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NEURO Flashcards

1
Q

Inc. pressure w/in the skull DT inc. in one of the Intra-Cranial component

A

Increase ICP

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2
Q

Mneomonic Inc. ICP
“S T I T C H”

A

S-troke (Hemorrhage)
T-umor
I-nflammation- Meningitis, Encephalitis
T-rauma
C-erebral edema
H-ydrocephalus

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3
Q

The skull is a closed vault. An inc. in one component will inc. ICP.

A

Monro kelie Hypothesis

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4
Q

Composition of brain & Spinal cord

A

80%- Brain mass
10%- CSF
10%- blood

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5
Q

S/SX EARLY SIGNS OF ICP

A
  1. Blurred vision, visual acuity,diplopia
  2. Change or dec. LOC
    -Restlessness to confusion
    -Disorientation to lethargy
  3. Pupillary changes & eye movement problem
  4. Monoparesis/hemiparesis
  5. Headache
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6
Q

LATE SIGNS OF ICP

A

1.) Change in V/S:
BP inc. (Systolic Inc., diastole-Same)
Wide pulse pressure
•Normal adult BP 110/70
110-70= 40 (N) PP
Inc. ICP: 130/70=60 PP (wide)

  1. RR dec. -Irregular
    -Cheynes stroke
  2. Projectile vomiting
  3. Abnormal posturing:
    •Decorticate -abnormal flexion
    • Decerebrate-abnormal extension
  4. (+) Babinski reflex
  5. Hemiplegia
  6. Seizure
  7. Coma
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7
Q

Management of ICP
“H E A D S”

A

H-OB:
-Semi fowler’s- lung expansion (CI: on spinal injury)
-Head & Neck neutral position- venous drainage
E-valuate neuro status q1-2hrs
A-irway- Check RR NSG priority! -prepare for intubation & MV
-Avoid- coughing-(give anti-tissive-Vicks formula 44)
-straining of stos, Valsalva M. (Laxative/stool softener-Docusate sodume (Colace)
-Excessive vomiting (Anti-emetic- Ondasetron (Zofran)

D-rainage- Fromears CSF if (+) for glucose Nsg. Mgt.: Sterile dressing, evaluate SX of meningitis.

S-afety: -Seizure precautions
-Side rails up, No sedatives ot narcotics! - codeine sulfate for headache

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8
Q

Medication of ICP

A
  1. Corticosteroids- Dexamethasone (decadron) -dec. cerebral edema
  2. Osmotic diuretic : Mannitol (osmitrol) -Promotes cerebral diuresis by decompressing brain tissue
  3. Loop diuretic- Lasix (furosemide)
    -Act of loop of henle
    - 6hrs / morning
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9
Q

Dexamethasone (decadron) -dec. cerebral edema

A

Corticosteroids

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10
Q

Mannitol (osmitrol) -Promotes cerebral diuresis by decompressing brain tissue

A

Osmotic diuretic

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11
Q

Lasix (furosemide)
-Act of loop of henle
- 6hrs / morning

A

Loop diuretic

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12
Q

-partial or complete disruption of brain’s blood supply
-Death of brain cells

A

Cerebrovascular Accident

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13
Q

continues

A
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14
Q

Causes of Stroke

A
  1. Thrombosis - clot (attached)
  2. Embolism - dislodged clot - pulmonary embolism
    -CEREBRAL EMBOLISM
    s/sx:
    •Headache
    •Disorientation
    •Confusion
    •dec. in LOC
  3. Hemorrhage- Hemorrhagic stroke (Dedliest)
  4. Compartment syndrome- Compression of nerves/ arteries
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15
Q

Thrombotic
Embolic Strokes

gitawag siyag:

A

Ischemic Strokes

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16
Q

SIGNS AND SYMPTOMS OF CVA

A
  1. TIA- Warning Sx of impending stroke attacks:
    -Resolves in 24-72hrs
  2. Stroke in evolution- progression of s/sx of stroke
  3. Complete stroke- resolution of stroke
    cheyne-stroke resp. (same w/ inc. icp)
  4. (+) kernig’s brudzinski -Sx of positive hemorrhagic stroke
  5. Homonymous hemianopsia- loss of visual field.
  6. Unilateral neglect- unaware of paralyzed side existence
17
Q

Mnemonics signs of TIA
“FINCH PAD”

A

F-acial drooping
I-nc. ICP possible
N-umbness
C-hanges in speech & vision
H-eadache (initial sx)

P-aresis or pregia (monoplegia 1 extremity)
A-phasia
D-Dizziness/ vertigo, tinnitus

18
Q

DIAGNOSTIC TEST OF CVA

A
  1. CT SCAN- to know what stroke type
  2. Cerebral arteriography
    -site and extent of malocclusion
    -Allergy test
  3. MRI
    - to detect brain tissue damage
    -with dye injection
  4. Carotid UTZ- show plaque & blood flow of carotid ultrasound
  5. Echocardiogram- to find clot source in heart
19
Q

MNEOMONICS OF CVA
“BE FAST”

A

B-alance
E- yes

F-ace - uneven smile
A-rms - pt can’t raise the arms/ keep arms up
S-peech- slured
T-ime of onset/ call 911 or CT scan stat-if one sign is present

23
Q

MANAGEMENT OF CVA

A

9&10: TA Aspiration DT dysphagia

  1. Maintain patent a/w & adequate vent
    - Assist in mechanical ventilation
    - O2 2-4L/min via nasal canula (Flow rate (10 15L/mins)
  2. NPO- because of dysphasia
  3. HOB -15-30° ANGLE (low fowlers)-unless stroke is hemorrhagic
  4. Monitor VS,I&O, neuro-check
  5. Avoid Valsalva maneuver
  6. Maintain side rails
  7. Assist in passive ROME exercise q4h
  8. Prevent complications of immobility:
    -Turn client q2h
    -To prevent decubitus ulcer
    -Pneumonia etc.
  9. NGT
  10. Give thick fluids

Geitty (11 decks)

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