Neuro Disorders Flashcards
Cerebral lobes
- Frontal
- Parietal
- Temporal
- Occipital
Frontal lobe function
- Motor cortex, voluntary movement
- Broca’s expressive speech center
- Personality
- Behaviors: social, sexual, judgement, problem solving
Parietal lobe function
- Sensation interpretation & perception
- Social relationships such as body position
- Integration of sensory input, especially visual input
Temporal lobe function
- Auditory sensation and perception
- Long term memory
- Wernicke’s receptive speech center
Occipital lobe function
- Process visual information
- Perception of color and shapes
CT or CTA
- Assess for bleed, edema, masses
*Suspected ischemic stroke: CT rule out hemorrhagic stroke which would be contraindication to thrombolytic therapy
CT/CTA nursing implications
- Pt education about procedure
- Noninvasive and painless
- Patient IV (if giving contrast)
- Iodine allergies (shellfish or dye)
- Monitor BUN/Cr
- DM? Taking Metformin? If yes, Metformin held 48 hrs prior
- IV/PO fluids post-procedure to enhance excretion of dye
- Monitor for allergic rxn
Lumbar puncture
- Obtain CSF for analysis
- Measure ICP
- Spinal anesthesia, intrathecal meds
- Remove CSF to reduce pressure
- Performed between L3 and L4 (below level of spinal cord)
LP nursing implications
- Pt education about procedure
- Hold antiplatelet/anticoag drugs prior (decreased risk of bleeding)
- Check coagulation studies prior
- Informed consent
- Flat bedrest for 4-6 hrs to prevent CSF leakage
- Leakage can cause severe HA
- Encouraging fluids post LP
- Blood patch can seal CSF leak
Secondary headache
- Caused by underlying pathology
- Typical presentation: sudden onset, severe pain (not alleviated w meds)
Secondary headache work-up
- CBC and blood culture (infection)
- CRP and ESR (inflamm)
- CT and MRI (masses, cysts, vessel, osseous skull abnormalities)
- EEG (electrical activity: seizures, tumors, inflamm, brain injury)
- Sleep studies (fatigue, sleep apnea)
Primary brain tumor
Malignant:
- Glioma: from glial cells
- Oligodendroglioma: from oligodendrocyte
Benign:
- Meningioma: most common form
- Acoustic neuroma / schwannoma: from Schwann cell
- Pituitary tumor: hormone hypersecretion
Metastatic (secondary) brain tumor
Occurs at:
- Brain parenchyma
- Spinal cord
- Leptomeninges
Most common cancers resulting in CNS metastases:
- Lung, melanoma, renal, breast, CRC
Brain tumor medical management
- Chemotherapy
- Gliadal wafers: impregnanted w chemotherapy and put in surgical bed at time of surgical resection
- Radiation therapy
- Cyberknife: radiation directed to specific area of brain to spare normal tissue
Brain tumor surgical management
- Craniotomy: section of skull (bone flap) removed
- Debunk: removing as much of tumor as possible if not completely removable
Seizure nursing assess
- Airway and breathing: maintain airway patency during sz & postictal state
- VS: O2 sat & resp status, HR and BP may increase
- Sz activity: careful observation and document
- Presence of aura
Seizure nursing intervention
- O2 at bedside
- Suction equipment at bedside
- Safety measures: bed in low position, L side lying position during sz to prevent aspiration, do not restrain movements
- Place IV per orders, administer meds if needed
Seizure pt education
- *Medication regimen: therapeutic level monitor, possible SE
- *Understand triggers, aura
- Medic alert bracelet
- Driving restrictions
Parkinson’s clinical manifesations
- Resting tremors
- Muscle rigidity
- Bradykinesia
- Postural instability
- Unilateral weakness, upper extremity tremors
- Slow shuffling gate, postural instability, stooped posture, rigidity, generalized tumor, masklike face
Parkinson’s diagnosis
2 or more observable sympts w asymmetry on presentation:
1. Bradykinesia
2. Resting tremor
3. Rigidity
4. Postural instability
Herniated disc
Vertebral disk rupture or tearing that causes leaking into vertebral area resulting in back pain
Parkinson’s
Decreased level of dopamine in brain –> slow, tremor, etc.
Herniated disc conservative medical treatment
Most pt improve in 1-2 mos
- Pain management: NSAIDs, gabapentin, tramadol, pregabalin
- Physical therapy to increase strength, improve function, and prevent future injury
Herniated disc nursing assess
- *VS: pain, infection
- *Level of function/ability
- *Muscle tone/ strength
- *Surgical incision: signs of infection
- *Urine output: postoperative urinary retention d/t anesthesia
- Bowel elimination: constipation secondary to opioids
