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SOPN NEURO SYSTEM
Question | Answer |
---|---|
What are the only nerves who can recover from neuron trauma. The degree of recovery depends on the severity of the trauma | Peripheral nerves |
according to the Glascow Coma Scale a score of what indicates COMA | 7 or less |
LOC * patient is awake, alert, and oriented to person, place, and time | Full consciousness |
LOC * patient has difficulty following commands | Confusion |
LOC * Patient is disoriented to time and place and is possibly hallucinating | Delirium |
LOC * Patient is lethargic, aomnolent, and drowsy but will rouse when stimulated | *OBTUNDATION* |
LOC * Patient is very drowsy and appears unresponsive | Stupor |
LOC * Patient is unresponsive to stimuli. Although painful stimuli may result in moaning or stirring. Corneal, pupillary, gag, and tendon reflexes are intact | Semi-comatose |
LOC * Patient is UN*AROUSABLE and does not stir or moan in response to painful stimuli. Most brain stem reflexes are intact. Patient may exhibit decorticate or deverebrate posturing | Comatose |
LOC * Patient is completely unarousable and unresponsive to all stimuli including pain. Brain stem reflexes are absent | Deeply Comatose |
Glascow coma scale tests what responses | eye opening, verbal, and motor |
What is the priority in the unconscious patient | Patent airway |
How long would you suction the unconscious patient | 15 seconds |
Where would you obtain temps on the unconscious patient | rectal or tympanic |
Why is the unconscious patient NPO | no gag reflex and no swallowing reflex |
When feeding the unconscious patient what must you remember? | HOB up 30 degrees * aspirate for residuals * check GT/JT placement with air * FEEDS GIVEN AT ROOM TEMPERATURE |
What must you remember with regards to mouthcare for the unconscious patient | mouth care to teeth and gums every 4 hours, brush teeth and suction out excess, and patient should be on side |
Unconscious patient is subject to constipation and impaction.....WHY? | decrease in peristalsis |
When brain tissue is compressed and causes a lack of blood with O2 = brain damage or death causes increased BP with decreased HR | Intercranial Pressure ICP |
ICP * decreased LOC is because of a lack of what in the blood supply | Oxygen |
What is a late sign of ICP? | pupillary reaction |
what are the clinical manifestations of ICP | Decreased LOC * check PERRLA * decreased HR * pupillary changes * headache * weakness * nausea * projectile vomiting * restlessness |
What measures ICP directly as well as drainage of excess CSF / blood from ventricles : RISKS INFECTION and BRAIN DAMAGE | Ventricular Catheter |
What (ICP) allows direct measurement of ICP and removal of CSF * screw is inserted into ONLY the subarchnoid space * LESS RISK OF INFECTION BUT STILL A RISK | Subarachnoid Screw |
What is the least invasive and safest way to monitor ICP *BUT* also most unreliable because not a direct measurement as is only a sensor in the epidural space and drainage of CSF is not possible | Epidural Sensor |
What is the most common glucocorticoid used for increased ICP and is also given IV | dexamethasone (DECADRON) |
how would you measure the effects of diuresis | foley catheter |
what is a surgical intervention done to allow for drainage of the CSF that also decreases ICP | BURR HOLE in the cranium and insertion of a ventricular drain |
loss of impairment of language function caused by CVA, tumors, or trauma | aphasia |
aphasia from injury of Broca's area in frontal lobe of the brain. Patient comprehends and understands what is spoken or written but cannot speak or express effectively | Expressive Aphasia |
aphasia due to injury of Wernicke's area located in the temporal lobe of the brain. Patient cannot understand or comprehend what is being communicated to him BUT CAN SPEAK. Patient doesn't realize deficit | Receptive Aphasia |
both expressive and receptive aphasia. Prognosis is poor, they can't understand or communicate | Global Aphasia |
muscles continuously receive messages to tighten and contract | spasticity |
complete loss of muscle function in one or more muscle groups | papaplysis |
impairment of the lower extremities | paraplegia |
impairment affecting all 4 limbs | quadriplega |
half of one's body is paralyzed | hemiplegia |
overactive reflexes (twitching) | hyperreflexia |
absent reflexes | hyporeflexia |
lacking firmness, muscle tone | flaccidity |
slow movement | bradykinesia |
unintentional muscle movement | tremor |
irregular movements | chorea |
twisting motions | dystonia |
involuntary movements of tongue, face, extremities from psychotropic medications | dyskinesia |
what has happened when cerebral function is absent and the brain stem cannot maintain cardiovascular and respiratory vital functions. Requires mechanical ventilation and eventually the heart fails | BRAIN DEATH |
What color is CSF | clear |
Introduciton of contrast medium into the subarachnoid space via a lumbar puncture to diagnose changes in structures in the spinal cord | Myelography |
sterile needle into subarachnoid space at l4-l5 level | lumbar puncture |
sterile needle into subarachnoid space at c2 (neck area) | cisternal puncture |
measures electrical impulses of the brain | electroenchphalography (EEG) |
records electrical impulses of SKELETAL MUSCLES and NERVES | Electromyography |
done to remove tumors, hematomas, scar tissue, foreign objects, repair aneurysms, arteriovenous malformations, drain abscesses, repair skull fractures, biopsies, insert shunt to redirect CSF, relieve ICP | Intercranial surgery |
removal of part of vertebral bone to gain access to spinal cord and nerve roots | laminectomy |
union of vertebral bones - used to stabilize vertebral column | spinal fusion |