Med Surg Neurologic System Chap 21

Front 1

How would you explain an electroencephalogram to patient.

Back 1

The patient will be lying down or reclining and that about 16 electrodes will be postioned on his head using a gel-paste.
must be still with eyes closed and in a steady position for 45 mins to 2 hours, depending on special test that are administered along with the EEG. The test will be stopped so that he can move if needed about every 5 mins. he will not feel anything, while recording the brain waves is made. Ask him to wash his hair the evening before the test and not to put any hair products on it after shampooing. No caffeine before test. The gel-paste needs to be washed out after test.

Front 2

How many electrodes used in EEG

Back 2

about 16

Front 3

Where would the electrodes be positioned for an EEG

Back 3

On the head using gel-paste

Front 4

What position should a patient be in during an EEg

Back 4

Lying down or reclining

Front 5

During an EEG should the patient have their eyes open or closed

Back 5

closed

Front 6

An EEG takes approx. how long

Back 6

45 mins to 2 hours depending on special tests that are administered along with the EEG

Front 7

How often will the EEG test be stopped so that the patient can move, if needed

Back 7

About every five minutes.

Front 8

Will the patient feel any pain/anything from the EEG test.

Back 8

No, the patient will not feel anything during the EEG.

Front 9

An EEG records ______ waves

Back 9

brain

Front 10

What should the patient do/not do the evening/moring before an EEG

Back 10

wash hair before the test and do not put any hair products on it, after shampooing.
NO Caffeine

Front 11

After the test is completed the nurse must ______ the gel.

Back 11

wash out

Front 12

CT scan is a special type of

Back 12

X-ray that is computer assisted.

Front 13

What position is the patient in during a CT scan

Back 13

lying

Front 14

What can you do to alleviate a Patient Anxiety prior to a CT scan

Back 14

Show the patient a picture of the machine.

Front 15

If the patient has claustrophobia, what therapeutic measure can be implemented

Back 15

a sedative may be ordered for them

Front 16

True or False
Should a pt. be NPO prior to a CT scan

Back 16

true

Front 17

The Patient will be NPO____ hours prior a CT scan

Back 17

four

Front 18

True or Fasle
Prior to a CT scan a patient should have an IV started if there is not one in place.

Back 18

true

Front 19

True or fasle
An IV line is always needed if contrast medium is used during a CT scan.

Back 19

true

Front 20

Prior to a CT scan allergy to _____ must be asked.

Back 20

dyes

Front 21

Prior to a CT scan patients must remove all______

Back 21

metals, including dentures.

Front 22

Patient should be in what position during a CT scan

Back 22

supine, with the head secured within a water-filled box to prohibit movement throughout the test.

Front 23

True or False
During a CT scan the patients face will be covered.

Back 23

false,
the face will not be covered.

Front 24

True or False
The patient will hear a clicking sound as the CT scan is being proformed.

Back 24

True

Front 25

A CT scan will take approx. ___ to ___ hrs.

Back 25

one to two hours, depending on whether the test is done with or without contrast medium.

Front 26

During a CT scan if contrast medium is used the client may experience

Back 26

1) Salty taste,
2) Flusing
3) Warmth during injection

Front 27

After CT scan, if contrast medium was used the client needs to be insructed to.......,
(WHY).

Back 27

Drink a lot of fluids in order to flush the dye from his system and rehydrate.

Front 28

True or false
MRI exposes clients to radiation.

Back 28

False.

Front 29

True or false
During a MRI/CT scan sedation can be administed to a client who is clautrophobic

Back 29

true

Front 30

During a MRI the client should be instructed to remove all ____ objects.

Back 30

metal

Front 31

True or False
During a MRI moving by the client does not interfere with the test.

Back 31

False
The client needs to be motionless during the study

Front 32

True or false
For a MRI the client needs to be NPO prior to the study

Back 32

False, There are no food or fluid restrictions.

Front 33

True or False
A MRI machine makes a loud thumping sound

Back 33

True

Front 34

True or False
Ear plugs or earphones--for music--may be worn during a MRI test

Back 34

True

Front 35

True or false
The client should empty thier bladder before the a MRI test

Back 35

True

Front 36

True or False
For a MRI test the client will lie on a platform that will slide into the machine.

Back 36

True

Front 37

True or False
During a MRI the client will not be able to communicate with the technician

Back 37

False
The client can communicate with the technician

Front 38

An MRI test takes ____to___minutes

Back 38

30 to 90

Front 39

True or False
During a MRI a contrast medium may be injected via an IV line

Back 39

True

Front 40

What issues may a client have who has metal filling in their teeth

Back 40

The client may feel tinging in any teeth that have metal fillings

Front 41

For an MRI what postprocedure care is there

Back 41

There is no particular postprocedure care

Front 42

If you are to assess a client's neuro signs and they are using eyedrops for glaucoma that constrict the pupils, how would you evauate their pupillary responses

Back 42

Perform the baseline nero check just before the glaucoma drops are instilled. You can still perform pupil checks after the drops have been used, but you need to be aware that there will not be the degree of dilation that there would be in someone who is not using miotic drops.

Front 43

what assessments would you perform on a patient who suffered a head injury.

Back 43

1) oxygenation and respiration effort. 2) Neuro check and assess all the parameters for the Glasgow Coma scale score. 3) Assess the amount of CSF leakage by tracking its expansion on the dressing. 4) Monitor LOC frequently for signs of decreasing alertness. 5) Assess position for correct body alignment and head elevation.

Front 44

During a lumbar puncture to obtain CSF for studies, how would you position the patient

Back 44

On his side facing away from the the side of the bed, placing him as close to the edge of the bed as posible , while maintaining safety. Have the patient pull his knees up to his chest and pull his head down to meet his knees as far as he can. You will gently hold him in this position.

Front 45

During a lumbar puncture to obtain CSF for studies, what would you tell the patient about the procedure

Back 45

Explain that 1) A local anesthetic may be used to numb the skin and the tissue before the needle is inserted. 2) The needle will be inserted by the physician and pressure readings will be taken. 3) Some fluid will be withdrawn and placed in a sterile containers for special tests.

Front 46

True or False
Caffeine drinks and fluids may be encouraged to help prevent or alleviate headache.

Back 46

True

Front 47

A patient has leakage of CSF, what specific nursing measures would you include in your care plan concerning the leaking CSF

Back 47

Monitor for increase or decrease of CSF leakage. Observe for signs of infection since there is an open pathway to the brain.

Front 48

A patient with head injury, what measures would you take to provide appropriate respiratory care

Back 48

1) Assess the percentage of hemoglobin saturated with oxygen (SaO2) monitor closely!!! 2) Observe for abnormal respiratory patterns 3) Position on the side to keep the tonque from occluding the airway and the secretions will drain. 4) Monitor breath sounds for adventitious sounds indicating beginning atelectasis or hypostatic pneumonia.

Front 49

How would you plan the care of a patient with a spinal cord at the 6th thoracic vertebra during the acte stage of illness so that rehabilitation might be successful

Back 49

You would keep him immobilized during the acute stage to minimize further cord damage from edema and pressure. Nursing care for all the problems of immobility will be needed. The will not have normal bladder oan bowel function and will need to be intermittently catherterized or have care for an indwelling catheter. They will also need stool softeners and stimulation to produce a bowel movement via a suppository and/or digital stimulation.

Front 50

Which health care team members participate in the care and rehabilitation of a patient with severed spinal cord

Back 50

The physician, nurse, physical therapist, occupational therapist, and social worker. Other health care professionals will be call in for any special problems

Front 51

Jerking motion of the body,
what type of seizure is it most likely to be?

Back 51

This is most likely a generalized seizure, possibly a grand mal seizure.

Front 52

How do you care for a patient after a seizure is over

Back 52

Quietly and gently reorient them and explain that they have had a seizure. Check for injuries. If not in clinical setting call an ambulance or his family to come and get them. Allow them to sleep as long as they need after the seizure.

Front 53

If a patient is diagnosed with epilepsy, what patient teachings will they need

Back 53

1) Safety measures to prevent injuries. 2)Triggers that potentiate seizures. 3) Medication prescribed, emphasize the importancw of NOT STOPPING the medications abruptly or without notifying a Dr. 4) Side effect of medication and how to cope. 5) Obtain a bracelet that states they are epileptic with name and contact number. 6) Explain the importance of regular blood work and staying under the supervision of Dr. 7) Support group.

Front 54

What diagnostic test should be done for a tentative diagnosis of cardiovascular accident (CVA)

Back 54

1) A blood glucose level should be determined 2) A MRI study or a CT scan will be ordered. 3) An EEG may be ordered to see if there are abnormalities in the brain waves. 4) A neurolgic exam will be performed.

Front 55

What emergency care could you give a patient who may be having a CVA

Back 55

1) If not in clinical setting call ambulance. 2) Lower him to the floor with something placed under his head to decrease ICP. 3) Loosen clothing around neck. 4) Turn to side to prevent aspiration of secretions. 5) provide privacy 6) Talk to patient, reassure them that help is on the way (they may hear you although they appear unconscious).

Front 56

What are the priorities of care for a patient with CVA

Back 56

Protect the airway and provide oxygenation , blood presure to levels that will adequately perfuse the brain, control increasing ICP. Provide safety measures such as eyes while in comatose. Keep extremities in correct anatomical alignment if posible. Keep environment quiet and calm.

Front 57

What potential complications might a patient experience if they have had an intracerebral hemorrhage

Back 57

They may have a second intracerebral hemorrhage or develop hydrocephalus.

Front 58

Your patient had a bout of flu about a week ago. Today he noticed he was having trouble walking. When he got home from an errand, he had trouble pulling his sweater over his head. Which nerologic problem might he have.

Back 58

Guillain-Barre syndrome is a likely diagnosis. He seems to have an ascending weakness.

Front 59

Your patient had a bout of flu about a week ago. Today he noticed he was having trouble walking. When he got home from an errand, he had trouble pulling his sweater over his head. What might be done to establish a diagnosis(posible Guillain-Barre syndrome)

Back 59

A thorough history of his previous illness and of the onset of present complaints along with a thorough nerologic exam will provide sufficient data for diagnosis.

Front 60

Your patient had a bout of flu about a week ago. Today he noticed he was having trouble walking. When he got home from an errand, he had trouble pulling his sweater over his head. What would be a top priority in his care at this time.(posible Guillain-Barre syndrome)

Back 60

Closely assess respiration for adequacy of oxygenation. Safety, danger for falling

Front 61

With Guillain-Barre syndrome If the disorder progresses what further problems can occur

Back 61

May become paralyed, intubated and possibly mechanically ventilated. If dysphagia developes patient will not be able to communicate. Unable to perform ADL's or feed themselves. Experience considerable pain.

Front 62

Sinemet is a medication for what disease

Back 62

Parkinson's disease

Front 63

Teaching for Parkinson's disease

Back 63

They should be taught about schedule for taking medication and side effects. The need for excercise and streching. How to ambulate more safely. How to cope with excess secretions. How to deal with dysphagia. How to maintain adequate nutrition. How to deal with depression should it occur. Ways to make safe care easier.

Front 64

What are the potential complications of Parkinson's disease

Back 64

Contractures, complete immobility, constipation and possible dementia.

Front 65

Mestinon is used for which disease

Back 65

Myasthenia gravis

Front 66

What factors could cause myasthenia gravis to worsen

Back 66

Increase stress or emotional upset, respiratory infection and severe trauma

Front 67

1)What may happen if a patient with myasthenia forgets to take their medication.
2) The patient should watch out for

Back 67

1)They may begin to experience muscle weakness.
2) Diplophia (double vision), ptosis (drooping eyelid), extreme fatigue, dysphagia (difficulty in swallowing), and a weak speaking voice.