Medical-Surgical Nursing 2: Nervous System Disorders of Consciousness Quiz

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which of the following terms refers to the disruption of the reticular activating system (RAS)?

  • Wakefulness
  • Awareness
  • Unconsciousness (correct)
  • Consciousness

What abnormal posturing is typically present when there is metabolic depression?

  • Decebrate
  • Flexor Withdrawal
  • DTR unequal (+) Babinski Reflex
  • Decorticate (correct)

In a state of unconsciousness, what is the likely status of the corneal reflex?

  • Pinpoint
  • Unequal, maybe absent (correct)
  • Present and Equal
  • Large/Blown Pupil

Which condition may present with frontal headaches and local seizures?

<p>Behavioral Changes (D)</p> Signup and view all the answers

What is a common feature of Extraocular Movements in someone who is awake and aware?

<p>Normal Awake, aware (D)</p> Signup and view all the answers

What is a common characteristic of a confused person?

<p>Impairment in judgment and decision making (C)</p> Signup and view all the answers

In a person experiencing disorientation, what might be a symptom they exhibit?

<p>Restlessness and hallucinations (D)</p> Signup and view all the answers

What is a potential sign of delirium in a person with a 'mark deficit in attention'?

<p>Agitation and restlessness (D)</p> Signup and view all the answers

Which type of lesions are associated with structural manifestations that could lead to coma?

<p>Infratentorial Lesions (A)</p> Signup and view all the answers

What does 'Hemi-Paresis/plegia' refer to in the context of comatose states?

<p>Partial paralysis on one side of the body (B)</p> Signup and view all the answers

Which condition is most likely indicated by a Siriraj Stroke Score total score of (+2)?

<p>Hemorrhage (C)</p> Signup and view all the answers

What is a common clinical feature associated with aneurysms and AVMs?

<p>Photophobia (D)</p> Signup and view all the answers

Which diagnostic method is particularly useful for assessing cerebral edema and increased ICP?

<p>CT Scan (A)</p> Signup and view all the answers

What symptom is often associated with vascular lesions that lead to headache, specifically in the occipital area?

<p>Blurred vision (C)</p> Signup and view all the answers

What is the main purpose of pharmacotherapy involving osmotic diuretics in stroke management?

<p>Manage cerebral edema (C)</p> Signup and view all the answers

Which type of stroke accounts for 85% of all strokes?

<p>Ischemic Stroke (D)</p> Signup and view all the answers

In the context of Siriraj Stroke Score interpretation, what does a total score that is less than (-)2 most likely indicate?

<p>Infarction (C)</p> Signup and view all the answers

What is the most lethal type of stroke?

<p>Hemorrhagic Stroke (B)</p> Signup and view all the answers

Which type of edema involves an increase in the extracellular fluid volume due to increased permeability of the blood-brain barrier to proteins?

<p>Vasogenic Edema (A)</p> Signup and view all the answers

Which demographic group has a higher risk of stroke, with Blacks being more at risk compared to Caucasians?

<p>Blacks (C)</p> Signup and view all the answers

Where does intracerebral hemorrhage commonly occur in hypertensive individuals?

<p>Putamen (C)</p> Signup and view all the answers

What is the main pathological process in cellular edema, resulting in swelling of all cellular elements in the brain?

<p>Increased Intracellular Water (A)</p> Signup and view all the answers

Which statement best describes a person in a somnolent state?

<p>Displays excessive drowsiness and responds with incoherent mumbles (D)</p> Signup and view all the answers

What is a common characteristic of a person in a comatose state?

<p>Responds by grimacing or drawing away from pain stimuli (C)</p> Signup and view all the answers

What does brain death refer to?

<p>Irreversible damage to the cerebrum and brainstem (D)</p> Signup and view all the answers

What might be a symptom of brain death according to the text?

<p>Altered respiratory patterns (A)</p> Signup and view all the answers

What is a key characteristic of stupor according to the text?

<p>Unable to move voluntarily (C)</p> Signup and view all the answers

Which nursing management action is NOT recommended for a patient with increased intracranial pressure?

<p>Increase body temperature (A)</p> Signup and view all the answers

Flashcards

Decreased Alertness

Characteristic of disoriented patients with slowed responses.

Somnolent Patients

Patients showing excessive drowsiness, responding only incoherently.

Obtunded Patients

Patients with decreased interest, slowed responses, and sleepiness.

Comatose Patients

In a sleep-like state and cannot be aroused at all.

Signup and view all the flashcards

Stuporous Patients

Only respond to pain stimuli by grimacing or withdrawing.

Signup and view all the flashcards

Brain Death Definition

Irreversible damage to the cerebrum and brainstem indicates brain death.

Signup and view all the flashcards

Criteria for Brain Death

Includes unresponsive coma, no voluntary movement, and altered reflexes.

Signup and view all the flashcards

Unresponsive Coma

A state with no motor or sensory reflex response.

Signup and view all the flashcards

Cerebral Perfusion

The blood flow in the brain is crucial for its function.

Signup and view all the flashcards

Motor Responses

The best predictor of outcome in severe impairment patients.

Signup and view all the flashcards

Increased Intracranial Pressure (ICP)

Mythical pressure within the cranium caused by its content.

Signup and view all the flashcards

Increased ICP Vital Signs

Signs include widening pulse pressure and altered temperatures.

Signup and view all the flashcards

Cushing's Triad

A classic sign of increased ICP showing hypertension and bradycardia.

Signup and view all the flashcards

Cerebral Perfusion Pressure (CPP)

CPP is calculated from MAP minus ICP, normally 70-90 mmHg.

Signup and view all the flashcards

Medical Management Goal

Improve or correct causes of altered levels of consciousness.

Signup and view all the flashcards

Maintain Skin Integrity

Essential nursing management in patients with altered LOC.

Signup and view all the flashcards

Patent Airway

Critical to maintain in patients with decreased consciousness.

Signup and view all the flashcards

Nutritional Maintenance

Ensure patients receive proper nutrition despite their condition.

Signup and view all the flashcards

Aspiration Precautions

Preventing food or fluid from entering the lungs.

Signup and view all the flashcards

Oral Care Importance

Critical for comfort and hygiene in reduced LOC patients.

Signup and view all the flashcards

Protection from Injury

Key nursing role to safeguard patients with limited awareness.

Signup and view all the flashcards

Cerebral Perfusion Promotion

Supporting adequate blood flow to maintain brain function.

Signup and view all the flashcards

Doll's Eye Reflex

Reflex absent in comatose patients indicating brain dysfunction.

Signup and view all the flashcards

Caloric Test

Test indicating brainstem function, absent in coma.

Signup and view all the flashcards

Apnea Duration

No breathing for 30 minutes to 1 hour indicates severity.

Signup and view all the flashcards

Voluntary Movement Absence

Key sign of brain death indicating no conscious activities.

Signup and view all the flashcards

Altered Respiratory Patterns

Changes in breathing patterns a sign of brain dysfunction.

Signup and view all the flashcards

Study Notes

Levels of Consciousness

  • Decreased alertness and slowed psychomotor responses are characteristics of disoriented patients.
  • Somnolent patients show excessive drowsiness and respond to stimuli only with incoherent mumbles or disorganized movements.
  • Obtunded patients have decreased interest in their surroundings, slowed responses, and sleepiness.
  • Comatose patients are in a sleep-like state and cannot be aroused.
  • Stuporous patients only respond to pain stimuli by grimacing or drawing away.

Brain Death

  • Irreversible damage to the cerebrum and brainstem defines brain death.
  • Criteria for brain death include:
    • Unresponsive coma
    • Varying response to painful stimuli
    • No voluntary movement
    • Altered respiratory patterns
    • Altered pupillary response to light
    • No blinking

Coma

  • Unresponsive coma with no motor/sensory reflex response
  • No spontaneous respiration
  • No Doll's eye or Caloric test with fixed and dilated pupils
  • Persistence of symptoms for 30 minutes to 1 hour after onset of coma/apnea
  • No cerebral perfusion studies

Motor Responses

  • Most powerful predictor of outcome in patients with severe impairment
  • Spontaneous movement vs response to stimuli

Increased Intracranial Pressure

  • Increased pressure exerted in the cranium by its content
  • Vital signs:
    • Widening pulse pressure
    • Hypo/hyperthermia
    • Tachy/bradypnea
    • Tachy/bradycardia
    • Cushing's changes/triad
  • Nursing management:
    • Maintain skin integrity
    • Maintain patent airway
    • Maintain muscle tone and joint movement
    • Pneumonia and aspiration precautions
    • Oral care
    • Maintenance of nutrition
    • Protection from injury
    • Promote adequate cerebral perfusion

Cerebral Perfusion Pressure (CPP)

  • 70-90/120 mmHg
  • CPP = MAP - ICP

Medical Management

  • Goal: Improve or correct the cause of altered LOC
  • Management:
    • Maintain skin integrity
    • Maintain patent airway
    • Maintain muscle tone and joint movement
    • Pneumonia and aspiration precautions
    • Oral care
    • Maintenance of nutrition
    • Protection from injury
    • Promote adequate cerebral perfusion

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

More Like This

Use Quizgecko on...
Browser
Open
Browser
Browser