Disability and Neuro

Question 1

John is a 65-year-old man who has just been admitted to the hospital with a suspected cerebral vascular accident (CVA). Upon arrival, John is unresponsive and his vital signs are as follows: blood pressure 170/100 mmHg, heart rate 92 beats per minute, respiratory rate 18 breaths per minute, and oxygen saturation 93% on room air. CT scan of the brain reveals a large ischemic stroke in the right hemisphere.

What is the primary cause of an ischemic stroke?

Answer 1

A blood clot that blocks blood flow to the brain

Question 2

What are the Cues we should be assessing for in D - disability?

Answer 2

ACVPU
Temp
Pupils
BSL
Limb movement
FAST
pain assessment (PQRST)

Question 3

Which areas of the brain controls the motor functions

Answer 3

Cerebral cortex, cerebellum

Question 4

What area of the brain deals with higher cognitive functioning?

Answer 4

Frontal lobe

Question 5

What does the Vagus nerve control/ deal with

Answer 5

Motor F(n)’s = Heart, Lungs, Bronchi, GIT
Sensory F(n)’s = heart, lungs, trachea, larynx, pharynx, GIT, external ear

Question 6

What direction does a ‘message’ pass down a neuron?

Answer 6

from the dendrites, down the axon to the axon terminals

Question 7

What are some common neurological disorders?

Answer 7

MS, Guillen-Barre Syndrome, & degenerative disorders, e.g. Parkinsons, Huntingtons, Amyotrophic lateral sclerosis

Question 8

Can Neurological disorders be caused by bacteria/ viruses?

Answer 8

Yes

Question 9

What are the most common/ prevalent neurological conditions worldwide?

Answer 9

Stroke, Dementia/Alzheimer’s, epilepsy

Question 10

What are the two reasons why a virus or bacterial infection can cause neurological symptoms?

Answer 10

Due to the infection itself or
Due to an immune response to the virus/bacteria

Question 11

What are some common signs and symptoms indicative of neurological disorders?

Answer 11

Partial or complete paralysis
Muscle weakness
Partial or complete loss of sensation
Seizures
Poor cognitive abilities/ decline
unexplained pain
deceased alertness

Question 12

Traumatic brain injury (TBI) refers to any injury of the scalp, skull or brain that disrupts the brain’s function. A contrecoup injury describes an injury to the brain that occurs at what site in relation to the initial impact site?

Answer 12

Opposite the initial impact site

Question 13

What are the leading causes of TBI?

Answer 13

Falls, road traffic accidents, Assaults

Question 14

Secondary brain injuries occur after the initial injury and result as a progression of events which affect the perfusion and oxygenation of the brain cells. This occurs most commonly due to what?

Answer 14

Swelling to the brain stem

Question 15

Patients with TBI should be nursed in a head up position to promote cerebral venous drainage. The head should be raised to what degree?

1. 90 degrees
2. 30 degrees
3. 70 degrees
4. 10 degrees

Answer 15

A= 30 degrees

Question 16

Cerebral trauma induces a state of hypermetabolism and hypercatabolism. What nutritional support is utilised to avoid the effects of protein catabolism and loss of lean body mass?

1. Hight protein, low carb diet
2. high protein, high Na diet
3. low Na, high energy diet
4. High energy, high protein diet

Answer 16

High energy, High Protein

Question 17

Is GCS <15 at 2hrs post injury indicative of a potentially significant mild head injury?

Answer 17

Yes

Question 18

What is the falls risk assessment used by NSW health called?

Answer 18

FRAMP - Falls Risk Assessment and Management Plan

Question 19

What does CEASE stand for, and where is it used/ relevant?

1. Comfort, environment, activity, social contact, engaging
2. Consider, Engage, Activity, Social contact, Environment
3. Comfort, Environment, activate, Severity, Engage

Answer 19

Comfort, environment, Activity, Social contact, Engaging

In a patient with delirium

Question 20

What are some of the common causes of delirium? and what is the Pneumonic?

Answer 20

Drugs
Electrolyte imbalance
Lack of drugs (withdrawal)
Infection
Reduced sensory input
Intracranial problems
Urinary retention
Myocardial problems

DELERIUM

Question 21

What are the S&S that indicate brain death?

Answer 21

Irreversible condition
Apnoea with a CO2 greater than 60mmhg.
No response to deep stimuli
No spontaneous movements
NO gag or corneal reflex
NO oculocephalic reflex
absence of toxins or metabolic disorders.