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Med surg > Neuro > Flashcards

Neuro Flashcards

1
Q
  • neurons are lost, leading to a decrease in the number of synapses and neurotransmitters(results in slowed nerve conduction and response time)
  • brain weight decreases
  • Ventricle size increases to maintain cranial volume
  • temperature regulation is less efficient
  • myelin is lost in the PNS resulting in conduction velocity in some nerves.
  • VIsual and auditory nerves degenerate
  • Taste buds and sense of smell atrophy
  • Nerve cells of the vestibular system in the inner ear degenerate
  • DTR’s can be decreased
  • Overall slowing of ANS responses
  • Pupillary responses are reduced or may not appear at all in the presence of cataracts
A

The older adult

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2
Q

low-pitched clear voice, do not shout
provide auditory and visual aids
Provide instruction at an un-rushed pace

A

speaking to an older adult

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3
Q
  • Educate the patient about lying completely still
  • Review relaxation techniques for pt. with claustrophobia
  • assess for iodine or shellfish allergy if contrast was used.
  • Monitor kidney function for pt. receiving contrast
  • Encourage fluid intake
A

Nursing interventions for CT scan

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4
Q
  • Monitor BUN and creatnine
  • Keep patient well hydrated up until test
  • Instruct patient to void immediately before the test.
  • Mark peripheral pulses with a skin marker
  • They must lie still and they should expect a brief feeling of warmth in the face as dye is ejected and they may taste a metallic taste.
  • Neuro assessment as soon as they come back and check peripheral pulses
  • Monitor insertion site for bleeding or hematoma
  • Encourage fluids
A

Nursing interventions for Cerebral Angiography

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5
Q
  • Pt. may need to be deprived of sleep the night before
  • Anti-seizure meds, tranquilizers, stimulants, and depressants should be withheld 24 to 48 hours before an EEG because they alter the wave patterns.
  • Coffee, tea, chocolate and cola are omitted from the meal before the test
  • The patient SHOULD eat before the test because an altered blood glucose level can cause changes in brain wave patterns
A

Nursing interventions EEG

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6
Q
  • Have the patient remain prone
  • If more than 20 mL of CSF is removed have them positioned supine for 6 hours
  • Bed rest, analgesic agents, and hydration
A

managing a headache for post lumbar puncture

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7
Q

A test used to screen for balance that can be down with the patient seated or standing with feet together and arms at the side, first with eyes open and then with both eyes closed for 20 seconds.

  • Stay near them incase they fall
  • Swaying is normal but a loss of balance is not
A

Romberg test

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8
Q

The general loss of ability to recognize objects through a particular sensory system

A

Agnosia

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9
Q

The absence of reflexes is a significant finding

A

reflexes

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10
Q

a state of unresponsiveness to the environment in which the patient makes no voluntary movement

A

Akinetic mutism

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11
Q

a condition in which the unresponsive patient resumes sleep-wake cycles after a coma but is devoid of cognitive or affective mental function

A

persistent vegetative state

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12
Q

the patient has inconsistent but reproducible signs of awareness.

A

minimally conscious state

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13
Q

results from a lesion affecting the pons and results in paralysis and the inability to speak, but vertical eye movements and lid evaluation remain intact

A

locked-in syndrome

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14
Q

This is how the two hemispheres of the brain communicate.

A

The corpus callosum

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15
Q

has both excitatory and inhibitory actions and is largely responsible for coordination and movement.

A

the cerebellum

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16
Q

contains areas that control the heart, respiration, and BP

A

the brain stem

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17
Q

This score on the GCS indicates severe impairment of neurological function, brain death or pharmacologic inhibition of neuro response.

A

3

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18
Q

This GCS score indicates that the patient is fully responsive

A

15

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19
Q

The first priority for a patient with altered LOC

A

maintain patent airway

20
Q

These are some of the complications that could occur from altered LOC

  • respiratory failure
  • pneumonia
  • aspiration
  • pressure ulcer
  • VTE
  • contractures
A

complications

21
Q

The nurse must assume basic responsibilities for the patient until basic reflexes return (coughing, blinking and swallowing)

A

impaired reflexes in the comatose patient

22
Q
  • Temperature must be controlled because temperatures tend to rise when the person is unconscious
  • If temp. rises to high permanent brain damage can occur
  • Never take temp of an unconscious person by mouth
A

Unconcious patient

23
Q
  • Remove all bedding except maybe a light sheet
  • Administer acetaminophen as prescribed
  • Give cooling sponge baths and allow an electric fan to blow over the patient
  • Use a hypothermia blanket (cooling blanket)
  • frequent temp.monitoring to assess the patients response to therapy and to prevent an excessive decrease in temp.
A

reducing fever

24
Q

Because of limited space for expansion within the skull, an increase in the volume of with brain tissue, blood or CSF causes a change in the volume of the other components.

A

Monro-Kellie hypothesis

25
Q

Cerebral perfusion pressure= MAP-ICP

normal range 70-100 mm Hg

A

CPP

26
Q

when cerebral blood flow decreases significantly. It can be recoverable if fixed rapidly.

A

Cushing’s response

27
Q

bradycardia, HTN, and bradypnea. It is a grave sign

A

Cushing’s triad

28
Q

shifting of the brain tissue from an area of high pressure to low pressure

A

herniation

29
Q

The earliest sign of ICP

A

change in LOC. other early indicators agitation, slowed speech, delayed response

30
Q

This procedure is avoided in patients with increased ICP because it can lead to herniation.

A

lumbar puncture

31
Q

complications include brain stem herniation, diabetes insipid and SIADH.

A

increased ICP

32
Q

caused by increased secretion of ADH.
-Volume overload, urine output diminishes
(S-I-A-D-H, S-I-A-D-H, S-I-A-D-H,
This hormone stops the PeePee.)
tx- restrict fluids, and monitor electrolytes

A

SIADH

33
Q

the result of decreased secretion of ADH.
-Excessive urine output, decreased urine osmolality and serum hyperosmolarity.
(Pee pee give IV’s vasopressin they need.)

A

diabetes insipidus

34
Q
  • administer osmotic diuretics i.e(mannitol)
  • RESTRICT FLUIDS
  • drain CSF
  • control fever
  • maintain BP and oxygenation
  • reduce cellular metabolic demands
A

management of ICP

35
Q

this med helps to reduce edema surrounding the tumor(if a tumor is the cause of increased ICP)

A

corticosteroids i.e (Decadron)

36
Q

frequent pupil checks, assessment of cranial nerves, frequent measurements of vital signs and ICP, and use of the Glasgow Coma Scale

A

assessment of increased ICP

37
Q
  • keep patient’s head in a natural midline position, maintained with the use of a cervical collar if necessary to promote venous drainage.
  • elevate HOB 30-45 degrees
  • extreme rotation of head and neck are avoided
  • extreme hip flexion is avoided
  • avoid valsalvas maneuver(give stool softeners)
  • instruct the patient to exhale while moving in bed
  • maintain a calm atmosphere(noise and conversation should be minimal)
A

increased ICP

38
Q

monitor for these complications for the patient receiving mannitol

A

heart failure and pulmonary edema

39
Q

attention should be paid to this post craniotomy because it could indicate CSF trickling down the throat.

A

salty taste or postnasal drip

40
Q

a group of seizures characterized by unprovoked, recurring seizures

A

epilepsy

41
Q

inability to express oneself aka non-fluent aphasia

A

expressive aphasia

42
Q

inability to understand language aka fluent. They can read or speak but can’t understand the meaning of a message

A

receptive aphasia

43
Q
  • Paralysis or weakness on the right side of the body
  • Right visual field deficit
  • Aphasia
  • Altered intellectual ability
  • Slow and cautious behavior
A

Left sided stroke

44
Q
  • Paraylsis or weakness on the left side of the body
  • Left visual field deficit
  • Spatial-perceptual deficits
  • Increased distractability
  • impulsive behavior and poor judgement
  • lack of awareness of deficits
A

Right sided stroke

45
Q

blindness in half of the eye

A

hemianopsia

46
Q

inability to perform previously learned action

A

apraxia

47
Q

deficits in the ability to recognize previously familiar objects

A

agnosia

Med surg (15 decks)

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