neurologic - 1 Flashcards
naxolone
a medicine that rapidly reverses an opioid overdose. It
frontal lobe
controls executive function and personality
temporal lobe
receives input
parietal lobe
sensory input
occipital lobe
visual input
prior to lumbar puuncture
- empty bladder 2. procedure can be performed in lateral recumbent position or sitting upright. 3. insert in L3/4 or L4/5 space. 4. pain may be felt radiating down leg, but temporary. After procedure lie flat with no pillow for at least 4 hours to reduce of spinal leak and resultant headache. increase fluid intake at least 24h
ptosis
eye lid drooping
autonomic dysreflexia
massive, uncompensated cardiovascular reaction by the sympathetic nervous system (SNS) in a spinal injury at T6 or higher. Due to the injury, the parasympathetic nervous system cannot counteract the SNS stimulation below the injury. Classic triggers are distended bladder or rectum. Classic manifestations include severe hypertension, throbbing headache, marked diaphoresis above the level of injury, bradycardia, piloerection (goose bumps), and flushing. This is an emergency condition requiring immediate intervention. Management includes raising the head of the bed and then treating the cause.
guillain barre syndrome
syndrome is a rare disorder in which your body’s immune system attacks your nerves.
Broca’s dysphasia (also known as Broca’s aphasia)
It involves damage to a part of the brain known as Broca’s area. Broca’s area is responsible for speech production. People with Broca’s dysphasia have extreme difficulty forming words and sentences, and may speak with difficulty or not at all.
Spinal immobilization
N - Neurological examination. Focal deficits include numbness and decreased strength.
S - Significant traumatic mechanism of injury
A - Alertness. The client may be disoriented or have an altered level of consciousness (Option 2).
I - Intoxication. The client could have impaired decision-making ability or lack awareness of pain (Option 1).
D - Distracting injury. Another significant injury could distract the client from spinal pain.
S - Spinal examination. Point tenderness over the spine or neck pain on movement (if there is no midline tenderness) may be present (Option 5).
gastroparesis
A condition that affects the stomach muscles and prevents proper stomach emptying.
aspiration pneumonia
occurs when food or liquid is breathed into the airways or lungs, instead of being swallowed.
bells palsy
Bell’s palsy is an inflammation of cranial nerve VII (facial) that results in facial muscle weakness and inability to close the eyelids. Eye care (patch at night, artificial tears as needed) and oral care (eating on the unaffected side, oral hygiene after meals) are vital for these clients.
Myasthenia gravis
chronic neurologic autoimmune disease in which acetylcholine receptors are blocked, causing muscle weakness. Infection, under medication, and stress can lead to a myasthenic crisis, which is characterized by oropharyngeal and respiratory muscle weakness and respiratory failure. treatment - involves reduction of acetylcholine receptors in the skeletal muscles; this decreases the strength of muscles used for eye and eyelid movements, speaking, swallowing, and breathing. Treatment includes administration of anticholinesterase drugs before meals, easily-chewed foods, and appropriate vaccinations.
intracranial pressure (ICP)
Clients with increased ICP should be encouraged not to cough, strain, or increase abdominal or thoracic pressure. The head of the bed should be maintained at 30 degrees, and stimulation in the room should be minimized.
head injury
A client sent home with a head injury requires the presence of a responsible adult. This person should observe for the signs/symptoms of increased intracranial pressure including change in level of consciousness, projectile vomiting, motor alteration (eg, ataxia), ipsilateral pupil dilation, and seizures.
dysphagia
difficulty swallowing
Teaching clients who are susceptible to aspiration
swallowing techniques - chin down, positioning, avoidance of over-the-counter cold preparation medications (cause drowsiness and dry mouth), oral care, and smoking cessation can decrease the risk for aspiration pneumonia
T6 or above spinal cord injury
risk for autonomic dysreflexia. life-threatening condition in a client with high spinal cord injury. Classic signs/symptoms include severe hypertension, throbbing headache, diaphoresis, bradycardia, flushing, and piloerection. Emergency treatment includes correcting the cause (check bowel or bladder distention), removing tight clothing, and raising the head of the bed.
lethargic
lack of energy / sluggish
cushing’s triad
increased intercerebral pressure. Classic signs include bradycardia, rising systolic blood pressure, widening pulse pressure, and irregular respirations (such as Cheyne-Stokes).
Coup-contrecoup
brain injury in 2 area
cerebellum
involved in coordination of voluntary movements and maintenance of balance and posture. Balance is assessed with heel-to-toe gait testing. Coordination is assessed with finger tapping, rapid alternating movements, finger-to-nose testing, and heel-to-shin testing.
parkingson planning education
involved in coordination of voluntary movements and maintenance of balance and posture. Balance is assessed with heel-to-toe gait testing. Coordination is assessed with finger tapping, rapid alternating movements, finger-to-nose testing, and heel-to-shin testing.
parkingson disease characterized
a delay in initiation of movement (bradykinesia), increased muscle tone (rigidity), resting tremor, and shuffling gait.
transsphenoidal hypophysectomy
an effective neurosurgical technique for removing pituitary tumors, and other intrasellar tumors. thru the nose
clinical manifestations associated with diabetes inspidus
Diabetes insipidus (DI) is a metabolic disorder of decreased antidiuretic hormone, which is responsible for water retention in the kidneys. DI is often related to a preceding trauma, pituitary tumors, or neurosurgery (eg, hypophysectomy). Clinical manifestations of DI include polyuria, polydipsia, hypernatremia, hypovolemia, increased serum osmolality, and decreased urine specific gravity.
glasgow coma scale
eye, verbal, motor - 4,5,6 15-13 - good, 12-9- mod, 8-3 bad.
ALS, or amyotrophic lateral sclerosis
causes motor neuron degeneration that leads to progressive muscle weakness, twitching and muscle spasms, difficulty swallowing, difficulty speaking, and respiratory failure. There is no cure. Treatment focuses on symptom management.
hemorrhagic stroke nurse care
nurse should perform frequent neurological assessments, keep the client NPO, maintain seizure precautions and strict bed rest, and limit any activity that may increase bleeding (eg, anticoagulant administration) or intracranial pressure (eg, stimulation, straining during bowel movements).
The Valsalva maneuver is contraindicated
client diagnosed with increased intracranial pressure, stroke, head injury, heart disease, glaucoma, eye surgery, abdominal surgery, and liver cirrhosis.
Botulism
a result of ingesting improperly canned or stored food. Food in a can with a bulging end should not be used. Children under age 1 year should not be given honey as their immature gut system makes them prone to developing infant botulism.
abnormal neurological assessment
a result of ingesting improperly canned or stored food. Food in a can with a bulging end should not be used. Children under age 1 year should not be given honey as their immature gut system makes them prone to developing infant botulism.
bacterial meningitis with sepsis
fluid resuscitation is the priority. Blood cultures should be drawn before starting antibiotics. After a head CT scan is performed to rule out increased intracranial pressure and mass lesions, cerebrospinal fluid cultures should be drawn via lumbar puncture.
initial plan care stroke
performing baseline neurologic assessment to begin monitoring neurologic status trend, obtaining an immediate CT scan of the head to determine stroke type, and anticipating administration of thrombolytics (if indicated) within 4.5 hours of symptom onset.
reduce risk for developing alzheimer
Research suggests that healthy lifestyle choices (eg, smoking cessation, avoiding excessive alcohol intake, exercising regularly, participating in mentally challenging activities)
diplopia
seeing two images
order of survey assessment
a primary survey to determine status of airway, breathing, circulation, disability (eg, Glasgow Coma Scale to assess neurological impairment), and exposure. Health history, head-to-toe assessment, and level of pain are part of the secondary surve
aphasia
impaired communication
broca(expressive)
spontaneous speech - sparse and nonfluent. comprehension - relatively preserved
wernicke ( receptive)
spontaneous speech - fluent and voluminous but lacks meaning. comprehension - greatly diminished.
phenytoin
a hydantoin anticonvulsant, may decrease the effectiveness of some medications. receive education about the potential need for nonhormonal birth control as well as the importance of good oral hygiene and not abruptly stopping anticonvulsants. Other teaching for epilepsy includes avoiding seizure triggers and wearing a medical identification bracelet.
seizure nursing interventions
the nurse should call for additional help, turn the client on the side if possible, and have suction equipment ready to clear any excessive secretions that may block the airway. The nurse should not restrain the client or force anything into the client’s mouth.
carotid endarterectomy
surgical procedure performed to remove plaque from the carotid artery to improve cerebral perfusion. the client should be monitored for alterations in mental status that are unexpected in the context of typical postanesthesia symptoms (eg, diminished gag reflex, altered affect, drowsiness). The FAST assessment (Facial drooping, Arm weakness or drift, Speech difficulties, Time) assists with identifying alterations that may indicate stroke.
Aspiration pneumonia nursing actions
Measures for preventing aspiration pneumonia include administering medications to prevent vomiting, avoiding mealtime sedation, maintaining head-of-bed elevation at 30 degrees or more (90 degrees during and 30 minutes after meals), and encouraging neck flexion while swallowing. Clients with dysphagia should receive thickened liquids and be monitored for coughing, gagging, and pocketing food.
concussion
Expected neurological changes with a concussion include brief loss of consciousness, retrograde amnesia, and headache. These clients should be observed closely by family members and not participate in strenuous or athletic activities for 1–2 days
status epilepticus
A seizure that lasts longer than 5 minutes, or having more than 1 seizure within a 5 minutes period, without returning to a normal level of consciousness between episodes
seizure meds
IV or rectal benzodiazepines (lorazepam or diazepam) are used to rapidly control seizures.
