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Med Surg 1 > Neurological Conditions > Flashcards

Neurological Conditions Flashcards

1
Q

risk factors for infection

A

immunosuppression drug regimens

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2
Q

meningitis
- defintion

A

inflammation of the meninges that cover and protect the brain and spinal cord

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3
Q

meningitis
- types

A

bacterial
viral
fungal

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4
Q

meningitis
- classic triad

A

fever
headache
nuchal rigidity

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5
Q

what is nuchal rigidity

A

tightness and soreness of neck

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6
Q

meningitis
- other s/s

A

photophobia
kernigs
brudzinski
hemiparesis
altered LOC
cranial nerve palsies
petechial rash

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7
Q

kernigs sign

A

knee flexion and cannot straighten

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8
Q

brudzinskis sign

A

neck flexed and knees come in

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9
Q

meningitis
- bedside risk score

A

unfavorable outcome correlates with
- increased age
- HR >120
- postive gram stain 1 hour after presentation
- cranial nerve palsy
- decreased GCS

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10
Q

meningitis
- lumbar puncture

A

opening pressure is increased
leukocyte could is elevated
protein is elevated

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11
Q

meningitis
- prevention

A

meningococcal vaccination

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12
Q

meningitis
- priority for bacterial

A

antibiotics early administration

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13
Q

meningitis
- other meds we can give

A

antipyretic
antiseizure
IVF
steroids (controversial)

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14
Q

meningitis
- treatment is __________ and directed at __________ management

A

supportive, symptom

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15
Q

meningitis
- consult

A

epidemology
infection control

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16
Q

meningitis
- monitor

A

vital signs, respiratory status, neuro (safety)

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17
Q

meningitis
- why are we cautious about pain meds

A

we still need to do an accurate mental status exam

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18
Q

brain abscess
- most common in

A

immunocompromised

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19
Q

brain abscess
- how to get it

A

extended infection of ear, mastoid, or sinuses
metastasis from another site

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20
Q

brain abscess
- intracranial (brain) absecess ss

A

progressive symptoms
headache worse in morning
reduced vision
seizures
altered LOC

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21
Q

brain abscess
- intracranial epidural abscess s/s

A

nuchal rigidity
drainage from sinus or ears

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22
Q

brain abscess
- clinical presentation of frontal lobe

A

hemiparesis
expressive aphasia
seizures
frontal headache

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23
Q

brain abscess
- clinical presentation of temporal lobe

A

localized headache
changes in vision
facial weakness
receptive aphasia

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24
Q

brain abscess
- clinical presentation of cerebellar

A

occipital headache
ataxia
nystagmus

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25
Q

brain abscess
- labs

A

increase WBC
elevated erythrocyte sedimentation rate
blood cultures

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26
Q

brain abscess
- lumbar puncture

A

elevated opening pressure
increased protein levels
increased lympocytes

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27
Q

brain abscess
- what do we need to initiate asap

A

antibiotics

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28
Q

brain abscess
- monitor

A

VS, RR, neuro

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29
Q

brain abscess
- meds ot administer besides antibiotics

A

antipyretic therpy
analgesics

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30
Q

brain abscess
- coordinate with

A

home health care for long term antibiotic therapy

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31
Q

encephalitis
- defintion

A

acute inflmmatory process of the brain tissue
viral infections

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32
Q

encephalitis
- manifestations

A

flaccid paralysis
Parkinson like movement
headache
fever
confusion
changes in LOC
vector borne rash

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33
Q

encephalitis
- medication

A

acyclovir for HSV infection
amphotericin for anti fungal

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34
Q

encephalitis
- medication key

A

early administration

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35
Q

encephalitis
- what assessment is frequent

A

neuro

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36
Q

encephalitis
- supportive care consists of

A

pain meds
seizure prevention
injury prevention
patient safety

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37
Q

multiple sclerosis
- defintion

A

immune mediated demyelinating disease of the central nervous system

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38
Q

multiple sclerosis
- disease progression

A

replaces and remissions
slow steady progressive dysfunction

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39
Q

multiple sclerosis
- MRI results

A

disruption of blood brain barrier
inflammation
plaques
axonal loss
brain atrophy

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40
Q

multiple sclerosis
- how to get plaques

A

dead axons

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41
Q

multiple sclerosis
- same in every patient

A

no

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42
Q

multiple sclerosis
- prediction of disease

A

no

43
Q

multiple sclerosis
- relapsing and remitting course

A

residual deficits may occur

44
Q

multiple sclerosis
- s/s
- motor

A

weakness
spasticity
loss of coordination

45
Q

multiple sclerosis
- s/s sensory

A

numbness, tingling
lhermittes sign

46
Q

Lhermittes sign

A

numbers tingling down arm

47
Q

multiple sclerosis
- s/sbrain stem

A

nystagmus
dysphagia

48
Q

multiple sclerosis
- s/s cerebellar

A

gait ataxia
loss of balance

49
Q

multiple sclerosis
- promenint symptom

A

cognitive changes
fatigue!

50
Q

multiple sclerosis
- labs in CSF

A

banding

51
Q

multiple sclerosis
- cure

A

none

52
Q

multiple sclerosis
- medications are used to

A

treat relapses

53
Q

multiple sclerosis
- relapse management

A

steroids

54
Q

multiple sclerosis
- immune suppressants

A

immunomodulating disease-modifitying agents
immunosupporesive therapy

55
Q

multiple sclerosis
- symptom management for spasticity

A

baclofen
benzes (valium/dantrolene)

56
Q

multiple sclerosis
- symptom management for ataxia

A

betablocker (inderol)
antiseizure meds (neurotin, klonapin

57
Q

multiple sclerosis
- intervention about fatigue

A

avoid overheating
PT/OT
exercise to the point of fatigue and stop

58
Q

multiple sclerosis
- assess sequelae of spasticity

A

difficulty with gait/sitting
hygiene
energy levels
sexual activity

59
Q

multiple sclerosis
- education

A

mobility/transfers/safety
use of assistive devices

60
Q

myasthenia gravis
- defintion

A

autoimmune disorder in which normal transmission of nerve impulses is interrupted at the neuromuscular junction

61
Q

myasthenia gravis
- affects

A

voluntary muscle groups

62
Q

myasthenia gravis
- result

A

muscle is not able to fully contract
(acetylcholine)

63
Q

myasthenia gravis
- ocular MG

A

weakness of the eye and lid muscles only

64
Q

myasthenia gravis
- bulbar MG

A

involves breathing, swallowing (dysphagia), and speech (dysphonia)

65
Q

myasthenia gravis
- when impacting the intercostal muscles or shoulder girdle, what should me monitor

A

vital capaticty
respiratory

66
Q

what is vital capacity

A

amount of air moved in and out within one breath

67
Q

myasthenia gravis
- mRI

A

thymus gland

68
Q

myasthenia gravis
- medical management used

A

anti cholinesterase inhibitors
seroids
immunosuppressants

69
Q

myasthenia gravis
- anticholinesterase

A

mestinon

70
Q

myasthenia gravis
- important factors of mestinon

A

has to be given same time every day
usually 3-4 times away
timed around when patient is most active

71
Q

myasthenia gravis
- immunosuppressants risk

A

atypical infections

72
Q

myasthenia gravis
- when on immunosuppressants will they have normal s/s of infection

A

no

73
Q

myasthenia gravis
- plasma/IVIG what drives giving it

A

the response
if not responding then we won’t do it

74
Q

myasthenia gravis
- plasma/IVIG duration

A

short

75
Q

myasthenia gravis
- plasma/IVIG can be given during crisis

A

yes

76
Q

myasthenia gravis
- nursing interventions

A

respirations
dysphagia
dysarthria
monitor for myasthenia crisis

77
Q

myasthenia gravis
- cure

A

no

78
Q

complications of MG

A

cholinergic crisis
myasthenic crisis

79
Q

myasthenic crisis
- cause

A

under medications or lack of response to treatment

80
Q

myasthenic crisis
- s/s

A

increased weakness
severe ocular/bulbar symptoms
failure of respiratory muscles to maintain ventilation

81
Q

myasthenic crisis
- priority interventions

A

airway management typically through intubation

82
Q

myasthenic crisis
- meds given

A

IVIG
sterouds
plasma

83
Q

cholinergic crisis
- cause

A

too much acetylcholine

84
Q

cholinergic crisis
- treatment

A

withhold medications

85
Q

Guillain- barre syndrome
- definition

A

acute autoimmune attack on the peripheral nerve myelin, result is an acute rapid inflammatory demyelinating polyneuropathy

86
Q

Guillain- barre syndrome
- weakness type

A

ascending

87
Q

Guillain- barre syndrome
- s/s

A

dyskinesia
paresthesias
hyporeflexia

88
Q

Guillain- barre syndrome
- autoimmune?

A

yes

89
Q

Guillain- barre syndrome
- hallmark sign

A

inflammatory lesions throughout the peripheral nervous system

90
Q

Guillain- barre syndrome
- what attack the normal myelin

A

macrophages

91
Q

Guillain- barre syndrome
- s/s

A

ascending weakness
begins in legs and progress upwards

92
Q

Guillain- barre syndrome
- complications

A

ineffective ventilation if diaphragm and respiratory muscles are impacted

93
Q

Guillain- barre syndrome
- peak severity in ___ weeks

A

2

94
Q

Guillain- barre syndrome
- autonomic dysfunction

A

vagus nerve
- orthostatic hypo- hypert
- cardiac arrhythmias/instability

95
Q

Guillain- barre syndrome
- weakness usually preceded by

A

paresthesias (numbers and tingling)

96
Q

Guillain- barre syndrome
- lumbar puncture results

A

shows increased protein in CSF

97
Q

Guillain- barre syndrome
- pulmonary function tests

A

vital capacity and negative inspiratory force

98
Q

Guillain- barre syndrome
- what conversation is had with the patient upon admission

A

elective intubation

99
Q

Guillain- barre syndrome
- medication

A

plasma/IVIG (response determines frequency)

100
Q

Guillain- barre syndrome
- monitor hemodynamic compromise

A

ECG
BP
fluid status

101
Q

Guillain- barre syndrome
- monitor

A

VS
lung sounds
ABG
vital capacity
negative inspiratory force
neuro status
CN involmenet
increase weakness

102
Q

Guillain- barre syndrome
- complications

A

respiratory failure
DVT

103
Q
A

Med Surg 1 (47 decks)

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