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Nursing 101 & 102 > Nervous System Disorders > Flashcards

Nervous System Disorders Flashcards

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0
Q

Inhibit neural pathways. Local anesthetic capable of inhibiting impulse pathways.

A

Therapeutic nerve blocks

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1
Q

Instituted for those who suffer from chronic headaches. Acquired skill to control bodily functions: HR, BP. Teaching sessions are needed.

A

Biofeedback

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2
Q

What neuron recovers first?

A

Motor recovers sooner than sensation

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3
Q

This block is considered a regional anesthesia because the nerve block occurs distal to where the med is administered.

A

Nerve block

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4
Q

What medication is used for a nerve block?

A

Lidocaine benzopine

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5
Q

What contains side effects of dysrythmias, tachycardia, confusion, tinnitus, blurred vision, N/V, or metallic taste.

A

Nerve block

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6
Q

A permanent change or destruction of nerve fibers.

A

Neuroablation

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7
Q

Permanent destruction from administration of a chemical agent

A

Chemical ablation

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8
Q

Radio frequency (heat) to nerve to cause destruction

A

Thermal ablation

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9
Q

Surgical ablation of a nerve route

A

Rhizotomies

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10
Q

Extreme cold to nerves to cause destruction

A

Cryoablation

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11
Q

Severing of the spinothalamic tract

A

Cordotomies

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12
Q

Severing at the level of the brain stem

A

Tractotomies

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13
Q

Severing of only sensory fibers. Motor should still be intact.

A

Dorsal route

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14
Q

Produced by a better powered implant when it sends electrical impulses it blocks nerve pathways

A

Electrical stimulation

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15
Q

Implant into the chest wall for the spinal cord and vagal nerve (rarely used for pain, but used for Parkinson’s)

A

Deep brain stimulation

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16
Q

Standard with chronic low back pain

A

Spinal cord stimulation

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17
Q

Electrodes are wrapped around the vagal nerve used for treating seizures with varying frequencies and strengths to the vagus nerve

A

Vagal nerve stimulation

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18
Q

Where do most inflammatory conditions of the nervous system begin?

A

In the bloodstream

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19
Q

Acute inflammation of the meninges and infection of CSF and arachnoid Mater

A

Meningitis

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20
Q

Meningitis is usually associated with what disease?

A

Upper respiratory infection

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21
Q

What are the causes of meningitis?

A

Viral, bacterial, fungal, and Protozoa

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22
Q

What causes a thickened viscosity of the CSF fluid?

A

When proteins spills because the blood brain barrier is no longer intact

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23
Q

Why does less glucose pass?

A

When the blood brain barrier is damaged glucose levels decrease

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24
Q

This type of meningitis caused purulent secretions

A

Bacterial

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25
Q

What pathogen cause streptococcal meningitis?

A

Hemophilius influenza

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26
Q

What is the percentage of cases of streptococcal pneumonia/neisseria menigitides

A

80%

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27
Q

The mortality rate is

A

25% treated and 100% untreated

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28
Q

What is the first sign of bacteria meningitis?

A

Severe HA

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29
Q

What are the signs and symptoms of bacteria meningitis?

A 
HA
N/V
Fever
Stiff neck
Skin rash/petechiae
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30
Q

What is nuchal rigidity?

A

Stiff neck

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31
Q

Flexion of the neck; knees automatically flex

A

Positive brudzinskis sign

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32
Q

Lying down and hips flexed and cannot extend the knee

A

Positive kernig

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33
Q

What is a common complication of bacterial meningitis?

A

IICP

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34
Q

What cranial nerves are involved with IICP?

A

2,3,4,6,8

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35
Q

1/3 of the patients with bacterial meningitis will have?

A

Seizures

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36
Q

What is a common cranial nerve issue with bacterial meningitis?

A

Photophobia

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37
Q

What Could be a permanent complication of bacterial meningitis?

A

Deafness

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38
Q

A pathological process caused by numerous small clots (countless amounts)

A

DIC- disseminated intravascular coagulation

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39
Q

How is bacterial meningitis diagnosed?

A

C&S (blood, sputum, nasal)
Imaging (X-ray, CT, or MRI)
Lumbar Puncture (DEFINITIVE TOOL)

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40
Q

How is bacterial meningitis treated?

A

Broad spectrum antibiotics until the pathogen is identified. Given in large, rapid doses of IV and PO.

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41
Q

What is Waterhouse-Friderichsen syndrome?

A

Severe vascular dysfunction

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42
Q

Why is decadron used?

A

It decreases cerebral edema. It also reduces mortality rate and hearing loss.

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43
Q

What precautions will a bacterial meningitis patient be on?

A

Droplet precautions

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44
Q

Meningococcal meningitis is

A

HIGHLY CONTAGIOUS

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45
Q

What is key in bacterial meningitis?

A

Prevention

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46
Q

What is critical to manage with a patient positive for bacterial meningitis due to increased risk of seizures?

A

Fever

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47
Q

What is viral meningitis usually caused by?

A

Measles, mumps, herpes, HIV

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48
Q

This disease is not as severe as bacterial meningitis and usually resolves within

A

2 weeks

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49
Q

What is different about viral and bacterial meningitis?

A

Viral doesn’t have purulent secretions and may have a normal or low glucose level.

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50
Q

How is viral meningitis diagnosed?

A

CSF sample (clear or cloudy)
PCR (blood test)
Stains and grams (negative for organisms)

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51
Q

What is the treatment for viral meningitis?

A

Treat symptoms only

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52
Q

Acute inflammation of the brain usually caused by a virus

A

Encephalitis

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53
Q

Mosquitoes and ticks can transmit the virus to a human via an insect bite

A

Encephalitis

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54
Q

The onset of encephalitis is

A

2-3 days

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55
Q

Encephalitis is a mild to severe manifestation that has what type of symptoms?

A

Flu-like symptoms

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56
Q

Encephalitis needs to be diagnosed when to have a favorable outcome?

A

Early

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57
Q

How is encephalitis treated?

A

Acyclovir (antivirals) and decadron

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58
Q

What else is treated with encephalitis?

A

Symptoms

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59
Q

Localized collections of pus within the brain tissue

A

Brain abscess

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60
Q

The infection is usually by a direct extension by

A

The ear, mastoid, tooth, and sinuses

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61
Q

Trauma or neurosurgery including tongue piercing and chipped teeth can cause

A

Brain abscess

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62
Q

Brain abscesses can be because of the bloodstream and septic emboli because it

A

Travels to the CNS from somewhere else

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63
Q

What organisms are usually associated with brain abscesses?

A

Streptococci

Staph aureus

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64
Q

What side of the brain does the abscess occur on?

A

The same side as the primary infection

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65
Q

Liquid necrotic tissue is encapsulated in a thick fibrous wall within

A

2 weeks

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66
Q

What are the systemic signs and symptoms of brain abscess

A 
HA
Fever 
Chills 
N/V
Malaise
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67
Q

How does the brain abscess affect the temporal lobe?

A

Visual changes and receptive aphasia

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68
Q

How does the brain abscess affect the occipital lobe?

A

Visual impairment

69
Q

How does the brain abscess affect the frontal lobe?

A

Expressive aphasia and motor weakness

70
Q

How does the brain abscess affect the cerebellar region?

A

Ataxia

71
Q

How do we diagnose brain abscesses?

A

WBC and ESR (to determine infection)
Cultures (ear,nose, and throat)
Imaging (to actually see the abscess)

72
Q

How do we treat the brain abscess?

A

IV antibiotics administered in large doses to cross the blood brain barrier

73
Q

What surgery is performed to remove and drain the abscess?

A

Craniotomy

74
Q

Infection of ANY part of the nervous system

A

Neurosyphilis

75
Q

Tertiary syphilis “treponema pallidum” can invade the CNS in a few months of original infection and can lay dormant for

A

10 years

76
Q

Neurosyphilis is not contagious but can be fatal and Neuro deficits are

A

Permanent

77
Q

Neurosyphilis is diagnosed by

A

RPR (rapid plasma regain)

A specific syphilis test

78
Q

Signs and symptoms of Neurosyphilis are

A 
Progressive ataxia 
Lightening pain (shooting)
Slapping gait (toes slap the ground)
Loss of DTR and proprioception (deep tendon reflexes) (walking into the table)
Charcots joints  (enlarged with instability and loss of sensation)
79
Q

Treatment for Neurosyphilis

A

PCN

80
Q

Most common type of pain

A

Headache

81
Q

Primary or functional problem of a headache is

A

The actual headache

82
Q

The secondary or organic problem of a headache is

A

The headache is a result of another medical condition

83
Q

What are the three types of headaches

A

Tension
Migraine
Cluster

84
Q

This headache is mainly caused by stress

A

Tension Headache

85
Q

This is the most common type of headache

A

Tension headache

86
Q

Tension headaches occur

A

Intermittently (weeks to years)

87
Q

The duration of a tension headache is

A

Minutes to days

88
Q

Migraines are more prevalent in

A

Women

89
Q

The onset of migraines usually occur at what age?

A

20-30 years old

90
Q

The cause of migraines is

A

Unknown

91
Q

What are the triggers of a migraine?

A

Food, medications, hormones

92
Q

What kind of foods contain tyramine?

A

Chocolate, smoked fish, aged cheese, hot dogs, pickles, yeast, coffee, and wine.

93
Q

How long does a migraine typically last?

A

4-72 hours

94
Q

What are the symptoms of a migraine

A 
Unilateral pain
Throbbing 
Photophobia 
Phonophobia 
N/V
95
Q

What are some factors that contribute to migraines?

A 
Stress
Menses
Sleep problems
Bright lights
Missed meals 
Smells
96
Q

What is the most common type of migraine?

A

Migraine without an Aura

97
Q

What is an aura?

A

Sensation that immediately perceives a HA, paralysis of limbs, abnormal feeling, blurred vision, spots in the eyes.

98
Q

Hours to days prior to preceding migraine including mood and food craving

A

Prodromal period

99
Q

When the HA begins and intensifies over hours with a tendency to hibernate

A

Second phase or headache phase

100
Q

Pain is improving with residual effects of scalp tenderness and neck tenderness

A

Third phase and gradual subsiding

101
Q

What is the first line of defense for migraines and is highly effective?

A

Triptans

102
Q

What is the anti-inflammatory to take with Triptans?

A

Treximet

103
Q

Affects serotonin receptors to inhibit neurogenic inflammation and cause cranial vasoconstriction

A

Triptans

104
Q

What are side effects of Triptans

A

Flush
Tingling
Hot sensation

105
Q

Who is contraindicated to take Triptans?

A

Someone with vascular conditions, HTN, and CVD

106
Q

Tripten vs. Ergotamine

A

Can’t be taken together because it causes too much constriction

107
Q

This type of medication is used to treat migraines. It causes constriction by affecting vascular smooth muscle.

A

Ergotamine

108
Q

What are 4 treatments that are used prophylactically for migraines?

A

Antihypertensives
Anticonvulsants
Antidepressants
Botox

109
Q

With topamax it is recommended to increase fluids. Why?

A

It increases the risk of kidney stones

110
Q

When taking anticonvulsants what is important about treatment?

A

Do not abruptly discontinue treatment. Can trigger rebound seizure activity.

111
Q

A rare form of headache that occurs usually in males age 20-40 years old and tends to precede over the eye.

A

Cluster headaches

112
Q

What is the thought cause of cluster headaches?

A

Hypothalamic dysfunction

113
Q

What are the signs and symptoms of a cluster migraine?

A

Extremely severe
Unilateral burning or stabbing pain
Lasts 45 minutes
1-8 times a day

114
Q

What is unique about cluster headaches?

A

They come back at the same time of year and season

115
Q

What symptoms are present on the affected side of the cluster headache?

A 
Ipsilateral tearing 
Rhinorrhea (nasal congestion) 
Facial flushing/pallor
Miosis (constricted pupil-one sided)
Periorbital edema
116
Q

What are some triggers of cluster headaches?

A 
ETOH 
Smoke 
Strong odors
Vasodilators
Napping
117
Q

What treatment is used prophylactically for cluster headaches?

A

Migraine medications

118
Q

What is abortive treatment for cluster headaches?

A

Oxygen 100% by face mask
6-8L for 10 minutes AND
Triptans

119
Q

Two different types of surgery that can be performed for cluster headaches?

A

Ablation with percutaneous radio frequency

Deep brain stimulation to the hypothalamus

120
Q

Paroxysmal uncontrolled electrical discharge of neurons; interrupts normal function caused by abnormal motor and sensory autonomic activity.

A

Seizures

121
Q

Tumors may be a symptom of a disease. What is the primary reason for seizures.

A

Tumor

122
Q

Seizures may also spontaneously. What is the percentage of cases not related to a source?

A

75%

123
Q

A chronic condition of abnormal spontaneous depolarization or uncontrolled electrical discharge affecting 3 million people.

A

Epilepsy

124
Q

Is believed to start at the foci and is thought to be involved with gliosis or Astrocyte involvement.

A

Epilepsy

125
Q

Males, Alzheimer’s/stroke, AA, family history and socially disadvantaged are all what?

A

Risk factors

126
Q

20-30 years of age diagnosed with a seizure is usually related to

A

Tumor or trauma

127
Q

A diagnosis of seizure often due to a noxic event or inadequate oxygen is found in who?

A

Infants

128
Q

Seizures diagnosed in patients over the age of 50 are usually caused by

A

Stroke or tumor

129
Q

EEG is

A

Not a definitive test for seizures

130
Q

How is a seizure diagnosed?

A

CT scan
MRI
Cerebral angiography
MRA

131
Q

What test can look for seizures but only indicates abnormalities predisposing of seizures?

A

Serum labs

132
Q

Behavioral changes that precede the seizure

A

1st phase: Prodromal phase

133
Q

Sensory warning (smell, sound, heard)

A

2nd phase: aural phase

134
Q

During the seizure

A

3rd phase - ictal phase

135
Q

After the seizure

A

4th phase - post ictal phase

136
Q

Tingling or cheek biting, incontinence, excessive salivation and cyanosis are symptoms of what seizure?

A

Grand mal

137
Q

During what phase will a patient sleep for hours with no memory and soreness?

A

Post ictal

138
Q

In general seizures what part of the brain is involved?

A

Entire brain

139
Q

What is the most common type of seizure and results in loss of consciousness?

A

Tonic-clonic

140
Q

Medical term for stiffness during a seizure

A

Tonic

141
Q

Medical term for jerking during a seizure

A

Clonic

142
Q

How long does jerking last?

A

2-5 minutes

143
Q

Medical management is based on stabilizing the nerve cell membrane by what?

A

Administering anti-seizure medications

144
Q

What medication still needs to be monitored by blood serum labs?

A

Dilantin

145
Q

What is important about anti-seizure meds?

A

Start with a low dose and if inadequate add more. Give minimal dose necessary.

146
Q

What meds have numerous side effects?

A

Anti-epileptic drugs

147
Q

What patient teaching is pertinent to the medication regime?

A

Take med at the same time everyday and do not abruptly discontinue.

148
Q

Removing the epileptic focus to prevent the spread of abnormal firing. Must meet 3 criteria points:
Confirm diagnosis
Failed drug trial
Identify type of seizure

A

Surgical intervention

149
Q

A device that can be used to stop abnormal firing and is attached around the nerve with a battery and the electrode has varied strength and frequencies.

A

Vagal nerve stimulation

150
Q

A specific diet that has extremely low carbs and alters brain metabolism and prevent seizures is called

A

Ketogenic diet

151
Q

The state of continuous seizures and is 2x more of risk for death

A

Status epilepticus

152
Q

Status epilepticus is considered

A

A medical emergency and can cause brain damage

153
Q

What is the two priority treatments for emergency complications of seizures?

A

IV access

Airway

154
Q

When a patient is at risk for aspiration what does the nursing care include during a seizure?

A

Turn the head to the side to prevent swallowing the tongue and aspirating saliva contents.

155
Q

This type of seizure is unilateral due to local focal abnormality

A

Partial seizure

156
Q

This type of seizure is bilateral

A

Generalized seizure

157
Q

A partial seizure does NOT precede a loss of

A

Consciousness

158
Q

A generalized seizure DOES precede

A

Complete loss or alteration of consciousness

159
Q

This type of seizure manifests as intact consciousness, they tend to last less than a minute, will be one sided, and el have motor, sensory, and autonomic manifestations.

A

Simple partial seizure

160
Q

This seizure will manifest as altered consciousness with confusion or clouding, last longer than a minute, behavior changes, emotional changes, altered memory, and repetitive movement.

A

Complex partial seizures

161
Q

The medical term for repetitive movement

A

Automateisms

162
Q

What seizure usually involves the temporal lobe

A

Complex partial seizures

163
Q

The confused state is called

A

Post ictal

164
Q

Atypical absence associated with staring spells and peculiar behavior and post ictal confusion

A

Absence seizures

165
Q

What is the worst seizure?

A

Tonic-Clonic seizure

166
Q

This type of seizure can last seconds an is associated with forceful jerking and tends to occur in clusters

A

Myoclonic seizures

167
Q

This type of seizure is associated with stiffness abruptly with possible loss of consciousness

A

Tonic seizure

168
Q

This seizure is classified as abrupt jerking occurs with muscle flaccidity; seen on childhood and usually resolves or progresses to another type of seizure

A

Clonic seizure

169
Q

A seizure classified as a “drop attack” with sudden flaccidity and regains consciousness by the time they hit the floor. High risk for injury.

A

Atonic seizures

170
Q

Partial seizures usually progress to

A

Generalized seizures

Nursing 101 & 102 (19 decks)

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