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Denise Olivares, RN > NEUROLOGIC NURSING > Flashcards

NEUROLOGIC NURSING Flashcards

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1
Q

In ICP: Drug to decrease cerebral edema

A

Dexamethasone (Decadron)

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2
Q

Dexamethasone (Decadron) classification

A

CORTICOSTEROIDS

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3
Q

IN ICP: Promotes cerebral diuresis by decompressing brain tissue

A

Mannitol (Osmitrol)

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4
Q

Classification of mannitol

A

Osmotic Diuresis

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5
Q

main function of Henle’s loop

A

aims to reduce the volume of water and solutes within the urine without any change in its concentration.

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6
Q

Loop diuretic: ____

A

Furosemide

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7
Q

Furosemide acts in how many hours

A

6 hours

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8
Q

Infusions are monitored closely in ICP because

A

because of the risk of promoting additional cerebral edema and fluid overload

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9
Q

IN ICP: What position

A

Semifowlers

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10
Q

Monitor neuro status every ____

A

1-2 hrs

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11
Q

What to avoid in ICP

A

Avoid pressure like: Coughing, Straining of stools, valsalva manuever, excessive vomiting

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12
Q

In ICP: Seizure can also occur. Give what medication?

A

Phenytoin (dilantin)

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13
Q

ICP: What to give if have headache?

A

Codeine Sulfate

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14
Q

ICP: Limit fluids to _________

A

1200 liters/day

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15
Q

ICP: Maintain a patent airway because

A

because a high carbon dioxide (CO2) level increases intracranial pressure

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16
Q

Confirmatory test for Multiple Sclerosis

A

MRI

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16
Q

purpose of plasmapheresis

A

eliminates the antibodies in the plasma that are causing the autoimmune attack, and then returns the “cleaned” plasma and other blood components back to the body

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16
Q

MS:
What is more priority: Acute or Chronic exacerbation

A

ACUTE EXACERBATION

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16
Q

MS: MUSCLE RELAXANTS MEDS

A

Baclofen (Lioresal) & Dantrolene Na (Dantrene)

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16
Q

antiviral, antiparkinsonian, helps in fatigue

A

amantadine

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17
Q

MS: for tremors

A

propanolol

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18
Q

MS: key agent for acute relapse and shortens duration of relapse

A

IV methylprednisolone

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19
Q

MS: immunosuppressants drugs for chronic exacerbation

A

avonex, rebif

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20
Q

Atrophy of brain tissue to deficiency of SANS

A

Alzheimer’s Disease

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21
Q

what is SANS in alzheimers

A

Somatostatin, Acetylcholine, Norepinephrine, Substance P

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22
Q

initial sign of alzheimers disease

A

Progressive memory loss

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23
Q

5 A’s in alzheimers disease

A

amnesia, anomia, agnosia, apraxia, aphasia

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24
Q

In 5A’s, what is common in alzheimers

A

APHASIA

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25
Q

CONFIRMATORY TEST FOR ALZHEIMERS

A

AUTOPSY

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26
Q

DOC ALZHEIMERS

A

DONEPEZIL

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26
Q

PRIORITY FOR ALZEIMERS

A

SAFETY

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27
Q

PARKINSONS DISEASE: WEAKNESS OR NON

A

NO WEAKNESS

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28
Q

PARKINSONS DISEASE: WHAT NUEROTRANSMITTOR DECREASE

A

DOPAMINE

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28
Q

INITIAL SIGN IN PARKINSONS DISEASE

A

TREMORS

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29
Q

MNEMONIC TO REMEMBER IN PARKINSONS DISEASE

A

PARC DARK!

Pill rolling
About to fall: Shuffling Gait
Rigidity
Cant swallow, speak

Drugs
Artane
Resting Tremor
Keep tremors down with antihistamine

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30
Q

common surgery in PARKINSONS DISEASE

A

deep brain stimulation

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31
Q

drugs for PARKINSONS DISEASE

A

levodopa, carbidopa

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32
Q

combination of levodopa and carbidopa

A

sinemet

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33
Q

controls dyskinesias in long term use of Levodopa

A

Amantadine HCL (symmetrel)

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34
Q

What to consider in taking antiparkinsonian

A

-take before meals for increase absorption
-inform patient that urine stool may be darkened

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35
Q

Chronic autoimmune disorder in impulse transmission at neuromuscular junction

A

MYASTHENIA GRAVIS

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36
Q

WHAT IS AFFECTED IN MYASTHENIA GRAVIS

A

VOLUNTARY MUSCLES

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37
Q

MG: ANTIBODIES ATTACK WHAT RECEPTOR ____ LEADING TO ______

A

ACTH Leading to muscle relaxation –> muscle weakness

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38
Q

MG: INITIAL SIGN

A

PTOSIS

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38
Q

MG: CONFIRMATORY TEST

A

TENSILON TEST

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39
Q

MG: WHAT HAPPENS IN TENSILON TEST

A

IT STRENGTHENS MUSCLES FOR 5-10 MINS

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40
Q

TENSILON TEST: SHORT TERM OR LONG TERM

A

SHORT TERM

41
Q

MG: SURGERY

A

THYMECTOMY

42
Q

MG: MEDICATION WHICH INHIBITS CHOLINESTERASE

A

CHOLINERGIC/ANTI CHOLINESTERASE

43
Q

MG: DRUGS IN CHOLINERGIC/ANTI CHOLINESTERASE

A

Pyridostigmine (Mestinon)
Neostigmine (Prostigmin)

44
Q

MG: IMMUNOSUPPRESSANTS

A

Azathioprine and Methotrexate

45
Q

MG: SUPPRESS IMMUNE RESPONSE

A

Corticosteroids

46
Q

MG: Under medication

A

MYASTHENIC CRISIS

47
Q

MG: MANIFESTATION IN MYASTHENIC CRISIS

A

Cant See
Cant Swallow
Cant breathe
Increase BP, HR, RR, Decrease Urine Output

48
Q

MG: OVER MEDICATION

A

CHOLINERGIC CRISIS

49
Q

MG: MANIFESTATION IN CHOLINERGIC CRISIS

A

PNS!!
S - SALIVATION
L - lacrimation
U - urination
D - defecation
G - GI distress
E - emesis
Hypotension, Pupillary Miosis

50
Q

INITIAL SIGN IN GBS

A

CLUMSINESS

51
Q

IN GBS. WHAT IS THE RESULT IN CSF ANALYSIS

A

increase protein but normal WBC

52
Q

GBS: TO FIGHT GBS ANTIBODIES

A

IV IMMUNOGLOBLULINS

53
Q

Disruption of cerebral blood flow due to obstruction by embolus or thrombus

A

ISCHEMIC STROKE

54
Q

CAUSE OF ISCHEMIC STROKE

A

atherosclerosis, thrombus, embolism, DM, HPN, atrial fibrillation

55
Q

initial diagnostic test for stroke

A

CT SCAN

56
Q

ISCHEMIC VS. HEMORRHAGIC: DARK BLOOD SEEN IN CT SCAN

A

ISCHEMIC STROKE

57
Q

ISCHEMIC VS. HEMORRHAGIC: BLOOD IS BRIGHT SEEN IN CT SCAN

A

HEMORRHAGIC STROKE

58
Q

STROKE: DIAGNOSTIC TEST TO CHECK FOR ATRIAL FIBRILLATION

A

12 LEAD ECG

59
Q

STROKE: TO SEE IF THERE’S FORMATION OF PLAQUE

A

CAROTID ULTRASOUND

60
Q

STANDARD TESTS for Stroke

A

CT Scan, MRI, 12-Lead ECG

61
Q

MOST COMMON CAUSE OF CVA

A

THROMBUS –> EMBOLISM –> CEREBRAL HEMORRHAGE

62
Q

ISCHEMIC STROKE MEDICATION: Give the Classification

A

THROMBOLYTIC AND ANTICOAGULANT

63
Q

MNEMONIC FOR THROMBOLYTIC

A

UST!

UROKINASE
STREPTOKINASE
TPA

63
Q

SIDE EFFECT OF UROKINASE

A

HYPERTENSION

63
Q

MNEMONIC FOR TPA

A

ART

ALTEPLASE
RETEPLASE
TENECTEPLASE

64
Q

SIDE EFFECT OF STREPTOKINASE

A

PRURITUS

65
Q

SIDE EFFECT OF TPA

A

CHEST PAIN

66
Q

drug of choice to STEMI

A

TENECTEPLASE

67
Q

TPA CRITERIA

A

CRAB

CT SCAN
NO RECENT SURGERY
AGE - ALLOWED 18y/o ABOVE
BP CONTROLLED (should be <185/110), BLOOD TEST NORMAL

68
Q

IN TAKING TPA, WHAT TO CONSIDER IN BLOOD TEST

A

Glucose: 70-100
INR: less than 1 sec; but if taking warfarin: 2-3 secs
Platelet: 150,000 to 450,000

69
Q

best parameter of thrombolytic

A

EPISTAXIS

70
Q

Anticoagulant drugs

A

Heparin
Coumadin
Direct Oral Anticoagulants

71
Q

What to monitor in taking heparin

A

PTT.

72
Q

In taking Heparin, if PTT is prolonged, give antidote of ___

A

Protamine Sulfate

73
Q

NORMAL PTT

A

30-40 secs

74
Q

In taking Warfarin, if PT is prolonged, give antidote of ___

A

Vitamin K and aquamephyton

75
Q

normal PT

A

11-12 secs

76
Q

What are the Direct Oral Anticoagulants

A

Dabigatran (Pradaxa)
Apixaban (Eliquis)

77
Q

what are the Platelet Aggregation Inhibitors

A

ACT

Aspirin
Clopidogrel
Ticlopidine

78
Q

adverse effect of aspirin

A

tinnitus

79
Q

adverse effect of ticlopidine

A

GI discomfort

80
Q

if warfarin is contraindicated, give _____

A

aspirin

81
Q

aspirin can be given together with _____

A

clopidrogel

82
Q

Bleeding into the brain tissue, ventricles, and subarachnoid space

A

HEMORRHAGIC STROKE

83
Q

2 Types of Hemorrhagic Stroke

A

Primary intracerebral hemorrhage
Secondary intracerebral hemorrhage

84
Q

Type of hemorrhagic stroke wherein from spontaneous rupture of small vessels caused by uncontrolled HPN

A

Primary intracerebral hemorrhage

85
Q

Type of hemorrhagic stroke wherein associated with AVMs, cerebral aneurysm, neoplasm, or certain medications (anticoagulants)

A

Secondary intracerebral hemorrhage

86
Q

more definitive diagnostic for HEMORRHAGIC STROKE

A

MRI

87
Q

medication in hemorrhagic stroke

A

antihypertensive, fresh frozen plasma, anticonvulsant

88
Q

DOC FOR SEIZURE

A

PHENYTOIN (dilantin)

89
Q

In skull fractures, during glucose test for CSF, yellowish halo/ring sign indicates

A

CSF leakage

90
Q

jarring of the brain (naalog)

A

concussion

91
Q

brain is bruise/damage (nauntog)

A

contusion

92
Q

LAYERS OF MENINGES

A

DAP

DURA
ARACHNOID
PIA

93
Q

WHERE DOES SUBARACHOID SPACE IS PLACE

A

BELOW THE ARACHNOID

94
Q

WHAT CONTAINS IN SUBARACHNOID

A

CONTAINS IN CSF

95
Q

Between Skull and Dura mater

A

Epidural hematoma

96
Q

Between dura and arachnoid mater

A

Subdural hematoma

97
Q

Epidural hematoma: Arterial circulation —-> _________

A

Rapid hematoma development

98
Q

Subdural hematoma: Venous bleeding —-> _________

A

slow hematoma development

99
Q

Location of spinal cord injury: Quadriplegia
Respiratory muscle paralysis

A

cervical

100
Q

Location of spinal cord injury: Paraplegia (lower body is paralyzed)
Poor control of upper trunk

A

Thoracic

101
Q

Location of spinal cord injury:
Paraplegia
Bowel and bladder paralysis

A

Lumbar

102
Q

In above sacral 2: male allow ___________ but no _________

A

male allow erection but no ejaculation

103
Q

in sacral 2 to 4: no _______ & _________

A

no erection & ejaculation
Bowel and bladder incontinence

104
Q

complication in spinal cord injuries

A

Spinal Shock (Neurogenic Shock) & DVT

105
Q

Medical Management for meningitis

A

antibiotic: penicillin G + ceftriaxone
dexamethasone

106
Q

Most common causative agent in meningitis

A

Streptococcus pneumoniae & Neisseria meningitidis

Denise Olivares, RN (8 decks)

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