What normal change of aging would the nurse expect to see in a 90 year old man with a diagnosis of transient ischemic attack?
Decreased fine motor coordination
Why diagnostic test is contraindicated for a patient with a suspected brain tumor?
What would the nurse include in the teaching to prevent head and spine injury?
Lumbar support for sports activies.
What information is important to share with the pt who is scheduled to have a myelogram to rule out pathology of the spine?
That the pt will lie completely supine and still during the procedure.
What is important to do to prevent aspiration while eating for a patient who has suffered a stroke?
Tipping the head toward the unaffected side while swallowing
As a school nurse, what type of information would you give to the classmates of a student who has a history of tonic-clonic seizures?
That he may cry out at the beginning of a seizure
A pt comes to the ER after a snowmobile accident and presents with a widened pulse pressure, increased systolic blood pressure, and bradycardia. These signs are considered an important diagnostic sign of late stage increased intracranial pressure. Together, what do these signs represent?
What is a characteristic sign of Parkinson�s disease?
What sign is positive for meningitis and occurs when a pt cannot extend their legs completely without experiencing extreme pain?
What information is important to teach a patient regarding Bell�s palsy?
The eye is susceptible to injury if the eyelid does not close
What is the first nursing intervention that is necessary if a patient has autonomic dysreflexia?
Sit the pt upright, if permitted
When teaching the pt about Parkinson�s disease, what response would indicate the need for further education?
�If I miss an occasional dose of the medication, it is not of much significance.�
What is the resultant complication if injury to the spinal cord is in the cervical region?
When does a nurse determine that a pt is unconscious?
Pt only responds to painful stimuli
What is the best way to position a patient with intracranial pressure?
Maintain the head of the bed at 30 degrees
What is the highest priority on assessment of a pt admitted to the ER with a severe head injury?
Patency of airway
What is the primary goal of nursing interventions after a craniotomy?
Preventing increased intracranial pressure
A right-handed pt with right-sided hemiplegia and aphasia resulting from a stroke most likely has a lesion where?
Left frontal lobe
Why is a carotid endarterectomy done for a pt experiencing TIA�s?
To prevent a stroke by removing atherosclerotic plaques obstructing cerebral blood flow.
The pathophysiology of mayasthenia gravis is caused by what?
Antibodies attacking the acetylcholine receptors, damaging them and reducing their number.
Why is a 35 year old man who suffers from tension headaches not given narcotics for the pain?
Narcotics are avoided due to the risk of abuse
What foods attribute to the cause or worsening of migraine headaches?
What change is a late sign of increased intracranial pressure?
A widened pulse pressure
What measure may be implemented to reduce venous volume in a pt experiencing increased intracranial pressure?
Restrict fluid intake; avoid flexion of the hips; administer oxygen
What are the signs and symptoms of late stage increased intracranial pressure?
Increase in systolic BP; widening of pulse pressure; bradycardia; unequal pupils that react slowly to light
What protective techniques does the nurse teach to pts with potential aspiration problems?
Chin tuck, double swallow, full Fowler�s position, soft or pureed foods
In what position would the nurse place the pt have a lumbar puncture?
Side-lying, with legs pulled up and head bent down onto the chest
How does the nurse determine that a client understands postprocedure care after a CT scan with a contrast medium?
The pt will state that he will drink extra fluids for the day
What trends in vital signs would occur if increased intracranial pressure is rising?
Increasing temp, decreasing pulse, decreasing respirations, increasing BP
What position would a nurse avoid in a pt with increased intracranial pressure?
Head turned to the side
The nurse determines that the pt understands the measures to prevent elevations in intracranial pressure if the nurse observes the pt doing what activity?
Exhaling during repositioning
A pt has clear fluid leaking from the nose following a basilar skull fracture. How does the nurse determine that this is cerebrospinal fluid?
It separates into concentric rings and tests positive for glucose
A client is admitted to the hospital for observation after an MVA. How long does the nurse leave the cervical collar in place?
Until the result of spinal x-rays is known
In what position is a pt placed after a craniotomy with a supratentorial incision?
Head of bed is elevated 30-45 degrees, head and neck midline
A pt with a cervical spine injury has Crutchfield tongs applied in the ER. What would the nurse avoid when planning care for this pt?
Removing the weights to reposition the client
What are the signs and symptoms of autonomic dysreflexia?
Severe, throbbing headache
A pt with spinal cord injury suddenly experiences an episode of autonomic dysreflexia. After check vital signs, what should the nurse do immediately?
Raise the head of the bed and remove the noxious stimulus
What finding is an early indication that the level of consciousness is deteriorating in a pt with an intercranial aneurysm?
What is included as part of the precautions for a client with a cerebral aneurysm?
Remove the pillow and raise the padded side rails
A nurse is planning care for the pt with hemiparesis of the right arm and leg. The nurse incorporates in the care plan the placement of objects where?
Within the client�s reach, on the left side
A nurses assesses spinal cord-injured pt who is diaphoretic, with a flushed face and neck, pulse at 40 beats/min, BP is 230/10. What is this client experiencing?
What are the precipitating factors for a pt who has experienced an episode of mayasthenic crisis?
Omitted doses of medication
What would the nurse plan to do to ensure client safety in the pt who has an impairment of cranial nerve II?
Provide a clear path for ambulation without obstacles
What is the neurotransmitter that primarily affects motor function and is involved in gross subconscious movements of the skeletal muscles?
What accurately describes age-related changes of the neurologic system?
As neurons are lost with aging, there is deterioration in neurologic function
What is the term for the condition where a pt with a neurologic disorder is not able to comprehend the written or spoken word?
What diagnostic test involves the use of differential signal characteristics of flowing blood to evaluate extracranial and intracranial blood vessels?
Magnetic resonance angiography (MRA)
What is the earliest sign of increased intracranial pressure?
Change in the level of consciousness (LOC)
What is the appropriate nursing response for a pt who suddenly begins to have a seizure?
Observe and record the seizure activity
What is the appropriate nursing care for a pt with multiple sclerosis?
Encourage a well-balanced diet high in fiber and adequate fluids
What is the autoimmune disease of the neuromuscular junction characterized by fluctuating weakness of certain muscle groups?
What are the appropriate nursing interventions for the pt with increased intracranial pressure?
Place neck in neutral position; teach pt to avoid valsalva maneuver; position pt to avoid flexion of hips, wais, and neck; suction only as necessary, no longer than 10 seconds
What is the most common seizure?
What are the two stages of a seizure?
Tonic & clonic
What happens during the tonic stage of a seizure?
The pt stiffens up
What happens during the clonic stage of a seizure?
What is the name of the period after a seizure during which the pt feels groggy and acts disoriented?
What is the term for a period when seizure activity occurs at such frequency that full consciousness is not regained between seizures?
How is a pt placed during a seizure?
On their side
What is the term for a sensation as a light or warmth, that may precede an attack of migraine or an epileptic seizure?
What is the most common test used to evaluate seizures?
What are the nursing interventions when caring for a pt during a seizure?
Observe & record activity; lower pt to floor; don�t restrain; utilize padded side rails; do not leave pt alone