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33 Cards in this Set
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- Back
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Computed Tomography Scanning |
Uses narrow x-ray beam to scan body parts in successive layers. Provide cross-sectional view of the brain. Can be done with or without contrast. Ask women if they are pregnant. Assess kidney function. Assess for allergy to iodine and shellfish. Give mucomyst. Tell pt WHY they are having the test done; pt can't move in CT machine; not painful. IV? |
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Purpose of CT scan |
Used to look for tumor, masses in brain, and hemorrhage, and to diagnose stroke. Is PRIMARY diagnosis procedure for stroke/CVA. |
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MRI |
Assess for allergy to shellfish and iodine, and pain level, kidney function. Pt may need to be given IV anti anxiety meds. REMOVE ALL JEWELRY. Nothing metal or containing metal is allowed. No oxygen tanks, IV poles, metal patches, hip replacements. Open MRI is for people who are bigger or have anxiety. Can also be performed with or without contrast. |
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Purpose of MRI |
Diagnose MS (Multiple Sclerosis), brain tumors, and stroke. |
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Nursing intervention for MRI |
Pt is questioned about implants of any metal objects (pacemakers, artificial valves, UIDs, aneurysm clips, orthopedic hardware). Cochlear implants will be inactivated by MRI. Remove all metal objects from patient. Pt may be sedated with ease claustrophobia. Open MRI is available for larger patients or claustrophobic patients. |
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Nursing intervention for CT scan |
Educate pt about need to lie quietly throughout procedure. Sedation can be used if agitation, restlessness, or confusion interferes with a successful study. Ongoing pt monitoring is necessary. Assess pt for allergy to shellfish or iodine, kidney function. A suitable IV line for contrast injection and a period of fasting (usually 4 hours) are required before procedure. With IV, monitor pt for allergic reaction. |
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PET scan |
Computer-based nuclear imaging technique that produces images of actual organ functioning. Pt is given radioactive gas by inhalation or exhalation. |
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Purpose of PET |
Useful in showing metabolic changes in the brain (alzheimer's), location lesions (brains tumor, epileptogenic lesions). Used with cancer patients to see response to treatment; shows blood flow; detects alzheimer's. |
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Nursing interventions of PET scan |
Patient preparation involves explaining the test and educating the pt about inhalation techniques and the sensations that may occur. Radioactive gas makes pt feel hot, or like they have peed on themselves. Normal feeling. |
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Cerebral angiography |
X-ray that uses contrast agent inserted in the brachial or femoral artery. Similar to heart catheterization. Catheter is threaded through the femoral artery in groin and up to the desired vessel. Carotid artery may be used. |
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Purpose of cerebral angiography |
Used to determine vessel patency, identify presence of collateral circulation, and provide detail on vascular anomalies. Used to check for obstruction and blockages and narrowing. Carotid and vertebral arterial systems are visualized. |
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Nursing interventions for cerebral angiography |
Check kidney function (BUN and creatinine), allergy. Tell pt to void before test, and will have to lie still for 5-6 hours. Pt is at high risk for bleeding (at insertion site), so ask patient about OTC meds that may contain blood thinners (aspirin). Use local anesthetic at to decrease pan and discomfort at site of insertion. Mark peripheral pulses to check bilaterally. Use doppler if needed. Complication is hematoma. |
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Electroencephalography (EEG) |
Represent a record of the electrical activity generated in the brain. Is obtained through electrodes applied on the scalp or through micro electrodes placed within the brain tissue. Pt should expect brief warm feeling i the face, behind eyes, or in jaw, teeth, tongue, lips, and a metallic taste in mouth when contrast agent is injected. |
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Purpose of EEG |
Done on seizure patients, also coma, or organic brain syndrome. Also used for sleep studies. May have video recording, and EKG. Can be used to check brain activity/brain death. |
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Nursing interventions for EEG |
Antiseizure agents, tranquilizers, stimulants, and depressants should be withheld 24-48 hrs before procedure. No coffee, tea, chocolate, and cola drinks. It is sometimes recommended that the pt be deprived of sleep to increase changes of recording seizure activity. Pt needs to lie quietly during test. Sedation is not advisable, except for sleep study. |
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Carotid ultrasound |
Noninvasive; Checking for narrowing and blockage in arteries. |
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Electromyography (EMG) |
Obtained by inserting needle electrodes into the skeletal muscles to measure changes in the electrical potential of the muscles. |
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Purpose of EMG |
Used with MG (Myasthenia gravis) patients. Helps determine presence of neuromuscular disorders and myopathies. |
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Nursing interventions for EMG |
Explain procedure to patient. Muscles examined may ache for a short time after procedure. |
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Evoked Potential Studies (EP) |
Involve application of an external stimulus to specific peripheral sensory receptors with subsequent measurement of the electrical potential generated. Pt looks at a visual stimulus such as flashing light, or a checkerboard pattern on a screen. |
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Nursing intervention for EP |
Help pt relax and remain still during procedure. |
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Lumbar puncture and examination of CSF |
Carried by inserting a needle into the lumbar subarachnoid space to withdraw CSF. CSF should be clear and colorless. Pink, blood-tinged CSF may be sign of subarachnoid hemorrhage. |
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Purpose of spinal tap. |
Obtain CSF for examination, to measure and reduce CSF pressure, to determine the presence of absence of blood in the CSF, and to administer medication intrathecally. |
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Post-Lumbar puncture headache |
Is a throbbing bifrontal or occipital headache that is dull and deep in character. Is worse when pt is sitting or standing, but lessens or disappears when lies down. Headache is caused by CSF leak at puncture site, by way needle track. Can be avoided is small needed is used. When more than 20 mL of CSF is removed, pt is positioned supine for 6 hours. Managed by bed rest, OTC analgesics, and hydration. |
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More on CSF analysis |
Local anesthesia is given. Can be done with pt lying or sitting. Lying is most for safety and is done at bedside in patient's room. Pt should use bathroom before procedure. Consent needed. Invasive. Used to rule out infection. Label bottles in order of the draw. 1st bottle may have tiny amount of blood in it. Give to lab immediately. Avoid stimulates before procedure. |
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Seizures |
Episodes of abnormal motor, sensory, autonomic, or psychic activity that result from sudden excessive discharge from cerebral neurons. |
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Epilepsy |
A group of syndromes characterized by unprovoked, recurring seizures. Can be primary or secondary. |
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Status epilepticus |
aka acute prolonged seizure activity, is a series of generalized seizures that occur without full recovery of consciousness between attacks. Has been broadened to include continuous clinical or electrical seizures lasting at least 30 minutes. Can interfere with respirations. Is considered MEDICAL EMERGENCY. Causes: antiseizure med withdrawal, fever, concurrent infection, other illness. |
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Migraine |
Divided into 4 categories: prodrome, aura, headache, and recovery. |
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Herpes Simplex Virus Encephalitis |
Acute inflammatory process of the brain tissue.
HSV is most common cause of this in US. Pathology involves local necrotizing hemorrhage that becomes more generalized, followed by edema, with progressive deterioration of nerve cell bodies. S-S: fever, headache, confusion, and hallucination. |
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Multiple Sclerosis |
Autoimmune, progressive demyelinating disease of the CNS/destruction of the myelin sheath. Results in impaired transmission of nerve impulses. THINK PLAQUE with MRI. T and B cells can cross the bbb to check CNS for antigens, and then leave. But in this condition, T cells remain and promote infiltration of other agents that damage the immune system. |
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Mysthenia Gravis |
Autoimmune disorder affecting the myoneural junction, is characterized by varying degrees of weakness of the voluntary muscles. Most common symptoms are diplopia, drooping eyelid, and muscle weakness. Thymus is also enlarged. DIAGNOSED with TENSILON: given IV. after 30s, all s-s disappear. Lasts 5 minutes. Main treatment is MESTINON, an anti cholinesterase. Dysphonia (voice impairment) and dysphagia, increase the risk for chocking and aspiration. |
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Plasmapheresis |
Technique used to treat exacerbations. Pt's plasma and plasma components are removed through a catheter, separated, and new cells and plasma substitute are rein fused. This produces temporary reduction in level of circulating antibodies. |
