Neurology Flashcards
The most Important initial step in the treatment of head
injury
Secure the airway
What PRIORITY care to institute taking care of a patient
with acute cerebral vascular accident (CVA)?
By maintaining the patient’s respiratory function
(AIRWAY) r
Increase in the difference between systolic and diastolic
pressure in head injury
Widening of pulse pressure
Normal ICP adult
< 20mmg or (10-20 mmHg.)T
Bowel care for a client post craniotomy
High fiber diet, increased fluid intake, and stool
softeners. To prevent constipation as patient may
have valsava causing increased intracranial pressure.
Normal intracranial pressure (ICP) in children
< 5-20mmHg
Black eye(s) discoloration under the eye(s) may indicate a
basilar skull fracture and this is commonly called as what
sign?
Raccoon’s eye
Nursing care with Bell’s palsy
Steroid, analgesics as needed,
Provide eye care, dark glasses on days, eye pad at
night, eye ointment and artificial tears
Ascending paralysis
Guillaine-Barre Syndrome
Priority: airway, as paralysis may ascend to the
diaphragm
Bell’s Palsy
Eye care to protect cornea from injury.
Priority in Guillaine-Barre
Respiratory due to the ascending paralysis
Mildly dilated pupils with sluggish response may be an
early sign of?
Hemiation
Bilateral fixed and pinpoint pupils may indicate pontine
lesion or adverse effects of drugs such as?
Opiates overdose (Morphine)
A client will be receiving a Lovenox (enoxaparin), what is the
most important to diagnostic test that should be checked?
1. MRI of the calf 2. CT of the head
3. Abdominal ultrasound,
CT of the head to delermine if patient is having
cerebral hemorrhage. Answer: CT of the head
Early symptom of Parkinson’s disease is
slowness of movement or continued motor tremors.
Slowness of movement with activity of daily living.
Nursing priority to observe an hour post lumbar puncture
(1.) muscle weakness of upper extremities
(2.) headache
(3.) minimal oozing of clear fluid from the puncture site.
Answer (3) oozing of clear fluid from the puncture
site.
Headache is an expected symptom related to spinal
headache. Lower extremities should be a concern not
the upper extremities.
A surgical procedure to remove the atheromas causing
carotid stenosis, resulting to TIAs or CVA
Carotid endarterectomy
Carotid endarterectomy is diagnosed by?
[Carotid or femoral]
Ultrasound doppler or Magnetic Resonance
Arteriography (MRA)
Risks after endarterectomy
Swelling of the neck due to hematoma and could
compress trachea.
Purpose of displaying calendar to a client’s room with
Alzheimer’s disease.
To improve orientation to time.
T1 vertebrae injury
Affects the legs and trunk below the injury
Quadriplegia
Paralysis of the all 4 extremities with injury abovel
1 sI thoracic vertebra
Paraplegic
Paralysis of the legs and lower body
Common complication from Spinal anesthesia
Head ache
priority of a client with Myasthenia Gravis
Airway due to failure of the respiratory muscle
Parkinson’s disease
Avoid caffeine and decaffeinated drinks
Progressive weakness of the and atrophy of the muscles of
the arms, trunk, or legs with respiratory insufficiency
ALS (Amyotrophic Lateral Sclerosis)
(Lou Gehrig’s disease)
Priority: airways and safety against falling due to
weakness
Myelogram
Contraindicated with increased intracranial pressure
Involuntary muscle spasms and essential tremors
Dystonia
A temporary loss of function due to cerebral ischemia
Transient Ischemic Attack (TIA)
Neuroleptic malignant syndrome
Hyperthermia
Limps contract or stiffen, eyes roll, incontinence, loss of consciousness for 20-40 seconds.
Grand mal seizure (tonic phase)
A condition requiring structured environment
Alzheimer’s disease
Increased mucus production, repetitive movements and
slowly tapers.
Grand mal (clonic phase)
Indication of increased ICP
Halo around lights
Indication of Lactulose in hepatic encephalopathy
To decrease the ammonia level and expect diarrhea
Shuffling gait and early postural changes.
Increased salivation and drooling
Parkinson’s disease
Approach client in unaffected side and place food,
and belongings to unaffected side.
Teach client to compensate by turning head to see
things to the affected side.
Homonymous Hemianopsia
Indication of Topomax (topiramate)
To treat seizures (epilepsy)
Side effects: numbness and tingling in arms and legs,
loss of appetite, exhaustion, fatigue, nausea,
diarrhea, change in taste and weigh loss.
Nurse alert: 1. increase the risk of suicidal thoughts.
2. Should be gradually withdrawn to minimize the
potential for seizures or increased seizure frequency.
Further instructions needed to position Ménière’s disease.
Gradually change position and move body as a unit
and head is turned with the body.
Sundown Syndrome stage 1 Alzheimer
Reorient the client, stay calm and give sedatives.
Increased disorientation and agitation only during
evening and nighttime.
Sun downing Syndrome
Expressive and Receptive Aphasia
Use simple 1-2 words, yes or no, simple and short
questions, do not speak loudly (as hearing is not the
problem). Face the patient and be calm for questions.
May use communication board and be patient
Expressive aphasia
Patient unable to send desired message.
Listen and watch carefully when client attempts to
talk. Allow sufficient time for client to answer.
Anticipate the needs to decrease feelings of
hopelessness and frustrations.
Receptive aphasia
Unable to interpretlet or recognize message being
received.
Give simple and slow directions
A common symptom of detached retina
Bright flashes of light
Flexion of the upper extremities, extension of the lower
extremities, and plantar flexion
Decorticate posturing
Sudden, onset of pounding headache, pulse rate within
normal limits, sudden hypertension of a patient with spinal
cord injury, the nurse will be aware that client is having a.
Autonomic Dysreflexia (AD)
Action: Let the client sit up to allow blood pool the
legs to lower blood pressure and prevent
hypertensive hemorrhage.
Your instruction to patient with Multiple Sclerosis taking
Dantrium.
When going outside the house, use sunscreen, hat,
long sleeves, sunglasses, etc.
Client has a Parkinson’s disease, what to avoid when taking L-dopa
Vitamin B6 (organ meats, meat, whole grain cereals)
An autoimmune disorder with rapid progressive muscle weakness to paralysis
Guillain-Barre Syndrome (GBS)
weakness to paralysis
Medications avoided in Guillain-Barre Syndrome
Narcotics and sedatives (may depress respiration)
Extreme muscular weakness and easy fatigability
Myasthenia Gravis
