Week 4 Neurovascular

Question 1

Increased Intracranial Pressure (ICP)

Answer 1

Prolonged pressure above 15 mmHg

• Pathophysiology
• Causes
• Diagnostics and Tx
  + Ventriculostomy
  + Craniotomy
  + External ventricular drainage (EVD)
  + Cerebral perfusion pressure (CPP)
• Manifestations
  + Early s/s
  + GCS
  + Neurological assessment
  + Vitals
• Interventions (“ICP-SS”)
• Seizure precautions
• Complications

Question 2

Increased ICP Med: Osmotic diuretic

Answer 2

Mannitol

• MOA
• Goal
• SE

Question 3

Increased ICP Med: Hypertonic saline

Answer 3

3% saline

• MOA
• NI

Question 4

Increased ICP Med: Corticosteroids

Answer 4

Dexamethasone

• MOA
• NI

Question 5

Increased ICP Med: Barbiturates

Answer 5

Phenobarbital & Thiopental

• MOA
• NI

Question 6

Increased ICP Med: Anti-SZ

Answer 6

Phenytoin

• MOA
• NI

Question 7

Increased ICP Med: Opioids

Answer 7

Morphine sulfate or Fentanyl

• MOA
• NI
• Reversal agents

Question 8

Head injury

Answer 8

• Open v Closed
• Causes
• Types
  + Important nursing consideration
• Skull fracture manifestations
• Head injury assessments
• Base fractures

Question 9

Frontal lobe

Answer 9

• Personality
• Thinking, planning, problem solving
• Emotions
• Behavioral control
• Decision making

Question 10

Parietal lobe

Answer 10

• Object classification
• Perception/space
  + Visuospatial processing
• Numbers (i.e calculations)
  + Knowledge of numbers
• Spelling

Question 11

Temporal

Answer 11

• Language & hearing
• Aphasia
  + Receptive, expressive, global
• Memory, understanding, facial recognition, vision, speech, emotion

Question 12

Occipital lobe

Answer 12

• Vision, visual processing
• Color ID

Question 13

Cerebellum

Answer 13

• Balance
• Fine/gross motor skills
• Hand-eye coordination (finger-nose touch or heel-to-shin test)

Question 14

Brainstem

Answer 14

• Breathing & HR
• Regulates body temp & swallowing
• Components
  + Thalamus
  + Hypothalamus
  + Midbrain
  + Pons
  + RAS

Question 15

Cerebrovascular Accident (CVA) Stroke

Answer 15

• Pathophysiology
  +Affected bodily fxns
• Rx factors
• Manifestations
  + “BE FAST”
• Diagnostics
  + 1st test
  + Subsequent imaging
• Types of stroke
  + Ischemic v Hemorrhagic stroke
• Procedures
  + Coil embolization
  + Stent assisted coil embolization
  + Flow diversion
  + Clipping

+ Nursing assessment & priority interventions
+ Neuro assessments
+ Respiratory interventions
+ Cardiovascular
+ Nutrition
+ ADLs
+ Communication
+ Rehab

• Medication (tPA)

Question 16

Spinal Cord Injury (SCI)

Answer 16

Loss of mvt & sensation below injury

• Diagnostics
• Procedures
• Causes
• Key injury locations
  + Above T1 (C1-8)
  + C4
  + T6 & below
  + T1-12
  + L1-L5
  + S1-S5
• Immobilizers
• Assessments
  + Interventions
  + Emergency initial nursing care
  + Neurological assessment
  + Cardiac assessment
  + Respiratory assessment
• Types of SCI shocks
  + Spinal shock
  + Neurogenic (vasogenic) shock
• Complications
  + Autonomic dysreflexia
  + Orthostatic HOTN
• Continuous care
  + GI, GU, muscular, immobility, reproductive
• SCI classifications
  + Mechanism, level, & degree of injury
• Diagnostic studies
• SCI acute care
  + Emergency mgmt
  + Initial care
  + Initial assessment in ED
  + Additional assessment
  + Nonoperative stabilization
• Nursing assessments
  + Subjective v Objective data

Question 17

SCI Med: Vasopressors

Answer 17

Norepinephrine & Dopamine

• Use
• MOA
• NI

Question 18

SCI Med: Anti-muscarinic

Answer 18

Atropine

• Use
• MOA