NEUROLOGIC

Question 1

What is Bell palsy?

Answer 1

unliateral facial paralysis characterized by:

1. inability to completely close the eye on the affected side
2. flattening of the nasolabial fold on the affected side
3. inability to smile or frown symmetrically

Question 2

What are the cranial nerves and their functions?

Answer 2

Question 3

What is aphasia?

Answer 3

impaired communicataion due to a neurlogical condition such as stroke. there are two types of aphasia, receptive and expressive. receptive is when a client speaks full sentences but the words do not make sense. expressive is when a client is able to speak short phrases but have difficulty with word choice.

Question 4

What is apraxia?

Answer 4

loss of ability to performed a learned movement szuch as whistling, clapping or dressing due to neurlogical impairment

Question 5

What is dysarthria?

Answer 5

weakness of the muscles used for speech. comprehension and the meaning of the words are intact but speech is difficult to understand because of the weak muscles there

Question 6

What is autonomic dysreflexia?

Answer 6

a syndrome in which there is a sudden onset of excessively high BP. it is more commonly found in those with spinal cord injuries T6 or above.

Question 7

What is the most common cause of autonomic dysreflexia?

Answer 7

bladder irritation due to distention is the most common cause of autonomic dysreflexia so the client needs to be either catheterized or the possibility of a kink should be assessed.

Question 8

What is normal pupil dilation?

Answer 8

3-5 mm in diameter

Question 9

Whati s oculocephalic reflex?

Answer 9

oculocephalic reflex or doll’s eyes indicates an intact brainstem. it is tested by rotating the head and watching the eyes move simultaneously in the opposite direction.

Question 10

What is the normal Babinski’s reflex in adults?

Answer 10

the normal finding in aduts is an ABSENT Babinski’s reflex where the toes point downward with stimulus to the sole of the foot. presence of the Babinski’s reflex in adults may indicate a brain or spinal cord lesion.

Question 11

What is myasthenia gravis?

Answer 11

autoimmune disease involving a decreased number of acetylcholine receptors. as a result, there is a weakness of skeletal muscles, most often presented as ptosis, bulbar signs (difficult speaking or swallowing), and difficulty breathing. muscles are also stronger in the morning but become weaker with the day’s activities as the supply of acetylcholine is depleted.

Question 12

What are treatments for myasthenia gravis?

Answer 12

1. anticholinesterase drugs like pyridostigmine that are administered BEFORE meals so that the client’s ability to swallow is strongest during meal
2. semi solid foods are preferred over solid foods or liquids to avoid stressing muscles involved with swallowing and aspiration risk

Question 13

What is an epidural hematoma and what does it look like?

Answer 13

accumulation of blood between the skull bone. the client may lose consciousness at the time of impact. the cllient then regains consciousness quickly and feels well for some time after injruy. this transient period of well being is called a lucid interval and is followed by a quick decline in mental function that cna progress to death.

Question 14

What is the MOST important risk factor that causes stroke?

Answer 14

single most risk factor of stroke is hypertension. with proper management of hypertension, risk of stroke is decreased by 50%.

Question 15

What is arteriovenous malformation?

Answer 15

tangle of veins and arteries that are found in the brain and can cause seizures and other neurologic deficits.

Question 16

What are treatment options for arteriovenous malformation?

Answer 16

blood pressure control is crucial. clients with AVM are at high risk for intracranial bleeds as the veins can easily rupture. Any neurological changes such as severe headache should be check immediately as these are the first of hemorrhage.

Question 17

What is a COMPLICATION of taking mannitol?

Answer 17

if a high dose of mannitol is given or it accumulates, fluid overload may cause life threatening pulmonary edema. an early indicator of fluid overload is crackles in the lungs.

Question 18

What are the Kernigs and Brudzinski’s signs?

Answer 18

signs of meningitis

Question 19

What is a complication of a lumbar puncture?

Answer 19

continued leaking fluid after a lumbar puncture occurs indicates that the site did not seal off properly and a blood patch (blood into the epidural space) is required

Question 20

What is the best position to lie in to avoid aspiration pneumonia?

Answer 20

a side lying or lateral position is used to decrease the risk of aspiration pneumonia. if vomiting were to occur, this position promotes drainage of emesis out of the mouth instead of down the pharynx where it can be aspirated into the lungs.

Question 21

What is nicardipine?

Answer 21

fast acting vasodilator that is essential for hypertension. it is essential to monitor BP and make sure it is not lowered too quickly because then hypotension and reflex tachycardia can occur.

Question 22

What are points to follow when transferring a patient?

Answer 22

1. do not bend at the waist because it is bad for the back
2. the nurse should use a wide body stance for more stability
3. pivot on the foot distal to the chair

Question 23

What findings indicate the need for spinal stabilization?

Answer 23

1. disorientation or altered LOC
2. alcohol intoxication
3. spinal and neurological examination shows weakness in the area

Question 24

What is the main source of botulism?

Answer 24

the main source is improperly canned or stored food. a metal can’s swollen/bulding end can be caused by gases from botuism and should be discarded.

Question 25

What is botulism?

Answer 25

the neurotoxin blocks acetylcholine which results in muscle paralysis.the organism is found in soil and can grow in food contaminated with the spores

Question 26

What are characteristics of amyotrophic lateral sclerosis?

Answer 26

amyotrophic lateral sclerosis or ALS is a debilitating neurodegenerative disease with no cure. ALS causes muscle wakness, twitching or muscle spasms, difficult swallowing, and respiratory failure.

Question 27

Why is important to have sufficient thiamine intake?

Answer 27

low thiamine in the body can lead to Wernicke encephalopathy, a SERIOUS complication that manifests as altered mental status, oculomotor dysfunction, and ataxis.

Question 28

What is homonymous hemianopsia?

Answer 28

a loss in half of the visual field on the same side. a client unable to see the left side of the body is at higher risk of neglecting that part of their body.

Question 29

What is Cushing’s triad?

Answer 29

bradycardia, increased systolic BP, and Cheyne Stokes respirations (irregular)

Question 30

What do the different lobes of the brain do?

Answer 30

occipital lobe: registers visual images

frontal lobe: personality and behavior

temporal lobes: auditory input

parietal love: somatic and sensory input

Question 31

What does unexpected vomiting mean?

Answer 31

unexpected vomiting is a sign of increased ICP so the HCP should be contacted IMMEDIATELY. anti nausea medications will not work because the nausea is due to pressure changes in the cranium. decreasing the ICP will help the vomiting.

Question 32

What is the purpose of the cerebelium?

Answer 32

2 major functions:

1. coordination of voluntary movements
2. maintenance of balance and posture

Question 33

What is Guillain Barre syndrome?

Answer 33

body’s immune system attacks your nerves which is characterized by ascending muscle weakness and absent DTRs.

Question 34

What are the four phases of a seizure?

Answer 34

1. prodromal phase: period with warning signs that precede a seizure
2. aural phase: period before the seizure when the client may have visual or other sensory changes
3. ictal phase: period of active seizure
4. postical phase: client may have confusion while recovering from seizure.

Question 35

What is a contre coup injury?

Answer 35

in head injury, a coup injur occurs under the site of impact with an object, but with CONTREcoup, the side opposite the area is injured (occipital)–> causes visual changes.

Question 36

What is the nursing priority with a client experiencing seizures?

Answer 36

stopping seizure activity is the MAIN priority so giving IV or rectal benzodiazepines such as diazepam or lorazepam is used acutely to control seizures.

Question 37

What are signs of diabetes insipidus?

Answer 37

1, decreased USG concentration

2. hypernatremia
3. elevated serum osmolality
4. polydipsia (excess water intake)
5. poyuria (excess urine output)

Question 38

What is a carotid endarectomy?

Answer 38

surgical procedure performed to remove plaque from the carotid artery to improve cerebral perfusion. the main priority is to watch for STROKE, because surgical manipulation of arteries and blood flow increases risk for stroke.

Question 39

What is the FAST acronym to assess for stroke?

Answer 39

.1 facial drooping

2. arm weakness; weakness or drifting of one arm when raised to shoulder level
3. speech difficulties
4. onset of symptoms (time)