adult neuro for final

  1. s/sx of meningitis
    • nuchal rigidity
    • severe headache
    • fever
    • photophobia
    • petechial rash
    • positive kernigs and brudzinskis signs
    • nausea and vomiting
    • encephalopathy
  2. kernigs sign
    • flexion of pt hip to 90 degrees then extend knee
    • pain in hamstring indicates meningeal infection
  3. brudzinski's sign
    flexion of both hips when pts neck is flexed indicates meningeal infection
  4. nursing care for pt with meningitis
    • avoid coughing and don't hold breath during turning
    • monitor for signs of increasing ICP
    • lower body temp to reduce metabolic rate
    • elevate HOB
    • risk for seizure and fall precautions
  5. s/sx of encephalitis
    • directly related to area of brain affected
    • fever
    • nuchal rigidity
    • headache
    • nausea
    • vomiting
    • tremors
    • photophobia
    •  cofusion
    • delirium
    • agitation and restlessness
    • comatose or exhibition of aphasia
    • hemiparesis
    • facial weakness
  6. encephalitis
    • inflammation of the brain causing necrosis, edema and nerve cell damage
    • usually caused by insects or herpes simplex type 1
  7. initial signs of increased ICP
    • restlessness
    • irritability 
    • decreased LOC
  8. late signs of increased ICP
    • blown pupil on affected side
    • cushings triad
    • vomiting
    • headache
    • rising temperature
    • decorticate then decerebrate  posturing
  9. cushings triad
    • widening pulse pressure
    • irregular breathing
    • bradycardia
  10. treatment for pt with increased ICP
    • HOB at least 30 degress to promote drainage
    • mannitol
    • corticosteroids
    • controlled hyperventilation
    • avoid flexing neck and keep it in midline position
    • antiemetics and anittussives
    • stool softeners
    • minimal suctioning
    • avoid hip flexion to minimize thoracic pressure
    • low stimulus environment
  11. mannitol
    • hyperosmolar diuretic used to decrease ICP
    • draws fluid from tissue into blood stream
    • pt urine output should be increased
  12. purpose of corticosteroids for a person with ICP  or cerebral edema
    dexamethasone will decrease ICP and cerebral edema
  13. concussion
    • mild brain injury
    • characterized by nausea and vomiting, headache and dizziness
    • may have amnesia before or after event
    • loss of consciousness for 5 minutes or less
  14. epidural hematoma
    • arterial bleeding between dura mater and skull
    • pt loses consciousness right after injury
    • regains consciousness and is briefly coherent
    • rapidly deteriorates
    • must initiate airway management and control ICP immediately
    • develops dilated pupils and extraocular muscles
  15. epidural hematoma tx
    • mannitol 
    • mechanical hyperventilation constricts blood vessels
    • therapeutic coma
  16. spinal shock
    • spinal cord is damaged
    • cord below damage causes loss of reflex and flaccidity in extremities
    • urine and feces are retained
    • vasodilation, hypotension and bradycardia
  17. autonomic dysreflexia
    • complication of injury above T6
    • commonly cause by bladder distension, wrinkled sheets or  ingrown toe nails
  18. s/sx of autonomic dysreflexia
    • cool, pale skin below injury with gooseflesh
    • b/p rapidly rises to 300
    • bradycardia as low as 30
    • pounding headache and nasal congestion secondary to dilated blood vessels
  19. purpose of crutchfield and gardener-wells tongs
    keeps head and neck immobile while fusion and healing take place
  20. multiple sclerosis
    • progressive degenerative disorder
    • myelin sheath of neurons become inflamed and block signals
  21. s/sx of multiple sclerosis
    • aggravated by extreme heat and cold, fatigue, infection and physical and emotional stress
    • difficulty with concentration or forgetfullness
    • muscle weakness
    • diplopia
    • slurred speech
    • muscle spasticity
    • numbness and tingling
    • vertigo 
  22. MS has periods of exacerbation and remission, what are some factors that can exacerbate the condition
    • extreme heat and cold
    • fatigue
    • infection
    • physical and emotional stress
  23. MS tx
    • interferon therapy
    • steroids
    • immunosuppressants
    • anticonvulsants
  24. myasthenia gravis
    • weakness of the voluntary or skeletal muscles of the body
    • body attacks and destroys ACh receptors
    • muscle contractions cant be stimulated by ACh
    • muscle strength is reduced
    • associated with thymus disorders
  25. s/sx of myasthenia gravis
    • increased muscle weakness during activity and improvement in muscle strength after rest
    • often present with ptosis
    • voice fades after long conversation
    • stress exacerbates condition
  26. tensilon test
    • for myasthenia gravis pts
    • inject with tensilon
    • if muscle strength increases dramatically; diagnosed with myasthenia gravis
  27. myasthenic crisis
    • sudden onset of muscle weakness
    • not enough medication taken; meds must be taken on schedule
  28. cholinergic crisis
    • too much anticholinisterase drugs
    • causes increasing muscle weaknes
    • dyspnea
    • salivation
    • lacrimation
    • urination
    • sweating
  29. ALS
    • progressive degenerative condition that affects motor neurons
    • primary symptoms are progressive muscle weakness
    • pt may have inappropriate emotional outburst of laughing and crying
    • pts usually die from respiratory complications
  30. guillain-barre syndrome
    •  short term muscle weakness that either ascends or descends and progresses to paralysis
    • may require intubation and artificial ventilation
    • pts recover within a few months to a year
  31. trigeminal neuralgia
    • intense recurring pain described as sudden, jabbing or knife like
    • triggered by slight touch, cold breeze, talking or chewing
    • anticonvulsants and alcohol injections help with pain
  32. bells palsy
    • affects facial nerve
    • present in pregnant, hiv, diabetes, herpes
    • pain behind the ear followed by facial paralysis
    • facial sling helps
    • prednisone decreases inflammation
Card Set
adult neuro for final
adult neuro for final