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Adult Nursing II - Exam 2 > Neurology > Flashcards

Neurology Flashcards

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
**In emergency situations, what medications are used to stop seizures?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
**IV ativan or valium** ## Footnote 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
**Is coma a symptom or a disease?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
SYMPTOM -- we need to find the underlying cause
27
**What is administered when the cause of a coma is unknown?**
* Thiamine (banana bag) * Glucose * Narcotic agonist (NARCAN)
28
**What is a persistent vegetative state?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
Patients who have severe brain damage & are in a state of "wakefullness without awareness"
29
**What are the 2 different types of stroke?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
**Hemorrhagic Strokes:** rupture of blood vessels * cerebral artery ruptures * HTN = most common cause **Ischemic Stroke:** blood vessel occlusion * 87% of strokes are ischmeic
30
**What is the most common type of stroke?**
Ischmeic (blood vessel occlusion)
31
**What is the most common cause of a hemorrhagic stroke?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
Hypertension
32
**What are common signs & symptoms of an ischmeic stroke** vertebrobasilar (posterior) circulation?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
* Dysarthria * Ataxia * Vertigo
33
**What is a TIA (transient ischemic attack)**
**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 ## Footnote Precursor to ischmeic stroke
34
**Why do hemorrhagic & ischemic strokes cause increased ICP?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY**
**Hemorrhagic:** amount of blood in brain increases the ICP **Ischemic:** cerebral edema leads to increased ICP
35
**What is the door to read time of a non-contrast CT if a patient is being considered for fibrinolytic therapy like TPA?**
45 minutes
36
**What are treatments for ischemic stroke?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
* **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
**What medications can NOT be given after administration of TPA?** | **KNOW THIS!!!!!! - RED, BOLD...KEISER**
Antithrombotic or anti-platelet-aggregating drugs **NO aspirin, heparin, warfarin, etc. for first 24 hours after tpa**
38
**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**
**Door to Doctor = 10 minutes** **Door to CT = 25 minutes** **Door to CT read = 45 minutes**
39
**What is the door to TPA time?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
**1 hour!!!!!!**
40
**How long can TPA run for (maximum)?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY**
4 hours
41
**What anti-hypertensive medication is used most often in patients with a stroke?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY**
Labetalol (Beta-blocker)
42
**What is a subarachnoid hemorrhage? What is the most common cause of SAH?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY**
**Bleeding into subarachnoid space** **Most Common Cause = TRAUMA** ## Footnote Usually caused by rupture of cerebral aneurysm or rupture of AVM
43
**What are signs & symptoms of a subarachnoid hemorrhage caused by a ruptured aneurysm?**
* Headache (excrutiating) * Nuchal rigidity * Diplopia * Photophobia * Blurred vision * Storke symptoms
44
**What therapy is used for a subarachnoid hemorrhage? What is the purpose of this therapy?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
**Triple H...** * **H**ypertensive * **H**ypervolemic * **H**emodilution **It stops the vasospam that's occuring**
45
**Signs & Symptoms of Epidural Hematomas** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
* **Luicid episodes** * **LOC** * **Rapid deterioration** ## Footnote If the patient bleeds too much then the **increased ICP causes herniation which leads to death**
46
**What is a subdural hematoma?**
Spontaneous or venous bleeding after trauma
47
**What is Diffuse Axonal Injury (DIA)?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
**Damage to the axons often from an accelerated, decelerating accident** (car crashes) **Neuro deficits are permanent** (axons cannot regenerate) ## Footnote Petechial hemorrhages within the brain on an MRI
48
**What is normal ICP range & what is ICP range for treatment?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
**Normal ICP = 0 - 15** *Treatment Range = 20 - 25)
49
**What is CPP and how is it calculated? What is the goal for maintaining CPP?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
Cerebral Perfusion Pressure **normal = 70 - 100**
50
**How do you calculate CPP?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
**CPP = MAP - ICP** **MAP = 1/3 (SBP - DBP) + DBP**
51
**Calcuate the CPP for a patient with a BP of 100/40 and an ICP of 20.**
**MAP = 1/3 (100 - 40) + 40** = 60/3 + 40 = 20 + 40 = 60 mmHg **CPP = MAP - ICP --> 60 - 20 = 40 ** **CPP = 40**
52
**What is a brain herniation?**
Increased ICP that pushes the brain out of position
53
**What medication is used to decrease ICP when it's caused by cerebral edema?** | **KNOW THIS!!!!!! - RED, BOLD, HAYLEY & KEISER**
**MANATOL**
54
**How can we tell if a patient has a brain herniation?**
**Cushing's Triad** * bradycardia * widened pulse pressure * decreased respirations (cheyne-stokes breathing)

Adult Nursing II - Exam 2 (4 decks)

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