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Critical Care NSG > Neuro > Flashcards

Neuro Flashcards

1
Q

Drugs, drops, and damages to the pons cause what?

A

Pinpoint pupils

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2
Q

Fear, seizures, cocaine, crack, and phencyclidine can cause what?

A

Dilated pupils

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3
Q

bruising over the mastoid areas suggestive of a basilar skull fracture

A

Battle Sign

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4
Q

Periorbital edema and bruising suggestive of a frontobasilar fracture

A

Racoon eye

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5
Q

Drainage of CSF from the nose suggests fracture of the cribriform plate with herniation fragments of the dura and arachnoid through the fracture

A

Rhinorrhea

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6
Q

Drainage of CSF from the ear is usually associated with a fracture of the petrous portion of the temporal bone

A

CSF otorrhea

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7
Q

Includes nuchal rigidity (pain and resistance of the neck flexion), fever, headache, and photophobia are signs of

A

Meningeal irritation

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8
Q

Decreased LOC, Restlessness, confusion, combativeness are S/s

A

early signs of increased ICP

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9
Q

Changes in VS in increased ICP is considered what?

A

Late sign

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10
Q

Vitals
late sign of increased icp
bradycardia
wide pulse pressure
changes in respiratory patters (Cheyne-stokes)

A

Cushing triad

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11
Q

Benzos are usually avoided in patients with ICP unless needed for what?

A

Seizures

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12
Q

why is analgesics and sedative intervention used during increased ICP

A

It reduced O2 needs, agitation, pain, and or discomfort that can lead to an increase in ICP

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13
Q

Most common anesthetics used during increased ICP

A

Propfol

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14
Q

Why are NBA paralytics used

A

to decreased CO2 and O2 needs, its usually a last resort

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15
Q

Used for htn in those with increased ICP

A

Nicardipine

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16
Q

With brain bleeds you want to avoid a map of

A

greater than 110

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17
Q

first line with neurp patients to decrease systemic bp

A

Ace and beta

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18
Q

Avoided during IICP due to cerebral edema

A

Calcium channel blockers

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19
Q

nursing managements for IICP

A

BP management, A line, Seizure precaution, low stimulation,

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20
Q

removing portion of the skull to allow for more room to swell after swelling improves, it is replaced

A

decompressive craniotomy

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21
Q

Managements of brain tumors include

A

corticosteroids, h2 receptor blockers, seizure medications, surgical managements, radiation therapy, chemotherapy.

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22
Q

management of aneurysm includes

A

clipping, wrapping, coiling, and pipelin

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23
Q

Manangment of brain tumors should take place within

A

24-48hrs

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24
Q

a tubing of nickel-cobalt chromium

A

pipeline

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25
Q

Treatment of vasospasms

A

triple H therapy, Nimodipine, balloon angio, intra-arterial vasodilator

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26
Q

late signs of IICP

A

cushings
abnormal posturing
VFIB
dolls eyes

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27
Q

what happens if CPP is greater than 100

A

It indicates hyperperfusion and IICP

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28
Q

what does less than 60 CPP mean

A

decreased blood supply and hypoxia

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29
Q

what does it mean if MAP=ICP

A

indicates no cerebral BF

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30
Q

what CPP level is maintained for critically ill patients

A

70

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31
Q

normal ICP

A

0-15

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32
Q

to maintain functional autoregulation what needs to be present

A

Normal PaCo2, Cpp >60 and MAP <160

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33
Q

fluid filled catheter inserted into the lateral ventricles via a burr hole. Allows CSF drainage and bedside monitoring

A

Vebtriculostomy

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34
Q

hollow, threaded screw is placed in the subarachnoid space. Connected by fluid-filled tubing to a transducer level with lateral ventricles.

A

subarachnoid screw

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35
Q

fiber-optic sensor inserted into the epidural space. Measures the changes in light reflected from a pressure-sensitive diaphragm in the catheter tip. Noninvasive and measures ICP.

A

Epidural or subdural sensor

36
Q

Hypercapnua causes what?

A

Vasodilation

37
Q

why is hyperventilation a tempory treatment for IICP

A

is causes a decrease in Co2 and vasoconstriction

38
Q

what is contraindiciated in a patient with a TBI for the first 24hrs

A

Hyperventilation

39
Q

ischemic stokes can be reversed with fibrinolytic therapy using what?

A

tPA

40
Q

Can you use the same IV for other medications that was used for tPA?

A

No.

41
Q

clinicals manifestations of stoke

A

weakness, numbness, visual changes, dysarthria, dysphagia, aphasia

42
Q

Mycotic aneurysm is caused by what?

A

Infections

43
Q

what is triple H therapy?

A

treat hypertension, hemodilution and hypervolemia that is causing Vasospasms

44
Q

medications used to treat vasospasms

A

dopamin and levophed

45
Q

a tangle of vessels, usually congenital and may enlarge with age

A

AVM

46
Q

managements of ischemic stroke

A

tPa within 3-4 hrs of symptoms iv
interventional therapy to remove clots within 8 hrs
anticoagulation therapy
BP control

47
Q

management of hemorrhagic stroke

A

treat underlining condition such a hypertension, AVM,
diagnose with CT

48
Q

ensure what medication is available if the patient starts to have bleeding issues during code stroke

A

aminocaproic acid

49
Q

Central technique of stimulation

A

Trapeziues pinch, sternal rub

50
Q

arms are in full flexion on chest

A

decorticate

51
Q

arms are stiffly extended, extension of legs -Hands are C

A

decerebrate

52
Q

which pupil sign goes with brain stem injury

A

Dolls eyes

53
Q

Signs of IICP and meningeal irritation

A

nucha rigidity, kernigs sign, fever, headache, and photophobia

54
Q

Osmotic diuretic used to treat cerebral hypertension

A

Mannitol 0.25-2gm/ kg IV
Filter needle
target osmolality 320

55
Q

How should you suction a patient and for how long

A

Limit passes 1-2 no more than 5-10 seconds.

56
Q

Hypertonic NS 3% is an intervention for what?

A

Treat IICP.

57
Q

positoning for a patient with iicp

A

HOB raised, head facing straight, neck neutral.

58
Q

Accelerations injuries (head on collision) is what type of SCI

A

Hyperflexion

59
Q

backward snap of spine by rear end collision, downward fall onto chin is what?

A

Hyperextension

60
Q

caused by landing on feet from a height

A

axal loading/ compression

61
Q

trauma of C4 and above the patient is at risk for what?

A

Impaired ventalation

62
Q

priority intervention for SCI

A

Cervical spine stabilization

63
Q

with SCI, you should always assesse for what

A

tracheal deviation

64
Q

occurs with sci above T6 leading to vasoconstriction reflex

A

Autonomic dysreflexia

65
Q

managements of autonomic dysreflexia

A

1- sit upright to decrease BP, administer nitrates and hydralazine

66
Q

occures immediately or within hours of sci

A

spinal shock

67
Q

flaccid paralysis, loss of reflexes below level of injury and paralytic ileus is s/s of

A

spinal shock

68
Q

Can occur within 24 hrs of a SCI
Hypotension, bradycardia, dependent edema, abrupt fever
Tx with vasopressors, atropine, and IVF

A

neurogenic shock

69
Q

you provide traction; immobilize spinal column

A

halo fixation

70
Q

three cardinal findings of brain death

A

coma or unresponsiveness, absence of brainstem reflexes, apnea

71
Q

test for brain death

A

motor testing
pupillary repsponse
oculocephalic refelx (dolls eys)

72
Q

explain normal, abnormal and absent findings with a caloric water test

A

normal-eyes move
abnormal- eyes do not move
absent- eyes stay neutral

73
Q

near temporal bone is associated with the epidural bleed/hematoma

A

Linear skull fracture

74
Q

can be because they extend to brain matter at times. often results in a communication between the external and interbal environment (Risk for infection) but can allow movement of swelling with the brain

A

depressive

75
Q

around the anterior, middle or posterior fossa

A

basilar

76
Q

between the skill and dura, near the middle meneigeal artery.

A

Epidural hematoma

77
Q

in the arachnoid matter,

A

subdural hematoma

78
Q

aneurysms and avams are usually the cause. They can have surgery to stop the bleeding or balloon angioplasty.

A

subarachnoid hematoma

79
Q

covers the actual brain. When people bleed here it is true intracranial bleeding.

A

pia matter

80
Q

you should give patients with a brain bleed other things to treat fever besides what and why?

A

tylenol becuase it does not work with neurogenic fevers

81
Q

management for intracranial bleeds

A

euvolemic protocol, monitor ecg changes, seizure precatuions, neuro assessment.

82
Q

GSC score of 13-15 , lOC, amnesia for 5-60 seconds, no abnormal ct

A

mild head injury

83
Q

gsc 9-12, LOC amnesia up to 24hrs.

A

moderate

84
Q

gsc score 3-6 LOC. long term amnesia, cerebral contusuion, lascerations or hematoma

A

severe

85
Q

therapeutic hypothermia can help what

A

ICP

86
Q

seizures and fever are considered what

A

hyper metabolic situations

87
Q

another way to treat ICP bu placement of this drain

A

EVD

Critical Care NSG (1 decks)

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