Neuro Med Surg

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

The therapeutic level for Phenytoin sodium

10-20

The PNS consists of how many pairs of cranial nerves?

12

The glasgow coma scale of a patient who is not neurologically impaired

15

After an angiogram pressure is held to the puncture site for

15 minutes

The incubation period for a person with WNV is

2-14 days

Lowest possible glasgow coma scale

3

Glasgow Coma Scale

3 part neuro assessment

The PNS consists of how many pairs of spinal nerves?

31

How many stages of AD are there?

4

The ultimate confirmation of Parkinsons diseasae

A positive response to a low dose trial of antiparkinsonian medication such as carbidopa-levodopa

The first sign that a patient may have MS

A proliferation of gamma delta T cells

Dementia

A set of symptoms caused by a disease

Battles Sign

A small hemorrhagic spot begind the ear

Deep brain stimulation (DBS)

A surgery for PD that consists of blocking impulses that are causing the tremors

Craniotomy

A surgical opening though the skull

Parkinsons Disease

A syndrome that consists of a slowing down in the initiation and execution of a movement, increased muscle tone, tremor, and impaired postural reflexes

Thymoma

A tumor of the thymus

Concussion

A violent jarring of the brain against the skull

MRA (Magnetic Resonance Angiography)

Can be done with or without contrast. Views the flow of blood in the brain

Traction-inflammatory headaches

Caused by infection, intracranial or extracranial causes, and temporal arteritis

Effects of severe head injury include

Cerebral edema, sensory and motor deficits, and increased ICP

Epilepsy

Characterized by reccuren seizures

Decorticate response

Characterized by the flexion of the arms, wrists, and fingers with abduction of the upper extremities, and extension, internal rotation, and plantar flexion of the lower extremities

CSF normal color

Clear

The subsequent jerking of the extremities that lasts for about 30-40 seconds during a Tonic-Clonic seizure

Clonic phase

Nursing interventions for patients with GBS

Closely monitor respiratory function

Comfort measures for headaches

Cold packs and a quiet, dark room

Nursing interventions and patient teaching for neuropathic pain

Comfort measures and promotion of rest and relaxation

A total transection may also be called a

Complete cord injury

Paralysis

Complete loss of function

CLosed head injuries include

Concussions, contusions, and lacerations

Brain stem

Consists of midbrain, pons, and medulla oblongata

Diencephalon

Contains thalamus and hypothalamus

Dysphagia places patients at an increased for

Aspiration

Prior to a myelogram a nurse should

Assess and document baseline lower extremity strength and sensation.

Meningitis can be classified as

Bacterial (septic), or viral (aseptic)

Psychomotor seizure

Behaves as if partially conscious, often appears intoxicated, complex hallucinations or illusions with the presence of an aura

Where is the needle inserted during a lumbar puncture?

Below the level of the spinal cord

Characteristic appearance of a patient with PD

Blank facial expression, forward tilt to posture, slow monotonous slurred speech, tremor, and short shuffling gait

Brain tumors include

Both benign and metastatic lesions

Effects of normal aging on the nervous system

Brain decreases in weight, loss in neurons, decrease in cerebral blood flow

Time lost is

Brain loss

Parts of the nervous system commonly subjected to trauma include

Brain, spinal cord, and peripheral nerves

Spinal cord extends from

Brainstem to L2

Many infections of the nervous system can be diagnosed by examining the

CSF

An angiogram places a patient at a high risk for a

CVA (stroke)

Second stage of AD

Obvious memory lapses, disoriented to time, loss of personal belongings is common as is confabulating, may lose ability to recognize familiar faces, places and objects, may get lost in familiar places, loss of impulses is common, as are behavioral changes

Increased ICP

Occurs suddenly, progresses rapidly, and requires surgical intervention

Cranial nerve III

Oculomotor. Testing of ability of eyes to move together in all directions; testing pupillary response

Crainial nerve I

Olfactory. Identifaction of common odors

CNS myelin is produced by

Oligodendrites

How should a client with PD lie in a bed?

On a firm matress, with no pillow

During a lumbar puncture the patient is positioned

On his/her side with head and knees flexed at an acute angle

Tetraplegic patients are those who sustain injuries to

One of the cervial segments of the spinal cord

Cranial nerve II

Optic. Testing of visual acuity and visual fields

Awareness associated with LOC has 4 components

Orientation, memory, calculation, fund of knowledge

Mental status assessment

Orientation, mood and behavior, general knowledge, short and long term memory, and attention span and ability to concentrate

Three types of medications to treat ICP

Osmotic diuretics, corticosteroids, and anticonvulsants

What is not a common symptom of MS?

Pain

Intractable

Pain that is unbearable and does not respon to treatment

Sensory and perceptional status assessment

Pain, touch, temperature, and proprioception

Hemiplegia

Paralysis of one side of the body

Paresis

Partial loss of function

Lumbar puncture is contraindicated in

Patients with an increased ICP, because it can cause the brain to herniate

Oriented times 4

Person, place, time, and purpose (or event)

Medication for preventing and controlling seizures

Phenytoin sodium

Atherosclerosis

Plaque buildup

Examples of neuropathic pain

Postherpetic neuralgia, diabetic neuropathies, trigeminal neuralgia, and phantom limb pains

Carbidopa

Prevents breakdown of levodopa

Aura

Prodominal signs that occur before a headache

Spastic

Prone to spasms, involuntary sudden movements or muscular contractions

Protection of what is important with Bell's Palsy?

Protection of the eye

Signs and symptoms of occular MG

Ptosis and diplopia

Immediate care after spinal cord injury is directed towards

Realignment of the body column in the presence of fractures or dislocations

Neuropathic Pain

Refers to pain originating from the PNS or CNS caused by direct stimulation of the myelinated fibers

Early stage of AD

Relatively mild memory lapses, may have difficulty using correct words, attention span decreased, disinterest in surroundings, depression may occur

MRI patient education

Remove jewelry, ask patient about any metal objects inside of body (pacemaker, orthopedic devices), educated patient that the machine makes a loud noise, and assess for fear of small spaces

Resection

Removing small area of brain that is experiencing the misfiring and causing the seizure

Why do seizures cause brain damage or death?

Repeated seizures cause the brain to use more energy than supplied and the neurons become tired and cease function

Pons

Respiratory center

What is the main cause of death in patients with MG?

Respiratory failure

Patients with ALS usually die from

Respiratory failure secondary to compromised respiratory function

As ICP increases

Respiratory paralysis occurs

Alert

Responds appropriately to auditory, tactile, and visual stimuli

Stupor

Responds to verbal commands with moaning or groaning, if at all; seems unaware of the surroundings

Parasympathetic

Rest and digest

Patient teaching for headache management

Rest and relaxation

Throughout all stages of hospitalization of the patient with a spinal cord injury, nursing and medical interventions are directed towards

Restoring structural or body integrity

The most common deficits of a stroke

Contralateral weakness

Hypothalamus

Controls body temperature

Cerebellium

Coordination of voluntary body movements

Choose an insect repellent that contains

DEET

What does Levodopa cause in PD?

Decrease in the severity of the symptoms

In parkinsons what is happening to dopamine and AcH?

Decreased dopamine, and increased AcH

Cushings response includes

Deepending, irregular respirations, widening pulse pressure, increased systolic pressure, and bradycardia

Hemianopa

Defective vision or blindness in half of the visual field

Ischemic stroke

Deficient blood flow to the brain from a partial or complete occlusion of an artery. Either thrombotic or embolic

Increased ICP must be

Detected early to be reversible

Thymectomy

Excision of the thymus

Trigeminal neuralgia is characterized by

Excrutiating, knifelike, or lightning-like shock in the lips, upper or lower gums, cheek, forehead, or side of the nose

The 4 categories of the FOUR Score Coma Scale

Eye response, motor response, brainstem reflexes, and respiration pattern

Cranial nerve VII

Facial. Ability of face to move in symmetry; identification of tastes

WNV meningitis is usually associated with a sudden onset of

Febrile illness, headache, chills, and neck pain

WNV encephalitis often have

Fever, headache, altered LOC, behavioral and speech disturbances, and other neurologic signs such as hemiparesis, seizures, and coma

Those who develop west nile fever have flulike manifestations of

Fever, headache, back pain, myalgia, and anorexia

Sympathetic

Fight or flight

Blown pupil

Fixed and dilated

Brudzinkis sign

Flexion of the hip and knee when the neck is flexed

CT with contrast may cause these symptoms, which are common

Flushing sensation and a metallic taste

The presence of Battles sign usually indicates

Fracture of a bone of the lower skull

Motor function assessment

Gait, stance, muscle tone, coordination, involuntary movements and the muscle stretch reflexes

ABG's

Gas levels may be altered with neurologic diseases

Global cognitive dysfunction

Generalized impairment of intellect, awareness, and judgment

Two types of MG

Generalized, and occular

Hunningtons Disease

Genetically transmitted autosomal dominant disorder that involves overactivity of dopamine pathways

Immediately before an angiogram a nurse should

Get baseline vitals, pusles and nuero check

After an angiogram the nurse should

Get vitals, encourage bed rest, do neuro checks, and assess the puncture site for a hematoma

AIDS patients that have ADC may exhibit difficulty concentrating, or a recent memory loss, which may progress to a

Global cognitive dysfunction

Cranial nerve IX

Glossopharyngeal. Identification of tastes

What must the client practice if they are on long term phenytoin?

Good oral hygiene

Myasthenia Gravis is also known as

Grave muscular weakness

If a patient has increased ICP what bed position should they be in?

HOB 30-45 degrees with neck in midline neutral position

EEG nursing roles

Hair and scalp must be cleaned before electrode placement

The second most common cause of neurologic injuries

Head injury

What is a common complaint after a lumbar puncture?

Headache

Clinical manifestations of brain abscesses

Headache and fever

Common symptoms with a suspected neurologic condition

Headache, clumsiness, change in visual acuity, any new or worsened seizures, numbness or tingling in one or more extremities, pain in an extremity of other part of the body, personality changes or mood swings, extreme fatigue or tiredness

Manifestations of encephalitis resemble those of meningitis but they have a more gradual onset and they include

Headache, high fever, seizures, and a change in LOC

Medulla Oblongata

Heartbeat, rhythm of breathing, swallowing, coughing, sneezing, vommiting, and regulation of blood pressure through dilation of blood vessles

Common long term disabilities associated with strokes are

Hemiparesis, inability to walk, complete or partial dependence in ADLs, aphasia, and depression

An aneurysm is often the cause of a

Hemmorrhage

Risk factors for neruological problems

High blood pressure, high cholesterol levels, smoking, obesity, stress, and lack of exercise

A patient with Hunningtons requires a diet

High in calories, typically 4000-500 calories

Once GBS is suspected what is essential?

Hospitalization

Drug holiday

Hospitalization, during which time all drugs are withdrawn

The single most modifiable risk factor associated with strokes

Hypertension

As ICP increases failure of the thermoregulatory center occurs causing

Hyperthermia

Cranial nerve XII

Hypoglossal. Tongue motion

How are medications given to a client having a seizure?

IV

Myelogram

Identifies lesions in spinal cord

Ataxia

Impaired ability to coordinate movements

In AD where does the neuronal damage primarily occur?

In the cerebral cortex

PET Scan

In this procedure the patient recieves an injection of deoxyglucose combined with radioactive fluorine. The area in question is scanned

Sensory or Receptive Aphasia

Inability to comprehend the spoken word or written word

Anomic Aphasia

Inability to name objects

Visual agnosia

Inability to recognize objects by sight

Motor Aphasia

Inability to speak or write, using symbols of speech

Global Aphasia

Inability to understand the spoken word, or to speak

A decreasing LOC is the earliest sign of

Increased ICP

Rigidity

Increased muscle tone

Changes in a patients LOC is one of the earliest signs of

Increasing ICP

The reactivation of HSV associated with Bell's Palsy causes

Inflammation, edema, ischemia, and eventual demyelination of the facial nerve, creating pain and disturbances in motor or sensory function

Patient education for an EMG

Inform patient that it is uncomfortable when the electrode is inserted and when the current is used and that their muscle may ache afterwards

Autonomic Nervous System

Involuntary. Transmits messages from CNS to smooth muscle, cardiac muscles, and certain glands

Stereotactic biopsy

Involves drilling a small hole through the patients skill, after which the tumor biopsy is obtained

Agnosia

Is a total or parial loss, as a result of organic brain damage, of the ability to recognize familiar objects by sight, touch, or hearing or to recognize familiar people through sensory stimuli

Semicomatose

Is in an inpaired state of consciousness, characterized by stupor, from which a patient can be aroused only by energetic stimulation

Levodopa

Is the most commonly prescribed medication for PD, which is converted to dopamine in the brain

Strokes are classified as

Ischemic or hemorrhagic

Why should the first specimen obtained during a lumbar puncture not be sent to the lab?

It may contain blood from the puncture site which would give a false sample

Two abnormal signs that occur with meningitis are

Kernigs sign, and Brudzinkis sign

Cerebrum

Largest part of the brain. Consists of left and right hemispheres.

Cushings response is a

Late sign of brain herniation

After a lumbar puncture the patient should

Lie flat for several hours

Amyotrophic Lateral Sclerosis (ALS)

Loss of both upper and lower motor neurons

Other symptoms of Bell's Palsy may include

Loss of taste, altered chewing ability, reduction of saliva on the affected side, pain behind the ear on the effected side, and ringing in the ear or other hearing loss

ALS is also known as

Lou Gehrigs disease

Primary function of autonomic nervous system

Maintain internal homeostasis

The most important nursing intervention for the client having a seizure

Maintaining an airway and providing safety

Neurotransmitters Norepinephrine

Maintaining arousal, dreaming, and regulation of mood

Sport, car, and swimming safety

Wear protective sports pads, wear seatbelts, no diving

Status epilepticus

When recurrent, generalized seizure activity occurs at such frequency that full consciousness is not regained between seizures

Direct trauma occurs

When the head is directly injured

Sundowning

When the patient becomes more confused and agitated in the late afternoon or evening

Supratentorial shift

When the pressure buildup is greater than the brains ability to compensate, pressure is exerted on the surrounding structures where the pressure is lower

Late signs of increased ICP and signs the brain is about to herniate

Widening pulse pressure, bradycardia, and abnormal respirations.

GBS results in

Widespread inflammation and demyelination of the peripheral nervous system

Micrographia

Words become tiny and different from earlier handwriting

The bacteria in meningitis cause

an inflammatory reaction in the pia mater, with pus accumulation in the arachnoid space high protein and white blood cell levels in the CSF, and possiblre injury to nervous tissue

Patient teaching and nurse interventions for patients with disturbances in muscle tone and motor function

Safety, skin care, activity, medications, good nutrition, ADLs, bladder care, and follow up care

PNS myelin is produced by

Schwann cells

Embolic stroke

Second most common cause of a stroke, they most frequently occur in the midcerebral artery

A tonic-clonic seizure can be treated with first aid, it is not necessary to

Send the patient to the hospital

Aura

Sensation that preceeds an attack, occurs a few seconds to a few minutes before seizure

Plasmapheresis

Seperates plasma from blood

Clinical signs of autonomic dysreflexia

Severe bradycardia, hypertension, diaphoresis, flushing, dilated pupils, blurred vision, restlessness, nausea, severe headache and nasal stiffness

The onset of meningitis is usually sudden and is characterized by

Severe headache, stiffness of the neck, irritability, malaise and restlessness

Terminal stage of AD

Severe mental and physical deterioration

PD rarely causes

Shaking of the head

Open head injuries result from

Skull fractures of penetrating wounds

Neurotransmitters Serotonin

Sleep, sensory perception, controls temperature, and plays role in mood control

The first most subtle clue to trouble in the brain is a

Slow, sluggish pupil reaction

Bradykinesia

Slowing down in the initating or execution of a movement

Ipsilateral pupil

Sluggish reaction on same side as the pressure

Fasciculations

Small, rapid muscle twitches

Cranial nerve XI

Spinal accessory. Shoulder and neck movement

During a myelogram dye is injected into the

Subarachnoid space

The clinical signs of an absence seizure

Sudden acant facial expression with eyes focused straight ahead

Absence seizure

Sudden impairment in or loss of consciousness with little or not tonic-clonic movement. With no presence of an aura

What is the most common cause of a seizure?

Sudden withdrawk from anticonvulsant medication

Aspetic (viral) meningitis is treated with

Supportive therapy, such as maintaining bed rest, ensuring fluid and electrolyte balance, and providing rest and comfort measures

Permanent relief of pain from trigeminal neuralgia is obtained by

Surgery

The general method of treatment for brain tumors includes

Surgival removal when feasible, radiation, and chemotherapy

Nonsurgical medical management for neuropathic pain

TENs unit, and accupuncture

The most important nursing intervention for the patient with sensory dysfunction is to

Teach the patient protective measures

Indirect trauma is caused by

Tension strains and shearing forces transmitted to the head by stretching the neck

The current standard for diagnosing WNV is by

Testing bloof or CSF with the immunoglobulin M, antibody capture enzyme-linked immunosorbent assay, and imminoglobulin G indirect ELISA

In GBS the antibodies attack

The Schwann cells, causing the sheath to break down and the uninsilated portion of the nerve to become inflammed

Carotid endarterectomy (CEA)

The artheromatous lesion is removed from the carotid artery to improve blood flow

The principal route of human infection with WNV is through

The bite of an infected animal mosquito

Seizures are classified according to

The features of the attack

What is happening to the myelin in MS?

The immune system is eating away at it

Kernings sign

The inability to extend the legs completely without extreme pain

Asprin

The most frequently used antiplatelet aggregation agent

A lesion on one side of the brain effects motor function on

The opposite side of the body

The first sign of improvement during recovery from Bell's Palsy

The recovery of taste

Craniectomy

The removal of part of the skull without replacement

Paraplegic patients are those who lesions are confined to

The thoracic, lumbarl, or sacral segments of the spinal cord

A primary brain tumor originates from

The tissues of the brain and forms when changes occur in the genetic structure of normal brain cells

In most spinal cord injuries

There is a period of flaccid paralysis and a complete loss of reflexes below the level of trauma

Bell's Palsy (Peripheral Facial Paralysis)

There is usually an abrupt onset of numbness, stiffness, or drawing sensation of the face

About 25% of patients with MG have been found to have a

Thymoma

Epidemic encephalitis is transmitted by

Ticks and mosquitoes

The goal of treatment for MS

To control symptoms

Goal of nursing management for a patient with Hunningtons

To provide the most comfortable environment possible by maintaining safety

The stiffening of the body that lasts for 10-20 seconds during a Tonic- Clonic seizure

Tonic phase

Third stage of AD

Total disorientation to person, place, and time, and motor problems

Severe traumatic lesions of the spinal cord may result in

Total transection of the spinal cord or tearing of the cord from side to side at a particular level, with a complete loss of spinal cord function

The classic triad consists of

Tremor, rigidity, and bradykinesia

Cranial nerve V

Trigeminal. Jaw strength, and sensation of face; corneal reflex

Cranial nerve IV

Trochlear. Tested with oculomotor; testing eye movement

What is a major problem with MS clients?

UTIs

Comatose

Unable to respond to painful stimuli; corneal and pupillary reflexes are absent, cannot swallow or cough, is incontinent or urine and feces, and electroencephalogram pattern demonstrates deceased or absent neuronal activity

Unilateral neglect

Unaware and unattentive to one side of the body

Proprioceptual problems

Unilateral neglect, and hemianopa

The exact cause of a migraine is

Unknown

FOUR Score Coma Scale

Used to assess patients with neurologic conditions that affect cognitive function. "User friendly"

Echoencephalogram

Uses ultrasound to depict intracranial structures of the brain

Cranial nerve X

Vagus. Gag reflex, movement of uvula and soft palate

Classification of headaches

Vascular, tension, and traction-inflammatory

Headaches occur by

Vasodilation

Areflexia

Vasodilation, increased venous capacity, and hypotension

An aneurysm often causes

Vasospasms

Auras commonly include

Viseal field defects, unusual smells or sounds, disorientation, paresthesias, and in care cases, paralysis

Clinical manifestations for MS

Visual problems, urinary incontinence, fatigue, weakness or incoordination of an extremity, sexual problems and difficulty swallowing

Angiogram

Visualizes the cerebral arterial system by injecting radiopaque material.

Somatic Nervous System

Voluntary. Sends messages from CNS to skeletal muscle

Flaccid

Weak, soft, and flabby. Lacking normal muscle tone

Primary symptioms of ALS

Weakness of the upper extremities, dysarthria, and dysphagia

Increased ICP is most commonly caused by

head injuries

The right side of the brain controls

the left side of the body

The left side of the brain controls

the right side of the body

Medications for neuropathic pain

Anticonvulsants, NSAIDs, and antidepressants

The primary treatment for brain abscess

Antimicrobial therapy

Trigeminal neuralgia is often treated with

Antiseizure medications and antispasmodic, muscle-relaxing agents

Neoplasm

Any abnormal benign or melignant mass

One can reduce the risk of becoming infected with WNV by

Applying insect repellent to exposed skin

Urine cultures

Are done to rule out infection

LOC has two components

Arousal and awareness

Aneurysm

A localized dilation of the wall of a blood vessle, usually caused by atherosclerosis and hypertension

Hyperrefliexia

A neruologic condition characterized by increased reflex actions

Carotid Duplex

A noninvasive study that evaluates carotid occlusive disease; often ordered after a patient has a TIA

People with MS do best in

A peaceful and relaxed environment

Cranial nerve VI

Abducens. Tested with oculomotor; testing eye movement

Seizures are the result of

Abnormal electrical activity within the brain

Clinical manifestations of Hunningtons

Abnormal, excessive, involuntary movements

Indirect trauma results in an

Acceleration-deceleration injury, with rotation of the skull and its contents

Cranial nerve VIII

Acoustic or vestibulochoclear. Testing of hearing through whisper or other means and checking equilibrium and balance

The first step in managing ICP

Adequate oxygenation

Postical period

After a seizure, complaints are usually of a headache, nausea, confusion, or drowsiness. This stage usually lasts about 30-50 minutes

Decerebrate response

All four extremities are in rigid extension, with hyper-pronation of the forearms and plantar extension of the feet

With a complete cord injury

All voluntary movements below the level of the trauma is lost

If a contrast is used in any procedure the nurse should assess for

Allergies

Clonus

Alternating contractions and partial relaxation of a muscle initiated by muscle stretching

Autonomic dysreflexia

An abnormal cardiovascular response to stimulation of the sympathetic division of the autonomic nercous system

Stroke

An abnormal condition of the blood vessles of the brain, characterized by hemorrhage into the brian or the formation of an embolus or thrombus that occludes an artery, resulting in ischemia of the brain tissue normally perfused by the damaged vessles

Aphasia

An abnormal neurologic condition in which the language function is defective or absent because of an injury to certain areas of the cerebral cortex

Brain abscess is

An accumulation of pus within the brain tissue that can result from a local or a systemic infection

Meningitis

An acute infection of the meninges

Encephalitis

An acute inflammation of the brain and is usually caused by a virus

Gullain-Barre Syndrome (Polyneuritis)

An acute, rapidly progressing, and potentially fatal form of polyneuritis

What is MG

An autoimmune disease of the neuromuscular junction, characterized by the fluctuating weakness of certain skeletal muscle groups

GBS is thought to be

An autoimmune reaction involving the peripheral nerves, most often following a respiratory or gastrointestinal viral infection

Transient Ichemic Attack (TIA)

An episode of cerebrovascular insufficiency with temporary episodes of neurologic dysfunction lasting less than 24 hours and often less than 15 minutes

Apraxia

An inability to carry out learned sequential movements on command, preform purposeful acts, or use objects properly

Halo Sign

An indication of CSF leakage

Alzheimers disease (AD)

A chronic, progressive, degenerative disorder that affects the cells of the brain and cause impaired intellectual functioning

Multiple Sclerosis

A chronic, progressive, degenerative neurologic disease with an unknown cause

AIDS

A disease that has serious implications for the nervous system, with more than 80% of patients with HIV having neurologic signs and symptoms

Any score of this or less is commonly accepted as a definition of coma

8

The commonly prescribed dose of Asprin

81-325mg/day

Percutaneous transluminal angioplasty (Stenting)

A balloon is inserted to open a stenosed artery to permit increased blood flow

A ventriculoperitoneal shunt

A catheter draining excess fluid from the brain into the abdomen

A stroke is also known as

A cerebrovascular accident or CVA

Patients with AIDS may have

AIDS dementia complex (ADC)

Pseudobulbar affect (PBA)

AKA emotional incontinence, sudden explosive emotional outburts of crying or laughing

With Bell's Palsy the face appears

Asymetric, with dropping mouth and cheek

A firm diagnosis of Parkinsons disease can only be made when the patient has

At least two signs of the classic triad

Common causes of spinal cord trauma

Automobile accidents, falls, violence, and sports

One important complication of spinal cord injury is

Autonomic dysreflexia or hyperreflexia

Aspiration precautions

Avoid choking foods, check affected side for food pocketing, small bites, do not mix solids and liquids, no straws, 90 degree angle, head up and chin slightly tucked

Prevention of neurological problems

Avoid drug and alcohol use, gun safety.

Dietary counseling for headache management

Avoid foods containing tyramines, nitrates, and glutamates

Teaching areas for patients with headaches

Avoidance of factors that trigger headaches Relaxation techniques Maintenance of regular sleep patterns Medications to be used The importance of follow up care

The term head trauma is used primarily to signify

Craniocerebral trauma, which includes alteration in consciousness, no matter how brief

Medical management of headaches

Dietary counseling, psychotherapy, and medications

Dysarthria

Difficult, poorly articulated speech that usually results rom interference in control over the muscles of speech

Dysgraphia

Difficulty communicating via writing

Dysphagia

Difficulty swallowing

Encephalitis is characterized by

Diffuse damage to the nerve cells of the brain, perivascular cellular infiltration of glial cells, and increasing cerebral edema

The primary cause of a brain abscess

Direct extension from ear, tooth, mastoid, or sinus infection

A CVA is the most common

Disease of the nervous system

Changes in a patients LOC that may indicate increasing ICP

Disorientation, restlessness, and lethargy

Disorientation

Disoriented; unable to follow simple commands; thinking slowed; inattentive; flat affect

Drug screens

Done to rule out drug use

When can an AD diagnosis be confirmed?

During an autopsy

Ictal

During the seizure and usually lasts about 60-90 seconds

LOC

Earliest and most sensitive indicator of patients neuro status

Contralateral weakness

Effecting the opposite side

CSF in patients with GBS commonly has

Elevated protien levels

If a femoral approach is used for an angiogram a nurse should

Mark bilateral pedal pulses

Tension headaches

May arise from psychological problems related to tension, stress, or from medical problems such as cervical arthritis

Nonepidemic encephalitis may occur as a complication of

Measles, chickenpox, or mumps

If a carotid approach is used for an angiogram a nurse should

Measure baseline neck circumference

EEG

Measures electrical activity of brain.

Electromyogram (EMG)

Measures the contraction of a muscle in response to electrical stimulation

Seizures are a

Medical emergency

Long term symptoms of encephalitis include

Memory impairment, epilepsy, anosmia, personality changes, behavioral abnormalities, and dysphasia

The first symptom of AD

Memory loss combined with the inability to carry out normal activities

The sequelae of encephalitis include

Mental deterioration, amnesia, personality changes, and hemiparesis

Vascular headache

Migraine, cluster, and hypertensive headaches

Thrombotic stroke

Most common cause of a stroke, symptoms usually occur while sleeping or soon after rising

Generalized Tonic-Clonic seizure

Most common, characterized by loss of conciousness and falling to the floor or ground. With the presence of an aura

Neurotransmitters Dopamine

Motor function, and emotional responses

What does dopamine deal with?

Motor functions and emotional responses

Midbrain

Motor movement, relay of impulses, and auditory and visual reflexes

Treatment of meningitis includes

Multiple antibiotics given intravenously over a 2-week period

Classic signs of GBS

Muscle weakness, tingling, and numbness. These signs usually begin in the legs or feet and work their way upwards

During MG, nerve impulses fail to pass at the neuromuscular junction resulting in...

Muscular weakness

What type of injury should you assume with a head injury?

Neck injury

Neurotransmitters AcH

Nerve impulse transmission

What does AcH aide in?

Nerve impulse transmission

Treatment for Bell's Palsy

No specific therapy, corticosteroids, especially prednisone, are started immediately, preferably before paralysis is complete

After a myelogram a nurse should

Observe for CSF leakage and instruct the patient to lie flat

Lumbar puncture is done to

Obtain CSF for examination, to relieve pressure, or to introduce dye or medication

The 3 parts of the Glasgow coma scale assessment

eye opening, best motor response, and best verbal response


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