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NS 406 Exam 1!! > Neuro dysfunctions > Flashcards

Neuro dysfunctions Flashcards

1
Q

Normal cerebral blood flow rate

A

750mL/min

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2
Q

How to calculate CPP (Cerebral perfusion pressure)

A

CPP=MAP-ICP

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3
Q

Normal MAP

A

70 to 105mmHg

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4
Q

Normal ICP

A

5 to 15mmHg

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5
Q

Normal CPP

A

60 to 100mmHg

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6
Q

When does CPP autoregulation (arteriole diameter alteration) not work?

A

If CPP under 50 or over 150mmHg

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7
Q

Early signs of ICP

A

LOC change

Restless

worsening HA

small reactive pupils

Rising SBP

Weakness

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8
Q

Late signs of ICP (often indicate irreparable brain ischemia)

A

Cushing’s triad

Deterioration of LOC

Ipsilateral dilation/fixation(pupil on side of lesion is dilated)

Seizure

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9
Q

Cushing’s triad (indicative of ICP)- very bad

A

Bradycardia

Irregular respirations

Widening pulse pressures (large difference between SBP and DBP)

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10
Q

muscle strength scale (refresher)

A

0: No movement
1: flickers or contraction noted
2: Active movement, but not against gravity
3: Active movement full ROM against gravity
4: Weak
5: Strong (relative to pt age)

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11
Q

Cingulate brain herniation syndrome

A

Lateral shift of one hemisphere (one side shifts to the other)

Often from pressure on one side of brain pushing the brain over- like through the corpus callosum almost

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12
Q

Tentorial brain herniation

A

Middle of brain moves down towards brain stem

Most often from TBI causing edema- squeezes brain out the Foramen Magnum

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13
Q

Transcalvarial brain herniation

A

Brain herniates out of duramater

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14
Q

Uncal brain herniation

A

Uncus of temporal lobe (outer part of the back of the brain, posterior and slightly inferior) pushed MIDLINE and DOWN

Think of pressure from edema on the outside of the bain causing a collapse into the center

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15
Q

Cerebellar brain herniation

A

Cerebellar tonsils pushed through foramen magnum

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16
Q

Diffuse axonal injury

A

Widespread inflammation of brain from injury, raises ICP

17
Q

Battle’s signs are

A

Basilar skull fractures that show up as bruising behind the ear due to hematoma

18
Q

Subdural hematoma

A

Venous bleed (slower)

Can occur spontaneously

Between dural and arachnoid!!

HEADACHES, IRRITABLE, LOWER LOC

19
Q

Epidural hematoma

A

Arterial bleed

RAPID

Assoc. w/ linear skull fracture

WATCH FOR loss of consciousness at time of injury–>seem fine–»rapidly deteriorate

Dilated nonreactive ipsilateral pupil

YOU CAN PALPATE THESE since they are EPI (outside) dural (duramater)

20
Q

Nursing interventions for brain bleeds and ICP

A

AIRWAY MAINTENANCE and prevent aspiration

Monitor ICP and temp

Prepare pt for surgery (Burr hole, CT/MRI, clot evac.)

Avoid nasal suctioning, anything that will cause pressure to rise (bear down)

Monitor glucose levels: High glucose causes more liquid to be pulled in, increasing pressure. (You want higher osmotic pressures to suck liquid out of brain)

21
Q

How to posture a patient with brain hematoma

A

Bed elevated 20-30 degrees (venous drainage)

No pillows- neutral neck angle

Avoid excess hip flexion

22
Q

Brain tumors (Glimoas) all bad

A

Astrocytomas

Oligodendrogliomas

Ependymomas

Medullablastomas

Glioblastoma multiforme

23
Q

Guillian-Barre Sydrome (GBS)

A

ACUTE Autoimmune disorder

Destruction of myelin which impairs conduction of impulses

DESCENDING: Progress from face down, RESPIRATORY FUNCTION compromised- watch for aspiration, airway

ASCENDING: Most common, ends with brain symptoms last

Can take years to remyelinate

24
Q

GBS remyelination stages

A

Initial: 1-4 weeks, symptoms of GB

Plateau period: days to 2 weeks after initial, not much progress on recovery

Recovery period: 6months to 2 years is when remyelinization happens

25
Q

GBS treatment

A

Plasmapheresis: Removing current antibodies assumed to cause disease. Plasma removed .

Immunoglobulin administration: weight based

26
Q

Decorticate posturing

A

DeCOREticate: bringing limbs to midline

Very bad

Precursor to decerebrate posturing

27
Q

Decerebrate posturing

A

Mega bad, likely death

Comes after decorticate

Feet brought to midline, plantar flexion

hands flexing out from body at sides

NS 406 Exam 1!! (9 decks)

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