (decadron), Mannitol (osmitrol)

Antibiotics: penetrate blood-brain barrier: PCN, Cephalosporin

32
Q

Bacterial Meningitis Nursing Dx

A 
Acute confusion
Disturbed sensory perception
Acute Pain
Hyperthermia
Ineffective tissue perfusion (Cerebral)
33
Q

Bacterial Meningitis Health Promotion

A

meningitis vaccine
pneumococcal vaccine
influenza vaccine
vigorous treatment of respiratory illness

34
Q

Bacterial Meningitis acute interventions

A 
pain relief
position
tx for photophobia
seizure precautions
tx of fever
fluid replacement
droplet precautions
35
Q

Viral Meningitis

A

spread through direct contact w/ resp. secretions

Enteroviruses/arboviruses
Human immunodeficiency virus (HIV), Herpes Simplex Virus (HSV)

Prognosis: self-limiting

36
Q

viral meningitis clinical manifestations

A

headache, fever, photophobia, stiff neck

37
Q

viral meningitis dx studies

A

lumbar puncture

38
Q

viral encephalitis

A

acute inflammation of the brain usually cause by viruses

transmitted through ticks, mosquitoes, west nile virus

39
Q

Viral encephalitis clinical manifestations

A

fever, headache, N/V
alteration in mental status
symptoms of increased ICP
focal neurological deficits

40
Q

viral encephalitis Dx studies

A

MRI, PET scan, Lumbar puncture

41
Q

Viral encephalitis collaborative care

A 
prevention
mosquito control
diuretics
corticosteroids
antiviral meds
antiseizure meds
42
Q

Brain Abscess

A

Accumulation of pus within the brain tissue by:

streptococci
staphylococcus aureus

43
Q

Brain Abscess clinical manifestations

A

Headache
N/V
signs of increased ICP
focal symptoms

44
Q

Brain Abscess Dx studies

A

CT scan, MRI

45
Q

Brain Abscess collaborative tx

A

antimicrobial therapy
Surgical drainage
Surgical removal

Adult ll (11 decks)

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