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NUR 333 Funds II > Neuro > Flashcards

Neuro Flashcards

1
Q

When beginning a neuro assessment what is most important to confirm?

A

Airway
Breathing
Circulation

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2
Q

Neuro assessment

A

general survey
LOC
orientation
subjective data
mental status
gait
reflexes
sensation
coordination
proprioception
GCS/EMV
pupils
visual fields
muscle strength
speech
swallowing
gag reflex

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3
Q

Who would need a focused neuro assessment?

A

bc of neuro disease
changes in neuro status
trauma
drug induced states
neuro complaints

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4
Q

4 Hs

A

hypoxia
hypoglycemia
hypotension
hypoventilation

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5
Q

Alert

A

awake
responsive
easily aroused
receptive and responsive

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6
Q

Lethargic

A

not fully alert
drifts off to sleep when not stimulated
drowsy
awakes to NAME
responds appropriately
slow to respond

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7
Q

Are lethargic patients airway ability intact?

A

yes

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8
Q

Obtunded

A

sleeps most of the time
doesn’t arouse to name
SHAKE to awake, LOUD shout
confused when aroused
mumbled speech, incoherent
requires constant stimulation

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9
Q

Are obtunded patients airway ability intact?

A

concerning, don’t feed for aspiration precautions

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10
Q

Stupor/Semi comatose

A

spontaneously unconscious
responds only to SHAKE or PAIN
groans, mumbles

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11
Q

Are stupor patients airway ability intact?

A

no, high concern

don’t feed, aspiration precautions

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12
Q

Comatose

A

completely unconscious
no meaningful stimuli
no motor response

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13
Q

GCS/EMV

A

graded 3-15
<7-9 comatose
objective assessment

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14
Q

What EMV score is the airway protection a concern?

A

7-9

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15
Q

What EMV score is unresponsive?

A

3

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16
Q

What is an exception to a low EMV score?

A

trach patients, who have no verbal ability

11T- appropriate and airway is protected

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17
Q

Proprioception

A

recognize where your limbs are in space

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18
Q

Coordination

A

rapid alternative movements

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19
Q

What is the goal for neuro patients?

A

protect status and maintain safety
assist patients in gaining independence

protect airway!

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20
Q

Skin care for neuro patients

A

monitor and assess skin
q2 turns
pressure distribution
mobility
elimination needs

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21
Q

Neuro Dx

A

x-ray
CT scan
contrast
MRI
EEG

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22
Q

What is the least invasive way to diagnose?

A

x ray

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23
Q

X ray

A

skull
spinal

no NPO
keep c collar on
remove metal objects
painless

24
Q

CT scan

A

3D images of organs, bones, tissues
detects hemorrhage, vascular abnormal, tumor, cysts
no NPO

identify allergies to iodine
NPO for some
claustrophobic

25
Q

Contrast

A

PO, IV, rectal
helps distinguish selected body parts from surrounding tissues
*blood flow through brain

can be iodine based-allergies

26
Q

MRI

A

more detailed than CT
no exposure to radiation
expensive
screen for metal-remove it!
remove medicated patches

27
Q

Who should you call if you are questioning if a MRI is safe for the patient?

A

radiology

28
Q

Electroencephalogram EEG

A

monitors brain activity
helps diagnose seizures
confirms brain death
electrodes places on skull with conduction paste

29
Q

Factors influencing sensory function

A

age
meaningful stimuli
amount of stimuli
social interaction
enviromental factors
cultural factors

30
Q

Who is at risk for for sensory alterations?

A

farmers
outdoor laborers
night shift workers
nuns, monks
OA
confined environments
acutely ill

31
Q

Common visual deficits

A

presbyopia
cataracts
computer vision syndrome
dry eyes
glaucoma
DM retinopathy
macular degeneration

32
Q

Receptive aphasia

A

inability to understand written or spoken language

trouble to UNDERSTAND

33
Q

Expressive aphasia

A

inability to name common objects or express ideas in words or writing

trouble to TALK
can still understand

34
Q

Care for visual deficits

A

announce self
stay in visual field
speak in warm, present tones
explain care prior
keep paths clear
orient to room

35
Q

What is the technique with ambulating a patient with visual deficits?

A

pace of patient
1/2 step in front of patient
walk beside patient
have them hold your arm

36
Q

What size and color of text should you supply with visual deficit patients?

A

red and yellow
large text

37
Q

Care for hearing deficits

A

check for cerumen impaction
amplify sounds
add flashing lights for safety
slow/normal tone
short sentences
communication boards
face patient when speaking

38
Q

Care with taste deficits

A

well seasoned food
several textured food
stimulate smell with aromas
serve most appealing foods
use plate as clock
don’t bland or blend food

39
Q

Care with smell deficits

A

smoke detector
check food dates and appearance (teach)
danger with cleaning chemicals
no gas appliances

40
Q

Care with tactile deficits

A

touch therapy
turning, repositioning
hyperesthesia, minimize irritation, avoid loose linens
adapt with water temp, ice/heat, shoes

41
Q

When are yes/no questions appropriate?

A

common communication deficits

42
Q

Sensory deprivation causes

A

isolation
loss/impairment of senses
confinement
emotional disorders
brain injuries

43
Q

Nursing care for sensory deprivation

A

slow opportunity for stimuli
interaction
tactile stimulation
reorientation
assistive devices
**meaningful stimuli

44
Q

For sensory deprived patients, is constant visitors or small 1-1 visits more appropriate?

A

small 1-1 visits

45
Q

Care for community dwelling deprivation

A

encourage community agencies
programs, rehab, OT clinic

46
Q

Sensory overload

A

excessive stimuli
often confused with mood swings

47
Q

Causes of Sensory overload

A

pain
lack of sleep
ICU care
visitors/ staff

48
Q

Care for Sensory overload

A

orient
control stimuli
uninterrupted periods
schedule
visitor control

49
Q

Migraine types

A

tension headache
migraine headache
cluster headache

50
Q

Migraine

A

recurring headache characterized by unilateral throbbing pain

51
Q

Who are migraines more common in?

A

women

52
Q

Who are cluster headaches more common in?

A

men, 25-55 years

53
Q

What are premature sx of migraines?

A

aura, hours to days before

54
Q

Care for migraines

A

rule out intracranial or extracranial disease, meningitis
meds-NSAIDS, tylenol, aspirin, excedrin, caffeine
high flow O2 for cluster headache (no rebreather 6-8L/10 min)

55
Q

CYP 450 pathway

A

substrates: 2nd drug
Inducers: speed up, less absorbed, DECREASE effects
Inhibitor: slows down, substrate stays in body longer, more toxic

NUR 333 Funds II (9 decks)

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