Neuro Ch 27-29
Small patches of demyelination of white matter of the optic nerve, brain and spinal cord?
Myathenia gravis
What set of vital signs would indicate a rise in ICP
162/62 > 52
When is TPA given to pt?
3 to 4.5 hours
partial seizure (simple or complex)
Affect part of one cerebral hemisphere and consciousness is not impaired
Nurse is preparing a client who is scheduled to have a cerebral angiography performed. What should the nurse check before procedure?
Allergy to iodine or shellfish
Client w/spinal cord injury has experienced more than one episode of automatic dysreflexia. The nurse should avoid which action that could trigger an episode of this complication?
Allowing the clients bladder to become distended
Spinal cord injury for signs of spinal shock. What sign is indicative of this complication of spinal cord injury?
Areflexia below the level of injury
Nursing preparing a plan of care for a client w/Stroke who has global aphasia. Nurse incorporates communication strategies in plan of care knowing clients speech should fit which characterization?
Associated w/poor comprehension
What is Guillain-Barre syndrome?
Autoimmune neurological disorder, attacks part of the peripheral nervous system, acute inflammatory, effects motor and sensory
Nurse is monitoring a client w/blunt head injury sustained from motor vehicle. What will indicate basal skull fx?
Bloody or clear drainage from auditory canal
Signs & sxs of ^ ICP
Blown pupil, low BP, ^ pulse
How is patient evaluated for meningitis?
CSF lab sample
Adrengic blockers are prescribed by the physician to treat?
Cardiac Arrhythmias > hypertension
Decorticate injured
Cerebral hemisphere
Drugs that block the actions of the parasympathetic nervous system are called?
Cholinergenic blockers
Nurse preparing to care for a client w/stroke. Nurse notes clients record the client had anosognosia. Nurse plans care know characteristics of anosognosia?
Client neglects the affected side
Client w/T4 spinal cord injury is to be monitored automatic dysreflexia (hyperreflexia). What sign is indicative to complication?
Complains of headache, & BP elevated
status epilepticus
Continuous or repeated seizures in rapid for 30 min or more
Nurse caring for client w/aneurysm who has precautions and is monitoring signs of aneurysm rupture. Early signs are?
Decline in LOC
ALS aka Lou Gehrig signs and sxs
Degenerative neurologic disease ... progresses rapidly and death ensures approx 3 yrs after diagnosing
How is trigeminal neuralgia treated?
Dilantin and tegretol
Nurse admitting a w/Guilian Barre syndromes to the nursing unit. Client has ascending paralysis to the level of the waist. What should be in client room d/t complications of disorder?
Electorcardiographic monitoring electrodes & intubation tray
generalized seizures (grand mal w/tonic - clonic & postictal Phase)
Entire brain from onset and consciousness is lost
Most important referral for Huntingston dx?
Genetic testing
Treatment meningitis
HIB and Meningococcal vaccine
Cushing triad
HTN, bradycardia and widening pulse pressure
Nurse collecting neurological data on a post stroke adult client. What technique should nurse perform the adequately check proprioception?
Hold the sides of the clients great toe, and while moving it, ask what position it is in
MS signs and sxs
Hyperactive deep tendon reflexes, vision changes, fatigue and spasticity are all symptoms of MS
Mannitol is used for
ICP
Nurse is caring for client w/ICP. Which change in vital signs would occur?
Increasing temp. & BP decreasing pulse & resp.
What causes meningitis?
Inflammation of the meningeal coverings of brain and spinal cord
What is the most accurate indicator of neurological status
LOC
What does neuro exam entail
LOC, pupillary evil, neuromuscular response and vital signs
absence seizure (petit mal)
Lasting 10-30 secs no consciousness lost
Decerebrate injured
Midbrain
Client has experienced myasthemic crisis. The nurse collects data to determine whether the client has experienced which precipitating factor?
Omitted doses of medication
Palilledema
Optic disk inflammation
What is trigeminal neuralgia?
Pain of the CN 5 (trigeminal n.)
Signs and sxs of bells palsby
Paralysis of 7th cranial nerve
Client w/stroke experiencing residual dysphasia. Nurse should remove which food items?
Peas
Client admitted to the hospital w/neuro prob indicate to the nurse that the MRI may be done. Which finding noted in the client hx indicated may be ineligible for diagnostic procedure?
Prosthetic valve replacement
Client has an impairment of cranial nerve 2. Nurse plans to do what to ensure patients safety w/this impairment?
Provide clear path for ambulatory w/o obstacles
What is Glasgow scale and what it measures
Rate patients eye opening response, motor response and verbal response
Nurse providing care to client w/pt ICP. Which approach would be beneficial in controlling clients environmental viewpoint?
Reducing environmental noise, maintain a calm atmosphere and allowing client uninterrupted time for sleep
Nurse is monitoring a client w/spinal cord injury experiencing spinal shock. Which assessment will provide the nurse w/best information about recovery spinal shock?
Reflexes
How to test for MG
Tensilon test
Jacksonian March
Term used when abnormal activity begin in one area and "marches" to adjacent motor areas
Parkinson's signs and sxs
Triad sxs: tremor, rigidity and bradykinesia
Nurse given suggestion to the client suggestion to the client w/Trigrminal neuralgia about strategies to minimize episodes of pain. The client needs more teaching by saying?
Try to eat my food either very warm or very cold
Client has a cerebellar lesion. Nurse determines that the client is adapting successfully to the prob if the client demonstrates proper use of?
Walker
Signs & sxs of myasthenia gravis
Weakness of voluntary muscle, ptosis and diplopia
epidural hematoma
a collection of blood in the space between the skull and dura mater
Decerebrate posturing
all four extremities in rigid extension away from the body (e's)
What causes MG?
antibodies attacking the acetocholine
Decorticate posturing
arms flexed inward and bent in toward the body and the legs are extended (c's)
Difference between bells palsy and stroke?
bell palsy is a disorder of the facial nerve
Nurse should assess the patient for what condition if spinal injury is at T1
bladder fullness
subdural hematoma
collection of blood under the dura mater
What condition can a patient not be roused by powerful stimuli
comatose
Adaption following CVS is considered successful if the following is present
consistent uses adaptive equipment and dresses self
Patient recovering from a stroke is suffering nutritionally because?
coughing while eating
Best injection site for paraplegic
deltoid
Patient w/ICP an appropriate resp. goal would be?
eliminate CO2
Paralysis and spinal shock is referred as
flaccid
Nurse should avoid what position when transferring a patient w/ICP
head turned to the side
Treatment areas for acute phase of stroke
hyperglycemia, hypertension and oxygenation
How to know if ICP is working?
increase urine output
TPA is used for what condition
ischemic stroke
Nursing care for patient w/C2 injury includes first priority of?
maintain airway w/jaw thrust
Drug is expected to be administered to reduce damage in 4 to 8 hrs
methylopredinsone
First priority in caring for a patient w/Guillan - Barre
monitor resp. status
C4 fx fitted w/halo traction instructions are?
move entire torso
Early sxs of ALS
muscle weakness of the hands
Patient w/ALS will eventually display?
paralysis of the extremities
Browns-Sequard syndrome
partial transection effecting half of the cord, same sensory
Patient w/ suspected meningitis can not extend their legs w/o extreme pain sign is
positive for kernig sign
Nurse test peripheral response to pain of unconscious patient?
pressing nail bed
Statement understanding ALS
progressive degenerative disease of the CNS
Why would a nurse administer ephinephrine?
prolonged bronchospasm
What assessment finding would indicate neurologic problem
pupils are sluggish to light
Best assessment about recovery from spinal shock?
reflexes
Patient w/ seizure in the bed the first action for nurse would be contraindicated?
restraining the limbs
jerking movements and reporting smell of bake apple pie
simple/partial seizure > sensory and motor
Nurse caring for patient w/trigeminal neurolgia would report what to the oncoming nurse?
time of last medication administration
Triad sxs for Parkinson's dx
tremor, bradykinesa and mask like appearance
Patient w/spinal cord injury exhibiting polkilothermia what is the appropriate nursing intervention?
warm the client
Male patient w/ droopy eye and occasional muscle weakness over 70 y.o. is most likely to have
Myasthenia Gravis