Week 2: Neuro

Question 1

intracranial pressure

Answer 1

the pressure exerted bc of the combined total volume of the three components within the skull: brain tissue, blood, and CSF

Question 2

cerebral blood flow

Answer 2

the amount of blood in mL passing through 100g of brain tissue in 1 min

Question 3

cerebral perfusion pressure

Answer 3

pressure needed to ensure adequate brain tissue perfusion

Question 4

compliance

Answer 4

the expandability of the brain

Question 5

increased ICP

Answer 5

life threatening situation that results from an increase in any or all of the three components within the skull

Question 6

why is elevated ICP clinically significant

Answer 6

diminishes CPP, increases risks of brain ischemia & infarction, and is associated with a poor prognosis

Question 7

major complications of uncontrolled, increased ICP

Answer 7

inadequate cerebral perfusion and cerebral herniation

Question 8

gold standard for monitering ICP

Answer 8

ventriculostomy, in which a catheter is

inserted into the lateral ventricle and coupled to an external transducer.

Question 9

nursing goals for pt with increased ICP

Answer 9

(1) maintain a
patent airway, (2) have ICP within normal limits, (3) demonstrate normal fluid and
electrolyte balance, and (4) have no complications secondary to immobility and
decreased level of consciousness.

Question 10

head injury

Answer 10

any trauma to the scalp, skull, or brain. The term head trauma
is used primarily to signify cranio-cerebral trauma, which includes an alteration in
consciousness, no matter how brief.

Question 11

scalp lacerations

Answer 11

most minor type of head trauma. Because the scalp contains
many blood vessels with poor constrictive abilities, the major complications
associated with scalp laceration are blood loss and infection.

Question 12

skull fractures

Answer 12

frequently occur with head trauma. There are several ways to describe
skull fractures: (1) linear or depressed; (2) simple, comminuted, or compound; and (3)
closed or open.

Question 13

concussion

Answer 13

sudden transient mechanical head injury with disruption of neural
activity and a change in the LOC and is considered a mild brain injury.

Question 14

diffuse axonal injury

Answer 14

widespread axonal damage occurring after a mild,

moderate, or severe TBI.

Question 15

contusion

Answer 15

bruising of the brain tissue within a focal area. A contusion often
develops in areas of hemorrhage, infarction, necrosis, and edema and frequently
occurs near the site of a skull fracture.

Question 16

complications from head injury

Answer 16

epidural hematoma, subdural
hematoma, intraparenchymal or intracerebral hematoma, and traumatic subarachnoid
hemorrhage.

Question 17

epidural hematoma

Answer 17

collection of blood that results from bleeding between the

dura and the inner surface of the skull

Question 18

subdural hematoma

Answer 18

collection of blood that results from bleeding between the

dura mater and the arachnoid layer of the meningeal covering of the brain.

Question 19

intraparenchymal hematoma

Answer 19

collection of blood within the
parenchyma that results from bleeding within the brain tissue itself and occurs in
approximately 16% of head injuries.

Question 20

nursing goals for pt with acute head injury

Answer 20

(1)
maintain adequate cerebral oxygenation and perfusion; (2) remain normothermic; (3)
be free from pain, discomfort, and infection; and (4) attain maximal cognitive, motor,
and sensory function.

Question 21

tumours of the brain may be

Answer 21

primary, arising from tissues within the brain, or secondary, resulting from a
metastasis from a malignant neoplasm elsewhere in the body.

Question 22

why do brain tumours rarely metastisize

Answer 22

they are contained by structural (meninges) and

physiological (blood-brain) barriers.

Question 23

preferred tx of brain tumours

Answer 23

surgery

Question 24

nursing goals for pt with brain tumour

Answer 24

will (1) maintain
normal ICP, (2) maximize neurological functioning, (3) be free from pain and
discomfort, and (4) be aware of the long-term implications with respect to prognosis
and cognitive and physical functioning.

Question 25

stereotactic radiosurgery

Answer 25

procedure that involves closed-skull destruction of an intracranial target using ionizing radiation focused with the assistance of an intracranial guiding device. A sophisticated computer program is used while the patient’s head is held still in a stereotactic frame.

Question 26

nursing goals for pt with cranial surgery

Answer 26

(1) return to normal consciousness, (2) be free from pain and discomfort, (3) maximize neuromuscular functioning, and (4) be rehabilitated to maximum ability.

Question 27

meningitis

Answer 27

an acute inflammation of the meningeal tissues surrounding the brain and the spinal cord. Bacterial meningitis is considered a medical emergency.

Question 28

key signs of meningitis

Answer 28

Fever, severe headache, nausea, vomiting, and nuchal rigidity

Question 29

common causes of viral meningitis

Answer 29

``` enteroviruses, arboviruses, human immunodeficiency virus (HIV), and herpes simplex virus (HSV). ```

Question 30

encephalitis

Answer 30

acute inflammation of the brain, is a serious, and sometimes fatal, disease.

Question 31

brain abcess

Answer 31

accumulation of pus within the brain tissue that can result from a local or a systemic infection. Direct extension from ear, tooth, mastoid, or sinus infection is the primary cause.

Question 32

cerebrovascular accident

Answer 32

occurs when there is ischemia (inadequate blood flow) to a part of the brain or hemorrhage into the brain that results in death of brain cells. Functions such as movement, sensation, or emotions that were controlled by the affected area of the brain are lost or impaired.

Question 33

ischemic stroke

Answer 33

inadequate blood flow to the brain from partial or | complete occlusion of an artery, and account for approximately 87% of all strokes.

Question 34

transient ischemic attack

Answer 34

a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, but without acute infarction of the brain.

Question 35

thrombotic stroke

Answer 35

a blood clot forms in a diseased and narrowed blood vessel in the brain. If the narrowed lumen of the blood vessel becomes occluded, infarction occurs.

Question 36

embolic stroke

Answer 36

embolus lodges in and occludes a cerebral artery, | resulting in infarction and edema of the area supplied by the involved vessel.

Question 37

hemorrhagic stroke

Answer 37

account for approximately 15% of all strokes and result from bleeding into the brain tissue itself (intracerebral or intraparenchymal hemorrhage) or into the subarachnoid space or ventricles.

Question 38

subarachnoid hemorrhage

Answer 38

intracranial bleeding into the cerebro-spinal fluid–filled space between the arachnoid and pia mater membranes on the surface of the brain.

Question 39

motor deficits of strokes

Answer 39

``` impairment of (1) mobility, (2) respiratory function, (3) swallowing and speech, (4) gag reflex, and (5) self-care abilities. ```

Question 40

health management of strokes

Answer 40

on (1) BP control, (2) blood glucose control, (3) diet and exercise, (4) smoking cessation, (5) limiting alcohol consumption, and (6) routine health assessments.

Question 41

nursing goals of stroke pts

Answer 41

(1) maintain a stable or improved level of consciousness (2) attain maximum physical functioning (3) attain maximum self-care abilities and skills (4) maintain stable body functions (e.g., bladder control) (5) maximize communication abilities (6) maintain adequate nutrition (7) avoid complications of stroke (8) maintain effective personal and family coping

Question 42

migraine headache

Answer 42

a recurring headache characterized by throbbing pain, a triggering event or factor, strong family history, and manifestations associated with neurological and autonomic nervous system dysfunction. Some migraines are preceded by auras and/or prodromes.

Question 43

tension type headache

Answer 43

characterized by its bilateral location and pressing/tightening quality. Tension- type headaches are usually of mild or moderate intensity and can last from minutes to days.

Question 44

cluster headaches

Answer 44

are a rare form of headache with a sharp stabbing pain. Cluster headaches involve repeated headaches that can occur for weeks to months at a time, followed by periods of remission.

Question 45

auras

Answer 45

neurological symptoms such as visual field defects, tingling or burning sensations, paresthesias, motor dysfunction (e.g., weakness, paralysis), dizziness, confusion, and even loss of consciousness that usually precede the onset of migraine pain

Question 46

prodrome

Answer 46

(signs or symptoms that may precede a MH), includes psychic | disturbances, gastro-intestinal upset, and changes in fluid balance.

Question 47

seizure

Answer 47

transient, uncontrolled electrical discharge of neurons in the brain that interrupts normal function. Seizures are often symptoms of an underlying illness.

Question 48

epilepsy

Answer 48

condition in which a person has spontaneously recurring seizures (at least two, more than 24 hours apart) caused by a chronic underlying pathology.

Question 49

generalized seizures

Answer 49

characterized by bilateral synchronous epileptic discharges in the brain from the onset of the seizure. Because the entire brain is affected at the onset of the seizures, there is no warning or aura.

Question 50

tonic clonic seizure

Answer 50

characterized by loss of consciousness and falling to the ground if the patient is upright, followed by stiffening of the body (tonic phase) for 10 to 20 seconds and subsequent jerking of the extremities (clonic phase) for another 30 to 40 seconds.

Question 51

typical absence seizure

Answer 51

usually occurs only in children and rarely continues beyond adolescence. The typical clinical manifestation is a brief staring spell that lasts only a few seconds, so it often occurs unnoticed.

Question 52

atypical absence seizure

Answer 52

characterized by a staring spell accompanied by other signs and symptoms, includes brief warnings, peculiar behaviour during the seizure, or confusion after the seizure.

Question 53

focal seizures

Answer 53

caused by electrical activity | that is focal to a particular area of the brain, resulting in unilateral manifestations.

Question 54

status epilepticus

Answer 54

state of continuous seizure activity in which seizures recur in rapid succession without return to consciousness between seizures. It is the most serious complication of epilepsy and is a neurological emergency.

Question 55

multiple sclerosis

Answer 55

a chronic, progressive, degenerative autoimmune disorder of the CNS characterized by disseminated demyelination of nerve fibres of the brain, spinal cord, and optic nerves.

Question 56

MS characterization

Answer 56

by chronic inflammation, demyelination, and gliosis (scarring) in the CNS.

Question 57

parkinsons disease

Answer 57

progressive, neurodegenerative disease of the basal ganglia characterized by slowness in the initiation and execution of movement (bradykinesia), increased muscle tone (rigidity), tremor at rest, and impaired postural reflexes. It is the most common form of parkinsonism (a syndrome characterized by similar symptoms).

Question 58

myasthenia gravis

Answer 58

autoimmune disease of the neuro-muscular junction | characterized by the fluctuating weakness of certain skeletal muscle groups.

Question 59

MG cause

Answer 59

autoimmune process in which antibodies attack acetylcholine (ACh) receptors, resulting in a decreased number of ACh receptor sites at the neuro- muscular junction.

Question 60

myasthenic crisis

Answer 60

acute exacerbation of muscle weakness triggered by infection, surgery, emotional distress, drug overdose, or inadequate drugs in a person with MG. The major complications of MG result from muscle weakness in areas that affect swallowing and breathing, resulting in aspiration, respiratory insufficiency, and respiratory infection.

Question 61

restless leg syndrome

Answer 61

characterized by unpleasant sensory (paresthesias) and motor abnormalities of one or both legs. There are two distinct types of RLS: primary (idiopathic) and secondary.

Question 62

amyotrophic lateral sclerosis

Answer 62

a rare progressive neurological disorder characterized by loss of motor neurons and by weakness and atrophy of the muscles of the hands, the forearms, and the legs, spreading to involve most of the body and the face. ALS usually leads to death within 2 to 6 years after diagnosis.

Question 63

huntingtons disease

Answer 63

genetically transmitted, autosomal dominant disorder that affects both men and women of all races, and is characterized by chronic, devastating loss of all neurological function, resulting in dementia.

Question 64

HD s&s

Answer 64

abnormal and excessive involuntary movements (chorea) and psychiatric abnormalities. The chorea involves writhing, twisting movements of the face, limbs, and body. The movements get worse as the disease progresses.