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Nursing 105 > Neurological 2- Exam 2 > Flashcards

Neurological 2- Exam 2 Flashcards

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1
Q

Definition: Failure to recognize familiar objects perceived by the senses.

A

Agnosia

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2
Q

What is the functional abnormality of the CNS that occurs when the blood supply to the brain is disrupted?

A

Cerebrovascular Disorder

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3
Q

What is the most important modifiable risk factor in CVA prevention?

A

Hypertension

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4
Q

What are some risk factors of cerebrovascular disorders?

A

-Age
-Gender
-Ethnicity
-HTN
-CV disease
-^ chol & ^ Hct
-Obesity
-Diabetes
-Smoking/alcohol/drug use
-Oral contraceptives

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5
Q

What is a stroke known as? (in hospital)

A

“brain attack”

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6
Q

What are the 2 types of strokes?

A

Ischemic & Hemorrhagic

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7
Q

What type of stroke is most common?

A

Ischemic

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8
Q

What types of ischemic strokes are there?

A

-Large artery thrombosis
-Small penetrating artery thrombosis
-Cardiogenic embolism
-Cryptogenic
-Other

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9
Q

What do symptoms of a stroke depend on?

A

Location & size of affected area

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10
Q

What are some C.M. of a stroke?

A

-Numbness or weakness of face, arm, or leg, especially on one side
-Confusion or change in mental status
-Trouble speaking & understanding speech
-Difficulty in walking, dizziness, loss of balance
-Sudden, severe HA

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11
Q

Definition: Paralysis on 1 side of body.

A

Hemiplegia

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12
Q

Definition: weakness on 1 side of body.

A

Hemiparesis

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13
Q

Definition: difficulty speaking caused by brain damage, results in inability to control the muscles used in speech.

A

Dysarthria

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14
Q

Definition: difficulty swallowing.

A

Dysphagia

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15
Q

Definition: can understand but not talk or express themselves.

A

Expressive aphasia

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16
Q

Definition: can talk but can’t understand.

A

Receptive aphasia

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17
Q

Definition: blindness over 1/2 of the visual field.

A

Hemianopsia

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18
Q

Definition: loss of ability to identify objects or people.

A

Agnosia

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19
Q

What is a temporary neurologic deficit resulting from a temporary impairment of blood flow?

A

TIA

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20
Q

What is a TIA a warning of?

A

Impending stroke

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21
Q

What are preventative tx of TIA & stroke?

A

-Carotid endarterectomy for carotid stenosis
-Anticoagulant therapy for A-Fib
-Antiplatelet therapy
-“Statins”
-Antihypertensive meds

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22
Q

What type of stroke is thrombolytic therapy used for?

A

Ischemic

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23
Q

Why should the HOB be elevated in the acute phase of a stroke?

A

Decreased ICP & ^ venous drainage

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24
Q

What diagnostic should be performed if a stroke is suspected?

A

Head CT

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25
Q

What are C.M. of a hemorrhagic stroke?

A

-Severe HA
-Early & sudden changes in LOC
-Projectile vomiting w/out nausea
-Bleeding

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26
Q

How is the type of stroke differentiated?

A

CT

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27
Q

What is the most important NURSING intervention if a patient is experiencing a hemorrhagic stroke?

A

ABC’s

28
Q

How should the HOB be positioned in a post stroke pt?

A

High Fowler’s ~ 90 degrees to prevent aspiration

29
Q

How is impaired physical mobility after a stroke improved?

A

PT

30
Q

Why are analgesics usually prescribed after a stroke?

A

Shoulder pain

31
Q

Who can help with self-care deficits after a stroke?

A

OT

32
Q

Who assesses for gag reflex after a stroke?

A

Speech therapist

33
Q

Should a Foley catheter be inserted in a patient with urinary incontinence following a stroke?

A

No, bowel & bladder retraining should take place

34
Q

What is nuchal rigidity a C.M. of?

A

Hemorrhagic stroke OR meningitis

35
Q

What are potential problems in a hemorrhagic stroke?

A

-Vasospasm
-Seizures
-Hydrocephalus
-Rebleeding
-Hyponatremia

36
Q

What is the #1 reason for morbidity or mortality for subarachnoid hemorrhagic stroke?

A

Vasospasm

37
Q

When will a patient begin rehabilitation after a stroke?

A

Same day

38
Q

Definition: inflammation of the meninges, which cover & protect the brain and spinal cord.

A

Meningitis

39
Q

What are the 2 types of meningitis?

A

Bacterial & viral

40
Q

What are some C.M. of meningitis?

A

-HA
-fever
-changes in LOC
-behavioral changes
-nuchal rigidity (stiff neck)
-photophobia

41
Q

What is the positive Kerning sign?

A

Pt. is lying w/ thigh flexed, other leg cannot be completely extended w/out severe back pain

42
Q

What is the positive Brudzinski sign?

A

Nuchal rigidity causes the knees to flex when the neck is raised

43
Q

How can meningitis be prevented?

A

Meningococcal vaccine to youth 11-12 y/o, booster at 16.

44
Q

What is the tx for bacterial meningitis?

A

-Early administration of IV broad spectrum abx
-Dexamethasone
-Tx for dehydration, shock, & seizures

45
Q

What type of precaution is bacterial meningitis?

A

Droplet

46
Q

What is a brain abscess?

A

Collection of infectious material w/in brain tissue

47
Q

What is the tx for a brain abscess?

A

CT-guided aspiration or drain content of abscess & treat for pathogen to decrease ICP

48
Q

What can cause encephalitis?

A

Viral infections (HSV, west nile), fungal infections

49
Q

What are C.M. of encephalitis?

A

-HA
-fever
-confusion
-hallucinations
-rash
-flaccid paralysis
-Parkinson-like movements

50
Q

What is the tx regimen for encephalitis?

A

Acyclovir for HSV infection, amphotericin, & other antifungal agents for fungal infection

51
Q

What is the normal ICP?

A

<20 mmHg

52
Q

What is the anti-seizure medication given to a pt. with meningitis?

A

Lorazepam

53
Q

What is the antidote to a benzodiazepine?

A

Flumazenil

54
Q

Why is the GCS used?

A

Detects early deterioration of a patient LOC

55
Q

A GCS of 15 is good or bad?

A

Good

56
Q

A GCS of 8 is good or bad?

A

Bad

57
Q

What is retrieved during a lumbar puncture?

A

CSF

58
Q

Name some interventions for seizure precautions.

A

-Side rails up
-Side lying position
-Seizure pads against the side rails
-Pillow under head
-Suction available
-Bed in low position
-Curtain for privacy

59
Q

What are some common anti epileptic medications?

A

-Carbamazepine
-Lamotrigine
-Gabapentin
-Levetiracetam
-Phenytoin
-Valproic Acid

60
Q

Phenytoin is used for what condition?

A

Seizures

61
Q

What are some infections that can lead to bacterial meningitis?

A

-Upper respiratory infections
-Otitis media
-Strep throat
-Influenza B

62
Q

What type of meningitis is usually more mild? Bacterial or viral

A

Viral

63
Q

What are some risks associated with bacterial meningitis?

A

-Increased ICP
-Cerebral Edema
-Septic Shock
-Coma
-Death

64
Q

Can tPA be used for an ischemic stroke?

A

Yes

65
Q

Can tPA be used for a hemorrhagic stroke?

A

No

66
Q

What is the IV medication used to decrease ICP?

A

Mannitol

Nursing 105 (11 decks)

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