Neuro Flashcards

Bacterial meningitis, brain lobes, ischemic stroke, autonomic dysreflexia, multiple sclerosis, TBI

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1
Q

Autonomic dysreflexia patho

A

Caused by noxious stimuli below level of injury
Distended bladder - obstructed urinary cath, neurogenic bladder
Impacted rectum
Constricted clothing

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2
Q

S+S of autonomic dysreflexia

A

Severe HTN
Severe HA, nasal stuffiness, and flushing
Bradycardia

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3
Q

Tx of autonomic dysreflexia

A

Raise HOB
Loosen tight clothing
Check bladder distention or fecal impaction
Antihypertensive meds

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4
Q

Bacterial meningitis S+S (early for neonates, peds, adults)

A

Neonates: poor feeding
Peds: fever, HA, vomiting
Adults: fever, HA, vomiting

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5
Q

Bacterial meningitis (late cues for neonates, peds, adults)

A

Neonates: bulging fontanels
Peds: rash, neck stiffness
Adults: neck stiffness, Brudzinski, Kernig

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6
Q

Brudzinski vs. Kernig

A

Brudzinski: Bend neck forward -> knee flex
Kernig: knee extension -> pain

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7
Q

Labs of bacterial menigitis

A

Cloudy
High opening pressure
High WBC
High protein
Low glucose
Positive culture

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8
Q

Frontal lobes

A

Voluntary mvt
Planning
Intellect
Problem solving
Abstract reasoning

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9
Q

Temporal lobe

A

Hearing

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10
Q

Parietal lobe

A

Touch perception
Mvt control
Manipulation

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11
Q

Occipital lobe

A

Visual reception

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12
Q

Cerebellum

A

Coordination
Balance

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13
Q

Ischemic stroke risk factors (embolic)

A

Carotid artery dz
Atrial fibrillation
Abnormal cardiac values

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14
Q

TIA

A

Angina of brain attack
Warning sign of stroke
Localized ischemic event -> resolves
Neuro deficits last only mins to hrs
Full fx recovery w/in 24 hrs

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15
Q

Ischemic stroke S+S

A

BE FAST
Balance: ataxia and vertigo
Eyes: blurry vision, diplopia, visual field deficits
Face: weakness, drooping, numbness
Arms and legs: extremity numbness or weakness
Speech and swallowing: aphasia, dysarthria, dysphagia
Time: onset of symptoms

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16
Q

Left hemi stroke

A

Language, reasoning, science, and thought

17
Q

Right hemi stroke

A

Spatial process, emotion, and visualization

18
Q

Nursing interventions of ischemic stroke

A

tPA
Monitor in ICU: bleeding precautions, neuro assessments, VS
Elevate HOB 15-30 degrees
Turn to unaffected side w/ head positioned midline

19
Q

tPA CI

A

Active bleeding
Recent brain/spinal surgery
Uncontrolled HTN (>185/110)
Low platelets or high PT/INR

20
Q

Hemianopsia pt teaching

A

Ask pt to move their head to scan full range of vision
Approach pt from unaffected side
Place pt’s personal objects w/in their visual field

21
Q

Ischemic stroke med management

A

Antiplatelet agents (aspirin)
Statins
ACE inhibitors

22
Q

Multiple sclerosis patho

A

Chronic autoimmune disorder
Brain and spinal cord are involved

23
Q

S+S of multiple sclerosis

A

Extreme fatigue
Eye symptoms
Lhermitte sign
Motor symptoms
Sensory symptoms
Bowel/bladder dysfx
Symptoms increase w/ heat exposure

24
Q

Tx of multiple sclerosis

A

Corticosteroids
Frequent rest

25
Q

Concussion (mild TBI)

A

Mild blow to head
Brief or no loss of consciousness
HA, dizziness, and amnesia
No brain injury on brain scans
Symptoms resolve w/in 3 days

26
Q

Contusion

A

Bruising of brain tissue
Focal injury
Symptoms depend on area of injury

27
Q

Diffuse axonal injury (cerebral edema)

A

High speed motor vehicle collision
Shearing of white matter tracts
Diffuse brain swelling
Severe DAI -> coma

28
Q

Skull fracture

A

Linear, depressed, comminuted
Underlying brain tissue injury
Raccoon eyes
Battle sign (bruising behind ear)
Halo ring (CSF leakage)

29
Q

Basilar skull fractures are associated w/ what injury?

A

Intracranial injury

30
Q

Nursing interventions of TBI

A

Assume neck injury and stabilize cervical spine
Oxygen
IV access for 0.9% NaCl
Endotracheal intubation for GCS score < 8
Pupillary assessment
Check for rhinorrhea, ear drainage, scalp wounds
HOB elevated 15-30 degrees

30
Q

Battle sign description?

A

Bruising behind ear

31
Q

Craniectomy interventions

A

Monitor for polyuria
Manage pain w/ short-acting opioid analgesics
Assess surgical site dressing for halos around drainage (clear-yellow ring = CSF leak)
Place sign above sign indicating cranial bone flap or not

32
Q

Increased ICP S+S

A

Cushing triad: bradycardia, irregular respirations, widening pulse pressure
Restlessness
Unilateral pupil dilation (mydriasis)
Flexed and pronated

33
Q

Cerebellum testing

A

Finger tapping
Rapid alternating mvts
Finger-to-nose
Heel-to-shin

34
Q

Need for spinal immobilization

A

Neuro exam - numbness and decreased strength
Significant trauma mechanism of injury
Alertness (decreased)
Distracting injury
Spinal exam
(NSAIDS)