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Med Surg > Chapter 60/62: Neuro > Flashcards

Chapter 60/62: Neuro Flashcards

1
Q

______________ are the cells of the nervous system

A

neurons

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2
Q

Branch-type structures for receiving electrochemical messages are structures known as:

A

Dendrites

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3
Q

An _________ is a long projection that carries electrical impulses away from the cell body

A

axon

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4
Q

______________ are at the end of an axon, which transmits messages to other cells via the neurotransmitters known as synapses

A

Terminals

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5
Q

A __________ is the place where neurons connect and communicate with each other

A

synapse

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6
Q

The major transmitter of the sympathetic nervous system is known as __________________. Imbalances of this neurotransmitter includes:
- high levels cause mania
- low levels cause anxiety, depression, ADHD

A

norepinephrine

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7
Q

_____________ affects behavior and fine movements
Imbalances of this hormone leads to diseases such as Parkinson’s

A

Dopamine

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8
Q

_________________ is the transmitter of the parasympathetic nervous system. Imbalances lead to diseases such as:
- Myasthenia gravis

A

Acetylcholine

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9
Q

The three main areas of the brain include:

A

Cerebrum
Brain Stem
Cerebellum

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10
Q

The __________ is responsible for thinking
The ________ ______’s major function is to sustain life
The ___________’s function is the integration of information for movement

A

cerebrum
brain stem
cerebellum

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11
Q

The __________ lobe is responsible for concentration, abstract thought, information storage or memory, and motor function. This lobe contains the Broca’s area, which is critical for the motor functions of speech.

A

frontal

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12
Q

The ________ lobe has the main responsibility of Sensation

A

parietal

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13
Q

The _________ lobe has the main responsibility of Hearing. Cranial Nerve VII, the acoustic nerve is assessed when checking this lobe.

A

temporal

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14
Q

The ___________ lobe has the main responsibility for Vision

A

occipital

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15
Q

Cerebral Spinal Fluid (CSF) is produced in the choroid plexus of the ______________ and circulates around the surface of the brain and the spinal cord

A

ventricles

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16
Q

CSF is important for ___________ and____________ function in the brain

A

metabolic
immune

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17
Q

What should CSF look like?

A

clear, colorless fluid

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18
Q

The meninges consists of these 3 layers:

A

Duramater
Arachnoid
Pia Mater

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19
Q

The duramater is the _____________ layer that covers the brain AND the spinal cord

A

outermost

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20
Q

The arachnoid is the ________ membrane; an extremely thin, delicate membrane that closely resembles a spider web. The arachnoid membrane has _______ in the space below it (subarachnoid membrane)

A

middle
CSF

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21
Q

The pia mater is the ____________ layer; thin, transparent layer that hugs the brain closely and extends into every fold of the brain’s surface

A

innermost

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22
Q

The _______ _______ _________ is used to describe the unique properties of the microvasculature of the central nervous system (CNS). It consists of blood vessels that vascularize the CNS. This helps to prevent the transmission of ____________ and _______ to the brain. This is made of endothelial cells and mural cells

A

blood brain barrier
pathogens/toxins

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23
Q

A __________ represents the area of skin that provides cutaneous inner action by fibers of specific nerve. For each CN and spinal nerve, there is a dermatologist (skin surface area) associated with it

A

dermatomes

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24
Q

Assessment of the sensory system involves test for _________ sensation, superficial pain, temperature, vibration, and position sense (proprioception). During the sensory assessment, the patient’s eyes are ________. Simple directions and reassurance that the examiner will not hurt or startle the patient. Encourage the cooperation of the patient. Tactile sensation is assessed by lightly touching a _______ _____or finger tip to corresponding areas on each side of the body. The sensitivity of proximal parts of the extremities is compared with that of ________ parts, and the right and left sides are compared

A

tactile
closed
cotton wisp
distal

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25
Q

MRIs with or without contrast is useful in diagnosing brain _________, strokes, and multiple sclerosis. It also shows how cells change in response to treatments.

A

tumors

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26
Q

Computed Tomography (CT) is a non-___________ test that shows tissue densities. Only ______ of ischemic strokes are found this way

A

contrast
10%

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27
Q

An electroencephalography (EEG) represent a record of electrical activity in the _______ ( a snapshot in time )
What is the main thing that this test is looking for?

A

brain
Seizures

28
Q

A cerebral angiography is a radiography study using ____ and fluoroscopy to find vascular abnormalities in the __________ circulation. Similar to _______ catheterization except the catheter goes into the _____ and dye shows the blood supplying the brain

A

dye
cerebral
cardiac
brain

29
Q

Before a cerebral angiography is performed , the nurse should assess the patients ______ and ___________, the nurse should __________ the patient, and ensure the patient has a working ______

A

BUN, creatinine
hydrate
PIV

30
Q

After a cerebral angiography is performed, the nurse should observe for __________ at the insertion site, should perform frequent _______ checks, and assess pulse, color, and ____________ checks of the affected extremity

A

bleeding
neuro
temperature

31
Q

The brain requires a constant supply of __________ — it does not does not store nutrients

A

oxygen

32
Q

The circle of Willis allows collateral __________ and blood flow to be redirected as needed

A

circulation

33
Q

The cerebral blood vessels one have ____ layers, which increased the risk for rupture

A

2

34
Q

The circle of Willis is formed by ____ arterial sources:
- The internal _________ arteries
- The Vertebrobasilar system — formed by 2 vertebral arteries and the basilar artery

A

2
carotid

35
Q

What are the 2 major types of strokes?

A

ischemic (approx 87%)
hemorrhagic (13%)

36
Q

An ischemic CVA is due to vascular __________ and significant hypoperfusion

A

Occlusion

37
Q

A hemorrhagic CVA is due to extravasating of _______ into the brain or subarachnoid space

A

blood

38
Q

What are some risk factors for a stroke/ CVA?

A

age
gender
ethnicity
HTN is the primary risk factor
Elevated cholesterol
Obesity
Diabetes — especially uncontrolled DM
oral contraceptive use
Smoking and drug/alcohol abuse

39
Q

Prevention of Recurrent Stroke or TIA
- Moderate — Severe Carotid Stenosis
- Carotid E______________ (CEA)
- Carotid angioplasty and S_________
- Atrial fibrillation : Anticoagulation
Anticoagulation:
- Dose adjusted ___________(Coumadin): target= therapeutic INR level 2-3
- Direct oral Anticoagulants
Dabigartran (Pradaxa)
Apixaban (Eliquis)
Edoxaban (Savaysa)
Rivaroxaban (Xarreto)

A

Endarterectomy
Stenting
Warfarin

40
Q

If anticoagulants are contraindicated:
- Antiplatelet therapy
Aspirin (ASA) alone
Dual antiplatelet therapy = ASA + Clopidogrel (Plavix)
Extended release dipyridamol plus aspirin (Aggrenox)
**Platelet inhibiting medications decrease the incidence of _______ or recurrent stroke in patient s who have experienced TIAs and stroke from suspected emboli or thrombotic causes. These are taken for a period of ___-___ days after the stroke or TIA. May be taken indefinitely if high risk

A

stroke
21-90

41
Q

Statins reduce coronary events and ___________ strokes

A

ischemic

42
Q

Preferred drugs for secondary stroke prevention:

A

Angiotensin converting enzyme (ACE) inhibitors or ARB is cannot tolerate ACE
Thiazide diuretics
Combination of both

43
Q

Manifestations of a stroke depend on the location and size of the affected area. What are some common signs and symptoms of a stroke?
be FAST

A

Facial drooping
Arm weakness
Speech change
Time — get help now!

Numbness/weakness of face/ arm/ or leg one one side
Confusion or change in mental status
Trouble speaking or understanding speech
Difficulty walking, dizziness, or loss of balance/ coordination
Sudden, severe headache
Perceptual disturbances

44
Q

A transient ischemic attack (TIA) is a ______________ neurological deficit resulting from a _____________ impairment of blood flow.
There is ______ permanent damage
However Warning of an impending stroke
Usually resolve within _____ hours

A

temporary
temporary
NO
24

45
Q

What is the initial test used to diagnose a stroke?

A

Non-contrast CT
**Should be initiated within 20. minutes of the arrival to the ER

46
Q

Seizures are abnormal episodes of motor, sensory, autonomic, or psychic activity resulting from a sudden, abnormal, uncontrolled electrical discharge from cerebral _____________

A

neurons

47
Q

Classifications of Seizures
- F_______: originates in one hemisphere
- G______________: occur and engage bilaterally
- P_________: related to acute, reversible condition

A

focal
generalized
provoked

48
Q

What are some causes of provoked seizures?

A

Stroke
Hypoxemia
Fever (childhood)
Head injury
HTN
CNS infections (Meningitis)
Brain tumor
Drug and alcohol withdrawal
Allergies

49
Q

________________ medications are given to prevent seizures such as Phenytoin

A

Anticonvulsant

50
Q

A __________ diet is believed to prevent seizures. High fat, Low carb to create ketotic

A

ketogenic

51
Q

Tonic clonic : total body __________ and stiffing
Myoclonic : brief jerking
Atonic : sudden loss of __________ tone and client falls
Complex focal: may loose _______________ briefly
Simply focal : remains conscious with jerking in ____ _____

A

jerking
muscle
consciousness
one area

52
Q

One of the number one priorities for a patient having a seizure is to ensure they remain __________

A

SAFE! protect form injury, raise side rails/ ease person to the floor, pad side rails, monitor onset, duration, pattern, adm meds

53
Q

** After care for seizures**
- Position patient to prevent __________
- Provide oxygen and ___________ if needed
- Reorient patient
- Record event

A

aspiration
suction

54
Q

Multiple Sclerosis is an autoimmune nervous system disorder causing progressive __________________ of neurons resulting in impaired transmission of nerve impulses

A

demyelination

55
Q

MS is a progressive disease that may lead to ______________( muscle weakness in all 4 extremities)

A

quadriparesis

56
Q

What are some MS manifestations?

A

Fatigue
Depression
Weakness
Numbness
Difficulty with coordination and balance
Spasticity
Pain
Diplopia

57
Q

The main nursing outcome for MS is maintaining ______________

A

independence

58
Q

Nursing interventions for MS
- Teach coordination __________
- Teach active ROM
- Encourage _______mL fluids a day
- Administer medications: immunosuppressants, corticosteroids, antispasmodics
- Bladder and bowel __________
- Self-help devices
- ___________ support

A

exercises
2000
training
Emotional

59
Q

Myasthenia travis is an autoimmune disorder affecting the __________ junction. Patients experience varying degrees of weakness of the ______________ muscles

A

myoneural
voluntary

60
Q

Clinical manifestations of myasthenia gravis
- ____ muscles often affected: diplopia and ptosis (drooping of __________)
- Weakness in _____ and _______ leading to dysphonia and dysphagia
- Weakness of the intercostal muscles

A

eye, eyelids
face, throat

61
Q

Medical treatment of myasthenia gravis
- ** Improve function and remove _________**
- Plasmapheresis
- IVIG
- Immunosuppressive therapy
- Anticholinesterases

A

antibodies

62
Q

Main outcome for myasthenia gravis is to maintain mobility and prevent _______________

A

complications

63
Q

Nursing interventions of Myasthenia Gravis
- Promote family understanding of dx. it is not _____________
- Administer medications before eating
- Good _____ care
- Passive and active _____
- Teach rest and recovery

A

hereditary
eye
ROM

64
Q

Bell’s Palsy is an idiopathic facial paralysis caused by inflammation of Cranial Nerve ___. It usually resolves completely over time. Medical treatment includes _________________ medication

A

7
corticosteroid

65
Q

The nursing outcome for bell’s palsy is to minimize any ______________.
- Cover affected eye if eyelids do not ________
- Keep eye moist with ______ or ____________
- Assess swallow and phonation / consult ________ therapy
- Psychological support

A

complications
close
drops, ointment
speech

Med Surg (20 decks)

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