Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adults? > Nervous System > Flashcards

Nervous System Flashcards

1
Q

31 - Stroke/Cerebrovascular accident (CVA)
+ 3 Types
+ Risk FActors
+ Overall symptoms

A

3 TYPES OF STROKE
+ Hemorrhagic: Ruptured artery/aneurysm
+ Thrombotic: Blood clot in cerebral artery
+ Embolic: Blood clot from another part of body that travels to cerebral artery

KEY RISK FACTORS: Smoking, hypertension, diabetes, AFIB, hyperlipidemia

OVERALL SYMPTOMS: Visual disturbances, dizziness, slurred speech, weak extremities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

32 -
LEFT CEREBRAL HEMISPHERE: What is it responsible for? Symptoms of stroke?

RIGHT CEREBRAL HEMISPHERE: What is it responsible for? Symptoms of stroke?

A

LEFT HEMISPHERE: Language skills, math skills, analytical thinking.
SYMPTOMS: EXPRESSIVE APHASIA (inability to speak and understand language), reading and writing difficulty, right-sided hemiparesis (weakness) or hemiplegia.

RIGHT HEMISPHERE: Visual and spatial awareness
SYMPTOMS: Overestimation of abilities, POOR JUDGEMENT AND IMPULSE CONTROL, one-sided neglect syndrome (ignore left side of body), left-sided hemiparesis or hemiplegia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

33 - Stroke: Nursing Care, Medications, Surgery

A

NURSING CARE:
+ Monitor patients BP, SBP>180 or DBP >110 can indicate an ischemic stroke.
+ Assess swallowing and gag reflex before allowing patient to eat. Thicken liquids if needed. Teach patients to swallow w/head and neck flexed forward.

MEDS: Anticoagulants, antiplatelets, thrombolytic meds (give within 4.5 hours of initial symptoms).

SURGERY: Carotid artery angioplasty w/stenting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

34 - Spinal Cord Injury (SCI)
+ What causes paraplegia vs. quadriplegia?
+ Neurogenic shock - symptoms
+ Upper vs. lower motor neuron injuries: muscle tone/bladder

A

PARAPLEGIA: Injuries below T1, resulting in paralysis/paresis of lower extremities.

QUADRIPLEGIA: Injuries in cervical region, resulting in paralysis/paresis of all 4 extremities.

NEUROGENIC SHOCK: Occurs after SCI for several days to weeks. Symptoms: hypotension, dependent edema, temperature regulations issues.

UPPER MOTOR NEURON INJURIES (ABOVE L1/L2): spastic muscle tone, spastic neurogenic bladder.

LOWER MOTOR NEURON INJURIES (BELOW L1/L2): flaccid muscle tone, flaccid neurogenic bladder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

35 - Spinal Cord Injury (SCI)
+ Medications
+ Autonomic dysreflexia
+ What is it, symptoms, nursing actions

A

MEDS: Glucocorticoids (reduces spinal cord edema), vasopressors (treats hypotension during neurogenic shock), muscle relaxers (baclofen, dantrolene), stool softeners (in addition to a bowel/bladder schedule).

AUTONOMIC DYSREFLEXIA: For injuries above T6: stimulation of sympathetic nervous system with inadequate response from parasympathetic nervous system.
+ SYMPTOMS: EXTREME HYPERTENSION, severe headache, blurred vision, diaphoresis.
+ NURSING ACTIONS: Sit patient up, notify provider, DETERMINE CAUSE (DISTENDED BLADDER, FECAL IMPACTION, TIGHT CLOTHING, UNDIAGNOSED INJURY), treat cause catheterize patient, remove impaction, remove tight clothing), administer antihypertensives.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

3 - Glasgow Coma Scale (GCS)

A

Score between 3 and 15. Less than 8 = severe head injury and/or coma. Between 9-12 = moderate head injury. Add up sub scores.

EYE OPENING: (4) spontaneously, (3) in response to voice, (2) in response to pain, (1) no eye opening.

VERBAL RESPONSE: (5) coherent/oriented, (4) incoherent/disoriented, (3) inappropriate words, (2) sounds, no words, (1) no vocalization.

MOTOR RESPONSE: (6) follows commands, (5) local reaction to pain, (4) general withdrawal to pain, (3) decorticate posture, (2) decerebrate posture, (1) no motor response.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

6 - Magnetic Resonance Imaging (MRI)

Pre-procedure nursing care

A

+ Assess for allergy to shellfish/iodine if contrast will be used.
+ Assess for history of claustrophobia.
+ Have patient remove all jewelry.
+ Make sure patient does not have any metal implants (pacemaker, orthopedic joints, artificial heart valves, IUDs, aneurysm clips).
+ Earplugs can be provided, as MRIs are loud.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

7 - Nociceptive vs. Neuropathic Pain

A

NOCICEPTIVE PAIN: Damage/inflammation of tissues (not part of CNS). Pain described as: THROBBING, ACHING, and is usually localized. 3 types:
+ SOMATIC: bones/joints, muscle, connective tissue
+ VISCERAL: internal organs
+ CUTANEOUS: skin, subcutaneous tissue.

NEUROPATHIC PAIN: Result of damaged nerves. Pain described as: SHOOTING, BURING, “PINS AND NEEDLES:. Adjunct meds often used: antidepressants, muscle relaxants.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

9 - Non-opioid vs. opioid analgesics
+ When to use
+ Key side effects and concerns

A

NON-OPIOID: Use for MILD TO MODERATE PAIN,.
+ Key concerns: acetaminophen intake should NOT EXCEED 4G/DAY.
+ Monitor for salicyclism w/aspirin (sx: tinnitus, vertigo).
+ Administer w/food to prevent GI upset.
+ Long-term NSAID use carries risk of bleeding.

OPIOID: Use for MODERATE TO SEVERE PAIN,
+ Key side effects include: constipation, hypotension, urinary retention, n/v, sedation, respiratory depression.
+ NALOXONE IS ANTIDOTE.
+ Administer around the clock (vs. PRN).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q 
12 - Seizures
\+ What are they?
\+ What is epilepsy?
\+ Risk factors
\+ Triggering factors
A

SEIZURES: Uncontrolled electrical discharge of neurons in brain.
+ Epilepsy = chronic seizures (2 or more).

RISK FACTORS: Fever, cerebral edema, infection, toxin exposure, brain tumor, hypoxia, alcohol/drug withdrawal, fluid or electrolyte imbalances.

TRIGGERING FACTORS: Stress, fatigue, caffeine, flashing lights.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

13 - Types of Seizures

+ Tonic Clonic, Absence, Myoclonic, Atonic, Status Epilepticus

A

TONIC CLONIC: May be preceded by aura. 3 phases:
+ TONIC EPISODE: stiffening of muscles, loss of consciousness.
+ CLONIC EPISODE: 1-2 minutes of rhythmic jerking of extremities.
+ POSTICTAL PHASE: confusion, sleepiness.

ABSENCE: Loss of consciousness for a few seconds. Key features: blank staring, eye fluttering, lip smacking, picking at clothes.

MYOCLONIC: brief stiffening of extremities.

ATONIC: Loss of muscle tone, results in FALLING

STATUS EPILEPTICUS: Repeated seizure activity within 30 minutes, or a single seizure lasting more than 5 minutes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2 - Electoencephalography (EEG)
+ What is it?
+ Pre-procedure Nursing Care

A

EEG: Analyzes electrical activity in the brain. It is used to identify seizure activity, sleep disorders, behavioral changes. Small electrodes are placed on the scalp. Takes approximately one hour.

PRE-PROCEDURE PATIENT INSTRUCTIONS:
+ WASH HAIR PRIOR TO PROCEDURE.
+ Arrive sleep-deprived (as this increases chance of seizures).
+ NO NPO IS NEEDED. Avoid stimulants, sedative medications 12-24 hours before procedure.
+ Inform patient that flashing lights may be used during procedure, to patient may be instructed to hyperventilate (to increase electrical activity).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q 
4 - Intracranial Pressure (ICP) monitoring
\+ What is it?
\+ Indications
\+ Symptoms of increased ICP
\+ Normal ICP range
A

ICP MONITORING: Device inserted into cranial cavity in the OR to measure pressure. Huge risk of infection.

INDICATIONS: Patient with GCS score of 8 or less (or in a coma).

SYMPTOMS OF INCREASED ICP: IRRITABILITY (EARLY SIGN!), restlessness, headache, decreased LOC, pupil abnormalities, abnormal breathing (ex: Cheyne Stokes), abnormal posturing.

NORMAL ICP RANGE: 10-15 mmHg.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

5 - Lumbar Puncture
+ What is it?
+ Indications
+ Pre-procedure and post-procedure nursing care

A

LUMBAR PUNCTURE: Cerebral Spinal Fluid (CSF) sample is taken from the spinal canal for analysis.

INDICATIONS: Used to diagnose multiple sclerosis, syphilis, meningitis, infection in CSF.
+ PRE-PROCEDURE: Have patient void. Position patient in cannonball position on their side, or have patient stretch over table while sitting.
+ POST-PROCEDURE: Patient should stay flat for several hours. If the dura puncture site does not heal, CSF may leak, resulting in headache (administer pain meds and encourage increased fluid intake). Epidural blood patch can b used to seal off the hole.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q 
19 - Amytrophic Lateral Sclerosis (ALS)
\+ What is it?
\+ Symptoms
\+ Nursing care
\+ Meds
A

ALS: Degenerative neurological disorder of upper and lower motor neurons, resulting in progressive paralysis. Eventually causes respiratory paralysis within 3-5 years. Cognitive function not impacted. No cure.

SYMPTOMS: Muscle weakness, atrophy.

NURSING CARE: MAINTAIN PATENT AIRWAY, suction/intubate as needed. Monitor for pneumonia, respiratory failure.

MEDS: Riluzole - slows deterioration of motor neurons, extends patient’s life 2-3 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

20 - Myasthenia Gravis (MG)
+ What is it?
+ Symptoms
+ Diagnosis

A

MG: Autoiummune disorder that causes severe muscle weakness. Caused by antibodies that interfere with Ach at neuromuscular junction (NMJ). Characterized by periods of exacerbation and remission. Associated with thymus hyperplasia.

SYMPTOMS: Muscle weakness (worse w/activity), diplopia, dysphagia, impaired respiration, DROOPING EYELIDS, incontinence.

DIAGNOSIS: Administer EDROPHONIUM, which increases Ach at NMJ. If symptoms improve, it is MG. If not, it is a cholinergic crisis (Atropine is antidote).

17
Q

21 - Myasthenia Gravis (MG)
+ Nursing Care
+ Medications
+ Therapeutic procedures and surgical intervention

A

NURSING CARE:
+ Maintain patent airway (Oxygen, suction and intubation equipment at bedside)
+ Encourage periods of rest
+ Provide small/frequent/high-calorie meals, have patient sit upright while eating, thicken liquids
+ Administer lubricating eye drops, TAPE EYES SHUT AT NIGHT (to prevent damage to cornea)

MEDICATIONS: Anticholinesterase agents (pyridostigmine or neostigmine), imunosuppressants

PROCEDURES/SURGERIES:
+ Plasmapheresis - removes antibodies from plasma
+ Thymectomy - removal of thymus

18
Q 
22 - Migraine headaches
\+ Risk factors/triggers
\+ Symptoms
\+ Nursing care
\+ Medications
A

RISK FACTORS/TRIGGERS: Allergies, bright lights, fatigue, stress, anxiety, menstrual cycles, certain foods (MSG, tyramine, nitrites).

SYMPTOMS: PHOTOPHOBIA, N/V, UNILATERAL PAIN (USUALLY BEHIND ONE EYE OR EAR). Can happen with or without aura (visual disturbances, numbness/tingling). Pain persists for 4-27 hours.

NURSING CARE: Provide cool/dark/quiet environment. Teach patient to avoid triggering foods, reduce stress levels.

MEDS: NDSAIDs (mild migraine), antiemetics (for n/v), sumatriptan or ergotamine for more sever migraines.

19
Q

23 - Cluster headaches
+ Symptoms
+ Medications

A

SYMTPOMS:
+ Severe, unilateral, non-throbbing pain that radiates to forehead temple, cheek.
+ Lasts 30 minutes - 2 hours. Usually occurs daily at the same time for 4-12 weeks.
+ More frequent in spring and fall. More common in men between 20 - 50 years old.
+ FACIAL SWEATING
+ NASAL CONGESTION

MEDICATIONS: sumatriptan, ergotamine (same as migraine headaches).

20
Q

24 - Macular Degeneration: What is it? Symptoms?

Cataracts: What are they? Symptoms? Post-surgery teaching

A

MACULAR DEGENERATION: Central loss of vision. Number one cause of vision loss over age 60. No cure.
+ SYMPTOMS: Blurred vision, LOSS OF CENTRAL VISION, blindness.

CATARACTS: Opacity in lens of an eye, impairing vision.
+SYMPTOMS: Decreased visual acuity, progressive/painless loss of vision, diplopia, halo around lights, photosensitivity, absent red reflex.

POST-SURGERY TEACHING: Wear sunglasses, AVOID INCREASING IOP (don’t bend over at waist, avoid sneezing/coughing/straining, avoid hyperflexion of head and restorative clothing, avoid tilting head back to wash hair, limit housework and rapid/jerky movements). Best vision occurs 4-6 weeks after surgery.

21
Q 
25 - Glaucoma
\+ What is it?
\+ 2 types glaucoma
\+ Normal IOP
\+ How to measure IOP and drainage angle
A

GLAUCOMA: Increase an IOP due to issue with optic nerve. Glaucoma is a leading cause of blindness.
+ OPEN ANGLE: Most common. Aqueous humor outflow decreased, resulting in gradual increase in IOP. SYMPTOMS: mild eye pain, LOSS OF PERIPHERAL VISION.
+ CLOSED ANGLE: Less common. Angle between iris and sclera closes completely, resulting in sudden increase in IOP. SYMPTOMS: SEVERE PAIN, nausea.

IOP: Normal range is 10-21 mmHg. Measure using tononetry, Measure draining angle w/gonioscopy.

22
Q

26 - Glaucoma
+ Medications
+ Patient teaching for eye drops
+ Post-surgery teaching

A

MEDICATIONS:
+ Pilocarpine (constricts the pupil)
+ Beta blockers - timolol (reduces aqueous humor production)
+ Mannitol - osmotic diuretic for closed angle glaucoma, quickly reduces IOP

PATIENT TEACHING FOR EYE DROPS: Administer 1 drop in each eye twice a day. Wait 5-10 minutes between eye drops. Do not touch tip of applicator to eye. Place pressure at lacrimal duct after installation.

POST-SURGEY TEACHING: Same as cataract surgery (i.e. avoid activities that increase IOP).

23
Q

29 - Head Injury
+ First priority
+ Signs of increased ICP
+ Intervention to decrease ICP

A

FIRST PRIORITY: Stabilize cervical spine.

SIGNS OF INCREASED ICP: IRRITABILITY (EARLY SIGN!), headache, decreased LOC, pupil abnormalities, abnormal breathing (ex: Cheyne Stokes), abnormal posturing. CUSHING’S TRIAD (SEVERE HYPERTENSION, WIDENING PULSE PRESSURE, BRADYCARDIA).

INTERVENTIONS TO DECREASE ICP: Reduce hypercarbia (hyperventilate patients), avoid suctioning, maintain HOB MORE than 30 degrees. Teach patient to avoid coughing, blowing nose, extreme neck flexion/extension, restrictive clothing.

24
Q

30 - Head Injury
+ Medications
+ Surgical Interventions
+ Complications

A

MEDICATIONS:
+ Mannitol: Osmotic diuretic to treat cerebral edema
+ Pentobarbital: Induces coma, decreases metabolic demands
+ Phenytoin: Prevents/treats seizures
+ Morphine: Treats pain

SURGICAL INTERVENTIONS: Craniotomy to remove nonviable brain tissue. Many risks (infection, death).

COMPLICATIONS:
+ Brain herniation (downward shift of brain tissue r/t cerebral edema). Symptoms: fixed dilated pupils, decrease LOC, abnormal respirations and posturing.
+ Hematoma, intracranial hemorrhage
+ SIADH

25
Q 
14 - Seizures
\+ Diagnosis
\+ Nursing care (during and post seizure)
\+ Medications
\+ Surgical interventions
A

DIAGNOSIS: EEG to identify origin of seizure.

NURSING CARE:
+ DURING SEIZURE: TURN PATIENT TO THE SIDE, loosen restrictive clothing, DO NOT INSERT AIRWAY OR RESTRAIN PATIENT, document onset/duration of seizure.
+ POST-SEIZURE: Check vital signs, neurological checks, reorient patient, seizure precautions, determine possible trigger.

MEDS: Anti-seizure drugs such as phenytoin.

SURGERIES: Vagal nerve stimulator, craniotomy to remove brain tissue causing seizures.

26
Q 
15 - Parkinson's disease
\+ Cause
\+ Symptoms
\+ Nursing Care
\+ Medications
A

CAUSE: Degeneration of substantia nigra, resulting in too little dopamine and too much acetylcholine

SYMPTOMS: TREMOR, MUSCLE RIGIDITY, SLOW/SHUFFLING GAIT, bradykinesia (slow movement), mask-like expression, drooling, difficulty swallowing.

NURSING CARE: Monitor swallowing/food intake, thicken food, sit patient upright to eat, have suction equipment available. Encourage ROM and exercise, assist w/ADLs.

MEDS: Levodopa/carbidopa (increases dopamine levels), benztropine (decreases acetylcholine levels).

27
Q

16 - Alzheimer’s Disease
+ What is it?
+ Stages of Alzheimer’s (important components)

A

ALZHEIMER’S: Non-reversible dementia, resulting in memory loss, problems with judgement, and changes in personality.

STAGES:
+ STAGE 1: No impairment.
+ STAGE 2: Forgetfulness, no memory problems.
+ STAGE 3: Mild cognitive deficits, short-term memory loss noticeable to family members.
+ STAGE 4: Personality changes, obvious memory loss.
+ STAGE 5: Assistance w/ADLs necessary.
+ STAGE 6: Incontinence (fecal, urinary), wandering.
+ STAGE 7: Impaired swallowing, ataxia, no ability to speak.

28
Q

17 - Alzheimer’s disease
+ Nursing care
+ Home safety measures
+ Medications

A

NURSING CARE: Maintain structured environment. Provide short directions, repetition. Avoid overstimulation. Use single-day calendar. Provide frequent reorientation. Maintain routine toileting schedule.

HOME SAFETY: REMOVE SCATTER RUGS. Install door locks, good lighting (particularly on stairs). Mark step edges w/colored tape, remove clutter.

MEDS: DONEPEZIL (prevents breakdown of ACh, improves ability to do ADLs), other meds to manage symptoms (anti-psychotics antidepressants, anti-anxiety meds).

29
Q 
18 - Multiple Sclerosis
\+ What is it?
\+ Triggers
\+ Symptoms
\+ Medications
A

MULTIPLE SCLEROSIS: Autoimmune disorder where plaque develops in white matter of the CNS. Age of onset is typically 20-40 years of age, more common in women. CHARACTERIZED BY PERIODS OF RELAPSING AND REMITTING.

TRIGGERS: Temperature extremes, stress/injury, pregnancy, fatigue.

SYMPTOMS: Eye problems (diplopia/nystagmus) muscle spasticity and weakness, bowel/bladder dysfunction, cognitive changes, ear problems (tinnitus/hearing issues), dysphagia, fatigue.

MEDS: Immunosuppressive agents (cyclosporine), prednisone (anti-inflammatory), muscle relaxants Idantrolene, baclofen).

Adults? (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions