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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
brain abscess - labs
increase WBC elevated erythrocyte sedimentation rate blood cultures
26
brain abscess - lumbar puncture
elevated opening pressure increased protein levels increased lympocytes
27
brain abscess - what do we need to initiate asap
antibiotics
28
brain abscess - monitor
VS, RR, neuro
29
brain abscess - meds ot administer besides antibiotics
antipyretic therpy analgesics
30
brain abscess - coordinate with
home health care for long term antibiotic therapy
31
encephalitis - defintion
acute inflmmatory process of the brain tissue viral infections
32
encephalitis - manifestations
flaccid paralysis Parkinson like movement headache fever confusion changes in LOC vector borne rash
33
encephalitis - medication
acyclovir for HSV infection amphotericin for anti fungal
34
encephalitis - medication key
early administration
35
encephalitis - what assessment is frequent
neuro
36
encephalitis - supportive care consists of
pain meds seizure prevention injury prevention patient safety
37
multiple sclerosis - defintion
immune mediated demyelinating disease of the central nervous system
38
multiple sclerosis - disease progression
replaces and remissions slow steady progressive dysfunction
39
multiple sclerosis - MRI results
disruption of blood brain barrier inflammation plaques axonal loss brain atrophy
40
multiple sclerosis - how to get plaques
dead axons
41
multiple sclerosis - same in every patient
no
42
multiple sclerosis - prediction of disease
no
43
multiple sclerosis - relapsing and remitting course
residual deficits may occur
44
multiple sclerosis - s/s - motor
weakness spasticity loss of coordination
45
multiple sclerosis - s/s sensory
numbness, tingling lhermittes sign
46
Lhermittes sign
numbers tingling down arm
47
multiple sclerosis - s/sbrain stem
nystagmus dysphagia
48
multiple sclerosis - s/s cerebellar
gait ataxia loss of balance
49
multiple sclerosis - promenint symptom
cognitive changes fatigue!
50
multiple sclerosis - labs in CSF
banding
51
multiple sclerosis - cure
none
52
multiple sclerosis - medications are used to
treat relapses
53
multiple sclerosis - relapse management
steroids
54
multiple sclerosis - immune suppressants
immunomodulating disease-modifitying agents immunosupporesive therapy
55
multiple sclerosis - symptom management for spasticity
baclofen benzes (valium/dantrolene)
56
multiple sclerosis - symptom management for ataxia
betablocker (inderol) antiseizure meds (neurotin, klonapin
57
multiple sclerosis - intervention about fatigue
avoid overheating PT/OT exercise to the point of fatigue and stop
58
multiple sclerosis - assess sequelae of spasticity
difficulty with gait/sitting hygiene energy levels sexual activity
59
multiple sclerosis - education
mobility/transfers/safety use of assistive devices
60
myasthenia gravis - defintion
autoimmune disorder in which normal transmission of nerve impulses is interrupted at the neuromuscular junction
61
myasthenia gravis - affects
voluntary muscle groups
62
myasthenia gravis - result
muscle is not able to fully contract (acetylcholine)
63
myasthenia gravis - ocular MG
weakness of the eye and lid muscles only
64
myasthenia gravis - bulbar MG
involves breathing, swallowing (dysphagia), and speech (dysphonia)
65
myasthenia gravis - when impacting the intercostal muscles or shoulder girdle, what should me monitor
vital capaticty respiratory
66
what is vital capacity
amount of air moved in and out within one breath
67
myasthenia gravis - mRI
thymus gland
68
myasthenia gravis - medical management used
anti cholinesterase inhibitors seroids immunosuppressants
69
myasthenia gravis - anticholinesterase
mestinon
70
myasthenia gravis - important factors of mestinon
has to be given same time every day usually 3-4 times away timed around when patient is most active
71
myasthenia gravis - immunosuppressants risk
atypical infections
72
myasthenia gravis - when on immunosuppressants will they have normal s/s of infection
no
73
myasthenia gravis - plasma/IVIG what drives giving it
the response if not responding then we won't do it
74
myasthenia gravis - plasma/IVIG duration
short
75
myasthenia gravis - plasma/IVIG can be given during crisis
yes
76
myasthenia gravis - nursing interventions
respirations dysphagia dysarthria monitor for myasthenia crisis
77
myasthenia gravis - cure
no
78
complications of MG
cholinergic crisis myasthenic crisis
79
myasthenic crisis - cause
under medications or lack of response to treatment
80
myasthenic crisis - s/s
increased weakness severe ocular/bulbar symptoms failure of respiratory muscles to maintain ventilation
81
myasthenic crisis - priority interventions
airway management typically through intubation
82
myasthenic crisis - meds given
IVIG sterouds plasma
83
cholinergic crisis - cause
too much acetylcholine
84
cholinergic crisis - treatment
withhold medications
85
Guillain- barre syndrome - definition
acute autoimmune attack on the peripheral nerve myelin, result is an acute rapid inflammatory demyelinating polyneuropathy
86
Guillain- barre syndrome - weakness type
ascending
87
Guillain- barre syndrome - s/s
dyskinesia paresthesias hyporeflexia
88
Guillain- barre syndrome - autoimmune?
yes
89
Guillain- barre syndrome - hallmark sign
inflammatory lesions throughout the peripheral nervous system
90
Guillain- barre syndrome - what attack the normal myelin
macrophages
91
Guillain- barre syndrome - s/s
ascending weakness begins in legs and progress upwards
92
Guillain- barre syndrome - complications
ineffective ventilation if diaphragm and respiratory muscles are impacted
93
Guillain- barre syndrome - peak severity in ___ weeks
2
94
Guillain- barre syndrome - autonomic dysfunction
vagus nerve - orthostatic hypo- hypert - cardiac arrhythmias/instability
95
Guillain- barre syndrome - weakness usually preceded by
paresthesias (numbers and tingling)
96
Guillain- barre syndrome - lumbar puncture results
shows increased protein in CSF
97
Guillain- barre syndrome - pulmonary function tests
vital capacity and negative inspiratory force
98
Guillain- barre syndrome - what conversation is had with the patient upon admission
elective intubation
99
Guillain- barre syndrome - medication
plasma/IVIG (response determines frequency)
100
Guillain- barre syndrome - monitor hemodynamic compromise
ECG BP fluid status
101
Guillain- barre syndrome - monitor
VS lung sounds ABG vital capacity negative inspiratory force neuro status CN involmenet increase weakness
102
Guillain- barre syndrome - complications
respiratory failure DVT
103

Med Surg 1 (47 decks)

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