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NRSG 126 > Final > Flashcards

Final Flashcards

1
Q

nervous system

A

peripheral (PNS)

central (CNS)

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2
Q

CNS

A

central nervous system

comprised of the brain and spinal cord

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3
Q

PNS

A

peripheral nervous system

comprised of ganglions and nerves

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4
Q

meninges

A

protects the brain, absorbs shock

skull -> epidural space -> dura (thick and strong) -> subdural space -> arachnoid (connecting) -> subarachnoid space (CSF is here) -> pia (thin and hugs the brain and spine)

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5
Q

forebrain

A

cerebrum

thalamus

hypothalamus

pituitary gland

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6
Q

midbrain

A

in between the forebrain and the hindbrain

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7
Q

hindbrain

A

pons

medulla oblongata

cerebellum

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8
Q

structures of the brain

A

outer layer (cortex) = grey matter

inner layer = white matter

spaces = ventricles

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9
Q

dermatomes

A

areas of skin on your body that rely on specific nerve connections on your spine

can be used to determine whether the sensory loss on a limb corresponds to a signal spinal segment

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10
Q

C3 to C5 verebrae

A

keep us alive

control the function of the body from the shoulders down

support the neck and head

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11
Q

phrenic nerve

A

controls your diaphragm by sending signals to make it expand and contract

provides motor innervation to the diaphragm

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12
Q

radiculopathy

A

aka. pinched nerve

a set of conditions in which one or more nerves are affected and don’t work properly

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13
Q

cerebral cortx

A

divided into 4 lobes

frontal
parietal
temporal
occipital

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14
Q

frontal lobe

A

motor function
motivation
agression
smell
moos

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15
Q

parietal lobe

A

reception and evaluation of sensory info

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16
Q

temporal lobe

A

smell, hearing, memory and abstract thought

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17
Q

occipital lobe

A

visual proccessing

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18
Q

left sided brain

A

more verbal, analytical, and orderly than right brain

better at reading, writing, and computations

speaking, reading, writing, number skills, logic

controls right side of body

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19
Q

right sided brain

A

more creative artistic, and intuitive

abstract meaning, emotion, intuition, imagination, face/visual recognition

controls left side of body

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20
Q

intracranial pressure

A

the pressure inside the cranial vault

is dependent on three volumes -> brain, CSF, and blood

volumes of cranial pressure = 80% brain, 10% blood, 10% CSF

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21
Q

inter cranial pressure during brain bleed

A

increases

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22
Q

effects on brain size (ICP)

A

atrophy - change with ageing, health conditions

tumor- takes up space

surgery - removal of tumor

health conditions- AD, stroke

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23
Q

effects on blood (ICP)

A

stroke - clot or bleed

deformity- AVM (blood vessels form incorrectly), aneurysm

injury- subarachnoid hemorrhage (SAH), subdural hemorrhage 9SDA), epidural hemorrhage

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24
Q

effects of CSF (ICP)

A

all of these changes occur in the subarachnoid space and ventricles

injury

surgery (cause) - can cause leak, complication of epidural (break through the dura - dural tear)

surgery (fix) - VP shunt to fix (hydrocephalus), EBP (epidural blood patch for dural tear)

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25
Q

CSF

A

cerebrospinal fluid

should be clear and colourless

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26
Q

PNS

A

peripheral nervous system

comprised of ganglions and nerves

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27
Q

afferent neurons

A

PNS to CNS

sensory neurons

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28
Q

efferent neurons

A

CNS to PNS

motor neurons

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29
Q

Autonomic nervous system

A

parasympathetic (PNS) -> far from the spine

sympathetic (SNS) -> close to the spine

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30
Q

grey matter

A

= neuron

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31
Q

white matter

A

= axon

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32
Q

ICP

A

increased cranial pressure

caused by increased blood, CSF, and brain

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33
Q

macular degeneration

A

leading cause of vision loss in > 50 yrs

incurable

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34
Q

cataracts

A

everyone will develop it with age, gradually without pain

blurs all vision

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35
Q

diabetic retinopathy

A

leading cause in vision loss <50 years

cause = uncontrolled diabetes

severe vision loss/blindness

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36
Q

glaucoma

A

second most common cause of vision loss >65

visual field loss, decreased acuity, halo, or blindness

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37
Q

refractive errors

A

myopia = nearsighted

hyperopia = farsighted

presbyopia = difficulty reading small print

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38
Q

conductive hearing loss

A

inefficient sound waves outer to inner ear

ear canal blockage -> cold, allergy, infection

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39
Q

central auditory processing disorder

A

auditory center damage -> pathway to medulla

central cortex pathway damage

TBI, tumor, heredity

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40
Q

otitis media

A

eardrum and middle ear damage

infection

can lead to permanent hearing loss

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41
Q

otosclerosis

A

hereditary

ossicle hardening

causes tinnitus (ringing, roaring buzzing, other people cannot hear it)

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42
Q

sensorineural hearing loss

A

cochlea or nerve damage

causes = excess noise, meds, virus

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43
Q

cerumen accumulation

A

wax build-up that can harden

common in elderly

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44
Q

presbycusis

A

low pitch sounds are heard better

muffles hearing

age related hearing loss

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45
Q

meniere’s disease

A

inner ear disease

fluid in the ears

can cause tinnitus, hearing loss, vertigo

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46
Q

xerostomia

A

dry mouth

decreases saliva and thicker mucus

causes = medications, cancer, and ageing

risks = food aversions, decreasing calorie intake

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47
Q

olfaction

A

action or capacity of smelling

decreased with age due to reduced sensory neurons and bulb cells

affects sensitivity to odours and taste discrimination

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48
Q

sensation in older persons

A

decreased blood flow = decreased cardiac output, decreased peripheral blood flow

changes to nervous system = decrease in nerve cells, myelin sheath degeneration, decreased neurotransmitters, and conduction rate

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49
Q

peripheral neuropathy

A

occurs when the nerves that are located outside the brain and spine are damaged

causes weakness, numbness, pain in hands and feet typically

can effect digestion and urination

50
Q

nociceptive pain

A

somatic and visceral

arises in tissue -> trauma, surgery, chemical burns

sharp, aching, throbbing

51
Q

neuropathic pain

A

nervous system

arises from diseases or damage to sensory nerves

shooting, radiating, burning

52
Q

pain in older persons

A

they have an altered sensitivity to pain

increase in pain threshold

decline of painful sensations

decrease in pain tolerance

53
Q

kinesthetic

A

movement awareness

54
Q

proprioception

A

position awareness

55
Q

stereognosis

A

recognition of object texture and size

56
Q

cognition

A

the mental action of processing or acquiring information through thought and senses

consider culture, education, values, beliefs, and previous experience of the client

remember 3Ds

57
Q

4 questions categories testing cognition

A

memory

knowledge

abstract thinking

judgement

58
Q

cognition tests

A

GCS (consciousness)

MOCA (dementia)

AEIOUTIPS (altered mental status)

Neuro (general)

MMSE (assess mental status)

CAM/PRISME (delirium)

NIHHS (evaluate stroke severity)

59
Q

CVA

A

cerebral vascular accident

aka stroke

includes TIA, ischemic stroke (blood clot), hemorrhagic stroke

60
Q

CVA risk factors

A

atherosclerosis
HYPERTENSION
smoking
age >65yrs
diabetes
obesity
afib

loss of neurological function due to vascular injury

61
Q

TIA

A

“mini-stroke”

its ischemic

lasts several minutes with no permanent damage

1 in 3 people who have TIA’s will have a stroke

S/S and risk factors are the same as ischemic stroke but resolve without intervention

62
Q

FAST VAN

A

face, arm, speech, time

Vision, aphasia, neglect (quickly assess functional neurovascular anatamy)

is a hot stroke (<6 hrs of symptoms) reference guide

63
Q

ischemic stroke

A

thrombotic (stationary blood clot) or embolic (moving blood clot)

ischemia = reduced or restricted blood flow

64
Q

ischemic stroke thromotic

A

in the blood vessels in the brain

risk factors same as all arterial diseases (smoking, hypertension, atherosclerosis)

atherosclerotic plaque

clot formation

the brain doesn’t get enough O2

65
Q

ischemic stroke embolic

A

blood clot moves to the blood vessels in the brain

afib is a very common cause

risk factors = atherosclerosis, smoking/ETOH (alcohol), obesity, high LDL (cholesterol), HTN

less commonly can be caused by air, vegetation, amniotic animals

66
Q

treatment specific for ischemic stroke

A

open up the blood vessels

increase the odds of recovery and don’t let it happen again

break up the clot = t-PA, a recombinant tissue plasminogen activator (thrombolytic)

remove clot = EVT (endovascular treatment) thrombectomy -> increases risk for intercerebral bleed

67
Q

ichemic stroke prevention

A

prevents clots, but do not thin blood

antiplatelets = platelets won’t stick as easily-> ASA, Plavix (clopidogrel)

anticoagulants = interfere with the coagulation cascade -> Heparin, Warfarin, Rivaroxaban, Apixaban

68
Q

hemorrhagic stroke

A

intracerebral and subarachnoid

69
Q

hemorrhagic stroke intracerebral

A

bleeding into the brain tissue

S/S = headache, nausea/vomiting, changes to LOC, seizure (ICP)

causes = HTN, trauma, tumor, infection, medication, AVM (arteriovenous malformations)

70
Q

hemorrhagic stroke subarachnoid hemorrhage

A

bleeding into the subarachnoid space

S/S = worst headache ever, nuchal rigidity (stiff neck), photophobia (extreme sensitivity to light), nausea/vomiting

causes = AVM, aneurysm, trauma, bleeding disorder, medication

71
Q

common symptom of increased ICP

A

headache

blurred vision

feeling less alert

72
Q

treatment specific for hemorrhage stroke

A

coiling or clipping

NO ANTIPLATELETS OR ANTICOAGULANTS

73
Q

CVA diagnostics

A

look for type of stroke and causes/risks

CT scan

lab work (ECG, INR, CBC)

74
Q

TOR-BSST

A

stroke swallowing assessment

75
Q

reticular activating system

A

a network of neurons located in the brain stem the project to the hypothalamus to mediate behaviour

76
Q

apraxia

A

inability to perform particularly purposive actions, due to brain damage

77
Q

expressive aphasia

A

Broca’s aphasia

cant form sentences, controls ability to speak words

78
Q

receptive aphasia

A

Wernicke’s aphasia

cant understand words

79
Q

Immediate stroke complications

A

airway
increased ICP - hemorrhagic stroke
seizure
death
infection - UTI/ urosepsis, pneumonia

80
Q

Ongoing stoke complications

A

nutrition
communication
motor function
behaviour
memory

81
Q

GU system organs

A

kidneys
ureters
bladder
urethra

82
Q

function of kidneys

A

waste removal
balance water, pH, electrolytes
urine formation
controls production of RBC’s (erythropoietin)
controls BP (renin)
reabsorption of glucose

83
Q

normal kidney changes with ageing

A

decreased tissue
decreased number of nephrons
decreased kidney function overall
hardening of kidney vessels -> slows filtration process
bladder muscles weaken
increased postvoid residual volume

increased risk of UTI, incontinence, leakage

84
Q

normal post void residual volume

A

50 - 100mL in elderly

greater than 200 mL is abnormal

85
Q

forebrain function in GU system

A

controls voluntary micturition

afferent signals result in simultaneous contraction of the bladder and relaxation of the sphincter

86
Q

male vs female urethra

A

female = 3-4 inches

male = 18-20 inches

87
Q

polyuria

A

excessive urination

= more than 2.5 L per day

88
Q

Oliguria

A

urinary output less than 400 mL per day

89
Q

hematuria

A

blood in urine

90
Q

dysuria

A

sensation of pain or burning when urinating

91
Q

kidney damage

A

feel pain under ribs, to the right or left of spine

fluid retention -> swelling in arms and legs
BP increases

Ca+ decreases (kidneys convert vitamin D to active form which helps absorb calcium)
RBCs decrease (anemia)
renin increases

92
Q

renin

A

an enzyme made by kidneys

helps regulate blood pressure

controls the production of aldosterone

93
Q

aldosterone

A

increases blood pressure and volume by casing kidneys to excrete potassium through urine and reabsorb sodium into the bloodstream with causes water retention

94
Q

nocturia

A

waking at night to urinate

95
Q

cystitis

A

the most common type of UTI, particularly in women

lower UTI

96
Q

pyelonephritis

A

upper UTI

urinary infection -> one or two kidneys are infected

97
Q

bacteremia

A

bacteria in the blood

when it it from a UTI it is called urosepsis

98
Q

UTI S/S in adults

A

dysuria
nocturia
urgency
frequency
cloudy foul smell
fever/chills (later)
nausea/vomiting, fatigue (later)

99
Q

UTI S/S older adults

A

change in LOC
confusion
delirium
agitation
behaviour change
falls

asymptomatic bacteriuria may not need to be treated

100
Q

urinary cytology

A

invasive

sending in a tissue sample, often for cancer screening

101
Q

non invasive urinary tests

A

urinalysis
ultrasound
ct scan

102
Q

UTI treatment and prevention

A

treatment = fluids, antibiotics

prevention = adequate hydration, movement, incontinent care, caution with indwelling catheter

103
Q

GI system

A

mouth (mechanical and chemical breakdown)
esophagus (transport to stomach)
stomach (pepsin and HCl, chemical and mechanical breakdown)
intestines and pancreas

104
Q

small intestine

A

where majority of absorption and digestion occurs

105
Q

Large intestine

A

absorbs remaining water and electrolytes and forms feces

106
Q

normal bowel movements

A

3-4 BM/day

some people will only have 2/3 per/day

should be soft and brown

107
Q

normal age related GI changes

A

sphincters weakened
reduced absorption
increase in peptic ulcers
decreased production of digestive enzymes
impact B12, Fe, Ca, and folic acid absorption
decreased saliva
increased constipation

108
Q

black stool

A

indicates blood in the stool

upper GI bleed

109
Q

pale stool

A

bile duct blocked

110
Q

super green stole

A

too many greens

infection

111
Q

red stool

A

hemorrhoids or bleeding in lower intestine

112
Q

yellow stool

A

too much fat or malabsorption

113
Q

factors influencing defecation

A

stress
diet
meds
viruses
age
enzymes
gut microbiome

114
Q

Common GI alterations

A

norovirus -> contagious virus that causes vomiting and diarrhea

c.diff -> bacteria that causes diarrhea

rotavirus -> spreads through hand to mouth contact, it most serious for the kids under 2

115
Q

constipation vs fecal impaction

A

constipation = when you aren’t passing stool as often or as easily as usual -> stool is hard and dry

fecal impaction = when have been constipated for a long time and have been using laxatives, lump of dry hard stool stuck in the rectum

116
Q

Constipation causes

A

acute = changes in diet, medication, lack of exercise, lack of fibre and water intake

chronic = IBS, medical conditions, pregnancy, lack of mobility

117
Q

Constipation S/S in older adult

A

<3 BM per week

lump/hard stool

feeling of being blocked or not emptying

118
Q

diarrhea

A

multiple loose stools/day

acute = food, travel, viruses

chronic = allergies/intolerances, medication, IBS

119
Q

constipation complication

A

hemorrhoids
anal fissure
fecal impaction
rectal prolapse
bowel obstruction

120
Q

diarrhea complication

A

dehydration
IAD (incontenenice associated dermatitis) type irritation
electrolyte imbalance
decreased intake

121
Q

GI diagnostic tests

A

fecal specimens
x-ray
ct scan
colonoscopy
endoscopy

122
Q

insoluble fibre

A

whole grains, wheat and veggies

pull in h20 and is better for constipation

NRSG 126 (3 decks)

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