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64 Cards in this Set
- Front
- Back
What do you assess pre craniotomy?
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What do you assess pre craniotomy? Baseline neuro status
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Craniotomy post op, what is abnormal?
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Craniotomy post op, what is abnormal? 117 sodium level
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Infratentorial (area between cerebellum and brainstem) position?
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Infratentorial (area between cerebellum and brainstem) position?
Flat or on their side for 24-48 hours |
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Supratentorial (cerebrum) craniotomy position?
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Supratentorial (cerebrum) craniotomy position? HOB at 30 degrees
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S/S when a closed head injury becomes SIADH?
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S/S when a closed head injury becomes SIADH? JVD
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S/S when a closed head injury becomes Diabetes Insipidus?
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S/S when a closed head injury becomes Diabetes Insipidus? Polyuria
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ICP monitoring and its going up what secondary thing do you monitor for?
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ICP monitoring and its going up what secondary thing do you monitor for? Infection
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Brain tumor with ICP increasing, how can you protect the patient?
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Brain tumor with ICP increasing, how can you protect the patient? HyperO2 patient with 100% and suction no more than 10 seconds, keep a quiet environment and STOOL SOFTENERS
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Intubated pt with increased ICP?
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Intubated pt with increased ICP? HyperO2 with 100% and suction no more than 10 seconds
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Pt with traumatic brain injury and comatose, how can you decrease ICP?
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Pt with traumatic brain injury and comatose, how can you decrease ICP? Keep PaCO2 @ 35
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Pt in coma with closed head injury, how can you keep ICP down?
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Pt in coma with closed head injury, how can you keep ICP down? Put pt head in midline and neutral with HOB 15 degrees
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Why do you place the head in midline and neutral?
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Why do you place the head in midline and neutral? Promote venous return
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Why do you place the head in midline and neutral?
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Why do you place the head in midline and neutral? Promote venous return
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dysarthria?
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dysarthria? slurred speech
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To do for pt with impaired swallowing?
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To do for pt with impaired swallowing? Thick liquids and soft foods
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Traumatic brain injury, what are you most concerned with?
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Traumatic brain injury, what are you most concerned with? Unilateral pupil changes
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Halo Sign?
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Halo Sign? Test for CSF. Take a drop of blood from nose or ear and drop onto a gauze pad, if the blood coagulates in the middle and a yellow colored "halo ring" forms around the outside = positive for CSF
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S/S of basilar skull fracture?
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S/S of basilar skull fracture? raccoon eyes and battle's signs
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Problem with chewing/swallowing, what do you assess for?
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Problem with chewing/swallowing, what do you assess for? Weight loss, get a baseline
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Head injury question, what do you notify MD about immediately?
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Head injury question, what do you notify MD about immediately? Pt is difficult to arouse
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Traumatic Brain Injury, what do you monitor for?
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Traumatic Brain Injury, what do you monitor for? Neuro status, VS, ABC's and increased ICP
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S/S of ICP?
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S/S of ICP? Cushings Triad = Severe HTN, wide pulse pressure, bradycardia and bradypnea
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How do you suction a pt with increased ICP?
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How do you suction a pt with increased ICP? HyperO2 with 100% and then suction for no more than 10 seconds
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Stroke (Brain Attack), take BP on unaffected side as affected side will read bottomed out
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Stroke (Brain Attack), take BP on unaffected side as affected side will read bottomed out
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Left sided hemiplegia, how can you help with rehab?
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Left sided hemiplegia, how can you help with rehab? Position to prevent contractures, perform ROM
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Stroke pt has double vision, how can you help? Cover the affected eye
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Stroke pt has double vision, how can you help? Cover the affected eye
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Stroke pt and MD orders bedrest, how can you prevent footdrop?
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Stroke pt and MD orders bedrest, how can you prevent footdrop? Splint
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Stroke pt and MD orders bedrest, how can you prevent footdrop?
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Stroke pt and MD orders bedrest, how can you prevent footdrop? Splint
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Right hemisphere CVA S/S?
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Right hemisphere CVA S/S? Implusiveness and poor judgement
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Pt with Guillain Barre Syndrome, what do you ask about history?
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Pt with Guillain Barre Syndrome, what do you ask about history? Recent viral infection of any kind. Most likely gastroenteritis or upper respiratory infection
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GBS assessment findings?
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GBS assessment findings? Ascending symmetric muscle weakness
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GBS diagnostic?
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GBS diagnostic? Electromyography (electric current to test muscles)
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Pt comes in with GBS and they are weak and tingly in both legs, what do you assess first?
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Pt comes in with GBS and they are weak and tingly in both legs, what do you assess first? AIRWAY, lungs and pulse ox
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Pt with GBS exacerbation and mild dyspnea, what do you do?
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Pt with GBS exacerbation and mild dyspnea, what do you do? Put them in a sitting position first and foremost
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S/S of GBS getting better?
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S/S of GBS getting better? Even unlabored respirations
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DX pt with diplopia, fatigue and ptosis?
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DX pt with diplopia, fatigue and ptosis? Myasthenia Gravis
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Myasthenia Gravis = Women 20-30 (more often) and men 60-70
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Myasthenia Gravis = Women 20-30 (more often) and men 60-70
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MG patho?
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MG patho? Autoimmune disease where the autoantibodies attack the acetycholine receptors
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MG is associated with the Thyroid
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MG is associated with the Thyroid
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MG history is being taken, what will you most likely hear about?
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MG history is being taken, what will you most likely hear about? muscle weakness and fatigue
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MG finding that you should report immediately?
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MG finding that you should report immediately? Inability to swallow
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Diagnostic for MG?
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Diagnostic for MG? Tensilon. (this confirms a diagnosis of MG. it temporarily improves muscle function within 30 to 60 seconds after IV injection of edrophonium and neostigmine and lasts up to 30 minutes) Tensilon also distinguishes between MG crisis and Cholinergic crisis. If you get improvement its MG crisis and if you get worsening its a cholinergic crisis
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S/S of MG crisis?
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S/S of MG crisis? Restlessness, dyspnea and increased salivation and tearing
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S/S of Cholinergic Crisis?
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S/S of Cholinergic Crisis? Abdominal cramps, blurred vision and facial twitch
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MG drugs?
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MG drugs? Neostigmine and Pyridostigmine
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MG drugs?
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MG drugs? Neostigmine and Pyridostigmine
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TX for malignant tumor?
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TX for malignant tumor? Chemo, Radiation and Surgery
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What do MG, GB and ALS all have in common?
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What do MG, GB and ALS all have in common? Respiratory complications
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Clinical indicator of Trigeminal Neuralgia (tic douloureaux)?
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Clinical indicator of Trigeminal Neuralgia (tic douloureaux)? Excruciating facial pain
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TN involves how many branches total?
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TN involves how many branches total? 3
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TN drug?
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TN drug? Gabapentin
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TN pt to help with disease instruct them to?
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TN pt to help with disease instruct them to? Avoid talking, smiling, shaving, washing face, brushing teeth, avoid walking swiftly and no fans. Discourage chewing on affected side and no hot or cold fluids
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TN #1 priority?
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TN #1 priority? Pain management with Gabapentin
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How do you provide a safe environment for Bells Palsy pt?
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How do you provide a safe environment for Bells Palsy pt? Prevent corneal damage
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Bells Palsy med used?
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Bells Palsy med used? Non narcotics (tylenol and ibuprofen)
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Transient Ischemic Attack pt on cardiac monitor, what would show if at risk for emboli?
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Transient Ischemic Attack pt on cardiac monitor, what would show if at risk for emboli? AFIB
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TIA S/S?
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TIA S/S? Unilateral Weakness
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Stroke pt #1 risk factor?
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Stroke pt #1 risk factor? Obesity
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S/S of cerebral aneurysm?
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S/S of cerebral aneurysm? Severe headache
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What do you do for the cerebral aneurysm pt with severe headache?
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What do you do for the cerebral aneurysm pt with severe headache? CALL MD
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HTN pt slurring and has right sided weakness, what to do?
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HTN pt slurring and has right sided weakness, what to do? Assess ABC's
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Pt recovering from stroke and NPO, what cranial nerves do you test to see if gag reflex is back?
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Pt recovering from stroke and NPO, what cranial nerves do you test to see if gag reflex is back? 9 and 10
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Stroke pt that is comatose what will you see?
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Stroke pt that is comatose what will you see? Urinary incontinence
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Global aphasia pt ok to assign to a CNA?
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Global aphasia pt ok to assign to a CNA? NO
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