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NRSG 202 > week 10/11 neuro > Flashcards

week 10/11 neuro Flashcards

1
Q

What are the characteristics of a left sided stroke?

A
  • Paralyzed right side
  • Speech-language deficits
  • Slow, cautious behavioural style
  • Memory deficits
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2
Q

What are the characteristics of a right sided stroke?

A
  • Paralyzed left side
  • Special perceptual deficits
  • Quick impulsive behavioral style
  • Memory deficits
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3
Q

name the different seizure phases, describe what happens in each

A
  1. prodromal
    - precedes seizure with signs/ activities
  2. aural
    - sensory warning
  3. ictal
    - seizure
  4. postictal
    - rest/ recovery
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4
Q

What are the different types of seizures?

A
  • metabolic related
  • extra cranial related
  • epilepsy
  • generalized
  • tonic-clonic
  • typical absence
  • atypical absence
  • myoclonic
  • atonic
  • tonic
  • clonic
  • focal (partial)
  • focal aware
  • focal impaired awareness
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5
Q

in regards to the different types of seizures, describe a metabolic related seizure

A
  1. Results from systemic/ metabolic disturbances
    - Acidosis
    - Electrolyte imbalances
    - Hypoglycemia
    - Alcohol withdrawal
  2. Not considered epilepsy
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6
Q

in regards to the different types of seizures, describe an extra cranial related seizure

A

originates from extra cranial disorders

  • heart
  • hypertension
  • lungs
  • kidneys
  • diabetes
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7
Q

in regards to the different types of seizures, describe epilepsy

A
  • Spontaneous recurring seizures occur more than 24hrs apart
  • Caused by underlying chronic condition
  • Abnormal neurons undergo spontaneous firing
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8
Q

What are the 3 types of epilepsy?

A
  • generalized onset
  • partial onset
  • unknown onset
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9
Q

in regards to the different types of seizures, describe generalized seizures

A
  • Bilateral synchronous epileptic discharges
  • Affects whole brain
  • No warning or aura
  • LOS from seconds to minutes
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10
Q

What are the different types of generalized seizures?

A
  • Tonic-clonic
  • Typical absence seizures
  • Atypical absence seizures
  • Myoclonic
  • Atonic
  • Tonic
  • clonic
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11
Q

in regards to the different types of seizures, describe tonic-clonic seizures

A
  • 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
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12
Q

in regards to the different types of seizures, describe typical absence seizures

A
  • 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
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13
Q

in regards to the different types of seizures, describe an Atypical absence seizure

A
  • Staring spells
  • Brief warnings
  • Peculiar behaviour during seizure
  • Confusion after
  • EEG atypical spike/ wave patterns
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14
Q

in regards to the different types of seizures, describe myoclonic seizures

A
  • Sudden/ excessive jerk of body/ extremities
  • Causes falls
  • Brief/ may occur in clusters
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15
Q

in regards to the different types of seizures, describe atonic seizures

A
  • tonic episodes
  • loss of muscle tone
  • falls
  • Consciousness returns when person hits ground
  • High risk for head injury
  • Wear helmet
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16
Q

in regards to the different types of seizures, describe tonic seizures

A
  • sudden onset of increased tone in extensor muscle

- falls common

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17
Q

in regards to the different types of seizures, describe clonic seizures

A
  • Begin with LOC/ sudden loss of muscle tone

- Limb jerking may/ may not be symmetrical

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18
Q

in regards to the different types of seizures, describe focal (partial) seizures

A
  • 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
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19
Q

what are the 2 types of focal (partial) seizures?

A
  • focal aware (simple)

- focal impaired awareness (complex partial)

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20
Q

in regards to the different types of seizures, describe focal aware seizures

A
  • Simple motor, sensory phenomena with elementary symptoms
  • No LOC
  • Doesn’t last longer than 1 min
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21
Q

in regards to the different types of seizures, describe focal impaired awareness seizures

A
  • Can involve behavioural, emotional, affective, sensory and cognitive function
  • Lasts longer than 1 min
  • Followed by confusion
  • Involves lip smacking, automatisms
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22
Q

What are some nursing considerations when caring for a client with a seizure?

A
  • 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
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23
Q

What are some nursing considerations when caring for a client at risk for a seizure?

A
  • Implement seizure precautions
  • Ensure patient is protected from injury
  • Have padding lining bed
  • Safety checks completed
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24
Q

What are complications resulting from alcohol withdrawal syndrome (AWS)?

A
  • Hypertension
  • Cardiovascular disease
  • Liver disease
  • Pancreatitis
  • Gastritis
  • Esophagitis
  • Bone marrow suppression
  • Chronic infectious diseases
  • Cancer
  • Depression/ anxiety
  • Poor sleep
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25
Q

what are signs and symptoms of alcohol withdrawal syndrome (AWS)?

A
  • Anxiety
  • Shaky hands
  • Sweating
  • Nausea/ vomiting
  • Confusion
  • Fever
  • High BP
  • Hallucinations
26
Q

What are some nursing considerations when caring for a client going through alcohol withdrawal syndrome (AWS)?

A
  • hypovolemia/ dehydration
  • malnutrition
  • electrolyte imbalances
27
Q

in regards to nursing considerations when caring for a client going through alcohol withdrawal syndrome (AWS), describe hypovolemia/ dehydration

A
  • Diaphoresis
  • Not enough water intake
  • Poor appetite
  • Nausea/ vomiting
  • Alcohol is a diuretic (causes fluid loss)
28
Q

in regards to nursing considerations when caring for a client going through alcohol withdrawal syndrome (AWS), describe malnutrition

A
  • Alcohol causes gastritis/ pancreatitis

- People don’t eat well balanced diet when drinking

29
Q

in regards to nursing considerations when caring for a client going through alcohol withdrawal syndrome (AWS), describe electrolyte imbalances

A
  • Severely malnourished have low levels of potassium, calcium, magnesium, phosphorus
  • At risk for refeeding syndrome
30
Q

What patients are at risk for ICP?

A
  • Chronic kidney failure
  • Obese
  • Thyroid condition
  • women of childbearing age (20-45)
31
Q

What are some signs/ symptoms of ICP?

A
  • Changes in LOC
  • Changes in vital signs
  • Ocular signs
  • Decrease in motor function
  • Headache
  • vomiting
32
Q

what do nurses need to monitor when caring for a client who has ICP or is at risk for it?

A
  • GCS, neurological function
  • Vital signs
  • Respiratory function
  • Abdominal distension
  • Pain/ anxiety
  • Opioid/ sedative medication use
  • ABGs
  • Fluid/ electrolyte balance
  • ICP
33
Q

What position should a nurse place a patient’s bed at if they have ICP or are at risk of it?

A

HOB at 30 degrees

34
Q

What are dermatomes?

A

areas on skin that are innervated primarily by a single spinal cord segment

35
Q

what are the 4 sections of dermatomes? How many dermatomes are in each?

A

cervical - 7 dermatomes
thoracic - 12 dermatomes
lumbar - 5 dermatomes
sacral - 5 dermatomes

36
Q

What is cranial nerve II?

A

optic nerve

37
Q

What is cranial nerve III?

A

oculomotor

38
Q

What is cranial nerve IV?

A

trochlear

39
Q

What is cranial nerve VI?

A

abducent

40
Q

What is cranial nerve IX?

A

glossopharyngeal

41
Q

What is cranial nerve X?

A

vagus

42
Q

What is cranial nerve XII?

A

hypoglossal

43
Q

What are the different classifications of head injuries?

A
  • scalp lacerations
  • skull fractures
  • head trauma
44
Q

in regards to he different classifications of head injuries, describe scalp lacerations

A
  • Most minor type

- Blood loss/ infection

45
Q

in regards to he different classifications of head injuries, describe skull fractures

A
  • Closed or open
  • Intracranial infections/ hematoma
  • Battle sign
  • Bilateral periorbital ecchymosis
  • CSF rhinorrhea/ otorrhea
46
Q

in regards to he different classifications of head injuries, describe head trauma

A
  • diffuse injury

- focal injury

47
Q

What are some complications of head injuries?

A
  • epidural hematoma
  • subdural hematoma
  • intraparenchymal/ intracerebral hematoma
  • traumatic subarachnoid hemorrhage
48
Q

in regards to complications of head injuries, describe an epidural hematoma

A

Collection of blood between dura/ inner surface of skull

49
Q

in regards to complications of head injuries, describe a subdural hematoma

A

Collection of blood from bleeding between dura mater/ arachnoid layer of meningeal covering of brain

50
Q

in regards to complications of head injuries, describe an intraparenchymal/ intracerebral hematoma

A
  • Collection of blood within parenchyma

- Results from bleeding within brain tissue

51
Q

in regards to complications of head injuries, describe a traumatic subarachnoid hemorrhage

A
  • Results from traumatic force damaging superficial vascular structures in subarachnoid space
52
Q

What are some nursing considerations when caring for a client with a head injury?

A
  • ensure patent airway
  • ensure IV access
  • assess for CSF rhinorrhea/ otorrhea
53
Q

what do nurses need to monitor when caring for a client with a head injury?

A
  • spinal stabilization
  • VS
  • LOC
  • GCS
  • Neurological status
  • Symptoms of ICP
  • Fluid intake
54
Q

What are some complications related to spinal cord injuries?

A
  • spinal shock
  • neurogenic shock
  • autonomic dysreflexia
55
Q

in regards to complications related to spinal cord injuries describe spinal shock

A
  • Temporary neurological syndrome
  • Decreased reflexes
  • Loss of sensation
  • Flaccid paralysis below level of injury
  • Experienced by 50% of people with acute spinal cord injury
56
Q

in regards to complications related to spinal cord injuries describe neurogenic shock

A
  • Loss of vasomotor tone
  • Hypotension/ bradycardia
  • Loss of sympathetic nervous system innervation
  • Peripheral vasodilation
  • Venous pooling
  • Decreased cardiac output
57
Q

in regards to complications related to spinal cord injuries describe autonomic dysreflexia

A
  • Uncompensated cardiovascular reaction caused by SNS
  • Occurs in response to visceral stimulation
  • Life threatening
  • Injury level at T6+ may develop this
58
Q

what is the most common precipitating factor for autonomic dysreflexia

A

distended bladder/ rectum

59
Q

if resolution does not occur for autonomic dysreflexia what can it lead to?

A
  • Status epilepticus
  • Stroke
  • Myocardial infarction
  • Death
60
Q

What are some nursing considerations when caring for a client with a spinal cord injury?

A
  • Patent airway
  • Adequate ventilation
  • Adequate circulating blood volume
  • Test muscle groups with/ against gravity
  • Note spontaneous movements
  • Sensory exam
  • Position sense/ vibrations

NRSG 202 (11 decks)

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