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Med Surg I - Exam 3 > Neurological Conditions > Flashcards

Neurological Conditions Flashcards

1
Q
  • What is meningitis?
  • What are the 3 categories of meningitis?
  • Which classification of meningitis is most worrisome / dangerous?
  • Which classification of meningitis is most common?

KNOW THIS (IN RED)!!!

BOLD = IN RED

A

Meningitis: inflammation of the meninges that cover & protect the brain & spinal cord

Types:
* Bacterial
* Viral (aseptic)
* Fungal

  • Bacterial is the most worrisome & needs to be treated with antibiotics
  • Viral meningitis is most common
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2
Q
  • What is the most dangerous form of meningitis?
  • What is the most common form of meningitis?
A
  • Most dangerous = bacterial
  • Most common = viral
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3
Q

What are the classic signs & symptoms (triad) of meningitis?

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A
  • Fever
  • Headache
  • Nuchal rigidity (neck tightness / sore neck)
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4
Q

What is Kernig’s sign?

A

Knee

  • Knee is flexed at 90 degrees. When it’s slowly straightened, pain occurs
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5
Q

What is Brudzinksi’s Sign?

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A

Neck flexion also causes flexion of the hips & knees

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6
Q

Diagnostics & Assessments used for meningitis

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A
  • Lumbar puncture
  • CSF studies - Gram Stain
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7
Q

Medical Management of Meningitis

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A
  • Prevention with meningococcal vaccination
  • Anti-pyretics
  • Anti-seizure medications
  • IV fluids (for dehydration / shock)
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8
Q

What is the top priority for patients diagnosed with bacterial meningitis?

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A

EARLY administration of antibiotics

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9
Q

Nursing Management for Meningitis

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A
  • Treatment is supportive & directed at symptom management
  • Consult with epidemiology / infection control departments
  • Monitor neuro status closely
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10
Q

What patient population has a higher rate of being diagnosed with a brain abscess?

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A

Immunocompromised
* indicative of underlying disease or use of immunosuppressive medications

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11
Q

Clinical Manifestations of Intracranial (brain) Abscess

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A

Progressive symptoms:
* fever
* nausea
* vomiting
* altered LOC
* focal neurological deficits
* seizures
* Headache (worse in the AM)
* Reduced vision

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12
Q

Clinical Manifestations of Intracranial Epidural Abscess

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A
  • drainage from sinus or ears
  • low grade fever
  • mild headache
  • Nuchal rigiditiy
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13
Q

What labs & other diagnostic tests are used in the assessment & diagnosis of neurological conditions?

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A

Labs
* ↑ WBC
* Blood cultures

Lumbar Puncture
* ↑ opening pressure
* ↑ protein level
* ↑ lymphocytes

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14
Q

Medical & Nursing Management of Brain Abscesses

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A

Medical Management
* start antibiotics ASAP

Nursing Management
* Monitor vitals & respiratory status
* Monitor neuro status
* Encourage rest
* Administer antipyretics
* Aminister antibiotics & analgesics

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15
Q

What is encephalitis? How is it managed?

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A

Encephilitis: acute, inflammatory process of brain tissue

Management
* Neuro Assessments
* Supportive Care (pain meds, seizure prevention, injury prevention & safety)

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16
Q

What is Multiple Sclerosis (MS)?

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A

Immune-mediated, DE-MYELINATING disease

  • periods of relapses & remissions

Progressive MS = no periods of remission

17
Q

Signs & Symptoms of Multiple Sclerosis (MS)

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A
  • Weakness
  • Spasticity
  • Loss of coordination
  • Gait ataxis (drunk walk)
  • Loss of balance
  • Cognitive changes
  • Fatigue
18
Q

Medical Management of Multiple Sclerosis

  • Relapse Management
  • Symptom Management

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A

NO CURE

Relapse Management
* Steroids (methylprednisolone & prednisone)
* Immune Suppressants

Symptom Management
* Bacolfen (Tx of choice for spasticity)
* Benzodiazepines (valium or dantrolene) - may also be used for spasticity
* Beta Blocker (inderol), Anti-seizure medications (neurotin, klonopin - tx of ataxia

19
Q

What is Myasthenia Gravis (MG)?

KNOW THIS (IN RED)!!!

A

Auto-immune disorder that affects voluntary muscle groups…the muscle cannot contract fully or normally

  • These muscle groups include ocular, oropharyngeal, facial, shoulder girdle, limbs

Occurs at neuromuscular junction

20
Q

Clinical Manifestations of Myasthenia Gravis

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A

Generalized weakness can result in decreased vital capacity & respiratory failure

Bulbar MG
* breathing
* swallowing (dysphagia)
* speech (dysphonia)

21
Q

Nursing Interventions for Myasthenia Gravis (MG)

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A
  • Assess respirations
  • Assess neuro status
  • Assist with mobility
  • Assess risk of impaired swallow & gag
22
Q

What occurs during a Myasthenia Crisis? Specify the ABG imbalance that occurs.

  • What medical interventions are used for a Myasthenia Crisis?

KNOW THIS (IN RED)!!!

A

Respiratory Acidosis

  • failure of respiratory muscles to maintain ventilation

Medical Interventions
* IVIG
* Steroids
* Plasma Exchange

23
Q

What is Gullian-Barre Syndrome (GBS)?

KNOW THIS (IN RED)!!!

A

Acute autoimmune disease that causes ascending weakness

  • Since Schwann cells are NOT impacted, so the schwann cells can repair the damaged myelin sheath
  • 80% recover; does NOT impact mental capacity
24
Q

Signs & Symptoms of Gullian-Barre Syndrome (GBS)

KNOW THIS (IN RED)!!!

A
  • ascending weakness
  • dyskinesia (involuntary, erratic movements)
  • paresthesia (numbness, tingling)
  • hyperreflexia

Patient’s are at risk for aspiration!!!!!

25
Q

Assessments & Diagnostic Testing used for Gullian-Barre Syndrome (GBS)

KNOW THIS (IN RED)!!!

A

Lumbar Puncture
* shows increased protein in CSF

Pulmonary Function Tests
* Vital capacity
* Negative inspiratory force (NIF)

26
Q

Medical Management of Gullian-Barre Syndrome (GBS)

KNOW THIS (IN RED)!!!

A

Plasma exchange
* gets rid of circuating antibodies

Moinitor hemodynamic compromise
* ECG (tachycardia, bradycardia)
* BP (hypo- or hypertension)
* Fluid volume deficit / overload

27
Q

Nursing Interventions for Gullian-Barre Syndrome

KNOW THIS (IN RED)!!!

A

Moinitor Respiratory Status
* RR, Pulse Ox, ABGs
* Vital capacity, NIF (negative inspiratory force)

Neuro exam
Vital Signs
Monitor for signs of increased weakness

Med Surg I - Exam 3 (17 decks)

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