Neuro

Question 1

• neurons are lost, leading to a decrease in the number of synapses and neurotransmitters(results in slowed nerve conduction and response time)
• brain weight decreases
• Ventricle size increases to maintain cranial volume
• temperature regulation is less efficient
• myelin is lost in the PNS resulting in conduction velocity in some nerves.
• VIsual and auditory nerves degenerate
• Taste buds and sense of smell atrophy
• Nerve cells of the vestibular system in the inner ear degenerate
• DTR’s can be decreased
• Overall slowing of ANS responses
• Pupillary responses are reduced or may not appear at all in the presence of cataracts

Answer 1

The older adult

Question 2

low-pitched clear voice, do not shout
provide auditory and visual aids
Provide instruction at an un-rushed pace

Answer 2

speaking to an older adult

Question 3

• Educate the patient about lying completely still
• Review relaxation techniques for pt. with claustrophobia
• assess for iodine or shellfish allergy if contrast was used.
• Monitor kidney function for pt. receiving contrast
• Encourage fluid intake

Answer 3

Nursing interventions for CT scan

Question 4

• Monitor BUN and creatnine
• Keep patient well hydrated up until test
• Instruct patient to void immediately before the test.
• Mark peripheral pulses with a skin marker
• They must lie still and they should expect a brief feeling of warmth in the face as dye is ejected and they may taste a metallic taste.
• Neuro assessment as soon as they come back and check peripheral pulses
• Monitor insertion site for bleeding or hematoma
• Encourage fluids

Answer 4

Nursing interventions for Cerebral Angiography

Question 5

• Pt. may need to be deprived of sleep the night before
• Anti-seizure meds, tranquilizers, stimulants, and depressants should be withheld 24 to 48 hours before an EEG because they alter the wave patterns.
• Coffee, tea, chocolate and cola are omitted from the meal before the test
• The patient SHOULD eat before the test because an altered blood glucose level can cause changes in brain wave patterns

Answer 5

Nursing interventions EEG

Question 6

• Have the patient remain prone
• If more than 20 mL of CSF is removed have them positioned supine for 6 hours
• Bed rest, analgesic agents, and hydration

Answer 6

managing a headache for post lumbar puncture

Question 7

A test used to screen for balance that can be down with the patient seated or standing with feet together and arms at the side, first with eyes open and then with both eyes closed for 20 seconds.

• Stay near them incase they fall
• Swaying is normal but a loss of balance is not

Answer 7

Romberg test

Question 8

The general loss of ability to recognize objects through a particular sensory system

Answer 8

Agnosia

Question 9

The absence of reflexes is a significant finding

Answer 9

reflexes

Question 10

a state of unresponsiveness to the environment in which the patient makes no voluntary movement

Answer 10

Akinetic mutism

Question 11

a condition in which the unresponsive patient resumes sleep-wake cycles after a coma but is devoid of cognitive or affective mental function

Answer 11

persistent vegetative state

Question 12

the patient has inconsistent but reproducible signs of awareness.

Answer 12

minimally conscious state

Question 13

results from a lesion affecting the pons and results in paralysis and the inability to speak, but vertical eye movements and lid evaluation remain intact

Answer 13

locked-in syndrome

Question 14

This is how the two hemispheres of the brain communicate.

Answer 14

The corpus callosum

Question 15

has both excitatory and inhibitory actions and is largely responsible for coordination and movement.

Answer 15

the cerebellum

Question 16

contains areas that control the heart, respiration, and BP

Answer 16

the brain stem

Question 17

This score on the GCS indicates severe impairment of neurological function, brain death or pharmacologic inhibition of neuro response.

Answer 17

3

Question 18

This GCS score indicates that the patient is fully responsive

Answer 18

15

Question 19

The first priority for a patient with altered LOC

Answer 19

maintain patent airway

Question 20

These are some of the complications that could occur from altered LOC

• respiratory failure
• pneumonia
• aspiration
• pressure ulcer
• VTE
• contractures

Answer 20

complications

Question 21

The nurse must assume basic responsibilities for the patient until basic reflexes return (coughing, blinking and swallowing)

Answer 21

impaired reflexes in the comatose patient

Question 22

• Temperature must be controlled because temperatures tend to rise when the person is unconscious
• If temp. rises to high permanent brain damage can occur
• Never take temp of an unconscious person by mouth

Answer 22

Unconcious patient

Question 23

• Remove all bedding except maybe a light sheet
• Administer acetaminophen as prescribed
• Give cooling sponge baths and allow an electric fan to blow over the patient
• Use a hypothermia blanket (cooling blanket)
• frequent temp.monitoring to assess the patients response to therapy and to prevent an excessive decrease in temp.

Answer 23

reducing fever

Question 24

Because of limited space for expansion within the skull, an increase in the volume of with brain tissue, blood or CSF causes a change in the volume of the other components.

Answer 24

Monro-Kellie hypothesis

Question 25

Cerebral perfusion pressure= MAP-ICP | normal range 70-100 mm Hg

Answer 25

CPP

Question 26

when cerebral blood flow decreases significantly. It can be recoverable if fixed rapidly.

Answer 26

Cushing's response

Question 27

bradycardia, HTN, and bradypnea. It is a grave sign

Answer 27

Cushing's triad

Question 28

shifting of the brain tissue from an area of high pressure to low pressure

Answer 28

herniation

Question 29

The earliest sign of ICP

Answer 29

change in LOC. other early indicators agitation, slowed speech, delayed response

Question 30

This procedure is avoided in patients with increased ICP because it can lead to herniation.

Answer 30

lumbar puncture

Question 31

complications include brain stem herniation, diabetes insipid and SIADH.

Answer 31

increased ICP

Question 32

caused by increased secretion of ADH. -Volume overload, urine output diminishes (S-I-A-D-H, S-I-A-D-H, S-I-A-D-H, This hormone stops the PeePee.) tx- restrict fluids, and monitor electrolytes

Answer 32

SIADH

Question 33

the result of decreased secretion of ADH. -Excessive urine output, decreased urine osmolality and serum hyperosmolarity. (Pee pee give IV's vasopressin they need.)

Answer 33

diabetes insipidus

Question 34

- administer osmotic diuretics i.e(mannitol) - RESTRICT FLUIDS - drain CSF - control fever - maintain BP and oxygenation - reduce cellular metabolic demands

Answer 34

management of ICP

Question 35

this med helps to reduce edema surrounding the tumor(if a tumor is the cause of increased ICP)

Answer 35

corticosteroids i.e (Decadron)

Question 36

frequent pupil checks, assessment of cranial nerves, frequent measurements of vital signs and ICP, and use of the Glasgow Coma Scale

Answer 36

assessment of increased ICP

Question 37

- keep patient's head in a natural midline position, maintained with the use of a cervical collar if necessary to promote venous drainage. - elevate HOB 30-45 degrees - extreme rotation of head and neck are avoided - extreme hip flexion is avoided - avoid valsalvas maneuver(give stool softeners) - instruct the patient to exhale while moving in bed - maintain a calm atmosphere(noise and conversation should be minimal)

Answer 37

increased ICP

Question 38

monitor for these complications for the patient receiving mannitol

Answer 38

heart failure and pulmonary edema

Question 39

attention should be paid to this post craniotomy because it could indicate CSF trickling down the throat.

Answer 39

salty taste or postnasal drip

Question 40

a group of seizures characterized by unprovoked, recurring seizures

Answer 40

epilepsy

Question 41

inability to express oneself aka non-fluent aphasia

Answer 41

expressive aphasia

Question 42

inability to understand language aka fluent. They can read or speak but can't understand the meaning of a message

Answer 42

receptive aphasia

Question 43

- Paralysis or weakness on the right side of the body - Right visual field deficit - Aphasia - Altered intellectual ability - Slow and cautious behavior

Answer 43

Left sided stroke

Question 44

- Paraylsis or weakness on the left side of the body - Left visual field deficit - Spatial-perceptual deficits - Increased distractability - impulsive behavior and poor judgement - lack of awareness of deficits

Answer 44

Right sided stroke

Question 45

blindness in half of the eye

Answer 45

hemianopsia

Question 46

inability to perform previously learned action

Answer 46

apraxia

Question 47

deficits in the ability to recognize previously familiar objects

Answer 47

agnosia