Ch. 14 care of the pt. with a neurologic disorder

how long is the spinal cord?

17-18 in cord that extends from brainstem to second lumbar vertebra.

How long should a pt. lay supine following an angiogram?

4-6 hours

This is caused by pressure on the nerve or degeneration as a result of unknown factors. It is characterized by excruciating, knifelike pain in the lips, upper or lower gums, cheek, forehead, or side of the nose: A. Trigeminal neuralgia B. Huntington disease

A. Trigeminal neuralgia Trigeminal neuralgia is a disorder of cranial nerve 5

what plays a vital role in control of body temperature, fluid balance, appetite and sleep? this also influences the heartbeat and hormone secretion. A. hypothalamus B. Thalamus

A. hypothalamus

form of aphasia characterized by the inability to name objects ? A. Motor aphasia B. Anomic aphasia C. Sensory aphasia

B. Anomic aphasia

LOC has two components : A. Alert and orientation B. Arousal and awareness

B. Arousal and awareness

_______________ is a genetically transmitted, autosomal dominant disorder that affects men and women of all races. It involves an overactivity of the dopamine pathway, resulting in abnormal and excessive involuntary movements (chorea) A. Trigeminal neuralgia B. Huntington disease C. Myasthenia gravis D. Amyotrophic lateral sclerosis

B. Huntington disease There is no cure, and death usually occurs 10 to 20 years after the onset of symptoms

what serves as a relay station on the way to the cerebral cortex for some sensory impulses; it interprets other sensory messages, such as pain, light touch, and pressure. A. hypothalamus B. Thalamus

B. Thalamus

many neuron fibers (axons and dendrites) are covered with a white, waxy, fatty material called : A. diencephalon B. Sulci C. Myelin

C. Myelin

The patient was involved in a snowmobile accident. On admission to the emergency department, he is receiving oxygen and is intubated. His Glasgow coma scale score is 6. About 10 minutes after arrival, he is noted to have a widened pulse pressure, increased systolic blood pressure, and bradycardia. These signs are considered an important diagnostic sign of late stage increased ICP. Together they are known as:

Cushing's response

what is the earliest sign of ICP?

Decreased LOC

What neurotransmitter primarily affects motor function and is involved in gross subconscious movements of the skeletal muscles? Acetylcholine Norepinephrine Dopamine Serotonin

Dopamine

The nurse is caring for a patient with multiple sclerosis. What appropriate nursing care should be implemented? a. Fluid restriction b. Teaching the patient to avoid cool bathwater c. Teaching the patient to exercise regularly, especially during an exacerbation d. Encouraging a well-balanced diet high in fiber and adequate fluids

Encouraging a well-balanced diet high in fiber and adequate fluids

postinfectious polyneuritis; acute, rapidly progressing, and potentially fatal form of polyneuritis;

Guillian-Barre syndrome

A 12 year old student has a history of generalized tonic-clonic seizures. The school nurse educates his classmates about his seizure activity by telling them

He may cry out at the beginning of a seizure

A 13 year old student is admitted to the pediatric unit with possible meningitis. The nurse finds that the patient cannot extend her legs completely without experiencing extreme pain. The nurse knows that this is an indication of meningitis and is called:

Kernig's sign

A patient is going for a diagnostic test. The nurse listens as the physician explains the procedure to the patient. The physician states that the test involves the use of differential signal characteristics of flowing blood to evaluate extracranial and intracranial blood vessels. In preparing to answer the patient's questions further, what diagnostic test will the nurse address? Cerebral angiography Magnetic resonance angiography (MRA) Computed tomography (CT) scan Magnetic resonance imaging (MRI) scan

Magnetic resonance angiography (MRA)

The nurse is taking care of a patient who suddenly begins to have a seizure. What is the appropriate nursing response? A. Run to the telephone and call for help. B. Pry the jaw open to place a padded tongue blade into the patient's mouth. C. Apply soft restraints until the seizure activity ceases. D. Observe and record the seizure activity.

Observe and record the seizure activity.

What nerve is identification of common odors?

Olfactory nerve

The nurse will implement which of these nursing interventions for the patient with increased intracranial pressure? (Select all that apply.) a. Place neck in neutral position. b. Keep head of the bed angled 10° to 20°. c. Force fluids up to 2 L/day unless otherwise contraindicated. d. Teach patient to avoid Valsalva maneuver. e. Position patient to avoid flexion of hips, waist, and neck. f. Suction only as necessary, but no longer than 10 seconds.

Place neck in neutral position Teach patient to avoid Valsalva maneuver. Position patient to avoid flexion of hips, waist, and neck. Suction only as necessary, but no longer than 10 seconds.

The nurse is caring for a patient who is being evaluated for a neurologic disorder. She is not able to comprehend the written or spoken word. Which term would the nurse use to document this problem? A. Receptive aphasia B. Expressive aphasia C. Global aphasia D. Anomia

Receptive aphasia

T / F Dysarthria is generally caused by damage to a central or peripheral nerve?

True

A nurse is preparing a client for lumbar puncture. The client has heard about post-lumbar puncture headaches and asks how to avoid having one. The nurse tells the client that these headaches can be avoided by doing which of the following after the procedure? a) "Remain prone for 2 to 3 hours." b) "Ambulate as soon as possible." c) "Remain NPO for 6 hours." d) "Remain on bedrest for 3 days."

a) "Remain prone for 2 to 3 hours."

Which of the following terms refers to the inability to coordinate muscle movements, resulting difficulty walking? a) Ataxia b) Rigidity c) Spasticity d) Agnosia

a) Ataxia

A nurse is performing a neurologic assessment on a client. The nurse observes the client's tongue for symmetry, tremors, and strength, and assesses the client's speech. Which cranial nerve is the nurse assessing? a) VI abducens b) IX glossopharyngeal c) XII hypoglossal d) IV trochlear

c) XII tongue movements

The nurse is preparing a client for a neurological examination by the physician and explains tests the physician will be doing, including the Romberg test. The client asks the purpose of this particular test. The correct reply by the nurse is which of the following? b) "It is a test for muscle strength." c) "It is a test for coordination." d) "It is a test for balance."

d) "It is a test for balance."

Damage to which area of the brain results in receptive aphasia? a) Parietal lobe b) Occipital lobe c) Frontal lobe d) Temporal lobe

d) Temporal lobe

A patient is admitted to the hospital with the diagnosis of transient ischemic attack. What normal change of aging would the nurse expect to see in this 90 year old man?

decreased fine motor coordination

double vision

diplopia

difficult, poorly articulated speech; usually resulting from interference with the control of the muscles of speech

dysarthria

A 35 year old patient is being seen for complaints of headache, which she has experienced for the past month. Her physician wants to rule out a brain tumor. In this case, what dx test is contraindicated?

lumbar puncture

any abnormal benign or malignant mass

neoplasm

involuntary, rhythmic movements of the eye; the oscillations may be horizontal, vertical, rotary, or mixed

nystagmus

partial loss of function

paresis

Seizures are followed by a rest period of variable length, this is called: A. Postictal Period B. Agnosia

postictal period

sensation; body's way of sensing where a limb is

proprioception

prone to spasms; sudden involuntary movements or muscular contractions

spastic

cerebral vascular accident (CVA); abnormal condition of the blood vessels of the brain, characterized by hemorrhage into the brain or the formation of an embolus or thrombus that occludes an artery, resulting in ischemia of the brain tissue normally perfused by the damaged vessels

stroke

a condition where a person is perceptually unaware of and inattentive to one side f the body

unilateral neglect

What is the autoimmune disease of the neuromuscular junction characterized by fluctuating weakness of certain muscle groups? a. Myasthenia gravis b. Amyotrophic lateral sclerosis

a. Myasthenia gravis

total or partial loss of the ability to recognize familiar objects by sight, touch, or feeling or to recognize familiar people through sensory stimuli; result of organic brain damage

agnosia

localized dilation of a blood vessel usually caused by atherosclerosis and hypertension, or less frequently, by trauma, infection, or a congenital weakness in the vessel wall

aneurysm

an abnormal neurologic condition in which the language function is defective or absent because of an injury to certain areas of the cerebral cortex: A. Aphasia B. Apraxis C. Aneurysm

aphasia

inability to carry out learned sequential movements on command, perform purposeful acts, or use objects properly A. Aphasia B. Apraxis C. Aneurysm

apraxia

impaired ability to coordinate movement

ataxia

prodromal signs that occur before the headache

aura

nurse is assisting during a lumbar puncture. How should the nurse position the client for this procedure? a) Lateral, with right leg flexed b) Lateral recumbent, with chin resting on flexed knees c) Supine, with the knees raised toward the chest d) Prone, with the head turned to the right

b) Lateral recumbent, with chin resting on flexed knees

slow movement

bradykinesia

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? a) Dysfunction of the spinal accessory nerve b) Dysfunction of the acoustic nerve c) Dysfunction of the vagus nerve d) Dysfunction of the facial nerve

c) Dysfunction of the vagus nerve

Which neurotransmitter demonstrates inhibitory action, helps control mood and sleep, and inhibits pain pathways? a) Acetylcholine b) Enkephalin c) Serotonin d) Norepinephrine

c) Serotonin

placing an electrode in the thalamus or globus pallidus, or subthalamic nucleus and connecting it to a generator placed in the upper chest (like a pacemaker) to allow it to deliver a specific current to the targeted brain location; used to control symptoms of Parkinson's disease

deep brain stimulation

the brain and spinal cord are surrounded by three protective coverings called the meninges. what are the 3 layers?

dura mater - outermost layer arachnoid membrane pia mater - innermost layer

difficulty swallowing

dyshphagia

weak, soft, and flabby muscles; lacking normal muscle tone

flaccid

quick, practical, and standardized system for assessing the degree of consciousness impairment in the critically ill and for predicting the duration and ultimate outcome of coma, particularly with head injuries; EVM=Eyes, Verbal, Motor

glasgow coma scale

generalized impairment of intellect, awareness, and judgement

global cognitive dysfunction

The outer portion of the cerebrum is composed of grey matter that is called cerebral cortex. it is arranged in folds, called ______, and grooves that are called ________.

gyri, sulci

A 70 year old with back pain is scheduled to have a myelogram in the morning to rule out a pathologic condition of the spine. In preparing him for the procedure, what info is important to share?

he may be asked to change positions during the procedure

defective vision or blindness in one half of the the visual field

hemianopia

paralysis of one side of the body

hemiplegia

overactive reflex actions

hyperreflexia

Low levels of the neurotransmitter serotonin lead to which of the following disease processes? a) Depression b) Seizures c) Myasthenia gravis d) Parkinson's disease

a) Depression

Speeds the transmission of nerve impulses.

Acetylcholine

What term most accurately describes age-related changes of the neurologic system? Becoming senile is an inevitable consequence of aging. Older people lose the ability to learn new things. Long-term memory is more affected by aging than is short-term memory. As neurons are lost with aging, there is deterioration in neurologic function.

As neurons are lost with aging, there is deterioration in neurologic function.

A male patient has been recently diagnosed with Parkinson disease. His wife asks the nurse numerous questions about the disease. What information is correct in addressing this wife's questions? A. Parkinson disease is more common in women. B. The tremor from Parkinson disease is more prominent with movement. C. Symptoms of Parkinson disease appear when there is either an increase in dopamine or a decrease in acetylcholine levels in the basal ganglia. D. Parkinson disease is a syndrome of bradykinesia, rigidity, tremor, and impaired postural reflexes.

D. Parkinson disease is a syndrome of bradykinesia, rigidity, tremor, and impaired postural reflexes.

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? a) V trigeminal nerve b) IV trochlear nerve c) III oculomotor nerve d) VI abducens nerve

a) V trigeminal nerve