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BEACON MedSurg/Peds > Test 3 Intracranial > Flashcards

Test 3 Intracranial Flashcards

1
Q

Acute focal neurologic deficit r/t a vascular disorder

A

Brain attack, aka stroke, aka CVA

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2
Q
  • risk factors for?
  • older age
  • male gender
  • african american
  • HTN
  • smoking
  • high cholesterol
  • diabetes
  • afib
  • polycythemia
  • sickle cell disease
  • atherosclerosis
A

risk factors for CVA

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3
Q

types of brain attack

A
  • transient ischemic attack
  • ischemic: thrombotic/embolic
  • hemorrhagic
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4
Q

-blood clot involved (embolism, or thrombosis) that impedes blood flow

A

ischemic

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5
Q

hypertension, aneurysm, AV malformations, blood disorders, decreasing clotting factors

A

hemorrhagic

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6
Q
  • obstruction of cerebral vessels
  • localized cerebral tissue hypoxia
  • oxygen depletion (10 seconds)
  • glucose and glycogen depletion (2-4 min)
  • intracellular ATP depletion (4-5) minutes
A

Ischemic pathogenesis

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7
Q

evolving stroke 3 areas

A

(from inside out) necrotic core–>penumbra–>normal tissue

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8
Q
  • occurs in larger vessels

- atherosclerotic plaques, particularly at points of arterial bifurcation

A

thrombotic stroke

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9
Q
  • site of origin
  • left heart, carotid arteries, aortic arch
  • predisposing conditions
  • afib, MI, ventricular aneurysm,rheumatic heart disease
A

cardiogenic embolic stroke

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10
Q

An area of penumbra without a necrotic core

-symptoms resolve within 24 hours

A

TIA, or mini stroke

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11
Q
  • rupture of a blood vessel
  • bleeding into brain
  • edema
  • compression of brain contents
  • spasm of adjacent vessels
A

Hemorrhagic stroke

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12
Q
  • Left-sided paralysis “hemiplegia”
  • Left-sided neglect
  • spatial-perceptual deficits
  • tendency to minimize or deny problems
  • impulsive
  • short attention span
  • impaired concept of time
  • impairment of judgement
A

Clinical manifestations of right brain damage

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13
Q
  • Right-sided paralysis “hemiplegia”
  • Aphasia: expressive/receptive
  • Slow/cautious behavior
  • Awareness of deficits: depression & anxiety
A

Clinical manifestations of left brain damage

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14
Q

thrombotic therapy can be given within…?

A

can be given within 3 hours of onset

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15
Q

antiplatelet drugs are _______with hemorrhagic CVA

A

contraindicated with CVA

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16
Q

spontaneous, abnormal, synchronous discharges from the cerebral cortex
-d/t a change in the excitability of a neuron or group of neurons

A

Seizures, aka convulsions

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17
Q
  • etiology
  • unprovoked: unknown “epilepsy”
  • provoked: hyperthermia (< age 5), metabolic disturbances, drugs, brain lesions, eclampsia in pregnancy
A

Seizures etiology

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18
Q
  • pathogenesis for?
  • Alterations in cell membrane permeability, ion distribution
  • inhibition of cortical or thalamic neuronal activity
  • excess acetylcholine
  • decreased gamma-aminobutric acid (GABA)
A

Seizure pathogenesis

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19
Q

Generalized or Partial?

-simultaneous onset of seizure activity in both hemispheres of the cerebral cortex

A

generalized seizure classification

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20
Q

Generalized or partial?

-activity begins in a localized area of one hemisphere

A

partial seizure classification

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21
Q
  • kind of seizure?
  • unilateral twitching
  • unilateral tingling or crawling sensations
  • conscious
  • Jacksonian epilepsy
  • Aura
A

Simple partial seizures

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22
Q

Jacksonian epilepsy

A

sequential involvement of body parts

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23
Q
  • type of seizure?
  • conscious but amnesic
  • may be provoked
  • repetitive movement
  • inappropriate behavior
A

Complex partial seizure

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24
Q

Type of seizure where there is a brief loss of consciousness, younger age

A

Generalized, absence seizures

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25
Q
  • preceeded by an aura: sensory simple partial seizure
  • tonic muscle tension
  • clonic muscle tension
  • clonic muscle jerking
  • incontinence (bowel and bladder)
  • postictal period
A

generalized, tonic-clonic seizure

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26
Q
  • dilantin
  • phenobarbital
  • mysoline
  • tridione
  • valium
  • depakene
  • clonopin
  • mesantoin
  • neurontin
  • lamictal
  • felbatol
  • cerebyx
A

Seizure medications, start low and go slow (often), often times taking more than one

27
Q

partial seizures can become?

A

can become generalized seizures

28
Q

4 seizure precautions

A
  • oxygen and suctioning equipment
  • IV access
  • Bed in low position
  • Padded side rails
29
Q

postictal period

A
  • groggy, tired, achy

- period following tonic/clonic seizure

30
Q

during seizure do ? (5 things)

A
  • lower to the floor, pillow under head, don’t restrain
  • no bite block or padded tongue blade
  • prevent aspiration
  • turn side; loosen clothing around neck
  • document everything
31
Q
  • a change in perception of sensory stimuli
  • examples are vision and hearing losses such as those caused by cataracts, glaucoma, and presbycusis (steady loss of hearing acuity that occurs with aging).
A

Sensory deficit

32
Q
  • a state of reduced sensory input from the internal or external environment
  • individuals can experience sensory deprivation as a result of illness, trauma, or isolation
A

sensory deprivation

33
Q

vagal nerve stimulator

A
  • used when they can pinpoint where the seizure activity is coming from
  • can help control the excessive hyper-exciteability
34
Q
  • myopia (nearsightedness: problems far away)
  • hyperopia (farsightedness: problems close up)
  • astigmatism
  • presbyopia (loss of accommodation of the eye that occurs as we get older)
A

visual deficits

35
Q
  • diabetes, HTN, Grave’s disease, infections (CMV, TB), vitamin deficiencies, immunosuppression (AIDS, Herpes)
  • all types of disorders that effect?
A

systemic disorders that affect the eye

36
Q
  • inflammation of the conjunctiva

- etiology: bacterial, viral, or rickettsial organisms, allergens, or irritants

A

Conjunctivitis, aka “pink eye”

37
Q
  • increased ocular pressure resulting from inadequate drainage or overproduction of aqueous humor
  • pressure leads to damage of retina and optic nerve
  • increased incidence: aging; African-Americans
A

Glaucoma

38
Q
  • most common type of glaucoma
  • bilateral
  • slow onset
  • usually painless
  • blurred vision
A

open angle glaucoma

39
Q
  • sudden onset
  • emergency
  • severe pain radiating around eyes and face
  • colored halos around lights
A

close angle glaucoma

40
Q
  • IOP
  • blurred vision
  • decreased accommodation
  • difficulty adjusting to darkness
  • all are____signs of?
A

Early signs of glaucoma

41
Q
  • loss of peripheral vision
  • decreased acuity (uncorrectable)
  • halos around lights
  • pain
  • all are____signs of?
A

Later signs of glaucoma

42
Q
  • miotics
  • sympathomimetic
  • beta blockers
  • carbonic anhydrase inhibitors
  • osmotic diuretcs
  • prostaglandin agonist
A

medications for glaucoma

43
Q

trabeculoplasty and iredectomy are both surgical procedures for?

A

surgical procedures for glaucoma

44
Q

3 types of glaucoma medications for increased drainage of aqueous humor?

A
  • Miotics
  • Pilocarpine hydrochloride (Isopto Carpine)
  • Osmotic Diuretcs
  • glycerin
  • Mannitol (Osmitrol)
  • Prostaglandin Agonists
  • Latanoprost (Xalatan)
45
Q

Glaucoma medications for decreased production of aqueous humor (3)

A
  • Beta Blockers
  • Timolol maleate (Timoptic)
  • CAI’s
  • Actetazolamide (Diamox)
  • Sympathomimetics
  • Dipivefrin (Propine)
46
Q

Surgical method that may be used in open-angle glaucoma if pharm rx ineffective or as primary rx
-laser rx to trabecular meshwork increases space between fivers and increased outflow of aqueous humor into conjunctivae

A

Trabeculoplasty

47
Q
  • Emergency rx for acute closed angle glaucoma

- Section of iris is removed to create pathway for flow of aqueous humor

A

Iridectomy

48
Q
  • An opacity of lens; distorts image
  • age related etiology=most common
  • All people > 70 y.o. have some degree
  • Etiology: Exposure to ultraviolet light, trauma, congenital defects, associated diseases
A

Cataract

49
Q
  • Clinical manifestations for?
  • blurred vision
  • decreased color perception
  • opacity of lens
  • absence of red reflex
  • vision better in dim light w/pupil dilation
  • gradual loss of vision
  • painless
A

Cataracts clinical manifestations

50
Q

Cataract surgical interventions?

A

Surgical removal of diseased lens and replacement with silicone prosthetic lens
-Extracapsular procedure, outpatient surgery

51
Q
  • eye is unpatched
  • dark glasses required
  • instill antibiotic-steroid eyedrops
  • mild itching normal
  • pain indicates complications
  • reduce IOP
  • prevent infection
  • assess for bleeding
A

cataract post-op care

52
Q

Signs of complication for cataracts

A
  • sharp, sudden pain in eye
  • bleeding or increased discharge
  • lid swelling
  • decreased vision
  • flashes of light or floating shapes
53
Q
  • Atrophy or deterioration of the macula, the point on the retina where light rays meet as they are focused by the cornea and lens of the eye.
  • The person loses central vision, but maintains peripheral vision.
  • Commonly associated with aging process.
A

macular degeneration

54
Q

________ intake decreases risk and slows progression of macular degeneration

A

Antioxidant intake

55
Q

types of macular degenerations

A

dry and wet

56
Q

_______have increased risk for macular degeneration

A

Smokers increased risk

57
Q
  • Presbycusis
  • Cerumen drier
  • Tympanic membrane less elastic
  • bony ossicles and cochlea function diminish
  • changes in vestibular function
  • acuity diminishes
A

the aging process of the ear

58
Q
  • “mycin” drugs
  • salicylates
  • loop diuretcs, diamox
  • Quinine, Quinidine
A

Ototoxic medications

59
Q
  • Sound wave blocked d/t external or middle ear disorders
  • causes: inflammatory process, tumors, scar tissue on ossicles, otosclerosis
  • correctible
  • type of hearing loss?
A

Conductive hearing loss

60
Q
  • type of hearing loss?
  • pathological process of inner ear or 8th cranial nerve
  • causes: Trauma, ototoxic medications, loud noise exposure, presbycusis
  • PERMANENT and progressive
A

Sensorineural

61
Q
  • A conductive hearing loss secondary to a pathologic change of the bones in the middle ear
  • bony overgrowth around ossicles
  • fixation of bones
  • stapes fixation leads to conductive loss
  • inner ear involvement leads to sensorineural loss
  • family tendency
A

Otosclerosis etiology

62
Q

-Slowly progressing conductive loss
-Bilateral; may be worse in one ear
-Ringing/roaring tinnitus
-Loud sounds when chewing
-Negative Rinne test
-Weber test shows lateralization of sound
to ear with most conductive loss
*clinical manifestations of?

A

Clinical manifestations of otosclerosis

63
Q

Stapendectomy Fenestration

A

otosclerosis surgical intervention

  • removal of stapes
  • prosthesis places between incus and stapes footplate

BEACON MedSurg/Peds (21 decks)

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