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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
Tensilon test
**a diagnostic test used to evaluate myasthenia gravis**, positive \*\*\* **if their muscles get stronger after being injected with Tensilon**.
26
# two terms relating to muscle problems Which type of MD is at risk for malignant hyperthermia? Muscular Dystrophy
* 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
Duchenne MD
EARLY onset * death in late teens * d/t cardiomyopathy / resp infections
28
Becker MD
LATE onset * death in 40s * d/t HF * Tx: steroids, CPAP, vaccine, baseline PFT, monitor HF, ACE/ARB's, * high risk – malignant hyperthermia
29
Brain death
complete, irreversible cessation of function of cerebrum, cerebellum, & brainstem
30
Before confirmation of brain death, must confirm: (7)
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
Clinical examination of Brain death
* 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
TWO openings in skull
Transtentorial shelf / notch (small) Foramen magnum (large)
33
Broca's area
controlls speech located on L expressive / receptive aphasia
34
Decorticate
Flexed arms hemispheric dysfunction
35
Decerbrate
straight / extention of arms midbrain / pons WORSE outcome
36
Dolls eyes (reflex)
Positive = eyes turn opposite of where head is turned Positive = GOOD
37
Cold Caloric Test
ice water \> ear canal positive = eyes toward ear with ice water injection Positive = GOOD
38
# CN ???? Homonymous hemianopia
* loss of vision in half field of both eyes * Damage to CN II * Opposite (contralateral) side of problem
39
Babinski's Reflex
Toes flair up and out when foot bottom stroked opposite (contralateral) side of problem
40
Reversal agent for BENZOS
ROMAZICON
41
1st sign of neuro problem
LOC / AMS
42
when is pupil changes the first sign
Epidural Hemotoma
43
eyes deviate (towards or away) from problem
towards
44
Cranial nerves
* 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
# define obtunded and stuporus GCS
best answer 15 = best \<8 poor prognisis Obtunded = **CAN** speak, mumbles Stuporus = **CAN NOT** speak; moans/grimaces
46
TBI
severity based on GCS 3-8 SEVERE 9-12 MODERATE 13-15 MILD
47
SKULL FX
LINEAR - no surgery DEPRESSED - surgery if \> 5mm BASILAR - surgery if _CSF leakage persistent_
48
Basilar skull fracture
* 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
CSF care
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
cushings triad
\*\*\*\*sign of brain herniation\*\*\*\* ⬆️ SBP ⬇️ HR ⬇️ RR
51
Central brain Herniation
**_Slower_** **_Down_**ward shift 1st sign **_LOC_** + Babinski bilat
52
Uncal Brain Herniation
swelling on one side of brain **_Rapid_** **_Lateral_** shift 1st sign **_Pupils_** \> LOC + Babinski opposite side
53
Neuro problems that cause a Pupil change as first sign
Unical brain herniation Epidural Hemotoma

Stacey - CCRN copy and fix (13 decks)

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