Neuro Flashcards by doshia Williams

abnormal “normal” labs for Hypothyroidism is:

low T4, high TSH

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Symptoms of hypothyroidism in newborn include:

too good baby= quiet & good baby, prolonged jaundice, lethargy, poor appetite, bradymacroglossia (large tongue), long gestation > 42 weeks

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What happens if levothyroxine sodium is not given to patient shortly after birth?

mental retardation and growth failure

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Inadequate treatment ( med underdose) for congenital hypothyroidism can lead to

fatigue, sleepy, decrease appetite, constipation

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Levothyroxine overdose includes

rapid pulse, irritability, fever, weight loss, and diarrhea

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What should you educate parents about in regards to congenital hypothyroidism tx with levothyroxine?

check pulse before tx, single dose in AM, and child will need lifelong tx

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_____ is defined as abnormal electrical activities in the nerve cells in the brain

seizures

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Convuslion

a more severe seizure characterized by involuntary spasmotic contraction of any or all muscles throughout the body

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Epilepsy

a chronic recurrent pattern of seizure activities

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How long can a status epilepticus seizure last

Tonic-clonic seizures up to 30 min

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Status epilepticus involves ____ involvement, ______, ___tension, PVCs

status epilepticus invovles airway involvement, hypoxia, hyptotension, and PVCs

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Biggest differences between generalized and partial seizure

Generalized = affect the entire brain surface consciousness loss. Partial = affects part of the brain surface

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What is the tonic-clonic (grand mal) breakdown?

tonic phase- generalized stiffness of entire body. Clonic phase- spasm followed by relaxation

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The 3 types of generalized seizures include:

tonic clonic (grand mal), absence (petit mal), myoclonic

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Biggest difference between tonic-clonic (grand mal) and absence (petit mal)

TC= loss of consciousness. A= momentary loss

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Absence (petit mal)

momentary loss of consciousness, posture maintained, minor face, eye and hand movement

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Difference between simple and complex partial seizure

simple= no impairment of conscientiousness. Complex= impaired conscioentiousness

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Patient has an aura, Loss of consciousness, stiffness, apnea, cyanosis, pupil dilated, incontinence is a description of ______

tonic-clonic (grand mal)

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This seizure lasts 5 - 10 seconds, appears inattentive, daydreaming, age 4-12 year old is an example of what type of seizure

absence seizures ( petit mal)

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What happens in post-ictal phase?

CNS depression, patietn may be disoriented and sleepy

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What is the most common cause of increased seizure activity?

non compliance with medication

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Tegretol, dilantin, and depakene are used to tx what?

partial simple or complex seizures

Zarontin and Depakene are used to treat what?

absence seizures ( petit mal)

Tx for status epilepticus includes

valium and ativan

Diazepam (Valium)

short acting and must be given in repeated doses. Usually followed by long acting anticonvulsant ( Dilantin)

Lorazepam (Ativan)

drug of choice for status epilepticus because it lasts longer than Valium

_____ _____ is seizure not controlled by meds

intractable epilepsy

If meds don?t work for epilepsy,what are alternatives?

Ketogenic diet, surgery, vagus nerve stimulator, experimental drugs

Ketogenic diet

high-fat, adequate protein, low-carb diet

What shoud the nurse educate parents about epilepsy home management?

drug monitoring, med withdrawal, counseling, safety, immunizations

You witness a seizure, what do you do?

assess immediate environment & protect pt. from harm, assess airway, O2 prn, medicate, side laying afterward, observe and describe (time, incontinece)

This disease is an acquired neuromuscular disorder with a bacterial, viral or congential origin leading to inflammation and demyelination of the myelin sheath causing impaired nerve conduction

Guillain-Barre Syndrome

Paresthesia

numbness and tingling

What would you find a nursing assessment of a patient with Guillain Barre?

paresthesia, muscle weakness of less (progressing to face, trunk and upper extremities), difficulty in talking, chewing, swallowing, increase HR, pain in back of leg, ortho HTN

What is supportive nursing care for guillan barre patients?

monitor respiratory status, positioning and skin care, ROM and PT, and urinary cath

Common medication managemnt for GBS include:

IV immunoglobulins (lessen the immune attack), steroids, and plasmapheresis (removes antibodies)

What are the #1 cause for spinal cord injury in a newborn and an infant?

newborn- shaken baby. Older child- MVA

True or false, you should use a rigid cervical collar on immobilization board for anyone with spinal cord injury

TRUE

Would you take a child that was just in a car accident out of his or her carseat?

You are the nurse caring for Timmy who has sustained a severe spinal cord injury. You need to give him some medication to prevent any further swelling. You have prednisone and methylprenisolone available. Which do you give and how often?

Methylprednisolone, Q 8 hours

Describe your assessment for Timmy ( spinal cord injury)

assess breathing pattern & ausculate lungs, check neurologic vital signs frequently (sensory and motor), cardio status, abdomen for distention, temp (hyperthermia common), psychosocial status

You are discharging Timmy (spinal cord injury), what education would you provide to him and his family as to when they should seek medication attention?

recurrent omiting, seizure, loss of consciousness, worsening headache, change in behavior, difficulty walking

In what disease does organisms spread to CNS causing inflammatory response?

Meningitis

Haemophilus influenza, neisseria meningitis, sterptococcus pneumoniae are all causes of which type of meningitis?

Bacterial

What might a lumbar puncture show in meningitis?

Increased WBC, decrease glucose, elevated protein, increase ICP, positive culture for meningitis

Clinical Manifestations of an older child with mengitis include:

s/s of increased ICP (LOC changes, irritability, vomiting), neck stiffness, photophobia, Kernig sign, Brudzinski sign, fever, chills)

Clinical Manifestations of an infant with meningitis include:

absence of classic signs, ill, poor feeding, vomiting, BULGING FONTANELS, seizures

True or False, there is a vacinne for meningitis

TRUE

Most brain tumors are _____, making them difficult to excise surgically. Also, are close to ___ structures

infratentorial, vital

What are common symptoms associated with brain tumors?

headache upon wakening, vomiting with nausea, loss of concentration, change in behavior, vision problems

Post-op care priorities for brain tumor excision include:

increased ICP and seizures, monitor I & O, admin steroids and osmotic diuretics

In post-op phase of brain tumor surgery, how are you going to position your client?

Keep HOB elevated to decrease swelling. Most infratentorial tumors are prescribed to lie flat or turn to either side

What 4 things can cause increased ICP?

suctioning, coughing, straining, and turning