final exam part 2 Flashcards
What are the parts of a neuro assessment?
level of consciousness; mental status exam; special cerebral functions; cranial nerve function; motor function; sensory function; cerebellar function; reflexes
What are the levels of consciousness?
alert; lethargic; stuporous
how to check cranial nerve 1- olfactory
olfactory- check that air moves through each nostril, check sense of smell
how to check cranial nerve 2- optic
optic- snellen eye chart and check visual fields and pupillary response
how to check cranial nerve 3 and 4- oculomotor, IV trochlear, VI abducens
measure by having patient visually trace something you draw in the air, or follow your finger in the air.
For III also check pupillary response
how to check cranial nerve 5- trigeminal
sensory and check it with sense of touch on upper eyelid, cheek and jawbone. motor- have clench jaw, check corneal reflex
how to check cranial nerve 7-facial
look for facial symmetry, have pt wrinkle forehead, smile, puff out cheeks and frown
how to check cranial nerve 8- vestibulocochlear
whisper in pt ear, use a tuning fork
how to check cranial nerve 9, 10, 12- glossopharyngeal, vagus, hypoglossal
check uvula, elicit gag reflex
how to check cranial nerve 11- spinal accessory
check motor strength of head and shoulders
What is delirium?
syndrome involving disturbance of consciousness with change in cognition;
etiology- usually from identifiable physiologic, metabolic, cerebral disturbance or disease or from drug intoxication or withdrawal
Interventions for patients with delirium?
promoting patient safety;
managing patient’s confusion: orienting cues, speaking in low clear voice, avoiding sensory overload; promoting sleep; proper nutrition
What is dementia?
multiple cognitive deficits; primarily memory plus any of the following- aphasia (echolalia, palilalia), apraxia, agnosia, disturbance in executive function
etiology: variable causes, decreased metabolic activity found postmortem
What are the types of dementia?
alzheimers disease, vascular dementia, pick’s disease, creutzfeldt-Jakob disease, parkinsons, huntingtons, dementia due to head trauma
Interventions for patients with dementia?
safety, sleep, proper nutrition, hygiene, activity, environmental and routine structure, emotional support, supportive touch, interaction, involvement (reminiscence therapy, distraction, time away, going along)
What is MS?
multiple sclerosis- chronic demyelinating neurologic disease;
myelin sheath normally protects nerve fibers but in MS, sheaths are destroyed in patches
What are the 4 classifications of MS?
relapsing-remitting, primary progressive, secondary progressive, progressive relapsing
Medications to treat MS manifestations?
immunomodulators, corticosteroid therapy, muscle relaxants, immunosuppressants
S/S of Parkinson’s disease?
blank facial expression; slow, monotonous, slurred speech; rigidity and tremor of extremities and head; forward tilt to posture; reduced arm swinging; short, shuffling gait
Pathophysiology and etiology of parkinson’s disease?
progressive, degenerative neurologic disease (characterized by tremors, muscle rigidity, bradykinesia); coordinated voluntary body movement (actions of neurotransmitters in brain, neurons in cerebral cortex lost, dopamine receptors decrease, dopamine no longer inhibits acetylcholine
What are the 5 stages of Parkinson’s disease?
- unilateral involvement, minimal impairment; 2. bilateral or midline involvement, without impairment of balance; 3. evidence of unsteadiness, mild to moderate disability; 4. able to walk, stand, markedly incapacitated; 5. client confined to bed, wheelchair
What is altruism?
concern for welfare and well-being of others
What is autonomy?
right to self-determination
What is human dignity?
respect fro inherent worth and uniqueness of individuals and populations
