Problems affecting neurological Functions Flashcards by Kailash Jagessar

What is sensory aphasia?

Inability to comprehend spoken or written word

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What is aphasia?

Language function defective or absent due to injury of cerebral cortex

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What is motor aphasia?

Inability to use symbols of speech

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What is global aphasia?

Inability to understand spoken word or to speak

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What is dysarthria aphasia?

Poorly articulated speech usually a physical (muscle/nerve) problem

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Why do we culture CSF?

To diagnose specific conditions

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If protein is in CSF what can it indicate

Degenerative disease such as multiple sclerosis

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If WBC is in CSF what can it indicate

Infection

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If blood is in CSF what can it indicate

Hemorrhage

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What are the early stages of increased inter cranial pressure

Change in LOC
Personality changes
Change in ability to think
Headache, nausea
Diplopia (double vision)

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Later stages of IICP

Pupillary changes
Changes in BP (widen pulse pressure)
Change in respiration
High uncontrolled temp
Seizures
Posturing

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What is decorticate posturing

Feet plantar flexed
Legs internally rotated
Wrist and fingers flexed 
Elbows flexed
Arms addicted

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What is decerebrate posturing

Feet plantar flexed
Wrists and fingers flexed 
Forearms pronated
Arms adducted
Elbows extended

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Treatment of IICP

Surgery (craniotomy)
Medications osmotic diuretics to draw water from brain
Corticosteroids
Dilantin (anticonvulsant)

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How should bed be positioned for IICP

Elevated HOB 30-45 degrees

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What should be restricted in IICP

Fluid
Bearing down (valsava maneuver) which includes bearing down to push still
No gagging, coughing, or vomiting

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Should we suction with IICP

No, only when completely needed

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Why is a hypothermia blanket needed in IICP

Uncontrollable high temp that can’t be controlled with meds

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What is proprioception

Ability to know the position of the body and it’s parts without directly looking at the part

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What is agnosia

Total or partial loss of ability to recognize familiar objects or persons as a result of organic brain damage

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Involuntary muscle contractions due to an abnormal discharge of neurons in the brain

Seizure

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What is aura

Sensation that precedes migraine or seizure

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Prolonged seizure and person does not regain consciousness

Status epilepticus

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Nursing care for seizure

Seizure precaution

Protect person from aspiration or injury

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What are seizure precautions

Padded side rails | O2 and suction at bedside

Degenerative neurological disease where demyelination occurs

Multiple sclerosis

What is affected in multiple sclerosis

Motor function

Signs and symptoms of MS

Slow developing paralysis, speech and vision disturbances. Slurred speech, Diplopia, clumsiness, bowel and bladder incontinence

Test for MS

MRI to show myelin sheath change | CSF look for protein

What worsens symptoms of MS

Heat

Progressive brain disease that causes bradykinesia, tremors, mask like facial features and shuffling

Parkinson's disease

Treatment for Parkinson's

Levodopa and or surgery

Degenerative disease that destroys brain cells and affects short term memory

Alzheimer's disease

Amyotrophic lateral sclerosis is also known as

Lou Gerhrigs disease

Signs and symptoms of ALS

Weakness in upper extremities, dysarthria (problems with speech) dysphagia muscle wasting and difficulty breathing

Frequent cause of CVA

Cerebral thrombosis

Other causes of CVA

Brain hemorrhage or embolus that occludes artery causing ischemia

What is a TIA

Transient Ischemic Attack - short sudden temporary oxygen deprivation to the brain

When someone has a TIA what does it usually mean

It is a warning sign for a more serious attack (stroke) and means an underlying pathological condition

Signs and symptoms of CVA

Headache, numbness and tingling, inability to think clearly, visual problems, hemiparesis, hemiplegia, change in LOC, signs of IICP, aphasia

Test for CVA

Lumbar puncture and CT or MRI of brain

Hemiplegia, hemianopsia, aphasia, dysphasia, brain damage, pain, personality changes and dysphagia are all results of

CVA

What is hemianopsia

Blindness of 1/2 of visual field

Treatment of CVA

Physical therapy ROM and supporting affected limbs Yes and no answers to reduce frustration Safety needs

Excruciating pain along the 5th cranial nerve

Trigeminal neuralgia or tic douloureus

Treatment for Trigeminal neuralgia

Tegretol, surgery, neurontin

What triggers pain in Trigeminal Neuralgia

Slight touch, breeze, food, temperature change

What is Bell's palsy

Partial facial paralysis (unilateral) that affects 7th cranial nerve

Is Bell's palsy permanant?

Yes it goes away

Treatment for Bell's palsy

Steroids, heat, eye drops and patch.

What eye is affected in Bell's palsy

The eye on the affected side stays open

What is Guillain-Barré syndrome

Widespread inflammation and demyelination of peripheal nervous system

What causes Guillain barre?

Virus or autoimmune

What happens in Guillain barre

Paralysis moves from lower extremities to upper

What is the main concern with Guillain barre

Safety and respiratory if it travels up

Treatment for Guillain barre

Steroids, anti virals, g-tube | Trach & vent if respiration is affected

Inflammation of the meninges that can be caused by bacteria or a virus

Meningitis

Who is more susceptible to meningitis

Children

How is meningitis spread

Direct contact with respiratory secretions

Signs and symptoms of meningitis

``` Increase ICP Severe headache Nuchal rigidity Fever chills Seizures Positive kernigs and brudzinski signs ```

What is a positive kernigs sign

Inability to extend the leg towards the ceiling from the supine position with hips and knees flexed

What is a positive brudzinski sign

Flexing hip and knees when bringing head forward towards chest

What is diagnostic test for meningitis

Lumbar puncture - spinal tap

What kind of isolation is required for meningitis

Respiratory isolation - airborne

Signs and symptoms of intracranial tumor

Personality changes, abnormal sensations, visual problems, head ache, hearing loss, motor problems

Treatment for brain tumor

Craniotomy | Radiation and chemo if malignant

Important nursing intervention for craniotomy

Baseline neuro assessment pre operatively

Nursing intervention post op craniotomy

Vital signs Neuro status Respiratory function Leakage of CSF out of nose and Ear

Types of head injuries (cranial-cerebral trauma)

Open Closed Laceration

Example of an open head injury

Skull fracture or penetrating wound

Example of closed head injury

Concussion

Types of brain hemmorhage

Epidural hematoma | Subdural hematoma

What do we do for a person with head injury

Wake up every 2 hours, no pain meds

Why do we not medicate for pain with head injury

It will mask symptoms of possible worsening condition

Signs and symptoms of worsening head injury/increase intracranial pressure

Nausea and vomiting Loss of consciousness Decrease level of consciousness Pupil and VS change

If CSF is noted coming out of ears and nose what do we NOT do

Do not cough, sneeze or blow nose

If the spinal cord has a cervical injury what is our primary concern

Respiration

What are the 3 categories in the Glasgow Coma Scale

Eye opening Verbal Response Motor Response

To have weak, soft and to be lacking muscle tone is what kind of motor function

Flaccid function

Best way to prevent a migraine is to

Find out triggers

How is pulse pressure defines

SBP - DBP

High uncontrolled temperatures, Posturing changes (Decorticate, Decerebrate), Respiratory depression, and abnormal response to pain are signs of

Increased ICP

Flexion is what posturing

Decorticate

Extension is what posturing

Decerebrate

Blindness in 1/2 of the visual field is called

Hemianopsia

What is destroyed in Multiple sclerosis

Myelin sheath

What must the patient diagnosed with Multiple sclerosis avoid that may make symptoms worse

Heat

Bradykinesia, and tremors are signs of

Parkinsons

Another word for very slow movements

Bradykinesia

Problems articulating and forming words because of inability to control muscles is called ________ and is a symptom of ________

dysarthria | Amyotrophic Lateral Sclerosis (Lou Gehrig's)

What is the main cause of death for Amyotrophic Lateral Sclerosis (Lou Gehrig's)

Decreased respiratory and cardiac function

What is the surgery called for CVA

endarterectomy

For trigeminal Neuralgia what must we try our best to avoid

Care that involves touching the face

Unilateral paralysis occurs in

Bells palsy

What is the most common S&S of Meningitis

Nuchal rigidity