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adult 2 exam 2 > neuro > Flashcards

neuro Flashcards

1
Q

what causes a stroke

A

stroke is caused by a narrowing or blocking of view.
ischemic and hemo stroke and tia

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2
Q

ischemic

A

ischemic
embolic stroke: afib blood clot that travels the blood vessels
thrombotic: HTN/hyperlipidemia: in the circulatory sys

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3
Q

where do the blood flow come from

A

carotid or vertebral arteries

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4
Q

apraxia

A

you cant use objects properly or carry our commands/movements

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5
Q

agonsia

A

cant recognize objects
loss of comprehension of visual, auditory through sensory sphere

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6
Q

dysphagia

A

cant swallow

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7
Q

dysphasia

A

cant comprehend or speak

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8
Q

dysarthria

A

difficulty speaking because of tongue muscles

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9
Q

hemiplegia

A

paralysis on one half of the body

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10
Q

paraplegic

A

lower body

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11
Q

quadplegic

A

4 extremities

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12
Q

hemiparesis

A

mild or partial weakness/loss of strength on one side of the body

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13
Q

subjective

A
  1. PMH
  2. Meds?
  3. ask them if they had any surgerys
  4. developmental delays
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14
Q

objective

A
  1. assess their appearance
  2. behavior
  3. cognition: time place person situation
  4. mooood aand affect.
  5. cranial nerves
  6. motor system
  7. sensory: touch
  8. reflexes
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15
Q

glasgow coma scale

A

3-15

higher the better

eyes

mouth

moving

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16
Q

less than 8 glasglow

A

intubate

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17
Q

NIH stroke scale

A

15

0-15

0 is normal

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18
Q

CSF

CSF Analysis-lumbar puncture

  1. is there a signed consent?
  2. what position should the patient be?
  3. what should the patient do after the procedure?
  4. what should the nurse encourage/advise the patient to do?
  5. nursing intervention
A
  1. yes. invasive and its aspects
  2. lateral recumbent position
  3. lay for an hour
  4. encourage fluids
  5. take vital signs and neuro status for headache
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19
Q

Cerebral Angiography

prep op

  1. is patient on NPO

post op

  1. how frequent are VS
  2. is patient ambulating or bedrest
A
  1. yes because its dye
  2. 15-30 mins for 2 hours, 1 for 6 hours, 2 for 24 hours
  3. bedrest
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20
Q

CT scan neuro with dye

A

assess for allergeis

IV in case allergies

patient is still

give IV fluids

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21
Q

MRI

MRI with angiography

A

metallic (tattoo)?

pacemaker)

may need xanny for claustrrophobia

takes one hour

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22
Q

SPECT

A

IVs

no sedatives

empty bladder

glucose monitor

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23
Q

myelogram

A

dye is injected into the spinal cord

empty bladder

SEDATE THE PATIENT

REMAIN FLAT

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24
Q

EEG

A

hold anti seizure meds because we want to see the seizures for one day

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25
Q

seizure

A

uncontrolled electrical discharge of neurons

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26
Q

seizures metabolic disturbances

A
  • acidosis
  • electrolyte imbalances
  • hypoglycemia
  • alc or barb withdrawal
  • too much water too little water
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27
Q

extracrancial disorders

A

sepsis

lupus

HTN

DM

heart lung kidney liver

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28
Q

risk factors for seizures

A

low ses

AA

male

heredity

60 yrs old

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29
Q

when is the sensory warning phase

A

aural

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30
Q

tonic-clonic

A

LOC

stiffening(tonic)

jerking (clonic)

could have tongue or cheek biting or incontinence

post itcal: muscle soreness, no memory, fatigue

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31
Q

abscene seizure

A
  • happens in children
  • daydreaming spell
  • can be mis dx as ADHD
  • child is hyperventilation and flashing lights
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32
Q

what can patients do in the prodromal stage

A

take their shirt off

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33
Q

what can patients do during the aural phase

A

smell things

hallucinate

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34
Q

atypical absence seizure

A

staring pell

lip smacking and eye twitching

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35
Q

myoclonic

A

excessive jerking

atonic: drop attack they will gain con after drop

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36
Q

tonic

A

increased muscle tone

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37
Q

clonic

A

LOC

loss of muscle tone while jerking

and it could be ASSYMETRIC

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38
Q

partial seizures

A

stays on one side but can spread to other side to turn into generralized

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39
Q

partial seizures only include

A

simple and complex

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40
Q

simple seizure

A

patient is conscious

has weird feelings of emotions like happy and sad

starts to hallucinate and see smell taste things that are not there

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41
Q

complex focal seizures

A

change or LOC: dream like

automatic behavior: repetitive movement

does not remember activity before the seizure

lasts a few sec

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42
Q

psychogenic seizures

A

physical manifestation of a psych disturbance

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43
Q

how long does status epi last

A

more than 5 mins back to back

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44
Q

why is SE an emergency

A

patient can go into respiratory or cardiac arrest

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45
Q

which seizure for SE is the worst

A

tonic clonic

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46
Q

what can happen from SE

A

permanent brain damage or even death or severe injurry

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47
Q

SE is more common in what gender

A

male

48
Q

what meds do you give for SE

A

IV lorazepam and diazepam

49
Q

what drugs do you give for generealized tonic clonic

A

pheny

carb

phenobarb

depakote

50
Q

what do the meds do for patients with seizures

A

stabilize nerve cell membrane and prevent spread of epileptic discharge

51
Q

what drug is contraindicated for liver disease

A

phenytoin

52
Q

absence and myoclonic meds

A

clozepam

depakote

53
Q

what are other therapies for seizures

A
  • keto
  • vagal nerve stimulation
  • anterior temporal lobe resection
54
Q

Nursing Assessment Subjective and Objective for seizures

A

what were you doing before? auras? where was it? also the time of it?

what the the post itcal phase? LOC/VS/ Muscle soreness and weakness

55
Q

1 number NANDA for seizures

A

ineffective breathing pattern

56
Q

can you leave the seizure patient alone

A

NO

57
Q

what should you do if the patient is having a seizure

A

place them on the side, loosening clothes, ease to the floor

PATENT AIRWAY

do not restrain patient

observe the movements and location

DO NOT POSITION, SUCTION, OR GIVE OXYGEN

58
Q

how can we prevent injury for seizures

A

wear helmet

padded bed rails

59
Q

what is TIA

A

transient episode of neuro dysfunction caused by focal brain, spinal cord, retinal ischemia

60
Q

how long can a TIA last

A

less than 1 hour

61
Q

what are carotid system symptoms?

A

numbness

hemiparesis

loss of sensation and vision

can’t speak

62
Q

what are vertebrobasilar systems

A

tinnitus

vertigo

blurred vision

ataxia

63
Q

what is the most common stroke

A

thrombotic

⅔ of the cases is because HTN and DM

64
Q

what is the main symptoms of intracerebral hemorrhage

A

HA

N

V

decreased LOC

65
Q

what causes intracerebral hemorrhage

A

HTN

66
Q

what causes subarachnoid hemorrhage

A

coke, aneurysm rupture, trauma

67
Q

what are signs and symptoms of subarachnoid

A

LOC

N

V

SEIZURES

STIFF NECK

68
Q

what is the right sided stroke

A
  • left-sided neglect ONLY WITH THE RIGHT SIDED STROKE
  • spatial and perceptual deficits
  • impulsive
  • short attention span
    *
69
Q

what is the left sided stroke

A
  • math
  • speech
  • writting
  • slow and cautious
70
Q

aphasia

A

total loss of comprehending and using lang

71
Q

expressive aphasia

A

patient can understand but can’t speak brocas

72
Q

receptive aphasia

A

patient cant understand whats writtten

wernecks

73
Q

dysphasia

A

impaired ability to understand or use the spoken word

74
Q

expressive dysphasia

A

they can’t put words together to make a meaning

75
Q

receptive dysphasia

A

difficult in comprehending. speak slowly so the patient can understand

76
Q

right side spatial and perceptual

A

agnosia

apraxia

incorrect perception of themselves

77
Q

what is the most important for stroke dx

A

non-contrast CT scan

MRI

78
Q

how can we prevent strokes

A

-healthy diet

weight control

regular exercise

no smoking

limit alc

control BP

79
Q

how can we prevent thrombus/emobolus

A

ASA and Plavis

80
Q

anticoag with a fib and TIAA

A

rda ans and warfarin

81
Q

what surgical interventions can we do for TIAA

A
  • carotid endartectomy
  • transluminal angioplasty
  • stenting
82
Q

carotid endarterectomy

A

move fatty plaques from BV

83
Q

transluminal angioplasty

A

balloon to crack it up

84
Q

stent

A

put a stent that holds up the blood vessel especially when its weakneded

85
Q

hemorrhage stroke surgical therapy

A

resection

clip the aneurysm

get rid of the hematomas

86
Q

tpa should be

administered within:

rule out:

prior to admin:

after admin:

A

3 hours

hem. stroke, GI bleeds, BP over 190, stroke, head trauma, major surgery in last 14 days

prior to admin: foley, IV sites, NG tube

after admin: monitor for bleedings, neuro EVERY 30 mins, BP control.

87
Q

what drugs are contraindicated in hem. strokes

A

anti coags and platelets

88
Q

for hem. strokes how can we manage HTN

A

IV metoprolol

make sure the BP is less than 160

89
Q

for hem. strokes how can we manage HTN

A

IV metoprolol

make sure the BP is less than 160

MANAGE SEIZURES

90
Q

how can we management ICP for hem strokes

A

dopamine(vasoconstrict)

mannitol

drain the fluid(ventriculostomy)

91
Q

SEIZURES CAN HAPPEN WITH WHAT STROKE

A

Hem Stroke

92
Q

what are the goals for stroke

A

preserve life

no furture brain damange

reduce disability

93
Q

emergency care for stroke: nurse should

A

airways: get rid of dentures

IV

CT scan non contrast for I stroke or H stroke

Elevate patient

Seizure precautions

NPO BECAUSE RISK OF ASPIRATION!

94
Q

who assessing the the gag reflex

A

speech therapist

95
Q

priority for stroke patients

A

risk for aspiration pneumonia if patient has dysphagia

96
Q

vital signs for stroke

A

assess for lung sounds because remember patient got mannitol

BP

bleeding

VTE assessment in case the clot travels or forms

97
Q

range of motion for stroke

A

early mobility

hand cones for contractures(hardening of muscles and this can stiffen their joints)

trochanter roll at hip

DO NOT pull the patient

use splints

98
Q

left-sided stroke communication

A

nonverbal cues and can’t comprehend

99
Q

Multiple Sclerosis is CPD

A

chronic

progressive

degenerative

demylination of nerrve fibers

100
Q

risk factors for multiple sclersosis

A
  • gender and age: women between age of 20-40
  • climate: temperate climites
101
Q

what triggers MS

A

bacterial

viral

102
Q

MS death occurs because of

A

infection

103
Q

lifespan for MS

A

more than 25 years after dx

104
Q

what are the first symptoms of MS

A

visual distubrances

105
Q

motor MS signs and symptoms

A
  • weakness
  • spanning speech: long pauses
  • spasticity of muscles
106
Q

sensory

A
  • flaccid/spastic bladder(incontience)
  • lhermittes
  • numbness/tingling
  • tinnitus
107
Q

cerebellar

A

dysphagia

dysarthria

108
Q

DX for MS

A

MRI: plaques

CSF: oliogbands

109
Q

how to diagnosis MS

A

evidence at least 2 lesions at two different locations within CNS

damange occuring usually one month part

eveything else has to be rule out

110
Q

what should you give if the MS is being exacerbations

A

corticos

111
Q

MS nutrition

A

Vitamin B12 and C

low fat, gluten free diet

high protein

112
Q

MS

A

Impaired physical mobility

113
Q

can ms patients have dysphagia

A

mid

114
Q

a male client is having a tonic clonic seizures what should you do first

A

take measures to prevent injury. dont elevate bed you have to lower it.

115
Q

can you give patients thin liquids if they have strokes

A

no

116
Q

does generalized have an aura

A

NO

adult 2 exam 2 (3 decks)

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