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nursing 2300 (vicky hansen) > Unit 14 - Intracranial Regulation > Flashcards

Unit 14 - Intracranial Regulation Flashcards

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1
Q

Brain/Spinal Cord are part of the _____ nervous system

A

central

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2
Q

Cranial & Spinal nerves, autonomic/somatic systems are part of the _____ nervous system

A

peripheral

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3
Q

basic functional unit

A

neuron

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4
Q

many neurologic disorders are caused be an imbalance in _____

A

neurotransmitters

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5
Q

Meninges:
It also contains an ample supply ofblood vesselsthat deliverbloodto _____ tissue. Another important function of the meninges is that it produces _____. This clear fluid fills the cavities of thecerebral ventriclesand surrounds thebrainandspinal cord. Cerebrospinal fluid protects and nourishes CNS tissue by acting as a _____, by circulating _____, and by getting rid of _____ products.

A 
CNS
cerebrospinal fluid
shock absorber
nutrients
waste
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6
Q

_____: follows derma tones

A

shingles

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7
Q

Autonomic Nervous System:

- regulate activities of _____ _____/maintain and restore internal _____

A

internal organ

homeostasis

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8
Q

Sympathetic Nervous System and Parasympathetic nervous system are part of the _____ nervous system

A

Autonomic

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9
Q
  • “fight or flight” responses

- main neurotransmitter is norepinephrine

A

sympathetic nervous system

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10
Q
  • controls mostly visceral function
A

parasympathetic

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11
Q

autonomic nervous system is regulated by centers in the…

A

spinal cord
brainstem
hypothalamus

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12
Q

mental status, intellectual function, thought content, emotional status, language ability, impact on lifestyle

A

consciousness/cognition

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13
Q

muscle size, muscle tone and strength, coordination and balance, Romberg test

A

motor system

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14
Q

tactile sensation, superficial pain, temperature, vibration and position sense (proprioception)

A

sensory system

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15
Q

DTRs, biceps, triceps, brachioradialis, patellar achilles, superficial, pathologic, plantar (Babinski)

A

reflexes

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16
Q

Neurological assessment includes what 5 things?

A
  • consciousness/cognition
  • cranial nerves
  • motor system
  • sensory system
  • reflexes
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17
Q

Important to distinguish normal aging changes from abnormal changes

A

gerontologic considerations

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18
Q

Alterations to intracranial regulation

  • affected by _____ or _____
  • brain function deterioration usually follows a predictable progression, that is, a pattern in which _____ _____ of function are impaired initially
A
  • affected by illness or injury
  • brain function deterioration usually follows a predictable progression, that is, a pattern in which higher levels of function are impaired initially
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19
Q

_____ of ______ and ______ is the most important indicator of the patient’s condition

A

level of responsiveness & consciousness

20
Q

_____ is a continuum from normal alertness and full cognition (consciousness) to coma

A

LOC

21
Q

altered LOC is not the disorder but the result of _____

A

pathology

22
Q

unconsciousness, unarousable unresponsiveness

A

coma

23
Q

unresponsiveness to the environment, makes no movement or sound but sometimes opens eyes

A

akinetic mutism

24
Q

devoid of cognitive function but has sleep-wake cycles

A

persistent vegetative state

25
Q

inability to move or respond except for eye movements due to a lesion affection the pons

A

locked-in syndrome

26
Q

bilateral _____ should be included in a neurological assessment

A

symmetry

27
Q

The GCS (Glasgow Coma Scale) is a standardized system for assessment of _____. A score of _____ indicates full alertness and a score of _____ or less is usually indicative of coma; the lowest possible score is _____. The client’s score is low so the nurse should follow the _____ (airway, breathing, and circulation) of care in this case.

A 
consciousness
15
8
3
ABCs
28
Q

Kernig’s sign (after Waldemar Kernig (1840–1917), a Russian neurologist) is positive when the thigh is flexed at the hip and knee at _____ degree angles, and subsequent extension in the knee is _____ (leading to resistance).

This may indicate _____ hemorrhage or meningitis manifestations of a sore neck, chills, fever, and photophobia are consistent with meningitis. Assessing for the Brudzinski sign (is, is not) a routine part of the physical assessment.

A 
90
painful 
subarachnoid 
meningitis 
is not
29
Q

Severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed.

A

Brudzinski’s sign

30
Q

Increased Intracranial pressure ( ICP):
A _____, quiet room is important to reduce stimuli. Family members should be encouraged to talk to the client in a _____ voice with minimal touching. Visitors should be limited. Care should be provided throughout the day for short periods of time to limit extended stress and stimulation. Elevating the head of the bed is important to reducing intracranial pressure but has no effect on stimulation.

A

dark

soft

31
Q

is a potent diuretic which, if given in excessive amounts, may lead to profound diuresis with water and electrolyte depletion. Therefore, careful medical supervision is required, and dose and dose schedule must be adjusted to the individual patient’s needs

A

EDECRIN* (Ethacrynic Acid)

32
Q

_____ _____ are commonly used to reduce ICP

A

Loop diuretics

33
Q

_____ such as _____ are used alone or in combination with a hypothermia blanket to treat hyperthermia

A

Antipyretics

acetaminophen

34
Q

Gastrointestinal _____ with intravenous _____ H2 _____ are often used because clients with IICP are at increased risk for developing stress gastritis and ulcers

A

prophylaxis
histamine
antagonists

35
Q

Antibiotics (are, are not) routinely prescribed as treatment for IICP.

A

are not

36
Q

because of limited space in the skull, an increase in any one of components of the skull (brain tissue, blood, CSF) will cause a change in the volume of the others

A

Monro–Kellie hypothesis

37
Q

Compensation to maintain a normal ICP of _____ to _____ mm Hg is normally accomplished by shifting or displacing CSF

A

10 to 20

38
Q

Increased ICP _____ cerebral perfusion and causes _____, cell death, and (further) edema

A

decreases

ischemia

39
Q

Brain tissues may shift through the dura and result in _____

A

herniation

40
Q

refers to the brain’s ability to change the diameter of blood vessels to maintain cerebral blood flow

A

autoregulation

41
Q

decreased CO2 results in _____, and increased CO2 results in _____

A

vasoconstriction

vasodilatation

42
Q

Early or Late manifestations of increased ICP?

Changes in LOC
Any change in condition
Restlessness, confusion, increasing drowsiness, increased respiratory effort, purposeless movements
Pupillary changes and impaired ocular movements
Weakness in one extremity or one side
Headache: constant, increasing in intensity, or aggravated by movement or straining

A

Early

43
Q

Early or Late manifestations of increased ICP?

Respiratory and vasomotor changes
VS: Increase in systolic blood pressure, widening of pulse pressure, and slowing of the heart rate; pulse may fluctuate rapidly from tachycardia to bradycardia; temperature increase
Cushing triad: bradycardia, hypertension, bradypnea
Projectile vomiting
Further deterioration of LOC; stupor to coma
Hemiplegia, decortication, decerebration, or flaccidity
Respiratory pattern alterations including Cheyne–Stokes breathing and arrest
Loss of brainstem reflexes: pupil, gag, corneal, and swallowing

A

Late

44
Q

Position with head in neutral position and elevation of HOB _____ to _____ degrees to promote venous drainage/Avoid extreme head rotation

A

0 to 60

45
Q

Instruct patient to avoid coughing, sneezing, or nose blowing, which may increase the risk of CSF _____

A

leakage

nursing 2300 (vicky hansen) (64 decks)

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