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Final Medsurg > Icp > Flashcards

Icp Flashcards

1
Q

What is a normal reading for ICP?

A

Normal icp= 5-15 mm Hg

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2
Q

Cerebral perfusion pressure is the pressure needed to ensure adequate brain tissue perfusion (CPP= mean arterial pressure - Inter cranial pressure) what is the normal CPP?

A

Normal 70-100 mm Hg

Minimum of 50-60mm Hg needed

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3
Q

Expandability of the brain is known as:

A) cerebral enlargement

B) compliance

C) brain growth

D) compressibility

A

B)compliance

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4
Q

What is Cushings triad?

A

Changes in vitals signs due to increasing pressure on the hypothalamus, thalamus, medulla, and pons.
-increased systolic pressure (increasing pulse pressure)
-bradycardia with a full and bounding pulse
-irregular respiratory pattern

This is medical emergency 🚨

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5
Q

What cranial nerves are most impacted when looking at inter cranial pressure?

A

-Oculomotor nerve (CN III) (results In Dilation of pupil, sluggish, and no response to light, inability to move eye upward)

Other cranial nerves may be affected causing blurred vision, diplopia, and changes in eye movement
Optic nerve (CN II)
Trochlear (CN IV)
Abducens (CN VI)

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6
Q

What do you call this surgery? Opening into the cream made with a drill call mom used to remove localize fluid in blood underneath the Dura.

A) burr hole
B) craniotomy
B) craniectomy
D) cranioplasty

A

A) burr hole

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7
Q

What do you call this surgery? Opening into the cranium with the removal of a bone flap an opening the Dura to remove a lesion, repair a damaged area, drain blood, or relieve increased ICP.

A) burr hole
B) craniotomy
B) craniectomy
D) cranioplasty

A

B) craniotomy

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8
Q

What do you call this surgery? Excision to the cranium to cut away a bone flat.

A) burr hole
B) craniotomy
B) craniectomy
D) cranioplasty

A

B) craniectomy

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9
Q

What do you call this surgery? Repair of a cranial defect resulting from trauma, malformation, or previous surgical procedure; artificial material used to replace damage your loss bone

A) burr hole
B) craniotomy
B) craniectomy
D) cranioplasty

A

D) cranioplasty

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10
Q

What is the difference between encephalitis and bacterial meningitis?

A

Encephalitis is acute inflammation of the brain caused by a virus. Commonly spread by ticks and mosquitoes. Fever, headache, nausea and vomiting, and any CNS Can be present. Treated with antivirals

Bacterial meningitis is acute inflammation of the meningeal tissues. It is a medical emergency, untreated leads to death. Treated with antibiotics and corticosteroids

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11
Q

What is the difference between decorticate posturing vs. decerebrate posturing?

A

Decorticate- flexion of arms, wrists and fingers with adduction in upper extremities

Decerebrate- all four extremities and Richard extension, with hyper pronation of forms and plantar flexion of feet

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12
Q

What is the earliest indicator of increased icp?

A) decorticate posturing

B) change in LOC

C) increased shortness of breath

D) dilated pupils

A

B) change in LOC

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13
Q

What are the symptoms of a concussion?

A

Headache, weakness, loss of balance, changing vision, or hearing, dizziness. May or may not lose consciousness. May lose memory before after injury.

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14
Q

What is the most common risk factor for strokes?

A) hypertension

B) depression

C) high cholesterol

D) history of MI

A

A) hypertension

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15
Q

Ischemic strokes result from inadequate blood flow to the brain from partial or complete occlusion of an artery. Which of these are ischemic strokes? Sata

A) transient ischemic attack

B) embolic stroke

C) subarachnoid hemorrhage

D) Intracerebral hemorrhage

E) thrombotic stroke

A

A) transient ischemic attack
—> short-lived episode of neurological dysfunction. Usually caused by temporary block a blood flow. Stroke risk increase following TIA. X < 1 hour

B) embolic stroke
—> occurs when an embolus lodges in and includes a cerebral artery. Rapid occurrence of severe clinical symptoms.

E) thrombotic stroke
—> occurs when a blood clot forms in a diseased and narrowed blood vessel in the brain. Most common.
sion of an artery.

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16
Q

Hemorrhagic strokes are the result of bleeding into the brain tissue itself or into the subarachnoid space or the ventricles.
which of these are hemorrhagic strokes? Sata

A) transient ischemic attack

B) embolic stroke

C) subarachnoid hemorrhage

D) Intracerebral hemorrhage

E) thrombotic stroke

A

C) subarachnoid hemorrhage
- intracranial bleeding into the CSF-filled space between the arachnoid, and the pia matter membranes. Commonly caused by rupture of cerebral aneurysm.

D) Intracerebral hemorrhage
-Bleeding within the brain caused by rupture of a vessel. Hypertension, most common risk factor. Commonly occurs during periods of activity.

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17
Q

What are the symptoms of a right sided stroke?

A

-Paralyzed left side (hemiplegia)
-difficulty in judging position, distance, and movement
-Impulsive, impatient, and denying problems related to stroke
-respond best to directions given verbally

18
Q

What are the symptoms of left brain damage from a stroke?

A

-paralyzed right side (hemiplegia)
- impaired speech – aphasias
-Slower in organization and performance of tasks
-Impaired spacial discrimination
-Have fearful, anxious response to stroke
-Responds well to nonverbal cues

19
Q

Which aphasia is shown as difficulty expressing thoughts through speech or writing. The patient cannot find the words needed, but knows what they want to say?

A) expressive aphasia (Broca’s aphasia)

B) global aphasia

C) receptive aphasia (wernickes aphaisa)

D) amnesic aphasia

A

A) expressive aphasia (Broca’s aphasia)

20
Q

Which aphasia is shown as the lease severe and involves difficulty finding the correct names for specific objects, people, places, or events.

A) expressive aphasia (Broca’s aphasia)

B) global aphasia

C) receptive aphasia (wernickes aphaisa)

D) amnesic aphasia

A

D) amnesic aphasia

21
Q

Which aphasia is shown as difficulty understanding, spoken, or written language.

A) expressive aphasia (Broca’s aphasia)

B) global aphasia

C) receptive aphasia (wernickes aphaisa)

D) amnesic aphasia

A

C) receptive aphasia (wernickes aphaisa)

22
Q

Which aphasia is seen as loss of all expressive and receptive function?

A) expressive aphasia (Broca’s aphasia)

B) global aphasia

C) receptive aphasia (wernickes aphaisa)

D) amnesic aphasia

A

B) global aphasia

23
Q

Explain the acute care interventions for. Ischemic stroke.

A

Goal is to prevent further brain damage

-Most important points of patient’s history is the time of onset

-Receive thrombolytic therapy within 4.5 hours from the onset of your symptoms. (Recombinant tissue plasminogen activator)

24
Q

What is the acute care treatment for a hemorrhagic stroke?

A

Anticoagulants and platelet inhibitors are Contraindicated here.

-Surgical therapy to immediately evacuate aneurysm, induced hematomas or cerebellar hematomas.
-Involves coiling or clipping of an aneurysm to prevent re-bleeding.

25
Q

Match the word to the symptom

A) homonymous

B) diplopia

C) ptosis

  1. Dropping eyelid
  2. Blindness in same half of each visual field
  3. Double vision
A

1c, 2a, 3b

26
Q

What are the 4 phases of a seizure?

A

1.Prodrome phase (signs that precede seizure)

  1. Aural phase (sensory warning)
  2. Ictal phase (full seizure)
  3. Postictal phase (period of recovery after the seizure)
27
Q

What’s the difference between generalized seizures vs focal onset seizures?

A

Generalized seizures affect the entire brain with no warning or aura.
-loss of consciousness a few seconds to many minutes.

-Focal onset seizures begin in a specific region of the cortex, may spread to partial or entire brain.

28
Q

If a patient has a tonic-clonic seizure, what first 4 steps of emergency management do we preform?

A
  1. Ensure the patient’s airway.
  2. Note aspects of seizure, when did it occur, how long did each stage last.
  3. Apply oxygen as needed, may also need suctioning.
  4. Assist ventilations if patient does not breathe spontaneously after seizure, anticipate need for intubation if gag reflexes absent.
29
Q

What is the most common form of multiple sclerosis?

A) primary-progressive

B) secondary-progressive

C) relapsing-remitting

D) progressive-relapsing

A

C) relapsing-remitting

30
Q

What is the mnemonic TRAP used for? And what does it stand for

A

Parkinson’s

-Tremor
-rigidity
-akinesia
-postural instability

31
Q

What are the 3 main symptoms of neurogenic shock (injury to T5 and above)

A

-hypotension, bradycardia, flushed/warm skin

32
Q

What are the three main characteristics of spinal shock? ( a temporay syndrome that occurs below the level of injury)

A

-decreased reflexes
-loss of sensation
-Flaccid paralysis

33
Q

What is autonomic dysreflexia?

A

Life-threatening and requires immediate resolution
-life-threatening Hypertension caused by an injury of T6 or higher.

Massive, uncompensated cardiovascular reaction, mediated by the SNS .

-Often caused by distention of bladder or rectum (check cath/bowels)

Manifested as a Hypertension up to 300 Mm HG, throbbing headache, bradycardia, and blurred vision or spots and visual fields.

34
Q

What a nursing interventions for autonomic dysreflexia

A
  • Elevate head of bed to at least 45°
    -Catheterize to relieve bladder, distention, if already in place, check catheter for kinks or folds, irrigate.
    -Check for stool impaction
    -Frequently monitor blood pressure 
35
Q

What complication of a spinal cord injury, resulting Hypotension and bradycardia and warm/flushed skin?

A) spinal shock

B) autonomic dysreflexia

C) neurogenic shock

D) none of the above

A

C) neurogenic shock

36
Q

If the patient has extreme Hypertension following a spinal cord injury, what is your priority action?

A) lay them flat

B) set patient up and elevate had a bed to at least 45°

C) provide fluids

D) all of the above

A

B) set patient up and elevate had a bed to at least 45°

37
Q

What is the 4 stages of shock?

A

-initial
-Compensatory
-Progressive
-refractory

38
Q

What is a classic clinical sign we’d see when a patient is in the compensatory stage of shock?

A

Hypotension
-Occurs because of decreased cardiac output. I never in pulse pressure.

You would also see pale and cool skin

39
Q

Nasal congestion is a symptom of what spinal cord complication?

A

AUTOnomic dysreflexia

40
Q

How is Giulian-barre syndrome treated?

A

Prevention of DVT and pulmonary embolism

-Plasma exchange or IV immune globulin

Paralysis from extremities up

41
Q

When administering any vasoactive drug during the treatment of shock, we want to make sure the mean arterial pressure stays at or above ____

A

> 65mm HG

Final Medsurg (1 decks)

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