Adult nursing
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| What are the nerve tissues? | White Matter and Grey Matter
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| What is white matter? | Neuronal axons covered with myelin sheath
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| What is grey matter? | Contains cell bodies, dendrites and axon terminals
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| What is myelin? | Fatty sheaths wrapped around nerve fibers- insulator and accelerator of impulse conduction
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| What does a neurotransmitter do? | Communicate messages to a neuron or specific target issue.
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| What can happen from a neurotransmitter imbalance? | Neurological disorders
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| Where are neurotransmitters made and stored? | In the Synapse
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| Why can a neurotransmitter do? | Can potentiate, terminate, or modulate a specific action or can excite or inhibit a target cell.
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| There are two types of neurotransmitters, What are they? | Excitatory and Inhibitory
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| What is excitatory? | A glutamate, acetylcholine-major transmitter of the PNS, norepinephrine major transmitter of the PNS
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| What is Inhibitory? | Gamma-aminobutyric acid (GABA). Dopamine will affect the behavior and fine movement. Serotonin will help control mood and sleep, also inhibits pain pathways.
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| What is Circle of Willis? | Arterial circulation of the brain.
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| Where does venous blood flow occur ? | Through the dural sinuses found between the dura mater and the brain.
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| What areas are affected by an ischemic stroke? | Basilar artery, posterior cerebral artery, middle cerebral artery, vertebral artery
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| What does the acronym BEFAST stand for? | Balance, Eyes, Facial droop, Arms, Speech problems, Time
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| Should you call 911 even if symptoms get better? | YES!
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| What is the percentage of Ischemic strokes and what does it affect? | 87%, Large vessel, small vessel (lacunar), embolic, and cryptogenic
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| What is the percentage of Transient Ischemic Attack (TIA)- Hemorrhagic stroke? | 13 %, Intra-cerebral hematoma (ICH), Subarachnoid hemorrhage (SAH)
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| What are some stroke terms? | APHASIA-speech difficulty, APRAXIA-difficulty with skilled movement, HEMIANOPIA-loss of sight in over half of vision, DYSPHAGIA- difficulty swallowing
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| What are some safety problems with stroke patients? | High fall risk, aspiration, lack of knowledge, psychological, communication, activities of daily living
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| What is an Ischemic Stroke? | A brain attack
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| What are some risk factors associated with Ischemic stroke? | Hypertension, cigarette smoking, dyslipidemia, diabetes, alcoholism, lack of physical exercise, cardiac dysrhythmias, drugs, oral contraceptive, hyper coagulability
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| What are some non-modifiable risk factors associated with Ischemic stroke? | History of stroke, Family history of stroke, older age, ethnicity, gender.
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| In what ways can we diagnose a stroke? | Computerized tomography (CT) scan, Magnetic resonance imaging (MRI), Doppler-Ultrasound of the carotid arteries. Cerebral angiography, Echocardiography-TTA, TEE, Late tests-Glucose, PT, PTT, Plt. ct and other tests for hyper coagulability
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| What are some nursing interventions-POST STROKE? | Serial neurological assessments, VS increase intracranial pressure, oral hygiene protocols, dysphagia screening, feeding (enteral) diet, DVT prophylaxis, Depression screening, skin assessments, rehab-begins upon admission, patient and family education.
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| What is the normal range for intracranial pressure? | 7-15
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| What is considered a late sign in neurological assessment? | Vital signs
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| What is increased ICP related to? | Disturbances in fluid balance in the brain.
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| What is Cushing's Triad? | Increased pressure in the brain- bradycardia, irregular respirations and widened pulse pressure.
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| What is Monroe-Kellie hypothesis? | The sum of volumes of brain, cerebrospinal fluid (CSF) and intracerebral blood is constant.
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| What does the peripheral nervous system consist of? | Spinal Nerves, Cranial nerves, and autonomic system
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| How many nerves are in the spinal nerves? | 31 pairs
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| How many nerves are in the cranial nerves? | 12
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| What is in the autonomic nervous system? | Sympathetic nervous system and parasympathetic nervous system.
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| What is the breakdown of the 31 pairs in the spinal nerves? | 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal.
Dorsal roots, DERMATOMES, and ventral roots
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| What is the blood brain barrier? | The protective structure of the brain
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| What does the blood brain barrier do? | Separates circulating blood volume from extracellular fluid in the brain=filtering system. Also prevents toxic materials from entering the brain.
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| What is cerebral spinal fluid? | A Shock absorber
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| What is the use of the cerebral spinal fluid? | It transports hormones and hormone releasing factors.
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| Where does cranial nerves originate from? | In the brainstem except for the olfactory and optic nerves
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| What is the cranial nerves use? | Transmit signals to receptors in the body
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| What are the cranial nerves? | Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Acoustic, Glossopharyngeal, Vagus, Hypoglossal, Spinal accessory
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| In the Autonomic nervous system, what does the sympathetic nervous system do? | Receive information from the thoracic and lumbar areas in the spinal cord. Elicits the "fight or flight" response
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| In the Autonomic nervous system, what does the parasympathetic nervous system do? | Receives information from the brainstem or sacral region of the spinal cord.
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| What is a seizure? | epidemiology:Uncontrolled, sudden, excessive discharge of electrical activity
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| What is the result of a seizure? | Range of manifestations from behavior changes to loss of consciousness.
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| Is there a way to explain seizures? | There is no conclusive pathophysiological explanation
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| What is the pathophysiology of seizures? | Genetic or developmental mutation of synapses, Ineffective activity of gamma-aminobutyric acid (GABA)
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| What are some clinical manifestations you would expect to see with a patient who has seizures? | Automatisms, Preictal phase, auras, posticital phase, tonic-clonic, episodes of day dreaming and no loss of consciousness, rhythmic jerkiness of all extremities and loss of consciousness
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| What is a tonic seizure? | Grand mal: skeletal muscles contract or tighten in a spasm lasting 3-5 seconds.
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| What is a clonic seizure? | Grand mal, Dysrhythmic (abnormal rhythms), muscular contraction, or jerkiness of legs and arms lasting 2 to 4 minutes.
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| What is a partial seizure? | Involves one half of the brain
simple partial- no loss of conscious
complex partial- loss of consciousness, client does not recall behavior immediately before, during and immediately after
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| What is an absence seizure? | Formally known as petit mal- brief loss of consciousness, lasting less than 10 seconds, and usually occurs in children.
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| What is a myoclonic seizure? | An isolated clonic contraction or jerks lasting 3 to 10 seconds; involving a minimum of one limb and up to the entire body
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| What are some complications from seizures? | Seizures greater than 5 minutes is a medical emergency. and status epilepticus
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| What complications can happen is a seizure last longer than 30 minutes ? | Respiratory failure, brain damage, and death.
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| What are ways to diagnose Seizures? | Electroencephalogram (EEG), CT, MRI, Laboratory tests
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| What are some nursing interventions for a seizure patient? | Assessment (ABCs, VS, presence of aura, O2), Actions and Teaching (avoid alcohol, no driving, identify triggers, keep follow up appointments)
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| What is Trigeminal Neuralgia? | A chronic pain condition affecting the trigeminal nerve in the face (sensation)
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| What are clinical manifestations of Trigeminal neuralgia? | Pain
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| What are treatments/managements for Trigeminal Neuralgia? | Medications and surgery
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| What are the nursing diagnosis for Trigeminal neuralgia? | Pain, fear, impaired nutrition
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| What are the nursing interventions for Trigeminal neuralgia? | Assessment, actions and teaching
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| What carnival nerve is associated with Bell's palsy? | Cranial Nerve VII (Facial)
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| What is Bell's palsy? | idiopathic facial palsy- temporary facial paralysis or weakness on one side of the face
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| Who is at risk for Bell's palsy? | Anyone
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| How is a patient diagnosed with bells palsy? | Clinical presentation
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| How can you treat a patient with bells palsy? | Oral steroids, protect the eye (blinking, moisture, physical therapy
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| What is NCD due to Alzheimer's Disease? | The most common cause of neurocognitive disorder- onset is slow and insidious- generally progressive and deteriorating
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| What are the stages of Alzheimer's disease? | 1-7, No apparent symptoms,FORGETFULLNESS, Mild cognitive decline, Mild-to-moderate cognitive decline, Moderate cognitive decline, Moderate-to-sever cognitive decline, Severe cognitive decline
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| What are the etiologies included in NCD? | Acetylcholine alterations, Plaques and Tangles, Head trauma and genetic factors
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| What is Parkinson's Disease? | A chronic neurologic disorder that affects the extrapyramidal motor tract that controls posture, balance and locomotion.
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| How does Parkinson's Disease develop? | It develops from deficiency in dopamine neurotransmitters that result in loss in neurons
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| How does Parkinson's Disease occur? | Frequently occurs as an adverse reaction to various drugs, carbon monoxide, manganese, or disorders (encephalitis, stroke, trauma)
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| What leads to the lack of dopamine? | Degeneration of dopaminergic neurons
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| What is Pseudoparkinsonism? | A reversible condition that resembles Parkinsonism- brain disorder causing irregular movements
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| What is Parkinson's? | An imbalance of neurotransmitters (dopamine and acetylcholine )
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| What are the characteristics of Parkinsons? | Involuntary tremors of the limbs, Rigidity of muscles, Bradykinesia (slow movement), Postural changes (head and chest thrown forward), shuffling walk, lack of facial expressions, Pill-rolling motions of hands
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| What is included in the Central Nervous System? | Brian and spinal cord
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| What is included in the Peripheral Nervous System? | Cranial nerves (12 pairs), Spinal nerves (31 pairs) and Autonomic Nervous System (sympathetic and parasympathetic)
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| The brain consists of what? | The cerebrum (4 loves and 2 hemispheres), The cerebellum and the brainstem
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| What are the brains 4 lobes? | Frontal, Parietal, Occipital, and Temporal
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| The left side of the cerebrum controls what? | Sensory, motor functions of body's right side
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| The right side of the cerebrum controls what? | Sensory, motor functions of the body's left side.
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| What is the left hemisphere responsible for? | Speech and abstract thinking
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| What is the right hemisphere responsible for? | Spatial thinking or imagery
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| The left side of the brain controls what? | The right side of the body
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| The right side of the brain controls what? | The Left side of the body
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| The Central Nervous System consists of what? | Thalamus, Basial ganglia, Hypothalamus, Limbic System
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| What does the Thalamus relay? | It is the relay center for sensory impulses to cerebral cortex. All sensations except smell
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| What does the basil ganglia regulate? | It regulates movement
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| What is the HYPOTHALAMUS responsible for? | It's the main regulator for the ANS
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| What is the Limbic systems primary role? | Its primary role in memory and emotions
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| What are the 2 types of specialized nerve cells? | Neuroglial cells and neurons
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| What is included in Neuroglial cells? | Astrocytes, Ependymal, Microglia, Oligodendrocytes, Schwann
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| What is included in Neurons? | Sensory neurons, motor neurons, and mixed (sensory and motor neurons)
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