Chapters 47 - 50

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Chapters 47 - 50
2013-07-12 18:29:07
Neuro System

Neuro Exam
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  1. What part of the brain initiates voluntary movement?
    Frontal Lobe
  2. What part of a neuron arrives impulses toward the cell body?
    The dendrites
  3. What structure electrically insulates neuron?
    Myelin Sheath
  4. What is the term for unequal pupils?
  5. While assessing a patient's pupils for light reactivity, which cranial nerve is being tested?
    Cranial Nerve 3 -- Oculomotor
  6. Which transmitter is in charge of the flight or fight response?
  7. Your patient has an impairment of CNS IX and X. What intervention should the nurse plan to maintain the patient's safety while diagnostic testing is being completed?
    Swallowing and Gag reflex
  8. Your patient was admitted with severe headaches. How would you prepare the patient for a CT scan of the brain?
    No prep needed
  9. What explanation should be provided to the patient and family regarding an MRI scan?
    No metals because magnetic energy is used to visualize the body
  10. What part of the brain would be involved if your patient has decerbrate posturing with extended extremities?
  11. What type of condition would your patient be experiencing if they had a stroke and is unable to understand what you are saying and appears frustrated?
    Receptive Aphasia
  12. What type of respond would the nurse observe if the nurse shines a light in a patient's left pupils and both of the pupils constrict?
  13. Your patient has had a stroke. What precaution would you take after testing noting the patient has a positive Romberg Test?
    Falls --- making sure that they don't fall
  14. What are early signs of ICP?
    Change in LOC, restlessness and irritablity
  15. What would be the most important function for the nurse while preparing the patient for placement of an emergency subarachnoid bolt due to ICP?
    Need a consent from family because its an invasive procedure
  16. What action would the nurse take if when ambulating her patient to the bathroom and patient begins a generalized tonic-clonic seizure?
    Get them to the floor safely by sliding them down your leg to prevent injury and turn them on side and maintain airway ..
  17. After your patient is status post brain surgery for tumor involvement and you observe jerking rhythmical movement in bed. What would you do?
    • Nasal airway
    • Padded Side Rails
  18. What seizure medication would you anticipate your patient being discharge on?
  19. What response would you give a patient who is crying and stating her life is over since her seizure because she will never be able to drive anymore?
    Explain if you are poorly controlled cannot get license back

    But if seizure free for 1 year you can get license back
  20. Your patient has been diagnosed with a concussion. What explanation should the nurse provide to the patient's mother?
    Its a Mild Brain Injury

    Check LOC for 5 mins

    Dizziness and headache, nausea, amnesia
  21. Your patient with a head injury has a widening pulse pressure. What action would the nurse do first?
    • Sign of ICP
    • raise HOB to 30 degrees to decrease edema
  22. Your C5 quadriplegia patient with a halo vest states of a headache, nausea and facial flushing after you transfer him to the wheelchair. What should you do first?
    • Autonomic dysreflexia
    • once BP  is under control assess where its coming from
  23. Women cares for her husband with a C7 SCI. After extensive caring for her husband, she is exhausted. What outcome criteria would be relevant to a nursing diagnosis of caregiver role strain for this care plan>
    • let her identify help
    • get resources help her
  24. A patient with a SCI arrives in the ECU, during assessment of motor and sensory function, finds the patient without sensation or movement in all 4 extremities. What are of the SCI located>
    C4 - C5 quadrapalegic from neck down
  25. What term do you use to document paralysis of all four extremities?
    quadriplegic --- tetrapalegic
  26. A patient has right sided weakness and aphasia due to TIA, which part of brain is affected?
    left hemisphere
  27. what term describes left sided flaccidity in a patient who has had a stroke?
  28. Ipsilateral ?
    same side
  29. Contralateral?
    Opposite side
  30. What medication is an example of antiplatelet med?
  31. Which artery is involved when a patient is experiencing bilateral hemiparesis, dysphasia, visual changes, Change in LOC, dysphagia, ataxia?
    Vertebrobasilar/ cerebellar artery
  32. Which type of CVA has the slowest rate of recovery and highest probability of causing extensive neurological deficits?
    Subarachnoid hemorrhage
  33. Which drug therapy does the nurse anticipate administering to help resolve an exacerbation of MS?
    Steroids --- ACTH and prednisone
  34. Which assessment finding would you include in your teaching about risk factors associated with exacerbation of MS?
    • Illness
    • emotional/physical stress
    • cold temp
    • fatigue
  35. your are caring for a mother of 3 young children who has MG. She states that she has become fatigued by the afternoon. What statement by the nurse can help her cope with fatigue?
    teach to schedule activities at the peak of meds
  36. what lab test should the nurse evaluate first when caring for a patient with GB?
  37. what nursing action is appropriate to help protect the affected eye with Bells Palsy?
    eyedrops and eye patch
  38. What lab test should the nurse verify and place on the medical record before preparing the patient with MG who is about to undergo plasmaphoresis?
    • CBC
    • Platelet
    • clotting factor studies
  39. FAST assessment ?
    • Facial drop
    • Arm drift
    • Slurred Speech
    • Time of onset
  40. What nursing interventions might help prevent aspiration during eating?
    • High fowlers
    • no straws
    • keep upright
    • remind to swallow 2 times
    • check cheek
    • no talking
    • no distractions
    • eat 1 thing at a time
    • place food on unaffected side of mouth
    • don't mix food with fluid
  41. Meds that you would question dr about for a patient with a hemorrhagic stroke
    anticoagulants: aspirin, heparin, Coumadin, Plavix, TPA
  42. What part of brain controls breathing
  43. What assessment does the neurologist complete to test the 4 and 6 cranial nerve
    following finger without moving head
  44. Why would you elevate HOB in patient with ICP
    decrease edema and pressure
  45. Subarachnoid Hemorrhagic
    below arachnoid mater following aneurysm rupture
  46. TIA
    • temp blockage of circulation
    • last mins to hours
    • no damage
    • usually resolves within 24 hrs
  47. What condition would be most at risk for hemorrhagic stroke?
    embolic stroke -- post treatment TIA
  48. Cerebrum
  49. Occipital?
  50. Medulla
  51. cerebellum?
  52. temporal
  53. Mannitol
    osmotic diuretic
  54. Cognex
  55. Decadron
  56. Sinemet
    converts dopamine in the brain
  57. heparin
  58. plavix
  59. TPA
  60. Zocor
    cholesterol lowering (statin)_
  61. 4 normal effects of aging on the CNS?
    • decreased blood flow to brain
    • decreased dopamine levels
    • decreased postural stability
    • decreased aging pigment -- impairment of cognition/orientation