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Fundies > Neurosensory > Flashcards

Neurosensory Flashcards

1
Q

first priority of a neuro assessment

A

Can they neurologically control their ABCs?

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2
Q

Who needs a focused neuro assessment?

A

has neuro disease, tremor, seizure, trauma, neurological change, drug-induced state, neuro abnormal finding in basic

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3
Q

4Hs of neurological changes

A

Hypoxia, hypoglycemia, hypoventilation, hypotension; check them first before moving on

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4
Q

Alert LOC

A

awake, easy to arouse, receptive and responsive

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5
Q

Lethargic

A

not fully alert, drifts off when unstimulated, awakens to name, slow to respond

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6
Q

obtunded

A

mostly asleep, hard shake or shout to wake, speaks but hard to understand

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7
Q

stupor or semi-comatose

A

can’t stay awake, groans and mumbles

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8
Q

comatose; light vs deep

A

no meaningful stimuli response, light coma—w/o purposeful movement, deep coma–no motor response

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9
Q

Comatose EMV

A

under 7-9

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10
Q

Brain injury EMV (severe, moderate, mild)

A

<8, 9-12, 13-15

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11
Q

proprioception

A

how you sense yourself in a space, action, and location

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12
Q

Lowest GCS score

A

3

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13
Q

coordination

A

rapid alternating movements like quickly touching each finger to your thumb

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14
Q

Nursing responsibilities for neuro deficits

A

monitor VS and LOC, basic vs focused assessment, report chx to HCP and include updates in report, PROTECT AIRWAY–lift head of bed

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15
Q

nursing care for neuro probs

A

calmly approach, assume they can hear you, fall safety, frequent rounding, may move closer to nurse station; good sleep, pain management (make sure you won’t mask neuro decline with meds), incorporate fam into care

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16
Q

Seizure precautions

A

Suction, oxygen, padded rails

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17
Q

x-ray

A

used for skull bones, common in kids; spinal–eval neck and back pain, degenerative changes; can be done with c-collar on

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18
Q

CT scan or CAT scan and what it detects

A

3D picture of organs, bone, tissue; detects hemorrhage, bone, vascular abnormalities, tumors, cysts

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19
Q

Contrast use, considerations, and route

A

Used for circulation on a CT; PO, IV, or rectal, iodine based; can be hard on the kidneys so force fluids

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20
Q

Nursing care for CT scan

A

informed consent and iodine allergies (for contrast), may be NPO, give anti-anxiety meds if claustrophobic

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21
Q

MRI

A

highly detailed 3D image of a slice of the brain; very expensive (last resort)

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22
Q

MRI considerations

A

screen for metal, remove med patches and tattoos–can cause burns; get MRI compatible oxygen and electrodes; may need anti-anx meds

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23
Q

EEG

A

monitors brain’s electrical activity, detect seizures, sleep disorders, helps to confirm brain death; completed while asleep, awake, or stimulated

24
Q

EEG considerations

A

may trigger seizures purposefully with lights, sound; electrodes stick very hard in hair

25
Q

3 parts of sensation

A

reception (stimuli), perception (interpretation), and reaction

26
Q

Fx influencing sensory function

A

extremes of age, meaningful stimuli, amount of stimuli, social interactions, environmental factors, cultural factors

27
Q

Hearing deficits

A

presbycusis, cerumen accumulation

28
Q

balance deficits

A

vertigo–dizzy and lack equilibrium

29
Q

Vision deficits

A

dry eyes, presbyopia, glaucoma, diabetic retinopathy, macular degeneration

30
Q

xerostomia

A

thicker mucus, dry mouth and loss of taste

31
Q

Tactile deficits

A

peripheral neuropathy, CNS injury, phantom pain

32
Q

communication deficits

A

neuromuscular control disease, expressive aphasia, receptive aphasia

33
Q

Expressive aphasia

A

know how they want to respond but just can’t, can’t name common objects

34
Q

Receptive aphasia

A

can’t understand written or spoken language

35
Q

Care with visual deficits

A

announce when you enter the room, speak pleasant and calm, not too loud, explain what you are going to do, assist with ambulation, orient to the room, items in reach, teach material in RED and ORANGE, use corrective devices

36
Q

Care with hearing deficits

A

amplify sounds, educate on hearing aides, use short sentences, communication board, ask how they can hear you best, use flashing lights for safety, slow speech in normal tones

37
Q

Considerations for olfactory deficits

A

smoke detectors, gas appliances, dangers of using strong chemicals, check food date and label

38
Q

Considerations for taste and smell deficits

A

well-seasoned food, separate textured foods, have appealing foods bc anorexia is concern, limit very strong odors and flavors

39
Q

Considerations for tactile deficits

A

touch therapy, turn and reposition esp with dec sensation, pt can have hyperesthesia (overly stimulating); dec irritating stim, avoid loose fitting linens; careful of water temp, ice/heat therapy (don’t use), well fitting shoes

40
Q

Sensory deprivation causes

A

isolation, loss of senses, confinement, emotional disorders, brain injury, prison, monks, amish

41
Q

Effects of sensory deprivation

A

Cognitive–dec problem-solving, dec ability to learn, dec attention; affective–cry, panic, anxious; Perceptual–dec color perception, time, and judgement

42
Q

Sensory deprivation considerations

A

give short amounts of stim thru day, tactile stim like brush hair, reorientation, encourage visitors/social stim but don’t overwhelm, environmental changes, assistive devices

43
Q

Sensory overload

A

excess stimulation can prevent the brain from blocking out certain stimuli

44
Q

causes of sensory overload

A

pain, lack sleep, dec problem-solving, ICU care, visitors/staff

45
Q

Things that can inc sensory overload

A

mood, lack of sleep, pain,

46
Q

Sx of sensory overload

A

fatigue, restless, anx, dec problem-solving

47
Q

Care for sensory overload

A

orient and assess orientation, control stimulation, create uninterrupted periods, be calm in room, schedule care and rest, visitor control, calm presence in room

48
Q

How to evaluate patients

A

ask them about sensory problems, observe the patient or self-demonstrate their skills

49
Q

Migraine

A

recurring headache characterize by unilateral throbbing pain, more common with family hx, fem between 25-49; may be preceded by aura

50
Q

Migraine/HA care

A

r/o intracranial or extracranial disease, give NSAIDs, Tylenol, Excedrin, high flo oxygen for cluster headaches–use for about 10 minutes, may do head CT

51
Q

Triptans

A

affect Sr receptors, dec inflammation and cause vasoconstriction; used for migraines–take at beginning of migraine or during aura but is NOT preventative–don’t take regularly for that

52
Q

Tension headache

A

most frequent in band around the forehead

53
Q

Migraine

A

usually unlateral in the temple on one side but pain can be bilateral

54
Q

Cluster headache

A

pain focused in and around 1 eye, may have face pain

55
Q

Sensory deprivation

A

Inadequate quality or quantity of stim

56
Q

What do you need to obtain before a CT?

A

Ask pt about iodine allergy and informed consent

57
Q

What colors are best for visual deficits?

A

Red and orange

Fundies (8 decks)

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