Neuro

Question 1

What is ICP?

Answer 1

Increased cranial pressure is when vessels in the brain are compressed and causes compression on the brain stem which decreases hr and rr

Question 2

What is the first sign of increased ICP?

Answer 2

Mental staus change

Question 2

What type of vomiting occurs with increased ICP?

Answer 2

Vomiting without nausea

Question 3

Late signs of ^ ICP

Answer 3

Cushing Triad:
-low hr and rr
- wide pulse pressure- systolic up, diastolic down
- HTN

Question 4

Deadly signs of ^ ICP

Answer 4

• pupils fixed, dilated, and unequal
  *8mm normal 2-6
• doll eyes- brain stem is intact when eyes can move on their own
  *severe brainstem damage when they remain fixed and dilated
• babinski reflex present- brain stem herniation
• decorticate- arms flex inwards
• decerebrate- arms flex out, worse

Question 5

What test is done for brain injuries?

Answer 5

Ct scan

Question 6

Normal ICP

Answer 6

5-15

Question 7

Lumbar punctures (spinal taps)

Answer 7

Should she avoided with increased ICP

Question 8

Interventions for Increased ICP

Answer 8

• immobilize head
• Log roll to turn pt
• HOB Semi Fowlers 30-45*

Question 9

What should you not allow for increased ICP patients

Answer 9

-No flexing or bending extremities
- No coughing, sneezing, blowing nose
- No valsalva maneuver
- No straining during bowel movement (give stool softener)

Question 10

Glasgow coma scale

Answer 10

3-15
less than 8 intubate

Question 11

Meds for increased ICP

Answer 11

• steroids to decrease swelling
• phenytoin- to prevent seizures
• mannitol- decreases pressure

Question 12

What causes seizures?

Answer 12

increased brain swelling
- stress
- sleep deprivation
- strobe lights
- low sugar
-low sodium

Question 13

prodromal phase

Answer 13

warning phase before seizure

Question 14

aura phase

Answer 14

visual, auditory, or swelling sensation clues before a big seizure
ex: burnt toast

Question 15

ictal phase

Answer 15

active phase of seizure
(ignition phase)

Question 16

postictal phase

Answer 16

after seizure when pt’s are confused and disoriented

Question 17

Interventions for seizures

Answer 17

1. Assist to the ground, turn to side
2. prepare suction
   - never insert anything in mouth
   - don’t restrain

Question 18

Best drug for seizures

Answer 18

Benzodiazepines
- lorezapam
- diazepam

Question 19

Electroencephalogram

Answer 19

EEG assess electrical activity for seizures
no caffeine 12-24 hrs before
no seizure meds before
want them to be sleep deprived to increase activity
pt can eat

Question 20

Open TBI

Answer 20

basilar skull fracture with csf leaking from eyes, ears, nose
- test clear fluid for glucose to determine if csf

Question 21

Closed TBI

Answer 21

skull not fractured

Question 22

Coup Contrecoup

Answer 22

Closed TBI
- front to back of brain ex: whiplash
- Frontal lobe injury= expressive aphasia and memory problems
- Occipital lobe= vison problems

Question 23

Meningitis

Answer 23

inflammation in the brain caused by bacteria or virus

Question 24

s/s of meningitis

Answer 24

Headache and photophobia hard stiff neck - nuchal rigidity high temp Peds: hight pitched cry, bulging fontanelle Adults: altered loc first sign

Question 25

Meningitis tests

Answer 25

CT scan lumbar puncture: viral- very clear bacterial- cloudy

Question 26

Meningitis requires what type of precautions

Answer 26

Droplet

Question 27

Diagnostics for meningitis

Answer 27

Kernig sign: straightening leg is painful Brudzinski sign: neck flex causes hip and knees to flex

Question 28

Parkinsons

Answer 28

Low dopamine and high acetylcholine - permanent and no cure

Question 29

s/s of Parkinsons

Answer 29

- shuffling gait with decreased arm swing -pill rolling - tremors at rest

Question 30

Meds for parkinsons

Answer 30

levodopa and carbidopa avoid protein blocks absorption

Question 31

Multiple Sclerosis

Answer 31

autoimmune disease that attacks myelin sheath of muscles

Question 32

MS s/s

Answer 32

muscle spams muscle stiffness

Question 33

Pts with MS need to

Answer 33

Mellow out and stay cool - Avoid sun, hot tubs, hot baths, sauna, extreme heat - smoking - surgery -stress -sepsis

Question 34

Pharm for MS

Answer 34

- IV IG - Cylcosporin- immunosupressant

Question 35

Myasthenia Gravis

Answer 35

autoimmune disorder think * dry asthenia gravity - present with dry body and muscle weakness, droopy eyelids - avoid sun, stress, smoking, sickness

Question 36

Meds for Myasthenia Gravis

Answer 36

pyridostigmine give before meals increases secretions to help swallow

Question 37

ALS

Answer 37

- all organs in the body shut down, mind still intact entire body becomes paralyzed safety concern= dysphagia increased resp secretions kill pt as diaphragm becomes paralyzed= can't breathe

Question 38

Guillian Barre Syndrome

Answer 38

rapidly ascending paralysis from ground up - killed from resp failure- diaphragm becomes paralyzed

Question 39

worsening signs of Gillian barre syndrome

Answer 39

inability to cough can't lift eyebrows or head

Question 40

Cervical injury

Answer 40

causes quadriplegia impaired breathing= deadly

Question 41

Thoracic injury

Answer 41

paraplegia- paralysis of the legs Pelvic organs

Question 42

Lumbar injury

Answer 42

legs and leaky bladder

Question 43

Autonomic Dysreflexia

Answer 43

Spine cord injury t6 or higher causes: - Bladder issue: example would be a distended or urinary tract infection Bowel issue: like hard stool that collects in the rectum leading to impaction Break down of skin: due to any type of binding devices or clothing, pressure injury, burns, infection, cuts etc. s/s: HTN, low hr, sweating, dilated pupils, flushing of face, cool and clammy below injury Prevent: bladder distention or infection, prevent bowel impaction, asses for skin issues Treat: position high fowlers with legs lower to lower bp look for what is causing problem BBS administer nitro