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Adult Nursing II - Exam 2 > Neurology > Flashcards

Neurology Flashcards

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1
Q

5 Components of Neuro Physical Exam

HAYLEY!!!

A
  • **LOC **
  • Motor function
  • Eye signs (pupillary function & eye movement)
  • Respiratory patterns
  • Vital signs
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2
Q

What is the earliest & most reliable indicator of increased ICP?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Level of consciousness

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3
Q

What are the sections & ratings for the GCS?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Eyes (4)
Verbal / Mouth (5)
Motor (6)

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4
Q

What is the difference in decerebrate & decorticate posturing? Which is worse?

A

Decerebrate: arms at side, stiffly extended elbows, jaw clenched, neck extended

Decorticate: upper arms at sides with elbows, wrists, & fingers flexed into the core

Decorticate is worse

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5
Q

What is proprioception?

A

Awareness of the body & where it is in space

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6
Q

Which 2 dermatomes are the same in EVERY patient?

A

T4 (nipple line)

T10 (umbilicus)

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7
Q

List the cranial nerves in order

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Oh Once One Takes The Anatomy Final Very Good Vacations Are Heavenly

I = Olfactory
II = Ooptic
III = Occulomotor
IV = Trochlear
V = Trigeminal
VI = Abducens
VII = Facial
VIII = Vestibulocochlear
IX = Glossopharengeal
X = Vagus
XI = Accessory
XII = Hypoglossal

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8
Q

What is the mnemonic for the cranial nerves in order?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

I = Oh (Olfactory)
II = Once (Optic)
III = One (Occulomotor)
IV = Takes (Trochlear)
V = The (Trigeminal)
VI = Anatomy (Abducens)
VII = Final (Facial)
VIII = Very (Vestibulocochlear)
IX = Good (Glossopharyngeal)
X = Vacations (Vagus)
XI = Are (Accessory)
XII = Heavenly (Hypoglossal)

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9
Q

What is anisocoria?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY

A

Pupils are different sizes from one another

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10
Q

What are Doll’s Eyes?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY

A

When a patient turns their head, one eye stays concentrated & one eye goes off to the side

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11
Q

What is Central Neurogenic Hyperventilation? What causes CNH?

xKNOW THIS!!!!!! - RED, BOLD, KEISER

A

Constricts vessels to shunt blood out of the brain

Cause: increased ICP

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12
Q

What is Cheyne Stokes breathing?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY

A

Alternating periods of hyperapnea & apnea

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13
Q

**What is the most important thing to look for when assessing vital signs for neuro patients? **

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Cushing’s Triad

  • Bradycardia (decreased HR)
  • Widened pulse pressure (big gap between SBP & DBP)
  • Irregular respirations (Cheyne-Stokes breathing)
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14
Q

Battle’s Sign & Raccoon Eyes are signs of what?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Basal Skull Fracture

Battle Sign = bruise behind the ear

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15
Q

What is hemianopsia?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY

A

Cut of visual field in half

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16
Q

What is ptosis?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY

A

Drooping of one eye

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17
Q

What is tardive dyskinesia?

A

Condition where you face, body, or both make sudden, irregular movements you cannot conrol

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18
Q

What is meningitis? What are the signs & symptoms??

KNOW THIS!!!!!! - RED, BOLD…KEISER

A

Inflammation of meninges (lining around brain & spinal cord)

S&S: headache, nuchal rigidity (neck stiffness), photophobia, + Kernig’s and/or Brudzinski’s sign, altered LOC, seizures, increased ICP

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19
Q

What is Kernig’s Sign (when positive)?

KNOW THIS!!!!!! - RED, BOLD…KEISER

A

Intense pain (& spasms, resisting further extension) when patient is supine, hip & knee are bent at 90 degrees, & provider tries to straigthen the leg

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20
Q

What is Brudzinski’s Sign (when positive)?

KNOW THIS!!!!!! - RED, BOLD…KEISER

A

Pain when neck is flexed causing the patient’s knees, & hips to flex too (as response to pain)

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21
Q

What are partial, generalized, simple, & complex seizures?

A

Partial: begin locally

Generalized: bilaterally symmetric

Simple: no impairment of consciousness

Complex: impaired consciousness

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22
Q

What are partial seziures?

A

Begin locally

23
Q

What are generalized seizures?

A

bilaterally symmetric

24
Q

What is the difference in simple & complex seizures?

A

Simple = NO impairment of consciousness

COMPLEX = IMPAIRED CONSCIOUSNESS

25
Q

In emergency situations, what medications are used to stop seizures?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

IV ativan or valium

Given when…

  • continuous seizure lasts more than 5 minutes
  • second seizure is experienced before patient has fully regained consciousness
  • single seizure lasts more than 30 minutes
26
Q

Is coma a symptom or a disease?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

SYMPTOM – we need to find the underlying cause

27
Q

What is administered when the cause of a coma is unknown?

A
  • Thiamine (banana bag)
  • Glucose
  • Narcotic agonist (NARCAN)
28
Q

What is a persistent vegetative state?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Patients who have severe brain damage & are in a state of “wakefullness without awareness”

29
Q

What are the 2 different types of stroke?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Hemorrhagic Strokes: rupture of blood vessels
* cerebral artery ruptures
* HTN = most common cause

Ischemic Stroke: blood vessel occlusion
* 87% of strokes are ischmeic

30
Q

What is the most common type of stroke?

A

Ischmeic (blood vessel occlusion)

31
Q

What is the most common cause of a hemorrhagic stroke?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Hypertension

32
Q

What are common signs & symptoms of an ischmeic stroke vertebrobasilar (posterior) circulation?**

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A
  • Dysarthria
  • Ataxia
  • Vertigo
33
Q

What is a TIA (transient ischemic attack)

A

Temporary blockage of blood flow to the brain

  • symptoms mimic stroke
  • symptoms only last a brief period of time
  • cannot be seen on a CT scan

Precursor to ischmeic stroke

34
Q

Why do hemorrhagic & ischemic strokes cause increased ICP?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY

A

Hemorrhagic: amount of blood in brain increases the ICP

Ischemic: cerebral edema leads to increased ICP

35
Q

What is the door to read time of a non-contrast CT if a patient is being considered for fibrinolytic therapy like TPA?

A

45 minutes

36
Q

What are treatments for ischemic stroke?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A
  • Fibrinolytic therapy (BP < 185/110 to recieve TPA)
  • Anti-hypertension therapy (only if pt is severely high)
  • Airway management
  • Blood sugar
  • Hypothermia
  • Cardia cmonitoring
37
Q

What medications can NOT be given after administration of TPA?

KNOW THIS!!!!!! - RED, BOLD…KEISER

A

Antithrombotic or anti-platelet-aggregating drugs

NO aspirin, heparin, warfarin, etc. for first 24 hours after tpa

38
Q

What is the door to doctor time, door to CT, & door to CT being read for a patient who is suspected of having a stroke?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Door to Doctor = 10 minutes

Door to CT = 25 minutes

Door to CT read = 45 minutes

39
Q

What is the door to TPA time?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

1 hour!!!!!!

40
Q

How long can TPA run for (maximum)?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY

A

4 hours

41
Q

What anti-hypertensive medication is used most often in patients with a stroke?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY

A

Labetalol (Beta-blocker)

42
Q

What is a subarachnoid hemorrhage? What is the most common cause of SAH?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY

A

Bleeding into subarachnoid space

Most Common Cause = TRAUMA

Usually caused by rupture of cerebral aneurysm or rupture of AVM

43
Q

What are signs & symptoms of a subarachnoid hemorrhage caused by a ruptured aneurysm?

A
  • Headache (excrutiating)
  • Nuchal rigidity
  • Diplopia
  • Photophobia
  • Blurred vision
  • Storke symptoms
44
Q

What therapy is used for a subarachnoid hemorrhage? What is the purpose of this therapy?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Triple H…
* Hypertensive
* Hypervolemic
* Hemodilution

It stops the vasospam that’s occuring

45
Q

Signs & Symptoms of Epidural Hematomas

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A
  • Luicid episodes
  • LOC
  • Rapid deterioration

If the patient bleeds too much then the increased ICP causes herniation which leads to death

46
Q

What is a subdural hematoma?

A

Spontaneous or venous bleeding after trauma

47
Q

What is Diffuse Axonal Injury (DIA)?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Damage to the axons often from an accelerated, decelerating accident (car crashes)

Neuro deficits are permanent (axons cannot regenerate)

Petechial hemorrhages within the brain on an MRI

48
Q

What is normal ICP range & what is ICP range for treatment?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Normal ICP = 0 - 15

*Treatment Range = 20 - 25)

49
Q

What is CPP and how is it calculated? What is the goal for maintaining CPP?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

Cerebral Perfusion Pressure normal = 70 - 100

50
Q

How do you calculate CPP?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

CPP = MAP - ICP

MAP = 1/3 (SBP - DBP) + DBP

51
Q

Calcuate the CPP for a patient with a BP of 100/40 and an ICP of 20.

A

MAP = 1/3 (100 - 40) + 40 = 60/3 + 40 = 20 + 40 = 60 mmHg

**CPP = MAP - ICP –> 60 - 20 = 40 **

CPP = 40

52
Q

What is a brain herniation?

A

Increased ICP that pushes the brain out of position

53
Q

What medication is used to decrease ICP when it’s caused by cerebral edema?

KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER

A

MANATOL

54
Q

How can we tell if a patient has a brain herniation?

A

Cushing’s Triad

  • bradycardia
  • widened pulse pressure
  • decreased respirations (cheyne-stokes breathing)

Adult Nursing II - Exam 2 (4 decks)

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