Neurological Conditions Flashcards
TBI types
Direct
Acceleration - deceleration - motor vehicle
Shock wave - explosion
Types of Primary TBI
Concussion - reversible
Contusion - brain bleed
Penetrating - cerebral tissue
Diffuse axonal; injury - stretching/tearing of axons
Hematome
Primary TBI
Direct injury (coup)
Secondary
Consequence of initial trauma
inflammation (release of cytokines from macrophages), counter coup
TBI Hematomas
Subdural - under dura
Epidural - above / on dura
Intra cerebral - in cerebral tissue
TBI nursing care
Neurological assessment
Glasgow Coma Scale
Airway assessment
ICP monitoring
Hemodynamic monitoring
Interventions to control elevated ICP
Evaluation of diagnostic tests
GCS
Mild - 13 - 15 LOC up to 15 min
Modeare - 9- 12 LOC up to 6 hr
Severe - 8 or less LOC 48 hr
Acute stroke - hemorrhagic
Bleeding in brain
MAP less than 130
Glycemic management (hypergly increases neuro symptoms)
Diagnostic (NON CONTRAST CT)
Meds - antihypertensive (IV) manage ICP mannitol
Acute stroke ichemic
Clot in brain.
TPA
SBP - less than 220
DBP less than 120
Glycemic management
Diagnostic Non contrast Ct
Meds 0 TPA
Subarachnoid hemorrhage
Bleeding in subarachnoid space from anerysm
SAH - caused by cerebral anerysm
Outpouching of the wall of a blood vessel that results from weakening of wall of that vessel
SAH - caused by ruptured AVM
Tangled mass of arterial and venous blood vessels that shunt blood directly from an artery into a vein, bypassing the capillaries
Aneurysms
Balloon out as BP increases
Assessment of SAH
“Worst headache of my life”
Loss of consciousness (LOC)
Nausea/vomiting
Focal neurologic deficits/CN palsy
Syncope or seizure
Nuchal rigidity (stiff neck) and photophobia
Pain above and behind the eye
Photophobia
Restlessness and irritability
Diagnosis SAH
S/S
CT scan
Lumbar puncture - Bloody, RBCs
