Chapter 54 Care of the Patient with a Neurological Disorder

Which Gasgow Coma Scale rating would a patient receive who opens the eyes spontaneously, but incomprehensible speech and obeys commands for movement ?

12

For which reason is the patient with suspected Guillain-Barré syndrome hospitalized immediately ?

The disease can rapidly progress into respiratory failure

Which symptom is specific to migraine headaches?

They are preceded by an aura

In which way will the nurse instruct a patient with Parkinson disease to improve activity level?

To walk with hands folded behind back to help balance

A patient has recently experienced a stroke with left-sided weakness and has problems with choking, especially when drinking thin liquids. Which nursing interventions would be most helpful in assisting this patient to swallow safely?

Tuck chin when swallowing

Which cranial nerve supplies most of the organs in the thoracic and abdominal cavities and carries motor fibers to glands that produce digestive juices and other secretions?

Vagus nerve

Which is a sign of Cushing's response?

Widening pulse rate, increased systolic blood pressure, bradycardia

Which food should the person who experiences migraine headaches avoid ?

Yogurt, Marinated foods, Caffeine

In which way will a nurse record the behavior when a patient with Alzheimer's disease attempts to eat using a napkin rather than a fork?

Agnosia

The nurse is aware that when assessing a patient by the FOUR coma scale, the patient is assessed in four categories: eye response, brain stem reflexes, motor response, and respiration. In which manner are these results reported?

As individual scores in each category

A patient who has experienced a stroke has expressive aphasia. Which abnormal manner of communication does the patient display?

Can understand the spoken word, but cannot speak

Which divisions are the two divisions of the nervous system?

Central and peripheral

What are surgical navigational systems?

Computerized devices that guide the surgeon

As the result of a stroke, a patient has difficulty discerning the position of his body without looking at it. In the nurse's documentation, which term would best describe the patients's inability to assess spatial position of his body?

Loss of proprioception

Which sign is the cardinal sign of increased intracranial pressure in a patient who has sustained a brain injury?

Decrease in the level of consciousness

The nurse explains that the two divisions of the autonomic nervous system work to maintain homeostasis. Which action is the first autonomic event following a stressful or frightening event?

Heart rate pressure rise, secretion of adrenaline

The nurse assures an anxious family member of a 92 year old patient who is demonstrating signs of dementia that many causes of dementia are reversible and preventable. Which disorder is one example?

Hypotension

A frantic family member is distressed about the flaccid paralysis of a relative following a spinal cord injury several hours ago. Which fact does the nurse know about this condition ?

I tis possibly a temporary condition and will clear.

Which sign is the first sign of Bell's Palsy

Inability to wrinkle forehead and pucker lips on affected side

Following a pyelogram the nurse will include in the post procedure care observing for which possible complication?

Loss of sensation in lower extremities

Which aspect is the nurse assessing when asking the patient, "who is the president of the United States?" during a level of consciousness data collection?

Knowledge

A patient is in which stage of Alzheimer's disease when demonstrating difficulty swallowing?

Late

Which effect is a factor of normal aging not he nervous system?

Loss of neurons, decrease oxygen use, reduction of cereal blood flow, lipfuscin

Which issue is the basic problem that prompts most of the early signs of Alzheimer's disease?

Memory loss that disrupts daily life

The newly admitted patient to the emergency room 30 minutes ago after a fall off a ladder gas gradually decreased in consciousness and has slowly reacting pupils, a widening pulse pressures and verbal responses that are slow and unintelligible. Which position is most appropriate for the patient?

Neck placed in neutral position

A patient is to have a pyelogram to confirm the presence if a herniated intervertebral disk. Which nursing action will be planned with respect to this diagnostic?

Obtain an allergy history before the test

Which action will the nurse take when caring for a child recently diagnosed with bacterial meningitis ?

Place the child in respiratory isolation

A family member of a patient who has just experienced a tonic-clonic seizure is concerned about the patient's deep sleep. What is this behavior called?

Postictal Period

The nurse is aware that the characteristic of gait of the person with Parkinson's disease is a propulsive gait, which causes the patient to walk in which manner?

Shuffle with arms flexed

Which factor is the nurse aware of when assessing a person with a craniocerebral injury?

Signs and symptoms may not occur until several days after the trauma

Tge nurse is caring for a patient who had a spinal cord injury at C5 3 years ago. The nurse expects the plan of care will focus on the knowledge that the patient will be able to do which activity independently?

feed self with set up and adaptive equiptment

The newly admitted patient to the emergency room after a motorcycle accident has serosanguineous drainage coming from the nose. Which is the appropriate nursing response to this finding?

gently wipe nose with absorbent gauze

A patient with a spinal cord injury T1 complains of stiffness of the nose and a headache. The nurse notes a flushing of the neck and "goose flesh". Which action will be the initial nursing intervention?

sit up right and check on blood pressure

Which question is likely to elicit the most valid response from the patient who is being interviewed about a neurologic problem?

"Can you describe the sensation you are having?"

An 83-year-old patient has had a stroke. The patient is right handed and has a history of hypertension and "little" strokes. The patient presents with right hemiplegia. To afford the patient the best visual field, the nurse will approach the patient in which manner?

from the left side