week 14

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thaoherbie
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217309
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week 14
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2013-05-10 16:09:07
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neuro nursing
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nursing vocabulary
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  1. CSF analysis through lumbar puncture
    • ensure that pt has no cerebral tumor
    • before start of procedure that could result in herniation with the removal of CSF

    • Pt assumes & maintain lateral
    • recumbent position.

    • Ensure maintenance of strict aseptic
    • technique.

    • Ensure labeling of CSF specimens in
    • proper sequence.

    Encourage fluids.

    Monitor neurologic signs & VS

    Administer analgesia as needed
  2. electroencephalography (EEG)
    • electrical activity of brain is recorded by scalp electrodes to evaluate seizure disorders, cerebral disease, CNS effects of systemic diseases, brain death
    • inform pt that procedure is noninvasive & w/o danger of e- shock
    • determine whether any meds (tranquilizers, antiseizure drugs) should be withheld
    • resume meds & instruct pt to wash electrode paste out of hair after test
  3. cerebral angiography
    • serial x-ray visualization of intracranial & extracranial blood vessels is performed to detect vascular lesions & tumors of brain. contrast medium is used
    • assess pt for stroke risk b4 procedure as thrombi may be dislodged during procedure. 
    • withhold preceding meal
    • pt may have hot flush of head & neck when medium is injected
    • stay absolutely still during procedure
    • monitor neurologic signs & VS every 15-30 for first 2hr, q1hr for next 6hr, then every 2 hr for 24hr
    • maintain bedrest until pt is alert & VS is stable
    • report any neurologic status change
  4. computed tomography
    • computer-assisted x-ray of multiple cross sections of body parts to detect problem such as hemorrhage, tumor, cyst, edema, infarction, brain atrophy, & other abnormalities. may use contrast media
    • assess for allergy of fish, iodine, dye
    • remain still during procedure
  5. MRI: Magnetic Resonance Imaging
    • imaging of brain, spinal cord, & spinal canal by means of magnetic energy. used to detect strokes, multiple sclerosis, tumors, trauma, herniation, & seizures. noninvasive. may use contrast media
    • screen pt for metal parts & pacemaker in body
    • lie very still for 1 hr
    • may need sedation
  6. PET: Positron Emission Tomography
    • measures metabolic activity of brain to assess cell death of damage. uses radioactive material that shows up as a bright spot on the image
    • 2 IV lines will be inserted
    • not take sedatives, tranquilizers
    • empty bladder b4 procedure
    • glucose monitoring due to injected venous scan material
  7. ageusia
    loss the sense of taste
  8. agnosia
    loss the ability to interpret sensory stimuli
  9. agraphia
    loss the ability to write
  10. akinesia
    loss of control of voluntary muscle movenments
  11. anisocoria
    unequal size of pupils
  12. anomia
    loss the ability to name objects
  13. anopsia
    suppression of vision in one area only
  14. anosmia
    lack of sense of smell
  15. anosognosia
    lack of awareness or denial of neurologic defect
  16. aphasia
    partial or total loss of ability to communicate either verbally or in writing
  17. apraxia
    loss the ability to perform physical activity which the pt is physically and willing to do
  18. asthenia
    lack or loss of strength and energy
  19. ataxia
    loss of the ability to coordinate muscle movements
  20. athetoxis
     repetitive involuntary, slow, sinuous, writhing movements, especially severe in the hands.
  21. aura
    A subjective sensation or motor phenomenon that precedes and indicates the onset of a neurological episode, such as a migraine or an epileptic seizure.
  22. automatisms
    mechanical, repetitive, and undirected behavior that is not consciously controlled, as seen in psychomotor epilepsy, hysterical states, and such acts as sleepwalking
  23. autonomic dysreflexia
    an uninhibited and exaggerated response of the autonomic nervous system to stimulation, as seen in many patients with high spinal cord injuries
  24. babinski reflex
    a reflex action of the toes, indicative of abnormalities in the motor control pathways leading from the cerebral cortex. A normal reaction is slight flexion of the toes. In a positive sign, the toes extend; seen with upper motor neuron lesions. Called also Babinski sign.
  25. ptosis
    prolapse or drooping of a part (eyelid)
  26. dysarthria
    Difficulty in articulating words, caused by impairment of the muscles used in speech.
  27. dysphagia
    difficulty swallowing
  28. basal skull fracture
    A fracture involving the base of the cranium Clinical May be asymptomatic; raccoon eyes, Battle sign, hemotympanum, CSF rhinorrhea Imaging Plain skull film may not reveal fracture; CT or MRI is more reliable.
  29. bell's palsy
    unilateral facial paralysis of sudden onset due to a lesion of the facial nerve, resulting in characteristic facial distortion.
  30. bradykinesia
    abnormal slowness of movemen
  31. brudzinski's sign
    An indication of meningitis in which passive flexion of the leg on one side causes a similar movement in the opposite leg.
  32. burr holes
    holes drilled in the skull during surgery to drain and irrigate an abscess
  33. cerebral edema
    Brain swelling due to increased volume of the extravascular compartment from the uptake of water in the gray and white matter.
  34. cerebral perfusion pressure (CPP)
    a parameter that is related to the amount of blood flow to the brain. It is calculated by subtracting the intracranial pressure from the mean systemic arterial blood pressure
  35. cheyne-stokes respiration
    breathing with rhythmic waxing and waning of depth of breaths and regularly recurring apneic periods.
  36. clonus
    alternate involuntary muscular contraction and relaxation in rapid succession
  37. coma
    a state of extreme unresponsiveness, in which an individual exhibits no voluntary movement or behavior. Furthermore, in a deep coma, even painful stimuli (actions which, when performed on a healthy individual, result in reactions) are unable to affect any response, and normal reflexes may be lost
  38. concussion
    a trauma-induced change in mental status, with confusion and amnesia, and with or without a brief loss of consciousness.
  39. consciousness
     subjective awareness of the aspects of cognitive processing and the content of the mind.
  40. consensual response
    a reflex action in which stimulation of one body part results in a response in another
  41. contralateral
    pertaining to, situated on, or affecting the opposite side
  42. contusion
     bruise; an injury of a part without a break in the skin
  43. coup/countrecoup
     an injury most often associated with a blow to the skull in which the force of the impact is transmitted through the skull bones to the opposite side of the head, where the bruise, fracture, or other sign of injury appears.
  44. craniotomy
    Surgical removal of part of the skull to expose the brain
  45. cushing's response/triad
    • –increased systolic pressure with a
    • widening pulse pressure

    • –Bradicardia
    • with a full bounding  pulse

    –Irregular respiration
  46. decerebrate posturing
    the head is arched back, the arms are extended by the sides, and the legs are extended. A hallmark of decerebrate posturing is extended elbows. The arms and legs are extended and rotated internally. The patient is rigid, with the teeth clenched
  47. decorticate posturing
    patients present with the arms flexed, or bent inward on the chest, the hands are clenched into fists, and the legs extended and feet turned inward.
  48. decussate
    In the brain, where nerve fibers obliquely cross from one lateral part to the other, that is to say they cross at a level other than their origin
  49. diabetes insipidus
    is a condition characterized by excessive thirst and excretion of large amounts of severely diluted urine, with reduction of fluid intake having no effect on the latter
  50. diplopia
    double vision, perceive 2 images from 1 object
  51. dysarthria
    a motor speech disorder resulting from neurological injury, characterized by poor articulation
  52. dyskinesia
    a movement disorder which consists of effects including diminished voluntary movements and the presence of involuntary movements,
  53. dystonia
    a neurological movement disorder, in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures
  54. encephalitis
    acute inflammation of the brain
  55. epidural hematoma
    a type of traumatic brain injury (TBI) in which a buildup of blood occurs between the dura mater (the tough outer membrane of the central nervous system) and the skull. The dura mater also covers the spine, so epidural bleeds may also occur in the spinal column. Often due to trauma, the condition is potentially deadly because the buildup of blood may increase pressure in the intracranial space and compress delicate brain tissue. The condition is present in one to three percent of head injuries. Between 15 and 20% of patients with epidural hematomas die of the injury.
  56. epilepsy
    a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or synchronous neuronal activity in the brain.
  57. fasciculations
    "muscle twitch", is a small, local, involuntarymuscle contraction and relaxation visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibers (muscle fascicle). Fasciculations have a variety of causes, the majority of which are benign, but can also be due to disease of the motor neurons.
  58. Halo traction
    application of skeletal traction to the head by means of a halo device
  59. hemianopsia
    Loss of vision in one half of the visual field of one or both eyes.
  60. hemiplegia
    paralysis of one side of the body
  61. homonymous
    the corresponding vertical halves of the visual fields of both eyes.
  62. hydrocephalus
    an abnormal expansion of cavities (ventricles) within the brain that is caused by the accumulation of cerebrospinal fluid
  63. infratentorial
    beneath the tentorium of the cerebellum
  64. intraventricular pressure monitor
    Intracranial pressure monitoring uses a device, placed inside the head, which senses the pressure inside the skull and sends its measurements to a recording device.
  65. ipsilateral
    situated on or affecting the same side
  66. kernig's sign
    in meningitis, inability to completely extend the leg when sitting or lying with the thigh flexed upon the abdomen; when in dorsal decubitus position, the leg can be easily and completely extended.
  67. meningitis
    a serious inflammation of the meninges, the thin, membranous covering of the brain and the spinal cord.
  68. mentation
    mental activity
  69. monoplegia
    paralysis of a single part
  70. neurogenic shock
    due to the loss of vasomotor tone caused by injury & is characterized by hypotension & bradycardia. loss of sympathetic innervation causes peripheral vasodilation, venous pooling, & a decreased cardiac output
  71. nuccal rigidity
    neck stiffness
  72. nystagmus
    Rhythmic, oscillating (swing back & forth) motions of the eyes
  73. obtunded
    Mentally dulled; “out of it”
  74. ommaya reservoir
    a device placed under the scalp and used to deliver anticancer drugs to the cerebrospinal fluid
  75. papilledema (chocked disc)
    a swelling of the optic nerve, at the point where this nerve joins the eye, that is caused by an increase in fluid pressure within the skull (intracranial pressure). Swelling of the optic nerve due to other causes such as infection or inflammatory disease is not called papilledema.
  76. paralysis
    complete loss of strength in an affected limb or muscle group
  77. paresthesia
    An altered sensation often described as burning, tingling, or pin pricks
  78. photophobia
    abnormal visual intolerance to light.
  79. poikilothermic
    an organism having a body temperature that varies with the temperature of its surroundings
  80. post-ictal
    the altered state of consciousness that a person enters after experiencing a seizure. It usually lasts between 5 and 30 minutes, but sometimes longer in the case of larger or more severe seizures and is characterized by drowsiness, confusion, nausea, hypertension, headache or migraine and other disorienting symptoms. Additionally, emergence from this period is often accompanied by amnesia or other memory defects. It is during this period that the brain recovers from the trauma of the seizure.
  81. prodrome
    an early symptom (or set of symptoms) that might indicate the start of a disease before specific symptoms occur.
  82. sensorium
    the total character of the unique and changing sensory environments perceived by individuals. These include the sensation, perception, and interpretation of information about the world around us by using faculties of the mind such as senses, phenomenal and psychological perception, cognition and intelligence
  83. shunts: ventriculolumbar
  84. shunts: ventriculoperitoneal
  85. shunts: ventriculoatrial
  86. shunts: ventriculojugular
  87. spasticity
    altered skeletal muscle performance occurring in disorders of the central nervous system (CNS) impacting the upper motor neuron in the form of a lesion. When there is a loss of descending inhibition from the brain to the spinal cord, such that muscles become overactive, this loss of inhibitory control can cause an ongoing level of contraction, with decreased ability for the affected individual to volitionally control the muscle contraction, and increased resistance felt on passive stretch.
  88. status epilepticus
    •a state of constant seizure or a condition in which seizures recur in rapid succession without return to consciousness between seizures

    •Trauma during seizures can cause severe injury and death

    •Permanent brain damage

    Psychosocial  problems
  89. stereognosis
    the ability to perceive the form of an object by using the sense of touch. In humans, this sense, along with tactile spatial acuity, vibration perception, texture discrimination and proprioception, is mediated by the posterior column-medial lemniscus pathway of the central nervous system. Sterognosis tests determine whether or not the parietal lobe of the brain is intact. Stereognosis is a higher cerebral associative cortical function
  90. strabismus
     a condition in which the eyes are not properly aligned with each other. It typically involves a lack of coordination between the extraocular muscles, which prevents bringing the gaze of each eye to the same point in space and preventing proper binocular vision, which may adversely affect depth perception.
  91. subarachnoid hemorrhage
    bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain. This may occur spontaneously, usually from a ruptured cerebral aneurysm, or may result from head injury.
  92. subdural hematoma
    a type of hematoma, a form of traumatic brain injury in which blood gathers within the outermost meningeal layer, between thedura mater, which adheres to the skull, and the arachnoid mater enveloping the brain. Usually resulting from tears in bridging veins that cross the subdural space, subdural hemorrhages may cause an increase in intracranial pressure (ICP), which can cause compression of and damage to delicate brain tissue. Subdural hematomas are often life-threatening when acute, but chronic subdural hematomas are usually not deadly if treated.
  93. supratentorial
    the part located above the tentorium cerebelli
  94. syncope
    loss of consciousness
  95. tic doloureux
    a neuropathic disorder characterized by episodes of intense pain in the face, originating from the trigeminal nerve. One, two, or all three branches of the nerve may be affected. It is, "one of the most painful conditions known to humans, yet remains an enigma to many health professionals." This pain may be felt in the ear, eye, lips, nose, scalp, forehead, cheeks, teeth, and/or jaw and side of the face; some patients also experience pain in their left index finger
  96. tonus
    refer to tone in muscle tone
  97. transient ischemic attack (TIA)
    •transient episodes of neurologic  dysfunction__caused by ischemia

    •Typically last 1-2 hrs to full day

    •Warning sign of impending_stroke__

    •1/3 will eventually go on to have a stroke

    •1/3 will have subsequent TIAs
  98. ventriculostomy
    a neurosurgical procedure. It is done by surgically placing a tube through the skull such that it terminates in the ventricle of the brain. The place of entrance on the skull is called Kocher's point. Ventriculostomy is done primarily to monitor the intracranial pressure as well as to drain CSF (primarily) or blood to relieve pressure from the CNS.

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