Neuro

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Michelle25
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113767
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Neuro
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2011-11-14 20:23:28
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  1. Which neurological disorder does not affect cognitive function or LOC?
    Guillain- Barre Syndrome
  2. Which disease is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary dancelike movements and dementia?
    Huntingtons disease
  3. Myasthenia Gravis occurs when antibodies attack which receptor sites?
    Acetylcholine
  4. What is the term for rapid, jerky, involuntary, and purposeless movement of the extremities or facial muscles?
    Chorea
  5. ______ is impaired ability to execute voluntary movements
    Dyskinesia
  6. What is the most common clinical manifestation in patients with multiple sclerosis?
    Fatigue
  7. Which disease is there a loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brian stem?
    Amyotrophic lateral sclerosis (ALS)
  8. Which anticholinergic agent control tremors and rigidity in parkinson's disease?
    Cogentin
  9. Which disease is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells in the substantia nigra in the basal ganglia of the brian?
    Parkinson's disease
  10. Which disease is a chronic, degenerative, progressive disease of the central nervous system characterized by the occurence of small patches of demyelination in the brain and spinal cord?
    Multiple sclerosis
  11. What disease is a progressive degenerative neurological disease resulting in decreased motor function in the upper motor neurons in the medulla oblongata and lower motor neurons in the spinal cord?
    Amyotrophic lateral sclerosis (ALS)
  12. Which disorder is characterized by the body unable to transmit nerve impulses which results in muscle weakness?
    Myasthenia Gravis
  13. Progressive demyelinating disease of motor and sensory neurons that has periods of remission and exacerbation:
    Multiple Sclerosis
  14. A chemical imbalance in the brain leads to movement and coordination problems:
    Parkinson's disease
  15. Dysfunction in the lower motor neuron pathways results in:
    Flaccidity
  16. Hyperventilation is recommended if there is any indication of increased ICP. This intervention decreases ICP by:
    Lowering Co2, which results in vasoconstriction
  17. The earliest sign of incresing ICP is a change in:
    level of consciousness
  18. What are the signs of Cushing's Triad?
    Bradycardia, hypertension, bradypnea
  19. You are caring for a patient with a brainstem injury. Your priority assessment should be:
    Respiratory rate and rhythm
  20. What is cranial nerve 4?
    Trochlear- Eye movement (down and inward)
  21. What is cranial nerve 5?
    Trigeminal (facial sensation)
  22. What is cranial nerve 8?
    Acoustic (hearing accuracy/ balance)
  23. What is cranial nereve 6?
    Abducens (lateral eye movement)
  24. What are the first 3 cranial nerves?
    • olfactory
    • optic (normal vision)
    • oculomotor (PERRLA)
  25. Before a cerebral angiography, what lab value needs to be assessed?
    Creatine levels (0.5-1.2 mg/dl)
  26. How should the patient be positioned after a lumbar puncture?
    Lying flat for several hours
  27. ______: stimulate to wake up, will fall back asleep on you, but when you wake them up again, they remember what happen before
    Lethargic
  28. ______: every time you go in room, you have to wake patient up. Disoriented, will not remember that you woke them up an hour ago.
    Somnolent
  29. ______: cognitively intact but cannot express what they want to say
    Expressive
  30. ______: can speak but cannot use right words/grammar
    Receptive
  31. ______: difficult due to impairment of muscles usde to produce speech
    Dysarthria
  32. _______: extension of legs, internal rotation and adduction of arms with flexion of elbows, wrists and fingers
    Decorticate
  33. ______: back arched, rigid extension of all extremities, hyperpronation of arms and plantar flexion of feet. Away from core of the body.
    Decerbrate
  34. ______: regular, rhythmic breathing, alternates between hyperventilation and apnea
    Cheyne- stokes
  35. What type of solution are you most likely going to hang in a patient with brain trauma?
    HYPERTONIC (prevents cerebral edema because keeps fluid from shifting into that tissue)
  36. What are the four earliest signs seen with increased ICP?
    • LOC changes
    • Pupil changes
    • Weakness
    • Headaches
  37. What is your highest priority in a brainstem injury?
    Respiratory rate and rhythm
  38. What is normal creatine level?
    0.5 to 1.2
  39. What can be given to patients with high levels of creatine (0.5-1.2) if they need to have a cerebral angiography done?
    Mucomyst and sodium bicarb
  40. what does normal spinal fluid look like?
    Clear, looks just like water
  41. What is used to take away ammonia?
    Lactulose
  42. If there is a positive babinski's reflex in an adult, think _____.
    CNS
  43. With decorticate posturing (extension of legs, internal rotation and adduction of arms with flexion of elbows, wrists and fingers) there is most likely damage to where?
    Corticospinal tracts, cerebral hemisphere
  44. With decerbrate posturing (back arched, rigid extension of all extremities, hyperpronation of arms and plantar flexion of feet) there is most likely damage to where?
    Upper brain stem, midbrain or pons
  45. With cheyne-stokes respirations (regular, rhythmic, alternates btw hyperventilation and apnea) there is most likely a ______ injury or ______.
    cerbral injury or blood sugar issue
  46. Central neurogenic hyperventilation (sustained, rapid, regular respiration of 25 or more per minute) indicates _______.
    Brainstem- ominous sign that they are nearing death (brain bleeding)
  47. How do you want to position a patient with altered LOC?
    Lateral or semi prone (recovery position- get off backside)
  48. What should you give the patient if they are shivering?
    Thorazine
  49. What is considered a high ICP?
    15 mmHG
  50. What are the three symptoms associated with Cushing's syndrome?
    • Hypertension
    • Bradycardia
    • Bradypnea
  51. Decreased cerebral flow causes ______
    vasodilation
  52. What hyperosmotic agent would you give to dehydrate the brain and reduce cerebral edema?
    • Mannitol (osmitrol)
    • - Short term use only
    • - Never give to client with cerebral hemorrhage
  53. What analgesic medication needs to be avoided?
    • Opiates
    • They effect respiratory patterns and effects pupils, which will alter our neurologic status checks
  54. What needs to be checked when administering Decadron?
    Blood sugars!!! (complication is high BS)
  55. What is the therapeutic drug level of phenytoin?
    10-20 mcg/ml
  56. Barbituates (such as phenobarbital) are beneficial how?
    Reduce metabolic demand so brain does not need as much oxygen
  57. Where is ICP measured?
    lateral ventricle
  58. ______ is caused by decreased ADH and is a complication of ICP
    Diabetes Insipidus
  59. _______ is caused by increased ADH and is a complication of ICP
    SIADH
  60. What is diabetes insipidus going to be treated with?
    • IVF
    • Electrolytes
    • Vasopressin
  61. What is SIADH treated with?
    Fluid restriction (<800 ml daily)
  62. Post-op nursing for a client who had supratentorial surgery is what?
    • 30-45 degree HOB, neck neutral
    • Back or unaffected side every 2 hours
  63. Post-op nursing for a client who had infratentorial surgery is what?
    • Flate or elevate HOB 20-30 degrees (small pillow)
    • No neck flexion
    • Turn side to side as unit (with sheet)
    • Monitor for respiratory distress
  64. What is the first choice inotrope for a patient with low cardiac output that does not improve with fluid resuscitation?
    Dobutamine (dobutrex)
  65. If you see a halo sign and use a dextrostix to check for glucose reaction and get a positive result, what does it suggest?
    CSF leak
  66. _______ post op includes no vigorous coughing, no sucking on a straw or sneezing.
    Transphenoidal
  67. ______ seizures occur in one area of the brain, begin focally
    partial
  68. ________ seizures- your consciousness is still intact
    Simple partial
  69. _________ seizures- consciousness impaired, automatisms
    Complex partial
  70. ________- muscle contraction and > tone and contraction with relaxation
    Tonic clonic (general seizure)
  71. _________- loss of awareness, motor activity stops
    Absence seizures (general seizure)
  72. What are automatisms?
    Lip smacking or swallowing
  73. What is the complication associated with Dilantin?
    Gingival hyperplasia
  74. What is defined by no recovery, 3 episodes of seizures that lasts >30 mins
    Status epilepticus
  75. Which headache is characterized by steady, constant feeling of pressure that usually begins in the forehead, temple, or back of teh neck. It is often bandlike or may be described as "weight on top of my head"
    Tension headache
  76. What medications are given for migraine headaches?
    Triptans- serotonin receptor antagonists (Zomig, Maxalt, Imitrex)
  77. What medications are given for cranial arteritis?
    Corticosteroids

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