Med Surg Chapter 65

The nurse obtains a Snellen eye chart when assessing cranial nerve function. Which cranial nerve is the nurse testing when using the chart?

CN 2

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 hypoactive reflexes. How will the nurse document this finding?

0

Primarily excitatory, can produce vagal stimulation of heart

Acetylcholine

Describe the role and functions of the autonomic nervous system

Autonomic nervous system regulates the activities of internal organs such as the heart, lungs, blood vessels, digestive organs, and glands. Maintenance and restoration of internal homeostasis is largely the responsibility of the autonomic nervous system

A patent who has suffered a stroke is unable to maintain respiration and so is intubated and placed on mechanical ventilator support. What portion of the brain is most likely responsible for the inability to breathe?

Brain stem

The preganglionic fibers of the sympathetic neurons are located in the segments of the spinal cord identified as _______ to _______

C8 to L3

A patient comes to the emergency department with severe pain in the face that was stimulated by brushing the teeth. What cranial nerve does the nurse understand can cause this type of pain?

CN 5

A patient is scheduled for an EEG in the morning. What food on the patient's tray should the nurse remove prior to the test?

Coffee

What clinical manifestations occur when there is destruction or dysfunction in the basal ganglia?

Destruction or dysfunction of the basal ganglia leads not to paralysis but to muscle rigidity, disturbances of posture, and difficulty initiating or changing movement.

Affects behavior, attentions and fine movement

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 no response elicited. What dysfunction does the nurse determine the patient has?

Dysfunction of the vagus nerve

Excitatory, inhibits pain transmission

Enkephalin

Muscle and nerve inhibitory transmissions

Gamma aminobutyric acid

A patient is having a lumbar puncture and the physician has removed 20mL of cerebrospinal fluid. What nursing intervention is a priority after the procedure?

Have the patient lie flat for 6 hours

The 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

The nurse is performing a neurologic assessment and requests 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

Inhibits pain pathways and can control sleep

Serotonin

What is the function of the blood brain barrier?

This barrier is formed by the endothelial cells of the brain capillaries, which form continuous tight junctions, creating a barrier to macromolecules and many compounds.

The brain center responsible for balancing and coordination is the

cerebellum

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

Parkinson's disease is cause by an imbalance in the neurotransmitter known as

dopamine

Name the principle signs of lower motor neuron disease

flaccid paralysis and atrophy of the affected muscles

A persons personality and judgment are controlled by the are of the brain know as the ___________ lobe

frontal

Voluntary muscle control is governed by a vertical band of "motor cortex" located in to _______ lobe

frontal

The sleep-wake cycle regulator and the site of the hunger center is known as the

hypothalamus

The master gland is also known as the _______ gland

pituitary

A neurotransmitter that helps control mood and sleep

serotonin

The lobe of the cerebral cortex that is responsible for the understanding of language and music is the ________ lobe

temporal

The major receiving and communication center for afferent sensory nerves is the

thalamus

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

The nurse is performing as assessment of cranial nerve function and asks the patient to cover one nostril at a time to see 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?

CN 1

The normal adult produce about _________ of cerebrospinal fluid daily from the ventricles

150 mL

The nurse is assisting with a lumbar puncture and observes that when the physician obtains CSF, it is clear and colorless. What does this finding indicate?

a normal finding. the fluids will be sent for testing to determine other factors

A patient had a lumbar puncture 3 days ago in the outpatient clinic and calls the nurse with complaints of throbbing headache. What can the nurse educate the patient to do for relief of the discomfort?

Force fluids (unless contraindicated) Get plenty of bedrest Take some over the counter analgesics

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

Excitatory, response mostly affecting moods

Norepinephrine

The parasympathetic division of the autonomic nervous system yields impulses that are medicated by the secretion of ________, the dominant neurotransmitter in parasympathetic nervous system functions.

acetylcholine