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Nervous system divided into:
Central nervous system =Brain and spinal cord
Peripheral nervous system = Cranial nerves and spinal nerves
Autonomic nervous system = Sympathetic and parasympathetic systems
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basic cell of the nervous system
neurons
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chemical substances that excite, inhibit, or modify response of another neuron
neurotransmitters
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how do both hemispheres of the brain communicate
nerve fibers in the corpus callosum
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left hemisphere specializes in?
analysis, problem solving, calculation, communication
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right side of the brain specializes in
art, music, nonverbal communication, spiritual aspects
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amount of CSF produced daily
500 ml
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main function of ANS
maintain homeostasis
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system activated by stress - flight or fight response
sympathetic nervous system
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system that restores, conserves, adn maintains vital body function
parasympathetic nervous system
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health history assessment includes
- Headaches
- Clumsiness
- Loss or change in function of extremity
- Seizure activity
- Numbness or tingling
- Change in vision
- Pain
- Extreme fatigue
- Personality changes
- Mood swings
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glasgow scale of 3
deep coma
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glasgow scale of 7
state of coma
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ability to recongnize object by feel
stereogenesis
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sense of joint position in space
propreoception
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ability to recognize shapes drawn on the skin
graphasthesia
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testing reflex: plantar flexion is normal or abnormal
normal
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fanning of the toes or dorsiflexion is normal or abnormal
abnormal - positive babinski indicates corticospinal disease
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Trauma to scalp, skull, or brain
head injury
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abscence of achilles reflex in the elderly is _____ considered _____-
not
abnormal
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TIA symptoms
- blurred vision
- balance
- loss of balance/coordiantion
- difficulty speaking/understanding
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mnemonic indicators of stroke
strtt
- smile
- talk
- raise both arms
- tongue
- time
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Brain Injury by Acceleration
moving object
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Brain Injury by decceleration
head strikes solid object
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major risk factor for stroke
hypertension
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Complications of head injury
Hemorrhage, cerebral edema, and ICP
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mgmt an focus of head injury
focuses on early recognition,treatment of increasing intracranial pressure, and maintenance of normal bodyfunctions
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Space-occupying intracranial lesions
–Either benign or malignant
brain tumor
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AKA brain attack or stroke
Loss of function, temporary or permanent
CVA
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Frequently precedes stroke
Temporary impairment of blood flow to
brain
May last from few seconds to 24 hours
TIA
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med surg mgmt of stroke
- Airway maintenance and supportive therapy
- during first 24 to 48 hours
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embolic stroke activity
HOB flat
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hemorrhagic stroke activity
HOB elevated
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Chronic, progressive, degenerative disease
Affects area of brain controlling movement
Symptoms: Muscular rigidity, bradykinesia, resting tremors, muscular weakness, and loss of postural reflexes
parkinsons
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cause of parkinsons
unknown, but maybe be associated with toxicity, hypoxia, encephalitis
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parkinsonian syndrome is caused by
- cocaine
- haldol
- clorpromazine
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nurse suspcts ___ when she notices monoone voice, pill rolling of hand, and mask like face, shuffling gait
parkinsons
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parkinsons major cause of death
imobility or injury
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med mgmt for PD
- control symptoms
- provide support
- phyio & psychotherapy
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is there a cure for PD
NO
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PD activity advisemnt for caregivers
encourage cleint to be independent as possible
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diet for PD
high fiber pureed diet with 2000 ml of fluids bc of constipation and dysphagia
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Chronic, progressive, degenerative disease of central nervous system
Characterized by loss of myelin by hardened patches: Decreases nerve conduction
Multiple sclerosis
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MS is more prevelent in _____ people, and in ____ gender
northern european ancestry
female
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why is MS sometimes hard to Dx
bc of periods of exacerbation and remission
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MS Dx is based on?
Hx and elimination of oher possible Dx
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MS exacerbation periods last?
hours - months
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complication of MS
- pneumonia
- depression
- UTI
- pressure ulcer
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is there a cure for MS
no
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Tx goals for MS
- limit exacerbation
- prevent complication
- maintain functional level
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it is also imporant to educated MS clients about
temperatre sensation
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MS cleints are a risk for?
falls
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emphasize avoiding ____ wih MS
stress, infection, fatigue
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encourage ___ with MS
independence
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medications for MS
- interferon
- immunosupresseive
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Progressive, fatal disease
Characterized by degeneration of motor
neurons in cortex, medulla, and spinal cord
No cure
lou gheregs (amyotrophyic lateral scerosis
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•Usual life expectancy from diagnosis for Lou Gheregs
3 yrs
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lou gheregs cause is unknown, bt researchers say it may be related to?
viral immune response or genetic defect
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areas that atrophy first in lou gheregs
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medsurg mgmt for lou gherigs
treat s/s to promote life as long as possible
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only drug currently approved for ALS
riluzole
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precaution with ALS?
aspiration
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Progressive, degenerative neurological disease
Brain cells destroyed
Clients with advanced disease cannot be left alone
alzheimers
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alzheimers: part of the brain responsible for learning, memory, and emotions that become affected
hippocampus
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risk factors for alzheimers
- age
- female gender
- head injury
- Hx thyroid disease
- chromosomal disease
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test to help MD Dx alzheimers
neuropsychological test
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difinitive Dx of alzehimers is
autopsy brain biopsy
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can progression of alzheimers be stopped by drugs
no
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nursing mgmt for alzhimers
maintain safe structered environment and keep consistent daily schedule
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AD risk for?
injury & insomnia
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AD:
______ care important for health of
caregiver
respite
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Acute inflammatory process involving motor and sensory neurons of peripheral nervous system
Cause unknown but many preceded by infection (autoimmune or viral)
Demyelination begins in distal nerves and
ascends symmetrically
Remyelination occurs from proximal to distal
guillain barre symdrome
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GB causes:
paralysis, weakness, difficult swallowing, abscence of reflexes.
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3 stages of GBS
- acute onset: 1-3 weeks
- Plateu: several days - 2 weeks
- recovery: remylination - 2 years
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Dx for GBS
- recent viral infection
- high protein level in CSF
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goal mgmt for GBS
prevent & treat complications : immobility, infection, resp failure
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nursing Dx for GBS
- impaired mobility
- ineffective breathing pattern
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Pain in head caused by stimulation of pain-sensitive structures in cranium, head, or neck can be primary or secondary
•Primary:Tension, migraine, and cluster
•Secondary: Result of pathological condition ie: aneurysm, brain tumor, inflamed cranial
nerves.
HA
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type of HA that is common and causes throbbing steady ache on both sides
tension HA
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migraine HA more prevelant in ___ gender
female
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type of HA that causes aura's (silent HA) vomiting, photophobia, nausea, irritabilty, anorexia and can be triggered by food or chemicals
migraine
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type of HA that develops around or behind eye and is very severe, eye ma tear, may become congested, awaken in sleep
occurs more in mean
Alcohol triggers attacks
cluster HA
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if no cause is found for HA suspect ____
primary HA
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nurse mgmt for HA
releive pain
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•Condition of cranial nerve V
•Characterized by abrupt paroxysms of pain
and facial muscle contractions
- treat pain (nerve blocks) get surgery
Trigeminal Neuralgia (Tic Douloureux)
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•Encephalitis–Inflammation of brain
•Meningitis–Inflammation of meninges
•Caused by virus, bacteria, fungi, or parasites
-give quiet environment minimize light, isolate
•Can cause cerebral edema, hemorrhage, and
necrosis of brain tissue
encephalitis/meningitis
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s/s of encephalitis/meningitis
- fever
- ha
- nuchal rigidity
- lethargy
- vomiting
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is meningitis contagious
yes
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meningitis - _____ IS PERFORMED BEFORE ABX
LP
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•Chronic, progressive hereditary disease of nervous system
•Symptoms:Chorea (abnormal, involuntary,
purposeless movements), difficulty chewing or swallowing, speech impairment, and bowel or bladder incontinence
•Mental or intellectual impairment
progresses to dementia
•Death usually results from heart failure,
pneumonia, infection, or choking
•Must collaborate with social worker,
chaplain, physician, and mental health worker
huntingtons
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onset of huntingtons
35-45 w/ death occuring 10-15 yrs after
everyone with gene will have it
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diet for huntingtons
high calorie
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Neurological movement disorder with Prominent behavioral manifestations
•Symptoms: Motor tics, involuntary repetitive
movements of mouth, face, head, or neck, involuntary swearing, echolalia, and
involuntary repetition of speech of others, copralalia (involuntary swearing)
common in males.
onset before 18
inhereted
•Treatment: haldol ritalin, psychotherapy, family
counseling, and emotional support
Gilles De La Tourette’s Syndrome
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controls all body functions from movement to thinking to processing info
nervous system
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frontal lobe specialized in
- emotions
- attitude
- judegment
- personality
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parietal lobe specialized in
all senses except smell
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temperol lobe specializes in
- memory
- audiotry
- interpretation
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occipital lobe specializes in
vision
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