Neuro

Question 1

What is MS?

Answer 1

Chronic auto-immune
demyelination of the white matter, brain and spinal cord
20-40
Women more common

Question 2

ALS (Lou Gerigs)

Answer 2

Paralysis of voluntary muscles
40-60
Men more common
Tx is symptomatic, no cure

Question 3

Guillain-Barre’

Answer 3

Reversible ascending paralysis that happens gradually
Acute inflammation disorder
Medications: steroids, plasmapheresis- immunoglobulin, analgesics

Question 4

Myasthenia Gravis

Answer 4

Nerve impulses fail to cross the myoneural junction
Loss of acetylcholine (ACh) receptors
Autoimmune
Interventions: meds- anticholinesterases to increase amount of acetylcholine (pyridostigmine, nesternone), steroids,
Get things done in the morning bc fatigue gets worse throughout the day

Question 5

Spinal shock

Answer 5

Temporary, sudden loss of reflex activity below the level of injury after spinal cord injury, temporary inflammatory response

Question 6

Neurogenic shock

Answer 6

Massive vasodilation –> Above T6, venous pooling, extreme hypotension
All blood is going to extremities and not getting pumped back to the heart, causing hypotension
Treatment: fluids, vasoactive drugs to increase BP

Question 7

Autonomic Dysreflexia

Answer 7

Exaggerated sympathetic response to noxious stimuli
It is characterized by paroxysmal HTN (the sudden onset of severe high blood pressure) associated with throbbing HEADACHE, profuse SWEATING, nasal stuffiness, flushing of the skin above the level of the lesion, BRADYCARDIA, anxiety, and sometimes by cognitive impairment
check bladder–>bladder scan
Autonomic dysreflexia is caused by an irritant below the level of injury, usually related to bladder or bowel

Question 8

MS: clinical manifestations and Tx

Answer 8

Limited mobility, with fatigue, and visual disturbances, weakness, numbness, dysarthria (difficulty speaking), dysphagia, ataxia (unsteady gait) , sexual dysfunctions, nystagmus, spastic bladder
Tx: no cure or specific treatment - corticosteroids for symptomatic relief, immunosuppressants, baclofen for muscle spasticity

Question 9

ALS: Clinical manifestations

Answer 9

Fatigue, cramps, twitching, loss of coordination
Slurred or nasal speech with dysarthria
Death occurs from failure of the respiratory system.

Question 10

Myasthenia Gravis: Clinical manifestations

Answer 10

Drooping eye
Vision, breathing, swallowing, chewing, head control- most affected
Respiratory failure is the primary challenge.
fatigue increases as the day progresses
Tensilon test for diagnosis

Question 11

Brain requirements

Answer 11

Glucose
O2
Blood (regulated by CO2)
Low ICP (

Question 12

Migraine

Answer 12

chronic, throbbing
4-72 hours 
Auras may precede
Women
want to be in a dark room and not move
Triptan meds

Question 13

Cluster headache

Answer 13

seasonal (4-12 weeks)
non-throbbing (usually around eye)
30 min-2 hours
Men 20-50 yrs old
Feels better with movement, oxygen and calcium channel blockers

Question 14

What to note during a seizure

Answer 14

Order of activity, when it started, how long it lasted

Question 15

Acute seizure meds

Answer 15

Lorazepam (IV) ativan
Diazepam (IV) valium
Diastat (Rectal)
Phenytoin (dilantin) or Fosphenytoin (IV)

Question 16

Status epilepticus

Answer 16

Series of generalized seizures with no period of recovery.
Airway collapse→hypoxia→brain damage
Medical Management: stop seizures to promote adequate cerebral oxygenation
Nursing Management: monitor respiratory and cardiac function

Question 17

Meningitis

Answer 17

headache, stiff neck (nuchal rigidity), fever, nausea and vomiting, skin rash, photophobia, decreased LOC, confusion
Droplet precautions

Question 18

Encephalitis

Answer 18

Arboviruses (human transmission via mosquito/tick)
Enteroviruses (herpes zoster, mumps & chickenpox)
Herpes Simplex
Nursing management that of meningitis and Acyclovir (Zovirax)

Question 19

Parkinson Disease CM, Tx

Answer 19

decreased dopamine level causes loss of the ability to initiate and control voluntary movements
Micrographia, shuffled gait, bradykinesia, akathesia, stiff extremities, flexion contractures, mask, drooling, pain, pill rolling
Tx: levodopa, carbidopa, dopamine agonsit (parlodel), anticholinergic (benztropine),

Question 20

Alzheimer’s Disease

Answer 20

Chronic, progressive cognitive impairment
Aricept (donepezil) – slows progression
No cure
Safety is priority

Question 21

Huntington’s disease

Answer 21

Autosomal dominant
Progressive mental status deterioration
Choreiform (worm-like) movements that the p/t can’t control
30-50 year old