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Study2 > Neurological Assessment & diagnostics > Flashcards

Neurological Assessment & diagnostics Flashcards

1
Q

GCS is what?

A

A scale that measures the degree or LOC

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2
Q

GCS is used to assess the LOC in a client who already has altered _____ or has the potential for it

A

Altered consciousness

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3
Q

Three responses of the GCS?

A 
Eye opening (4)
Verbal response (5)
Motor response (6)
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4
Q

We like a high number ranging from ____ for the GCS

A

13-15

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5
Q

What is always #1 with neurological assessment

A

LOC

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6
Q

Factors that can alter the GCS?

A

Drug use
Alcohol intoxication
Shock
Hypoxia

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7
Q

Normal pupil size is ?

A

2-6 mm

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8
Q

Hang grips/lifts legs/pushing strength of ___

A

Feet

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9
Q

Babinski reflex is normal in a child up to ___

A

1 year (depends when child starts walking)

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10
Q

Babinski is abnormal in ___

A

Adult (or basically anyone who walks)

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11
Q

The adult or child greater than one year should have a normal reflex or ___ of the toes when the bottom of the foot is stroked

A

Curling

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12
Q

What does it mean if the adult has a present Babinski reflex or fanning of the toes when you stroke the bottom of the foot?

A

A severe problem in CNS

  • tumor or lesion on brain or SC
  • MS
  • Lou Gehrig disease
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13
Q

A normal reflex response would be documented as ?

A

2+/4+

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14
Q

General diagnostic tests: CT

Dye?

A

With or without —if it has dye then need consent form

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15
Q

General diagnostic tests: CT

Take pictures in ___

A

Slices

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16
Q

General diagnostic tests: CT

Head

A

Keep head still

No talking

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17
Q

General diagnostic tests: MRI

What is better: CT or MRI?

A

MRI

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18
Q

General diagnostic tests: MRI

Dye?

A

Not usually used

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19
Q

General diagnostic tests: MRI

Radiation?

A

No..magnet used

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20
Q

General diagnostic tests: MRI

Position?

A

Will be placed in a tube where client will have to lie flat

21
Q

General diagnostic tests: MRI

What can you not have on

A

No jewelry
No credit cards
NO PACEMAKERS

22
Q

General diagnostic tests: MRI

Tattoos ?

A

Old tats may contain medal

23
Q

General diagnostic tests: MRI

Teeth fillings

A

Don’t matter

24
Q

General diagnostic tests: MRI

What client can’t tolerate this?

A

Clausterpobic

25
Q

General diagnostic tests: MRI

Can talk and hear others when in tube?

A

Yes

26
Q

Cerebral angiography

Consent form?
What is it?
What artery does it go through

A

Yes, because dye used

X-ray of cerebral circulation

Go through the femoral artery

27
Q

Cerebral angiography-Pre procedure

Well hydrated/void/peripheral pulses/groin prepped ….Explain

A

Anytime an iodine based dye used, client will need to be well hydrated to promote excretion of the dye

Watch: BUN and Cr, UO, and hold metformin

28
Q

Cerebral angiography-Pre procedure

What drug to hold?

A

Metformin

29
Q

Cerebral angiography-Pre procedure

Explain what?

A

Will feel warmth in face and a metallic taste

30
Q

Cerebral angiography-Pre procedure

Allergies?

A

Cannot have allergies to shellfish or iodine

31
Q

Cerebral angiography-Post procedure

Bed rest

A

4-6 hours

32
Q

Cerebral angiography-Post procedure

Monitor for?

A

Bleeding/hemorrhage!!!

33
Q

Cerebral angiography-Post procedure

Possible complication?

A

Embolus

*get baseline data because an embolus could go to arm, heart, lung, kidney, or brain

34
Q

Cerebral angiography-Post procedure

Embolus to brain s/s?

A

Change in LOC
One sided weakness
Paralysis
Monitor/sensory deficits

35
Q

EEG

Does what?

A

Records activity of the brain

36
Q

EEG

Used for what?

A
  • Diagnose and evaluate seizures
  • Evaluates LOC and dementia
  • Screening procedure for coma
  • Sleep disorders (narcolepsy, cerebral infarct, brain tumor or abscess)
37
Q

EEG

Use this for an indicator of ___

A

Brain death

38
Q

EEG-Pre-procedure

Sedatives?
Caffeine?
NPO?

A

Hold sedatives (sedatives decrease electrical activity in brain; alters test)

NO caffeine (changes electrical activity of brain)

Not NPO!!! (drops blood sugar)

39
Q

EEG

Beginning of procedure get what?
May be asked to do what?

A

Baseline first with client lying quietly (resting EEG)

May be asked to hyperventilate to assess brain circulation, assess photo stimulation for seizures, or sedate for sleep study

*if someone unconscious then pain response or noxious stimuli may be introduced to stimulate brain wave (strong smell/bright light)

40
Q

Puncture site?

A

Lumbar subarachnoid space

41
Q

Lumbar puncture

Purpose? (3)

A
  1. Obtain SF to analyze for blood, infection, and tumor cells
  2. Measure pressure readings with manometer
  3. To give drugs intrathecally (brain, SC)
42
Q

Lumbar puncture

Position

A

Back arched (side lying fetal or arched over)

43
Q

Lumbar puncture

Inspect?
Normal CSF?

A

Insect surrounding skin at puncture site for infection

CSF should be clear and colorless (looks like water)

44
Q

Lumbar puncture: Post procedure

Position?
Fluids?
Most common complication?

A

Lie flat or prone for 2-3 hours so seal can form

Increase fluids to replace lost spinal fluid

Most common complication: HA

45
Q

Lumbar puncture: Post procedure

HA pain increases when the client ___ and decreased when the client ____

A

Increase when sit up

Decrease when lie down

46
Q

Lumbar puncture: Post procedure

How to treat HA?

A

Bed rest
Fluid
Pain med
Blood patch

47
Q

Lumbar puncture: Post procedure

Life-threatening complications?

A

Brain herniation

Meningitis

48
Q

Lumbar puncture: Post procedure

Never do LP with someone who has ____

A

Known increased ICP—this is life threatening to do on this client!!!!

49
Q

Lumbar puncture: Post procedure

Meningitis

A

Bacteria can get in puncture site and into SF and cause meningitis

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