week 10/11 neuro Flashcards
What are the characteristics of a left sided stroke?
- Paralyzed right side
- Speech-language deficits
- Slow, cautious behavioural style
- Memory deficits
What are the characteristics of a right sided stroke?
- Paralyzed left side
- Special perceptual deficits
- Quick impulsive behavioral style
- Memory deficits
name the different seizure phases, describe what happens in each
- prodromal
- precedes seizure with signs/ activities - aural
- sensory warning - ictal
- seizure - postictal
- rest/ recovery
What are the different types of seizures?
- metabolic related
- extra cranial related
- epilepsy
- generalized
- tonic-clonic
- typical absence
- atypical absence
- myoclonic
- atonic
- tonic
- clonic
- focal (partial)
- focal aware
- focal impaired awareness
in regards to the different types of seizures, describe a metabolic related seizure
- Results from systemic/ metabolic disturbances
- Acidosis
- Electrolyte imbalances
- Hypoglycemia
- Alcohol withdrawal - Not considered epilepsy
in regards to the different types of seizures, describe an extra cranial related seizure
originates from extra cranial disorders
- heart
- hypertension
- lungs
- kidneys
- diabetes
in regards to the different types of seizures, describe epilepsy
- Spontaneous recurring seizures occur more than 24hrs apart
- Caused by underlying chronic condition
- Abnormal neurons undergo spontaneous firing
What are the 3 types of epilepsy?
- generalized onset
- partial onset
- unknown onset
in regards to the different types of seizures, describe generalized seizures
- Bilateral synchronous epileptic discharges
- Affects whole brain
- No warning or aura
- LOS from seconds to minutes
What are the different types of generalized seizures?
- Tonic-clonic
- Typical absence seizures
- Atypical absence seizures
- Myoclonic
- Atonic
- Tonic
- clonic
in regards to the different types of seizures, describe tonic-clonic seizures
- Also known as grand mal
- LOS/ falling
- Body stiffens with jerking or extremities
- Cyanosis
- Excessive salivation
- Tongue/ cheek biting
- Incontinence
- May not feel normal for days
- No memory of seizure
in regards to the different types of seizures, describe typical absence seizures
- Also known as petit mal
- Only in children/ rarely in adolescence
- Cease/ develop into another type
- Brief LOS
- Can occur up to 100X/day if not treated
- Caused by hyperventilation/ flashing lights
in regards to the different types of seizures, describe an Atypical absence seizure
- Staring spells
- Brief warnings
- Peculiar behaviour during seizure
- Confusion after
- EEG atypical spike/ wave patterns
in regards to the different types of seizures, describe myoclonic seizures
- Sudden/ excessive jerk of body/ extremities
- Causes falls
- Brief/ may occur in clusters
in regards to the different types of seizures, describe atonic seizures
- tonic episodes
- loss of muscle tone
- falls
- Consciousness returns when person hits ground
- High risk for head injury
- Wear helmet
in regards to the different types of seizures, describe tonic seizures
- sudden onset of increased tone in extensor muscle
- falls common
in regards to the different types of seizures, describe clonic seizures
- Begin with LOC/ sudden loss of muscle tone
- Limb jerking may/ may not be symmetrical
in regards to the different types of seizures, describe focal (partial) seizures
- Electrical discharges from one area of brain
- Caused by focal irritations
- Begin in specific region of cortex
- Can be confined one side of brain or spread to entire thing
what are the 2 types of focal (partial) seizures?
- focal aware (simple)
- focal impaired awareness (complex partial)
in regards to the different types of seizures, describe focal aware seizures
- Simple motor, sensory phenomena with elementary symptoms
- No LOC
- Doesn’t last longer than 1 min
in regards to the different types of seizures, describe focal impaired awareness seizures
- Can involve behavioural, emotional, affective, sensory and cognitive function
- Lasts longer than 1 min
- Followed by confusion
- Involves lip smacking, automatisms
What are some nursing considerations when caring for a client with a seizure?
- Have padding lining bed
- Ensure patient in safe area
- Patent air way
- Stay with client until seizure passes
- Time/ observe seizure activity
- Do not restrain patient
- Turn patient on side
- Apply O2
- Do not insure anything in mouth
- Establish IV/ administer meds
- Suction prn
- Assist with ventilation
- Call code blue if needed
What are some nursing considerations when caring for a client at risk for a seizure?
- Implement seizure precautions
- Ensure patient is protected from injury
- Have padding lining bed
- Safety checks completed
What are complications resulting from alcohol withdrawal syndrome (AWS)?
- Hypertension
- Cardiovascular disease
- Liver disease
- Pancreatitis
- Gastritis
- Esophagitis
- Bone marrow suppression
- Chronic infectious diseases
- Cancer
- Depression/ anxiety
- Poor sleep
what are signs and symptoms of alcohol withdrawal syndrome (AWS)?
- Anxiety
- Shaky hands
- Sweating
- Nausea/ vomiting
- Confusion
- Fever
- High BP
- Hallucinations
What are some nursing considerations when caring for a client going through alcohol withdrawal syndrome (AWS)?
- hypovolemia/ dehydration
- malnutrition
- electrolyte imbalances
in regards to nursing considerations when caring for a client going through alcohol withdrawal syndrome (AWS), describe hypovolemia/ dehydration
- Diaphoresis
- Not enough water intake
- Poor appetite
- Nausea/ vomiting
- Alcohol is a diuretic (causes fluid loss)
in regards to nursing considerations when caring for a client going through alcohol withdrawal syndrome (AWS), describe malnutrition
- Alcohol causes gastritis/ pancreatitis
- People don’t eat well balanced diet when drinking
in regards to nursing considerations when caring for a client going through alcohol withdrawal syndrome (AWS), describe electrolyte imbalances
- Severely malnourished have low levels of potassium, calcium, magnesium, phosphorus
- At risk for refeeding syndrome
What patients are at risk for ICP?
- Chronic kidney failure
- Obese
- Thyroid condition
- women of childbearing age (20-45)
What are some signs/ symptoms of ICP?
- Changes in LOC
- Changes in vital signs
- Ocular signs
- Decrease in motor function
- Headache
- vomiting
what do nurses need to monitor when caring for a client who has ICP or is at risk for it?
- GCS, neurological function
- Vital signs
- Respiratory function
- Abdominal distension
- Pain/ anxiety
- Opioid/ sedative medication use
- ABGs
- Fluid/ electrolyte balance
- ICP
What position should a nurse place a patient’s bed at if they have ICP or are at risk of it?
HOB at 30 degrees
What are dermatomes?
areas on skin that are innervated primarily by a single spinal cord segment
what are the 4 sections of dermatomes? How many dermatomes are in each?
cervical - 7 dermatomes
thoracic - 12 dermatomes
lumbar - 5 dermatomes
sacral - 5 dermatomes
What is cranial nerve II?
optic nerve
What is cranial nerve III?
oculomotor
What is cranial nerve IV?
trochlear
What is cranial nerve VI?
abducent
What is cranial nerve IX?
glossopharyngeal
What is cranial nerve X?
vagus
What is cranial nerve XII?
hypoglossal
What are the different classifications of head injuries?
- scalp lacerations
- skull fractures
- head trauma
in regards to he different classifications of head injuries, describe scalp lacerations
- Most minor type
- Blood loss/ infection
in regards to he different classifications of head injuries, describe skull fractures
- Closed or open
- Intracranial infections/ hematoma
- Battle sign
- Bilateral periorbital ecchymosis
- CSF rhinorrhea/ otorrhea
in regards to he different classifications of head injuries, describe head trauma
- diffuse injury
- focal injury
What are some complications of head injuries?
- epidural hematoma
- subdural hematoma
- intraparenchymal/ intracerebral hematoma
- traumatic subarachnoid hemorrhage
in regards to complications of head injuries, describe an epidural hematoma
Collection of blood between dura/ inner surface of skull
in regards to complications of head injuries, describe a subdural hematoma
Collection of blood from bleeding between dura mater/ arachnoid layer of meningeal covering of brain
in regards to complications of head injuries, describe an intraparenchymal/ intracerebral hematoma
- Collection of blood within parenchyma
- Results from bleeding within brain tissue
in regards to complications of head injuries, describe a traumatic subarachnoid hemorrhage
- Results from traumatic force damaging superficial vascular structures in subarachnoid space
What are some nursing considerations when caring for a client with a head injury?
- ensure patent airway
- ensure IV access
- assess for CSF rhinorrhea/ otorrhea
what do nurses need to monitor when caring for a client with a head injury?
- spinal stabilization
- VS
- LOC
- GCS
- Neurological status
- Symptoms of ICP
- Fluid intake
What are some complications related to spinal cord injuries?
- spinal shock
- neurogenic shock
- autonomic dysreflexia
in regards to complications related to spinal cord injuries describe spinal shock
- Temporary neurological syndrome
- Decreased reflexes
- Loss of sensation
- Flaccid paralysis below level of injury
- Experienced by 50% of people with acute spinal cord injury
in regards to complications related to spinal cord injuries describe neurogenic shock
- Loss of vasomotor tone
- Hypotension/ bradycardia
- Loss of sympathetic nervous system innervation
- Peripheral vasodilation
- Venous pooling
- Decreased cardiac output
in regards to complications related to spinal cord injuries describe autonomic dysreflexia
- Uncompensated cardiovascular reaction caused by SNS
- Occurs in response to visceral stimulation
- Life threatening
- Injury level at T6+ may develop this
what is the most common precipitating factor for autonomic dysreflexia
distended bladder/ rectum
if resolution does not occur for autonomic dysreflexia what can it lead to?
- Status epilepticus
- Stroke
- Myocardial infarction
- Death
What are some nursing considerations when caring for a client with a spinal cord injury?
- Patent airway
- Adequate ventilation
- Adequate circulating blood volume
- Test muscle groups with/ against gravity
- Note spontaneous movements
- Sensory exam
- Position sense/ vibrations
