Nursing

Front 1

What happens if IICP is unrecognized or untreated?

Back 1

If IICP is unrecognized or untreated, contents of the cranimum are futher compressed. Unrelieved pressure causes brain tissue to herniate or shift from normal locations intracranially and extracranially.

Front 2

Increased intracranial pressure is....?

Back 2

Inside the cranium are brain tissue, blood, and crebrospinal fluid (CSF). If any of these increase significantly without a decrease in either of the other two, intracranial pressure elevates.

Front 3

What are S & SX...? Box 39.1

Back 3

Signs and symptoms box 39.1 develope rapidly or slowly
1. ALOC
2. Head ache3.
3. Vomiting
4. Papilledema
5. Change in vital signs
6. Unequal pupils and adnormal response to light.
7. Posturing

Front 4

Papilledema....?

Back 4

(Swelling of the optic nerve) is caused by INTERFERENCE W/VENOUS DRAINAGE FROM THE EYEBALL AND IS OBSERVED THROUGH EXAMINATION WITH AN OPHTHALMOSCOPE. NORMAL RESPONSE TO PUPIL RESPONSE TO LIGHT IS RAPID CONTRICTION; IN IICP IT IS SLUGGISH OR NON EXISTENT(FIXED)

Front 5

Dx findings

Back 5

Diagnostic tests that detemine the underlying cause of LLCP include skull raiography, computed tomography (CT), magnetic resonance imaging(MEI), lumbar puncture, and cerebral angiography.

Front 6

Cushings Triad.....?

Back 6

occurs late in IICP the respiratory rate is IRREGULAR. Later, Cheyne-Stokes respirations occur. followed by apnea. Decorticate or decerebrate psturing developes spontaneously or in response to a painful stimulus when ICP is increased.

Front 7

Foramen Magnum...?

Back 7

The opening in the lower part of the skull though which the upper part of the spinal cord connects with the brain, PROVIDES THE ONLY EXTRACRANIAL EXIT FOR BRAIN TISSUE.

Front 8

Normal ICP...?

Back 8

is 1-15 mm HG Although ICP varies, arise of 2mm Hg from a previous mesurement is cause for concern.

Front 9

Osmotic diuretics such as...?

Back 9

Mannitol (osmitrol), glycerin (osmoglyn), or urea (Ureaphil) and corticostereoids such as deamethasone (Decadron) are given to reduce cerebral edema. Other treatment includes restriction of oral and IV fluids and hyperventilation therapy by means of mechanical ventilation, which produces vasoconstriction of cerebral arteries, followed by decreased cerebral blood volume and reduced ICP. An anticonvulsant may be ordered to prevent seizures, which elevate intracranial pressure.

Front 10

Nursing care plan for a patient with IICP.

Back 10

Nursing Doagnosis: Ineffective Tissue Perfusion(cerebral) related to IICP as evidence by decreased LOC, sluggish pupil response, papiledema, and posturing. Expected outcome; ICP will between 1-15mm of mercury and glucose cerebrial spinal (GCS) will be 9 or greater.

Front 11

Other Nursing Dx for ICP

Back 11

1. Risk for ineffective breathing pattern and ineffective airway clearence.
2. Risk for infection.
3. Impared verbal conmunication.(intubation)

Front 12

Four neurologic onditions have an infectious or inflamatory cause:

Back 12

Meningitis, encephalitis, Guillain-Barre syndrome and brain abscess.

Front 13

Encephalitis is...?

Back 13

An infectious disease of the CNS. Charectorised by pathologic changes of both the white matter and the gray matter of the spinal cord and brain.

Front 14

Patho & Etio...?

Back 14

Bacteria, fungi, or viruses cause encephalitis. THE DISEASE CAN FOLLOW A VIRAL INFECTION IN BODY SUCH AS MEASELS, OR VACINATION.

Front 15

What happens when a patient has encephalitis...?

Back 15

Sereve and diffuse inflammation of the brain occurs. Nerve cell destruction can be extensive. Cerebral edema and neurologic deficts such as paralysis and speech changes, IICP, respiratory failure, seizure disorders, and shock can occur.

Front 16

what are the sites of infectious and inflamatory disorders...?

Back 16

1. MENINGITIS
2. ENCEPHALITIS
3. GUILLAIN- BARRE SYNDROME
4. BRAIN ABCESS

Front 17

What signs occur when you have sever and diffuse inflamation of the brain...?

Back 17

1. Nerve cell distruction-(CAN BE EXTENSIVE)
2. Cerebral Edema and neurologic deficitis. such as paralysis and speech changes. IICP respitory failure, seizure disorders and shock can occur.

Front 18

What are the assesment Findings of severe and diffuse inflamation of the brain...?

Back 18

1. Sudden fevor
2. Severe headache
3. Stiff Neck
4. vomiting and drowsyness
all these signal the onset of viral encephalitis.

Front 19

What are the other SX of severe and ?

Back 19

1. Tremures
2. Seizures
3. Spastic` or flaccid paraylis
4. Muscle weakness
5. Lethargy, delirium,or coma develope.
6. incontence and visual disturbance ; such as photophobia, involentary eye movements,and double or blurred vision.

Front 20

What tests or procedures are performed to DX encephalitis or Sever and Diffused inflamtion of the brain...?

Back 20

1. A Lumbar puncture is performed.(CSF pressure is elevated, but fluid is clear.)
2. In some types of encephalitis, serologic studies a rise in viral antibodies.
3. Electro-encephalography, EEG studies reveals slow wave forms.

Front 21

NURSING MANAGEMENT;

How do nurses manage a patient with sever and diffuse inflamtion of the brain...?

Back 21

Monitor vital signs and LOC frequently and compare findings of previous assesments.
If urinary retention or uninary incontinece developes, consult physician to discuss whether or not urethral catheter is appropiate.
Measure fluid intake and output to detect signs of volume deficit and electrlyte imbalances.
Access bowl elemination to determin for enema or stool softener.

Front 22

What is GUILLAIN-BARRE SYNDROME...?

Back 22

Accute postinfectios poly neuropahy,poly radiculoneuritis.

Front 23

How does GUILLAIN-BARRE affect the patient...?

Back 23

It affects the peripheral nerves and the spinal nerve roots.

Front 24

How long does it take before patients recover...?

Back 24

1. Most recover in one month.
2. But recovery can be slow and take a year or more.

Front 25

Do people die from the GUILLAIN - BARRE...?

Back 25

Death can occur from complications of immobility such as pneumonia and infection.

Front 26

PATHO & ETIO

What causes GUILLAN-BARRE...?

Back 26

The exact cause is unknown, however, it is believed to be an autoimmune disorder that follows a primary disorder, especially an infectious one.
Many clients have a history of recent virial infections, PARTICULARLY OF THE RESPITORY TRACT. Others have history of recent surgery or vaccination for a viral disease like; INFLUEZA, or clients with MALIGANT DISEASE, and Lupus Erythematosus.
Nerve become inflammed, Myelin is lost, mild to severe muscle weakness or paralysis developes.

Front 27

ASSESMENT FINDINGS:

What are the Assesment Findings Guillan-Barre...?

Back 27

Symptoms vary, weakness, numbness, and tingling in arms and legs often are first symptoms.
Weakness is progressive and moves to upper areas of bodies and affecting MUSCLES OF RESPORATION.

Front 28

MUSCLES MANAGEMENT
(GUILLAN-BARRE)

What is Plasmapheresis...?

Back 28

Removal of plasma from blood and reinfusion of celluar components with saline shortens the course of the disease (Guillian-Barre)if perfomed within the first two weeks. otherwise treatment is primarily supportive.

Front 29

what if the respitory muscels are involved

Back 29

endotracheal intubation and mechanical ventilation are nessary.
Difficulting chewing and swollowing necessitate administration of IV fluids,gastric tube feedings, or total parenteral nutrition (TPN).

Front 30

Nursing Managment

What is the procedure the nurse must follow to manage her client...?

Back 30

1. Observe closely for signs of respitory distress.
2. Use a spirometer to evaluate ventilation capacitiy.
3. To access for pneumonia, check vital signs and lungs sounds frequently.
4. Because immobility incapcitates the client, provide meticulous skin care and change clients position (EVERY TWO HOURS).
5. Help client form passive ROM excerises to prevent muscle athrophy.

Front 31

WORKBOOK

Uncontrollable writhing and twisting movements of the body

Back 31

Choreiform movements

Front 32

double vision

Back 32

Diplopia

Front 33

Another term for drooping

Back 33

Ptosis

Front 34

slowness in performing spontaneous movements

Back 34

Bradykinesia

Front 35

Involuntary movement of the eyeball

Back 35

Nystagmus

Front 36

Shallow, rapid breathing followed by a period of apnea

Back 36

Cheyne-Stokes respirations

Front 37

Nerve pain

Back 37

Neuralgia

Front 38

chronic recurrent pattern of seizures

Back 38

Epilepsy

Front 39

Sensation that occurs immediately before a seizure

Back 39

aura (it can be a sound or a smell or a sensation)

Front 40

Manifestation of a seizure, characterized by spasmodic contractions of muscles

Back 40

Convulsion

Front 41

Which of the following drugs are used in the treatment of tonic-clonic seizures...?

Back 41

Dilantin and Phenobarbitol

Front 42

A client presents to the emergency department with a severe headache a few days after being bitten by a mosquito. The client may have ...?

Back 42

Encephalitis

Front 43

the nurse is aware that the care plan for a client with Guillan-Barre syndrome...

Back 43

is primarily supportive.

Front 44

a client is incontinent during a seizure and sleeps for seveal hours afterward. which of types of seizures did the client most likely have?
a. absence b. partial
c. Psychomotor d. tonic-clonic

Back 44

tonic-clonic

Front 45

what symptoms does the nurse anticipate during her assessment of a client with parkinsons disease?

Back 45

A slow shuffling gait, difficult swollowing,and pill-rolling tremor

Front 46

when a client takes phenytoin sodium (Dilantin)which hygiene measure is important to perform?

Back 46

Brushing the teeth

Front 47

A client in the terminal stages of amyototrophic (ALS) asks the nurse how most clients die when they have ALS. How should the nurse respond?

Back 47

Tell him most that most deaths occur because of the respitory failure

Front 48

Which of the following is the prominent symptom of tic douloureux?

Back 48

Facial neuralgia

Front 49

A client in a long-term facility encounters the following situations every day. which of the encounters may contribute to an exacerbation of the tic douloureux?

Back 49

overhead fan in the livingroom.

Front 50

The difference between Bell's palsy and the tic douloureux (TD) is that...

Back 50

Bell's palsy disturbs motor function and TD disturbs sensory function.

Front 51

A client ordered ordered 400 mg of Dilanin. The Dilantin is in a container marked "200mg/mL."
How many millileters wil the nurse need to give?

Back 51

2m

Front 52

How can brain tumors cause symptoms of increased intracranial pressure (IICP)

Back 52

Brain tumors displace brain tissue and take up space. They also block the low and absortion of spinal fluid.

Front 53

What is the pathophysiology behind Parkinson's Disease?

Back 53

Parkinson's disease is caused by the deletion of the neurotransmitte dopamine. This upsets the balance of dopamine and acetylcholine, resulting in movement disorders.