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Stacey - CCRN copy and fix > Neuro Etsy > Flashcards

Neuro Etsy Flashcards

1
Q

To lower ICP

A

Mannitol
3%
Lasix
Upright position

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2
Q

Things to avoid with increased ICP

A

no hypotonic fluids
No restraints
No pain/agitation (use PROPofol)
No acidosis (vasodilator)

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3
Q

PROPOFOL

A

is used with increased ICP to prevent agitation/pain

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4
Q

Which type of brain bleed develops fast? Which one develops slower?

A

Fast-epidural
Slow-subdural

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5
Q

Seizures can cause

A

Rhabdyomyolosis
Arrhythmias
Hypoglycemia
Hyper K

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6
Q

Seizure death is actually

A

Death by cerebral hyper metabolism

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7
Q

Early manifestation of brain tumors

A

Seizures

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8
Q

Steroid therapy in brain tumors helps to:

A

Prevent increased ICP

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9
Q

Etiology of encephalopathy

A

Metabolic
Hypoxia
Hepatic
Infection
Drugs

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10
Q

Encephalopathy s/s

A

****increased ICP****
Slow cognition
Personality changes
Memory loss
Agitation
Seizure>coma>brain death

notice that pupil changes is not a symptom

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11
Q

Encephalopathy tx

A

Identify and treat cause
Prevent ^ ICP
keep patient safe by (no hypotonic, no flat HOB, no restraint(

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12
Q

What does acidosis do to ICP? Why?

A

Increases ICP r/t vasodilation

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13
Q

CSF normals

A

Glucose 60%
Protein 20-45
LP pressure 80-180

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14
Q

Bacterial v. viral Meningitis

A

Bacterial: glucose low (<60%)
Viral: glucose normal (60%)

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15
Q

Bacterial Meningitis

A

CSF with:

HIGH: protein, LP pressure, WBC’s

NORMAL:

LOW: glucose

PURLENT COLOR

TX: ABX

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16
Q

Viral Meningitis

A

CSF with:

HIGH: protein, WBC’s

NORMAL: glucose & LP pressure

LOW:

CLEAR COLOR

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17
Q

S/S MENINGITIS

A
  • HA
  • nuchal rigidity
    • BUDZINSKI’s sign (neck stiffness with knee/hips to flexed neck
    • KERNIG sign (hamstring stiffness & neck pain with 90’ hip flexion
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18
Q

BUDZINSKI’s sign

A

neck stiffness with knee/hips to flexed neck

SIGN OF MENINGITIS

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19
Q

KERNIG’s sign

A

hamstring stiffness & neck pain with 90’ hip flexion

SX of MENINGITIS

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20
Q

is used with increased ICP to prevent agitation/pain

A

PROPOFOL

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21
Q

is there a change in LOC

Guillain-Barré syndrome

A
  • Viral Ascending paralysis
  • NO CHANGE IN LOC
  • diaphragm > resp failure
  • Monitor: resp, UOP,
  • Tx: steroids, plasmapherisis, IVIG (immunoglobulin)
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22
Q

whats that one treatment that i keep forgetting?

Myasthenia Gravis

A
  • Auto immune - progressive skeletal muscle weakness and paralysis
    • early onset = fatigue,
    • Late onset = paralysis
  • TX: steroids, plasmapherisis, IVIG, pyridostigmine(cholinestrase inhibitor), thymus gland removal
  • myasthenia crisis
    • TENSILON test
  • cholinergic crisis
23
Q

Myasthenic Crisis

A
  • caused by excess of acetylcholine
    • tensilon test (pt improves)
24
Q

Cholinergic crisis

A
  • caused by excess of acetylcholine
  • tensilon test (pt does not improve)
    • increased muscle weakness, lacrimation, salvation and GI distress
25
Q

Tensilon test

A

a diagnostic test used to evaluate myasthenia gravis,

positive *** if their muscles get stronger after being injected with Tensilon.

26
Q

two terms relating to muscle problems Which type of MD is at risk for malignant hyperthermia?

Muscular Dystrophy

A
  • inherited genetic disorder
  • starts at trunk and spreads, legs before arms
  • myopathy = progressive muscle weakness
  • atrophy = progessive loss of muscle mass
  • types:
    • Duchenne
    • Becker
27
Q

Duchenne MD

A

EARLY onset

  • death in late teens
  • d/t cardiomyopathy / resp infections
28
Q

Becker MD

A

LATE onset

  • death in 40s
  • d/t HF
  • Tx: steroids, CPAP, vaccine, baseline PFT, monitor HF, ACE/ARB’s,
  • high risk – malignant hyperthermia
29
Q

Brain death

A

complete, irreversible cessation of function of cerebrum, cerebellum, & brainstem

30
Q

Before confirmation of brain death, must confirm: (7)

A

coma irreversible, known cause

imaging confirms coma

No paralytics or CNS depressants

absence of severe acid-base imbalance

normal body temp / mild hypo

SBP >100

no spontaneous respirations

31
Q

Clinical examination of Brain death

A
  • ABSENT pupillary response, corneal reflex, gag, cough, motor response in all 4 extremities
  • apnea test, determines BD at bedside
  • cerebral angiograms, EEG, transcranial u/s
  • REFLEX testing:
      • (absent) dolls eyes
      • (absence) cold caloric test

abse

32
Q

TWO openings in skull

A

Transtentorial shelf / notch (small)

Foramen magnum (large)

33
Q

Broca’s area

A

controlls speech

located on L

expressive / receptive aphasia

34
Q

Decorticate

A

Flexed arms

hemispheric dysfunction

35
Q

Decerbrate

A

straight / extention of arms

midbrain / pons

WORSE outcome

36
Q

Dolls eyes (reflex)

A

Positive = eyes turn opposite of where head is turned

Positive = GOOD

37
Q

Cold Caloric Test

A

ice water > ear canal

positive = eyes toward ear with ice water injection

Positive = GOOD

38
Q

CN ????

Homonymous hemianopia

A
  • loss of vision in half field of both eyes
  • Damage to CN II
  • Opposite (contralateral) side of problem
39
Q

Babinski’s Reflex

A

Toes flair up and out when foot bottom stroked

opposite (contralateral) side of problem

40
Q

Reversal agent for BENZOS

A

ROMAZICON

41
Q

1st sign of neuro problem

A

LOC / AMS

42
Q

when is pupil changes the first sign

A

Epidural Hemotoma

43
Q

eyes deviate (towards or away) from problem

A

towards

44
Q

Cranial nerves

A
  • I. Olfactory (smell)
  • II. Optic (sight)
  • III. Oculomotor (pupillary function)
  • VIII. Vestibulocochlear (process of hearing & balance
  • *****all except I & II originate from brain stem***
45
Q

define obtunded and stuporus

GCS

A

best answer

15 = best

<8 poor prognisis

Obtunded = CAN speak, mumbles

Stuporus = CAN NOT speak; moans/grimaces

46
Q

TBI

A

severity based on GCS

3-8 SEVERE

9-12 MODERATE

13-15 MILD

47
Q

SKULL FX

A

LINEAR - no surgery

DEPRESSED - surgery if > 5mm

BASILAR - surgery if CSF leakage persistent

48
Q

Basilar skull fracture

A
  • causes meningeal tear
  • Risk of developing MENINGITIS
  • S/S
    • raccoon eyes
    • battles sign (bruise behind ears)
    • otorrhea (CSF from ear)
    • rhinorrhea (CSF from nose)
    • CN I damage (loss of smell)
  • TX: Check for CSF
49
Q

CSF care

A

CSF leakage frequent in basilar skull fx

  • cover ear or nose with dry sterile gauze (no packing)
  • NO NGT - use OG
  • DO NOT blow nose
  • CSF is + for glucose
  • Halo sign (yellow halo surrounding clot)
50
Q

cushings triad

A

****sign of brain herniation****

⬆️ SBP

⬇️ HR

⬇️ RR

51
Q

Central brain Herniation

A

Slower

Downward shift

1st sign LOC

+ Babinski bilat

52
Q

Uncal Brain Herniation

A

swelling on one side of brain

Rapid

Lateral shift

1st sign Pupils > LOC

+ Babinski opposite side

53
Q

Neuro problems that cause a Pupil change as first sign

A

Unical brain herniation

Epidural Hemotoma

Stacey - CCRN copy and fix (13 decks)

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