week 9 flash part 2

Question 1

what is meningitis

Answer 1

infection of the meninges of the spinal cord
means something has entered the CNS

Question 2

Who is at risk for meningitis

Answer 2

people aged 16-21, or people who live in crowded situations like dorms

Question 3

how do you diagnose meningitis

Answer 3

LP to get CSF
check WBC count
Xray of chest, sinuses, and mastoid to try and find opening of infection

Question 4

what is kerning sign

Answer 4

bending leg up causes pain

Question 5

what is brudzinski sign

Answer 5

if you try and bend neck, knees come up

Question 6

what are the key signs of meningitis

Answer 6

headache, kerning sign, brudzinski sign, petechial rash

Question 7

what is the main goal to treat meningitis

Answer 7

prevent IICP

Question 8

which type of meningitis is a medical emergency `

Answer 8

bacterial meningitis

Question 9

what is the main priority of bacterial meningitis

Answer 9

get antibiotics immediately! if cultures dont come back, just use broad spectrum
priority is to give abx 1-2 hours after being ordered

Question 10

what are some other important aspects of care for a bacterial meningitis patient

Answer 10

transmission precautions
give medication to decrease ICP
close contact tracing

Question 11

where does viral meningitis come from

Answer 11

herpes, chicken pox, shingles, etc.

Question 12

whats another word for viral meningitis

Answer 12

aseptic meningitis

Question 13

what is a TIA

Answer 13

brief interruption of blood flow to the brain, usually a warning sign for a stroke

Question 14

how long do TIA symptoms last

Answer 14

30-60 minutes

Question 15

what are the main nursing assessments for a TIA

Answer 15

• focused neuro assessment
• ABCD (age, BP, Clinical TIA features, duration of symptoms)
  blood work, head CT, angio

Question 16

what is the ABCD assessment for a TIA

Answer 16

Age: over 60
BP: over 140/90
Clinical TIA features
Duration of symptoms: the longer the symptoms, the greater the risk of stroke

Question 17

what is the main procedure used to prevent
stroke

Answer 17

carotid endarterectomy (cut into carotid and remove plaque)

Question 18

what is an arteriovenous malformation

Answer 18

arteries/veins in the brain are malformed (can cause hemmorhagic stroke)

Question 19

what should you include for patient history in a stroke patient

Answer 19

• when did the symptoms begin and what was the patient doing at the time
• how did the symptoms progress
• LOC and GCS
• medical history, current meds, allergies

also assess airway and cough obviously

Question 20

what deficits would a patient have if they had a stroke in the right brain

Answer 20

• visual and spacial awareness
• patient will be unaware of deficits
• disoriented to time and place
• impulsive, poor judgement

Question 21

what deficits would a patient have if they had a stroke in the left brain

Answer 21

• dominant hemisphere,
• obvious deficits
• language, math, analytic thinking

Question 22

whats the difference in symptoms between a thrombotic and embolic stroke

Answer 22

thrombotic: thrombus in the brain or carotid artery, slow onset (evolves over minutes to hours)
embolic: dislodged clot, sudden onset with max deficits

Question 23

what causes embolic stroke

Answer 23

usually fib or valve issue

Question 24

what are the main risk factors for thrombotic stroke

Answer 24

DM and HTN

Question 25

how long after symptom onset are you allowed to give TPA

Answer 25

3-4.5 hours

Question 26

whats door to needle time

Answer 26

45 minutes

Question 27

what are the BP parameters when getting TPA `

Answer 27

under 185/110

Question 28

how often do you monitor vitals when getting TPA

Answer 28

• 10-15 mins during treatment
• 30 mins 6 hours after treatment
• 1 hour 24 hours after treatment

Question 29

what are some signs that you need to call a Dr. if a patient is getting TPA

Answer 29

• bad bleed
• nausea/vomiting
• headache
• increase BP

Question 30

what is something I just learned about warfarin

Answer 30

high alert drug that needs a two nurse check

Question 31

what is the priority treatment with a hemmorhagic stroke

Answer 31

remove blood
repair bleeding
treat IICP

Question 32

what are some signs of a hemmorhagic stroke

Answer 32

severe headache
seizures
nausea/vomiting

Question 33

what is a vasospasm

Answer 33

vessels slam closed
happens when brain is irritated

Question 34

when does a vasospasm in the brain usually happen

Answer 34

4-14 days after a stroke

Question 35

what do we do to prevent vasospasm

Answer 35

• keep SBP 150-160
• give CCB (nimodipine)

Question 36

what are parameters of CPP for people with brain injuries

Answer 36

70-100

Question 37

what are burr holes used for

Answer 37

subdural hematoma

Question 38

whats the difference between a thrombotic and an embolic stroke

Answer 38

thrombotic: slower onset
embolic: sudden onset

Question 39

what is the main treatment for Guillian barre syndrome

Answer 39

plasmapheresis, IVIG