Neuro Degen 2 Flashcards
What is a head injury?
A head injury includes any trauma to the scalp, skull, or brain.
Head injuries range from mild concussions to severe diffuse axonal injuries.
What are the annual statistics for traumatic brain injury (TBI) in the United States?
Approximately 1.7 million treated, 50,000 deaths, and 275,000 hospitalized.
Majority of deaths occur immediately after the injury.
What complications can arise from head trauma?
Complications include:
* Epidural hematoma
* Subdural hematoma
* Intracerebral hematoma
What is the Glasgow Coma Scale (GCS) classification for mild traumatic brain injury?
GCS 13-15: Mild traumatic brain injury.
What GCS scores indicate moderate traumatic brain injury?
GCS 9-12: Moderate traumatic brain injury.
What GCS score indicates severe traumatic brain injury?
GCS below 8: Severe traumatic brain injury.
What are early signs of increased intracranial pressure (ICP)?
Early signs include:
* Disorientation
* Restlessness
* Increased respiratory effort
* Pupillary changes
* Headache
What are late signs of increased ICP?
Late signs include:
* Comatose state (GCS ≤8)
* Erratic pulse and respiratory rates
* Altered respiratory patterns
* Hemiplegia
* Loss of brainstem reflexes
What interventions can lead to increased ICP?
Interventions/factors that may lead to increased ICP include:
* Coughing and sneezing
* Endotracheal suctioning
* Extreme hip and neck flexion
* Fear and anxiety
* Pain
What is the priority action when increased ICP is suspected?
Apply oxygen via nasal cannula.
What is the nursing intervention for a patient in neurogenic shock?
Maintain airway and administer IV fluids like normal saline.
What are signs that neurogenic shock is resolving?
Signs include:
* Return of reflexes
* Development of hyperreflexia
* Ability to empty the bladder
What are the types of meningitis?
Types include:
* Septic (bacterial)
* Aseptic (viral)
What are the key manifestations of meningitis?
Manifestations include:
* Headache
* Fever
* Changes in LOC
* Nuchal rigidity
* Positive Kernig sign
* Positive Brudzinski sign
* Photophobia
What is the recommended preventive measure for meningitis?
Meningococcal vaccine for youth aged 11 to 12 years.
What diagnostic test is performed to confirm meningitis?
Spinal tap to obtain cerebrospinal fluid.
What is the treatment for bacterial meningitis?
Treatment includes:
* High doses of IV antibiotics
* Dexamethasone
* Antipyretics
* Analgesics
What nursing care is important for a patient with meningitis?
Nursing care includes:
* Frequent assessment of vital signs
* Pain and fever management
* Seizure precautions
* Infection control precautions
What is the purpose of administering dexamethasone in cases of bacterial meningitis?
To decrease meningeal irritation.
What are the expected lab results in a patient with bacterial meningitis?
Elevated white blood count and presence of polysaccharide antigens.
What are antipyretics used for?
To decrease body temperature
Antipyretics help manage fever in patients.
What nursing care should be implemented for a patient on droplet precautions?
Maintain transmission-based isolation until the patient has been on antibiotics for 24 hours
This is to prevent the spread of infection.
What measures can be taken to improve oxygenation in a patient?
Provide measures as ordered and as needed
This may include supplemental oxygen or positioning.
What is the purpose of instituting seizure precautions?
To ensure patient safety in case of seizures
This includes monitoring and having emergency medications available.
List some measures to decrease increased intracranial pressure.
- Head of bed at 30 degrees
- Avoid Valsalva maneuver
- Hyperoxygenate before suctioning
- Dim lights
- Provide a quiet environment
- Keep head and spine in neutral alignment
What should be monitored for in patients with SIADH?
Decreased urine output and signs of hypervolemia
Report symptoms and receive orders to treat syndrome.
What is Multiple Sclerosis?
A progressive immune-related demyelination disease of the CNS
Symptoms may vary and include fatigue, weakness, and visual disturbances.
What are common manifestations of Multiple Sclerosis?
- Fatigue
- Weakness
- Numbness
- Difficulty in coordination
- Loss of balance
- Pain
- Visual disturbances
What types of therapies are used in the medical management of Multiple Sclerosis?
- Disease-modifying therapies
- Interferon β-1a
- Interferon β-1b
- Glatiramer acetate
- IV Methylprednisolone
What is Myasthenia Gravis?
An autoimmune disorder affecting the myoneural junction
It impairs transmission of impulses due to antibodies directed at acetylcholine.
What are the initial symptoms of Myasthenia Gravis?
- Diplopia
- Ptosis
- Weakness of facial muscles
- Swallowing and voice impairment
- Generalized weakness
What is the Tensilon test used for?
To confirm the diagnosis of Myasthenia Gravis
A positive response indicates improvement in muscle strength.
What is a Myasthenic Crisis?
A severe exacerbation of Myasthenia Gravis, often due to respiratory infection
It can lead to respiratory failure.
What is a Cholinergic Crisis?
A result of overmedication with cholinesterase inhibitors
It causes severe muscle weakness and respiratory failure.
What is Guillain–Barré Syndrome?
An autoimmune disorder with acute attack of peripheral nerve myelin
It often follows a viral infection.
What are some medical management strategies for Guillain–Barré Syndrome?
- Intensive care management
- Continuous monitoring
- Respiratory support
- Plasmapheresis
- IVIG
What should nursing assessments focus on for Guillain–Barré Syndrome?
- Early detection of life-threatening complications
- Changes in vital capacity
- Continuous monitoring of ECG
What are the symptoms of Bell palsy?
- Drooping of the face
- Paralysis of the eyelid
- Increased lacrimation
- Slurred speech
- Facial muscle control impairment
What is the primary treatment for Bell palsy?
Prednisone to decrease inflammation and edema
This helps restore blood flow and reduce symptoms.
What nursing care should be provided for a patient with Bell palsy?
- Instruct on medications
- Teach safe heat application
- Eye care instructions
- Facial exercises
What should be monitored for in patients with Myasthenia Gravis receiving Tensilon?
Patient response confirming diagnosis
A brief improvement of symptoms indicates a positive response.
What are precipitating factors for Myasthenic crisis?
- Physical overexertion
- Emotional stress
- Taking excess medication
- Omitting a dose
- Pregnancy
- Influenza
