Neuro 10 Q

Question 1

Normal ICP; greater than _ TREAT!!

Answer 1

5-15; >20 treat!

Question 2

What is the earliest indicator of increased ICP?

Answer 2

Change in LOC

Question 3

Cushings triad is an emergency that indicates the brain is no longer compensating for increased ICP. What does this consist of?

Answer 3

increasing SBP, bradycardia with bounding pulse, and altered respirations

Question 4

Gold standard for ICP monitoring is the ventriculostomy. The transducer will need to be leveled with the _. Make sure it is level every time you move the patient

Answer 4

Foramen of Monroe (Tragus of the Ear)

Question 5

A normal ICP waveform resembles a

Answer 5

Staircase

Question 6

Normal CPP

Answer 6

60-100; CPP=MAP-ICP

CPP Less than 50 is bad, but CPP less than 30 is death

Question 7

Any patient who becomes acutely unconscious should be suspected of

Answer 7

increased ICP

Question 8

Primary cause of increased ICP

Answer 8

Cerebral edema

Question 9

2 major complications of increased ICP

Answer 9

inadequate CPP and cerebral herniation

Question 10

2 treatments used for increased ICP

Answer 10

mannitol, hypertonic saline

Question 11

When giving Mannitol, what is super important for the nurse to remember?

Answer 11

NEVER give it fast

Question 12

Fixed, dilated pupils are an _ sign

Answer 12

Ominous

Question 13

What volume status should be maintained for increased ICP?

Answer 13

Euvolemia

Question 14

Suctioning increases ICP, keep each pass < _ seconds

Answer 14

10

Question 15

Emergency with bleeding between the dura and the inner surface of the skull. It can be venous or arterial. Arterial develops more rapidly.

Answer 15

Epidural hematoma

Question 16

Acronym FAST describes symptoms of a CVA. What are these?

Answer 16

Facial drooping, arm weakness, speech difficulties, time (its critical)

Question 17

When a patient presents with a stroke, CT should be done within _ minutes and read within _ minutes

Answer 17

25 minutes, 45 minutes

Question 18

A major nursing goal for a stroke patient is to reduce secondary injury r/t

Answer 18

increased ICP

Question 19

What is the biggest risk factor for CVA?

Answer 19

Uncontrolled/undiagnosed HTN

Question 20

See back of card for emergency stroke management

Answer 20

Ensure airway, call code/stroke team, remove dentures, pulse ox, maintain O2, IV access w/ NS, maintain BP, immediate CT, baseline labs, tx hypoglycemia, position head midline with HOB 30, seizure precautions, anticipate thrombolytics for ischemic

Question 21

Cell death occurs in _ minutes without blood flow to the brain

Answer 21

5 minutes

Question 22

The patient with an ischemic stroke usually remains

Answer 22

conscious but has a headache

Question 23

Most important part of history in an ischemic stroke

Answer 23

Time of symptom onset

Question 24

For fibrinolytic therapy, you must maintain the BP less than

Answer 24

185/110 and for 24 hours after therapy

Question 25

In an ischemic stroke, avoid IV solutions that contain _ because they are hypotonic and further increase ICP

Answer 25

Glucose

Question 26

TPA must be given within _ to _ hours after ischemic stroke symptoms begin

Answer 26

3-4.5 hours

Question 27

Ischemic stroke can be _ or _

Answer 27

Thrombotic or embolic

Thrombotic is most common

Question 28

Hemorrhagic stroke often has a _ onset with progression over minutes to hours

Answer 28

rapid

Question 29

Manage _ in an hemorrhagic stroke

Answer 29

Hypertension

Question 30

3 tests for brain death

Answer 30

Oculocephalic (dolls eye), oculovestibular, apnea test

Question 31

Call KODA if a patient is < or equal to _ on the GCS scale

Answer 31

8

Question 32

Best GCS

Answer 32

15

Question 33

GCS less than _ is coma

Answer 33

8

Question 34

GCS less than _ is deep coma

Answer 34

3