Neuro Flashcards
Parts of the Frontal Lobe
Personality, creativity, problem solving, motor speech (Broca)
Parts of the Parietal Lobe
sensory Lobe; (pain, touch, temp, pressue), NO smell
Parts of the Temporal lobe
Hearing, smell, understand spoken language (Wernicke’s area), memory
Parts of the Occipital Lobe
Vision, visual interpretation
Normal ICP
Normal ICP less than 15
Nursing intervention for a CPP less than 60
Notify MD
Normal CPP
60-100mmhg
S/S of IICP
LOC (earliest sign) H/A (intermittend or constant) Vomiting Papilledema (swelling of the Optic Nerve) Unequal pupil or abnormal response Seizures Loss of gag reflex Abnorm BP (increase in pulse pressure) Brady cardia Irregular respiration
Late sign of IICP
Cushing’s Triad: increase in SBP (pulse pressure to improve cerebral perfusion)
Bradycardia (d/t increase in BP), and irregular or abnormal respiration (d/t brainstem compression)
Definition of Diabetes Insipidus and Tx
Decrease secretion of ADH, which l/d excessive urination.
Tx: increase fluids, and Desmopressin (DDAVP)
Definition of Syndrome of Inappropriate ADH (SIADH) and Tx
Increased secretion in ADH, which l/t retention in fluids.
Tx: fluid restriction, Diuretics, Dilantin (decreases release of ADH), and Declomycin (blocks effect of ADH on kidney)
What’s is the goal in managing cerebral aneurysm
Prevent development of vasospasm with Ca channel blocker Nimodipine (Nimotop)
First line tx of status epilepticus
Immediate control with benzodiazepine: Diazpam (Valium) Lorazepam (Ativan)
Tx for refractory Status Epilepticus
Pentobarbital
How to calculate Dilantin/Albumin Ratio
0.2 x albumin level + 0.1 = X
Dilantin Level/ X
If level is above 20 it’s above the therapeutic range (10-20mcg/ml)
Medication used as paralytic agent for neuromuscular blockage?
Norcuron or Pavulon
Why is a Neuromuscular Blockade used?
Do decrease oxygen conduction and decrease CO2
What must be done before a patient can have a neuromuscular blockade?
The patient must be intubated and sedated prior and during paralysis.
What is the Train of Four and what should be the goal?
Assess the degree of paralysis when a neuromuscular blockade was initiated. (NOT the degree of sedation)
90% of blockage is the goal (1/4 twitches)
Avoid 100% blockage (0/4 twitches)
What should be avoided to prevent an IICP?
Increase in intrathorasic pressure. Use of PEEP (5-10cm is OK) Hip flexion coughing vomitting Straining Valsvala
Nursing consideration when administering Mannitol
Rapid administration for optimal effect
Use filter
watch for crystallization
Monitor fo dehydration - Do NOT exceed 320***
Normal albumin and Prealbumin level
Albumin 3.5-5
Pre albumin >20mg/dl
Nursing consideration for Phenytoin
Flush IV line pre and post administration with NS
Verify IV patency
Use of a filter is recommended
Never mix with anything, especially Dextrose
Administer no faster than 50mg/min (in elderly 5-10)
Rapid adm. can result in cardiovascular collapse
Monitor serum level 10-20mcg/ml
