Neuro ch 65
A patient arrives to have an MRI done in the outpatient department. What information provided by the patient warrants further assessment to prevent complications related to the MRI?
"I am trying to quit smoking and have a patch on."
A patient comes to the emergency department with severe pain in the face that was stimulate by brushing the teeth. what cranial nerve does the nurse understand can cause this type of pain?
Cranial Nerve V: trigeminal
A patient had a lumbar puncture 3 days ago in the outpatient clinic and calls the nurse with complaints of a throbbing headache. What can the nurse educate the patient to do for relief of the discomfort? SATA
Force fluid (unless contraindicated) Get plenty of bed rest Take some OTC analgesics
The nurse is caring for a patient who was involved in a motor vehicle accident and sustained a head injury. When assessing deep tendon reflexes (DTR), the nurse observes diminished or hypo-active reflexes. how will the nurse document this finding?
1+ hypoactive
The nurse is assisting with a lumbar puncture and observes than when the physician obtains CFS, it is clear and colorless. What does this finding indicate?
A normal finding; the fluid will be sent for testing to determine other factors
Dopamine
Affects behavior, attention, and fine movement
A patient who has suffered a stroke is unable to maintain respiration and so is intubated and place on mechanical ventilator support. What portion of the brain is most likely responsible for the inability to breathe?
Brain stem
The preglanglionic fiber of the sympathetic neurons are located in the segment of spinal cord identified as
C8 to L3
The brain center responsible for balancing and coordination is the
Cerebellum
A patient is schedule for an electroencepahalogram (EEG) in the morning. What food on the patient;s tray should the nurse remove prior the test?
Coffee
The nurse is assessing the pupils of a patient who has had a head injury. What does the nurse recognize as a parasympathetic effect?
Constricted pupils
The nurse is performing an assessment of cranial nerves function and ask the patient to cover one nostril at a time to see the if the patient can smell coffee, alcohol, and mint. The patient is unable to smell any of the odors. The nurse is aware that the patient has a dysfunction of which cranial nerve?
Cranial Nerve I: Olfactory
The nurse obtains a Snellen eye chart when assessing cranial nerve function. Which cranial nerve is the nurse testing when using the chart?
Cranial Nerve II: Optic
How would the nurse differentiate delirium from dementia?
Delirium (transient mental confusion, usually with delusions and hallucinations) is seen in older adult patients who have underlying CNS damage or are experiencing an acute condition such as infection, adverse medication reaction, or dehydration. Dementia is a chronic and irreversible deterioration of cognitive status.
Parkinson's disease is caused by an imbalance in the neurotransmitter knows as
Dopamine
A patient is being tested for a gag reflex. When the nurse places the tongue blade to the back of the throat, there is not response elicited. What dysfunction does the nurse determine the patient has?
Dysfunction of the Vagus Nerve
Enkephalin
Excitatory; inhibit pain transmission
Cranial Nerve VII: Facial
Expression in forehead, eye, and mouth Taste
Cranial Nerve V: Trigeminal
Facial sensations chewing corneal reflex face and scalp sensations
Name the principal sign of lower motor neuron disease
Flaccid paralysis and atrophy of the affected muscles
A patient is having a lumbar puncture and the physician has removed 20 ml of cerebro-spinal fluid. What nursing intervention is a priority after the procedure?
Have the client lie flat for 6 hours
Cranial Nerve VIII: Vestibulocochlear
Hearing and equilibrium
the sleep-wake cycle regulator and the site of the hunger center is known as the
Hypothalamus
Cranial Nerve VI: Abducen
Lateral eye movement
What clinical manifestations occur when there is a destruction or dysfunction in the basal ganglia?
Leads to paralysis but not to muscle rigidity, disturbances of posture, and difficulty initiating changing of movement
Cranial Nerve III: Oculomotor
Most eye movement pupillary constriction upper eye lid elevation
Gamma-aminobutyric acid
Muscle and nerve inhibitory transmission
Acetylcholine
Primary excitatory; can produce vagal stimulation of the heart
The nurse is performing a neurologic test assessment and request that the patient stand with eyes open and then closed for 20 seconds to assess balance. What type of test is the nurse performing?
Romberg test
Cranial Nerve X: Vagus
Swallowing gag reflex talking sensation of throat larynx activities of thoracic and abdominal viscera (heart rate and peristalsis)
The lobe of the cerebral cortex that is responsible for understanding language and music is the
Temporal Lobe
The major receiving and communication center for afferent sensory nerves is the
Thalamus
What instructions does the nurse provide to an older adult patient prior laboratories studies and CT scan of the brain?
The Nurse should take in consideration the possibility of impaired hearing and slowed responses in the older adult. Provide instruction in an unrushed pace use reinforcement enhance learning and retention Material should short, concise, and concrete Vocabulary is matched to the patient ability, and terms are clearly defined. Provide adequate time to receive and respond to stimuli, learn, and react.
Cranial Nerve XII: Hypoglosal
Tongue movement
The parasympathetic division of the autonomic nervous system yields impulses that are medicated by the secretion of
acetylcholine, the dominant neurotrasmitter in parasympathetic nervous system function
Norepinephrine
excitatory response, mostly affecting moods
Cranial Nerve IV: Trochlear
eye movement - turns eyes down and in
Serotonin
inhibit pain pathways and can control sleep
serotonin
is a neurotransmitter that helps control mood and sleep
Cranial Nerve XI: Spinal Accessory
shoulder movement head rotation
Cranial Nerve I: Olfactory
smell
The master gland is also known as
the pituitary gland
What is the function of the blood-brain barrier?
this barrier is formed by endothelial cells of the brain capillaries, which form continuous tight junctions, creating a barrier to macro-molecules and many compounds
Cranial Nerve II: Optic
vision
Describe the role and functions of the autonomic nervous system
1. Regulates the activities of the internal organs such as the heart, lungs, blood vessels, digestive organs, and glands. 2. Maintenance and restoration of internal homeostasis is largely the responsibility of the ANS
The normal adult produces about
150 ml of CSF daily from the ventricles
A patient sustained a head injury during a fall and has changes in personality and affect. What part of the brain does the nurse recognize has been affected in this injury?
Frontal Lobe
A person's personality and judgment are controlled by the area of the brain known as the
Frontal Lobe
Voluntary muscle control is governed by a vertical band of "motor cortex" located in the
Frontal Lobe
A patient has expressive speaking aphasia after having a stroke. Which portion of the brain does the nurse know has been affected?
Inferior posterior frontal areas
A patient with memory deficit is brought to the hospital. What interventions does the nurse provide when assisting the patient to change into a gown or sitting in the examination table?
Institute safety and fall prevention
Cranial Nerve IX: Glosopharyngeal
Swallowing salivating taste