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