Neuro Exam 2 R-Review

Front 1

What do you assess pre craniotomy?

Back 1

What do you assess pre craniotomy? Baseline neuro status

Front 2

Craniotomy post op, what is abnormal?

Back 2

Craniotomy post op, what is abnormal? 117 sodium level

Front 3

Infratentorial (area between cerebellum and brainstem) position?

Back 3

Infratentorial (area between cerebellum and brainstem) position?

Flat or on their side for 24-48 hours

Front 4

Supratentorial (cerebrum) craniotomy position?

Back 4

Supratentorial (cerebrum) craniotomy position? HOB at 30 degrees

Front 5

S/S when a closed head injury becomes SIADH?

Back 5

S/S when a closed head injury becomes SIADH? JVD

Front 6

S/S when a closed head injury becomes Diabetes Insipidus?

Back 6

S/S when a closed head injury becomes Diabetes Insipidus? Polyuria

Front 7

ICP monitoring and its going up what secondary thing do you monitor for?

Back 7

ICP monitoring and its going up what secondary thing do you monitor for? Infection

Front 8

Brain tumor with ICP increasing, how can you protect the patient?

Back 8

Brain tumor with ICP increasing, how can you protect the patient? HyperO2 patient with 100% and suction no more than 10 seconds, keep a quiet environment and STOOL SOFTENERS

Front 9

Intubated pt with increased ICP?

Back 9

Intubated pt with increased ICP? HyperO2 with 100% and suction no more than 10 seconds

Front 10

Pt with traumatic brain injury and comatose, how can you decrease ICP?

Back 10

Pt with traumatic brain injury and comatose, how can you decrease ICP? Keep PaCO2 @ 35

Front 11

Pt in coma with closed head injury, how can you keep ICP down?

Back 11

Pt in coma with closed head injury, how can you keep ICP down? Put pt head in midline and neutral with HOB 15 degrees

Front 12

Why do you place the head in midline and neutral?

Back 12

Why do you place the head in midline and neutral? Promote venous return

Front 13

Why do you place the head in midline and neutral?

Back 13

Why do you place the head in midline and neutral? Promote venous return

Front 14

dysarthria?

Back 14

dysarthria? slurred speech

Front 15

To do for pt with impaired swallowing?

Back 15

To do for pt with impaired swallowing? Thick liquids and soft foods

Front 16

Traumatic brain injury, what are you most concerned with?

Back 16

Traumatic brain injury, what are you most concerned with? Unilateral pupil changes

Front 17

Halo Sign?

Back 17

Halo Sign? Test for CSF. Take a drop of blood from nose or ear and drop onto a gauze pad, if the blood coagulates in the middle and a yellow colored "halo ring" forms around the outside = positive for CSF

Front 18

S/S of basilar skull fracture?

Back 18

S/S of basilar skull fracture? raccoon eyes and battle's signs

Front 19

Problem with chewing/swallowing, what do you assess for?

Back 19

Problem with chewing/swallowing, what do you assess for? Weight loss, get a baseline

Front 20

Head injury question, what do you notify MD about immediately?

Back 20

Head injury question, what do you notify MD about immediately? Pt is difficult to arouse

Front 21

Traumatic Brain Injury, what do you monitor for?

Back 21

Traumatic Brain Injury, what do you monitor for? Neuro status, VS, ABC's and increased ICP

Front 22

S/S of ICP?

Back 22

S/S of ICP? Cushings Triad = Severe HTN, wide pulse pressure, bradycardia and bradypnea

Front 23

How do you suction a pt with increased ICP?

Back 23

How do you suction a pt with increased ICP? HyperO2 with 100% and then suction for no more than 10 seconds

Front 24

Stroke (Brain Attack), take BP on unaffected side as affected side will read bottomed out

Back 24

Stroke (Brain Attack), take BP on unaffected side as affected side will read bottomed out

Front 25

Left sided hemiplegia, how can you help with rehab?

Back 25

Left sided hemiplegia, how can you help with rehab? Position to prevent contractures, perform ROM

Front 26

Stroke pt has double vision, how can you help? Cover the affected eye

Back 26

Stroke pt has double vision, how can you help? Cover the affected eye

Front 27

Stroke pt and MD orders bedrest, how can you prevent footdrop?

Back 27

Stroke pt and MD orders bedrest, how can you prevent footdrop? Splint

Front 28

Stroke pt and MD orders bedrest, how can you prevent footdrop?

Back 28

Stroke pt and MD orders bedrest, how can you prevent footdrop? Splint

Front 29

Right hemisphere CVA S/S?

Back 29

Right hemisphere CVA S/S? Implusiveness and poor judgement

Front 30

Pt with Guillain Barre Syndrome, what do you ask about history?

Back 30

Pt with Guillain Barre Syndrome, what do you ask about history? Recent viral infection of any kind. Most likely gastroenteritis or upper respiratory infection

Front 31

GBS assessment findings?

Back 31

GBS assessment findings? Ascending symmetric muscle weakness

Front 32

GBS diagnostic?

Back 32

GBS diagnostic? Electromyography (electric current to test muscles)

Front 33

Pt comes in with GBS and they are weak and tingly in both legs, what do you assess first?

Back 33

Pt comes in with GBS and they are weak and tingly in both legs, what do you assess first? AIRWAY, lungs and pulse ox

Front 34

Pt with GBS exacerbation and mild dyspnea, what do you do?

Back 34

Pt with GBS exacerbation and mild dyspnea, what do you do? Put them in a sitting position first and foremost

Front 35

S/S of GBS getting better?

Back 35

S/S of GBS getting better? Even unlabored respirations

Front 36

DX pt with diplopia, fatigue and ptosis?

Back 36

DX pt with diplopia, fatigue and ptosis? Myasthenia Gravis

Front 37

Myasthenia Gravis = Women 20-30 (more often) and men 60-70

Back 37

Myasthenia Gravis = Women 20-30 (more often) and men 60-70

Front 38

MG patho?

Back 38

MG patho? Autoimmune disease where the autoantibodies attack the acetycholine receptors

Front 39

MG is associated with the Thyroid

Back 39

MG is associated with the Thyroid

Front 40

MG history is being taken, what will you most likely hear about?

Back 40

MG history is being taken, what will you most likely hear about? muscle weakness and fatigue

Front 41

MG finding that you should report immediately?

Back 41

MG finding that you should report immediately? Inability to swallow

Front 42

Diagnostic for MG?

Back 42

Diagnostic for MG? Tensilon. (this confirms a diagnosis of MG. it temporarily improves muscle function within 30 to 60 seconds after IV injection of edrophonium and neostigmine and lasts up to 30 minutes) Tensilon also distinguishes between MG crisis and Cholinergic crisis. If you get improvement its MG crisis and if you get worsening its a cholinergic crisis

Front 43

S/S of MG crisis?

Back 43

S/S of MG crisis? Restlessness, dyspnea and increased salivation and tearing

Front 44

S/S of Cholinergic Crisis?

Back 44

S/S of Cholinergic Crisis? Abdominal cramps, blurred vision and facial twitch

Front 45

MG drugs?

Back 45

MG drugs? Neostigmine and Pyridostigmine

Front 46

MG drugs?

Back 46

MG drugs? Neostigmine and Pyridostigmine

Front 47

TX for malignant tumor?

Back 47

TX for malignant tumor? Chemo, Radiation and Surgery

Front 48

What do MG, GB and ALS all have in common?

Back 48

What do MG, GB and ALS all have in common? Respiratory complications

Front 49

Clinical indicator of Trigeminal Neuralgia (tic douloureaux)?

Back 49

Clinical indicator of Trigeminal Neuralgia (tic douloureaux)? Excruciating facial pain

Front 50

TN involves how many branches total?

Back 50

TN involves how many branches total? 3

Front 51

TN drug?

Back 51

TN drug? Gabapentin

Front 52

TN pt to help with disease instruct them to?

Back 52

TN pt to help with disease instruct them to? Avoid talking, smiling, shaving, washing face, brushing teeth, avoid walking swiftly and no fans. Discourage chewing on affected side and no hot or cold fluids

Front 53

TN #1 priority?

Back 53

TN #1 priority? Pain management with Gabapentin

Front 54

How do you provide a safe environment for Bells Palsy pt?

Back 54

How do you provide a safe environment for Bells Palsy pt? Prevent corneal damage

Front 55

Bells Palsy med used?

Back 55

Bells Palsy med used? Non narcotics (tylenol and ibuprofen)

Front 56

Transient Ischemic Attack pt on cardiac monitor, what would show if at risk for emboli?

Back 56

Transient Ischemic Attack pt on cardiac monitor, what would show if at risk for emboli? AFIB

Front 57

TIA S/S?

Back 57

TIA S/S? Unilateral Weakness

Front 58

Stroke pt #1 risk factor?

Back 58

Stroke pt #1 risk factor? Obesity

Front 59

S/S of cerebral aneurysm?

Back 59

S/S of cerebral aneurysm? Severe headache

Front 60

What do you do for the cerebral aneurysm pt with severe headache?

Back 60

What do you do for the cerebral aneurysm pt with severe headache? CALL MD

Front 61

HTN pt slurring and has right sided weakness, what to do?

Back 61

HTN pt slurring and has right sided weakness, what to do? Assess ABC's

Front 62

Pt recovering from stroke and NPO, what cranial nerves do you test to see if gag reflex is back?

Back 62

Pt recovering from stroke and NPO, what cranial nerves do you test to see if gag reflex is back? 9 and 10

Front 63

Stroke pt that is comatose what will you see?

Back 63

Stroke pt that is comatose what will you see? Urinary incontinence

Front 64

Global aphasia pt ok to assign to a CNA?

Back 64

Global aphasia pt ok to assign to a CNA? NO