Week 3 - Neurological Nursing Flashcards
What is intracranial pressure (ICP)?
The hydrostatic force measured in the brain’s cerebrospinal fluid (CFS) compartment
Normal range of ICP:
0-15mmHg
Clinical manifestations of high ICP:
- Changes in LOC
- Headache
- Seizures (impaired sensory and motor function)
- Posturing (decerebrate, decorticate, flaccid)
- Decreased motor function (change in mobility ability, posturing)
- Vomiting
What does FAST stand for in regards to stroke?
F - Has their face drooped?
A - Can they lift both arms?
S - Is their speech slurred and do they understand you?
T - Call 000, time is critical
Non modifiable risk factors of a stroke:
- Age
- Gender
- Genetics
- Ethnicity
Modifiable risk factors of a stroke:
- Hypertension
- Cardiac disease
- Obesity
- Type 2 diabetes
- Sleep apnea
- Smoking
- Excessive alcohol consumption
- Illicit drug use
- Lack of physical exercise
- Poor diet
What is an ischaemic stroke?
Blood flow to an area of the brain is reduced or blocked (occlusion of a vessel by clot or embolus). Brain cells are starved of blood - hypoxia and a lack of oxygen and nutrients, such as glucose.
What is a haemorrhage stroke?
A blood vessel supplying part of the brain breaks or bursts. Bleeding occurs into the brain tissue, taking up space and damaging local cells. Increase in ICP results, and oedema again, leading to further damage. Again, the area of the brain damage is called a cerebral infarct.
Types of haemorrhage strokes:
- Intracerebral
- Subarachnoid
What is an intracerebral haemorrhage?
Occurs when an artery bursts and bleeds into the brain. The most common cause of this is hypertension.
What is a subarachnoid haemorrhage?
Subarachnoid haemorrhage is bleeding on the surface of the brain; that is, above the pia mater and below the arachnoid membrane. The main causes of this are a bursting aneurysm and malformation of arteries or veins.
Factors that determine the effects of a stroke:
- Type of stroke
- Location of the blocked or burst artery
- Which area of the brain is damaged
- How much brain tissue is permanently damaged
- General health before the stroke
- Level of activity before the stroke
How is a stroke diagnosed?
A CT or MRI can determine the size of the stroke, and identify if it is haemorrhagic or ischaemic. CT angiography can be used to visualise the affected cerebral blood vessels. Blood tests (such as coagulation studies, electrolytes, renal and hepatic tests) and an ECG are often performed to obtain a clear clinical picture.
What is the medication Alteplase used for?
A common thrombolytic medication given to patients who have experienced ischaemic stroke.
Whats the difference between alzheimers disease and dementia?
Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Alzheimer’s is the most common cause of dementia. Alzheimer’s is a specific disease. Dementia is not.
What is vascular dementia?
Vascular dementia is the second most common cause of dementia, after AD. There are a few different types, but all include an interruption to the blood supply in the brain. The most common cause is stroke.
Common risk factors of vascular dementia include:
- Diabetes mellitus
- High blood pressure
- High cholesterol
- Coronary heart disease
- Peripheral artery disease
What is dementia with lewy bodies?
As the name suggests, Lewy Body dementia is caused by widespread abnormal aggregation of Lewy bodies, which are abnormal spherical structures, and develop inside nerve cells.
Clinical manifestations commonly associated with Lewy Body dementia:
- Visual hallucinations
- REM sleep behaviour disorder
- Parkinsonism
- Fluctuating cognition
What is Parkinson’s disease?
The destruction of neurons in the substantia nigra part of the midbrain. These particular neurons are responsible for the production of the neurotransmitter dopamine.
Motor symptoms of Parkinson’s (trap):
- Tremour
- Rigidity
- Akinesia
- Postural instability
What is epilepsy?
It is characterised by recurrent seizures, which are short episodes of involuntary movement that might involve a part of the body, or the entire body.
What are the 3 different types of seizures?
- Partial
- Generalised
- Continuous
3 phases of a seizure:
- Prodromal
- Aural/ictal
- Post ictal
