Neurological Disorders Assessment Quiz
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Questions and Answers

What percentage of the global burden of disease is constituted by neurologic disorders?

  • 12% (correct)
  • 20%
  • 14%
  • 5%
  • Which of the following is NOT included in the health history assessment for neurological disorders?

  • Medications
  • Family history
  • Blood pressure readings (correct)
  • Allergies
  • What is one of the components assessed during a neurologic examination?

  • Nutritional status
  • Gait, stance, and coordination (correct)
  • Respiratory rate
  • Visual acuity
  • What is the maximum score obtainable on the Glasgow Coma Scale?

    <p>15 (A)</p> Signup and view all the answers

    Which aspect of the Glasgow Coma Scale assesses the best motor response?

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

    What type of symptoms might indicate a disturbance in the gastrointestinal system in neurological disorders?

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

    Which of the following symptoms is associated with disturbances in the nervous system?

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

    What component of the Glasgow Coma Scale represents a score of 6?

    <p>Obeys command (B)</p> Signup and view all the answers

    What major complaint should the nurse anticipate in a patient post-surgery?

    <p>Sore throat (A)</p> Signup and view all the answers

    Which action should NOT be taken if a patient develops a sore throat post-operation?

    <p>Administer numbing spray (A)</p> Signup and view all the answers

    What should the postoperative patient be monitored for regarding physical condition?

    <p>Change in blood pressure (D)</p> Signup and view all the answers

    After surgery, how long should the patient remain flat in bed?

    <p>12 - 24 hours (D)</p> Signup and view all the answers

    Which of the following is an appropriate intervention for a patient who has undergone cervical surgery?

    <p>Use a cervical collar (C)</p> Signup and view all the answers

    What position should be avoided while the patient is sleeping post-surgery?

    <p>Prone position (A)</p> Signup and view all the answers

    What should the patient do if they experience increased pain postoperatively?

    <p>Immediately contact their healthcare provider (D)</p> Signup and view all the answers

    What type of diet may be recommended for a patient complaining of dysphagia post-operation?

    <p>Soft diet (B)</p> Signup and view all the answers

    What is the significance of a GCS score between 3 and 8?

    <p>Indicates severe head injury (C)</p> Signup and view all the answers

    Which imaging technique involves injecting a contrast medium to visualize cerebral circulation?

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

    What is the purpose of a PET scan combined with a CT scan?

    <p>To create a clearer image for interpretation (D)</p> Signup and view all the answers

    What type of anesthesia is typically used for a lumbar puncture?

    <p>Local anesthesia (B)</p> Signup and view all the answers

    What is a common finding in normal cerebrospinal fluid (CSF) analysis?

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

    Which condition could contraindicate a lumbar puncture?

    <p>Increased intracranial pressure (D)</p> Signup and view all the answers

    What does an Electroencephalogram (EEG) record?

    <p>Electrical activity of the brain (D)</p> Signup and view all the answers

    Which type of disc herniation is the rarest?

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

    Which of the following symptoms is NOT commonly associated with cervical issues?

    <p>Lower back pain (B)</p> Signup and view all the answers

    What imaging technique is commonly used to evaluate spine disorders?

    <p>X-ray (D)</p> Signup and view all the answers

    Which of the following indicates a preparation for surgical intervention?

    <p>Significant neurological deficit (A)</p> Signup and view all the answers

    What is the primary focus of discharge planning for a patient with lumbar spine issues?

    <p>Promote proper posture and lumbar flexion exercises (A)</p> Signup and view all the answers

    What is a common non-surgical treatment method for muscle spasm control?

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

    What condition may result in chronic back and leg pain after spinal surgery?

    <p>Failed disc syndrome (D)</p> Signup and view all the answers

    In which scenario is a laminectomy most indicated?

    <p>Ruptured disc causing neurological symptoms (D)</p> Signup and view all the answers

    Which practice should be avoided to prevent exacerbating cervical spine issues?

    <p>Excessive automobile riding during acute phase (A)</p> Signup and view all the answers

    Flashcards

    Impact of Neurological Disorders

    Neurological disorders are common and impactful. They affect over 1 billion people worldwide, causing 12% of the global disease burden and 14% of global deaths.

    Health History in Neurological Assessment

    The process of gathering information about a patient's medical history and symptoms to understand their neurological condition.

    Chief Complaint and Onset

    Information about the patient's main concern, when it started, specific symptoms, factors that cause it to worsen or improve, and any potential risk factors.

    Mental Status Assessment

    Involves assessing a patient's mental state, including their level of consciousness, memory, ability to think clearly, and behavior.

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    Neurologic Examination

    A comprehensive evaluation of the nervous system, focusing on the functioning of the brain and spinal cord.

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    Cranial Nerve Examination

    Evaluates the function of the cranial nerves, which control sensory and motor functions of the head and neck.

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    Motor System Evaluation

    It assesses a patient's ability to move, including muscle strength, coordination, gait, and balance.

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    Sensation Assessment

    It assesses a patient's ability to feel touch, pressure, temperature, and pain.

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    Glasgow Coma Scale (GCS)

    The lowest score is '3' indicating deep coma, the highest is '15' most responsive, a GCS between 3 & 8 is generally accepted as indicating a severe head injury.

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    Cerebral Angiography

    A radiologic procedure where a contrast medium is injected into the cerebral arteries to visualize blood flow and detect abnormalities like aneurysms or tumors.

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    Lumbar Puncture (Spinal Tap)

    A diagnostic procedure involving insertion of a needle into the subarachnoid space, between the third and fifth lumbar vertebrae, to obtain cerebrospinal fluid (CSF).

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    Myelography

    A radiological technique using a contrast agent injected into the subarachnoid space through a lumbar puncture to visualize the vertebral column and disks.

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    Positron Emission Tomography (PET) Scan

    A procedure involving the injection or inhalation of a radioactive substance to assess blood flow, tissue composition, and measure brain function.

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    Disc Herniation

    A protrusion of the nucleus pulposus into the annulus fibrosis, causing nerve compression. It is a common cause of back pain.

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    Electroencephalogram (EEG)

    A form of brain imaging that records electrical activity in the brain via electrodes placed on the scalp.

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    Cervical Spondylosis Symptoms

    Pain and stiffness in the neck, shoulders, and scapular region, possibly extending to the upper extremities and head.

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    Lumbar Spondylosis Symptoms

    Lower back pain with motor impairment, radiating to the buttocks, aggravated by activities like sneezing or straining.

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    Laminectomy

    The process of removing the lamina, a part of the vertebral bone, to expose the spinal cord and nerves.

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    Myelogram

    A procedure that uses an injection of dye into the spinal canal to visualize the spinal cord and surrounding structures on an X-ray.

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    Computerized Tomography (CT Scan)

    A diagnostic test that creates detailed images of the bones, muscles, and soft tissues of the spine using X-rays.

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    Electromyography (EMG)

    A test that measures the electrical activity of muscles and nerves, helping to assess nerve damage or dysfunction.

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    Failed Disc Syndrome

    A common complication of spinal surgery, characterized by persistent back and leg pain that occurs after the initial surgery.

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    Arachnoiditis

    Inflammation of the arachnoid membrane, a delicate layer covering the spinal cord, often caused by infection or irritation.

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    What is a laminectomy?

    A surgical procedure that allows visualization of the spinal canal, enabling the identification and removal of any compression or pathology affecting the spinal cord and nerve roots.

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    Why is bed rest essential after a laminectomy?

    The patient should be positioned flat in bed for a period of 12-24 hours after a laminectomy to promote healing and reduce pressure on the surgical site.

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    How is pain managed after a laminectomy?

    Analgesics are administered based on the patient's individual pain level and experience to effectively manage post-operative pain.

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    After a laminectomy, how should the patient change directions?

    To prevent complications like neck strain and discomfort, the patient should be educated to turn their whole body instead of just their neck when changing positions.

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    How long is the cervical collar worn after a laminectomy?

    The cervical collar is typically worn for approximately 6 weeks to stabilize the neck and support healing after a laminectomy.

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    What specific movements should be avoided after a laminectomy?

    Patients are advised to avoid extreme neck movements, such as bending, extending, and rotating, to prevent strain and complications after laminectomy.

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    What sleeping position should be avoided after a laminectomy?

    The prone (face-down) sleeping position should be avoided after a laminectomy to reduce pressure on the surgical site and promote proper healing.

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    What signs should the patient monitor after a laminectomy?

    After laminectomy, the patient should be taught to monitor for signs of infection, including fever, wound drainage, and increased pain, which may indicate complications.

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    Study Notes

    Neurological Disorders and Intervertebral Disk Prolapse

    • Neurological diseases are common and costly, affecting over 1 billion people worldwide, accounting for 12% of the global disease burden and 14% of global deaths.

    Introduction

    • Neurologic diseases are common and costly.
    • Neurological disorders affect over 1 billion people worldwide.
    • They constitute 12% of the global burden of disease.
    • They cause 14% of global deaths.

    Neurological Assessment

    • Health History: Includes details about the patient's chief complaint, onset, signs and symptoms, predisposing factors, aggravating and relieving factors, medications, alcohol and recreational drug use, and any history of head or spinal cord trauma or falls. Also, allergies, habits/lifestyle changes, and family history are important factors.

    • General Signs/Symptoms: The assessment covers the nervous system, including disturbances in consciousness, memory loss, headaches, pain, dizziness, vertigo, and seizures. The musculoskeletal system assessment includes weakness, loss of coordination, tremors, numbness, and paralysis. Additional systems to consider include gastrointestinal and other systems (e.g., nausea/vomiting; bowel or bladder difficulties; swallowing difficulties; visual disturbance; speech difficulties).

    Physical Examination

    • Neurological Examination: The examination comprises mental status, cranial nerves, motor system assessment (muscle strength, gait, stance, coordination, sensation), reflexes, and the autonomic nervous system.

    Assessment Tools

    • Glasgow Coma Scale (GCS): Used to assess level of consciousness. It has three categories: Eye opening, Best motor response, and Best verbal response. The scores range from 3 to 15. A GCS between 3 and 8 indicates a severe head injury.

    Diagnostic Testing

    • Positron Emission Tomography (PET) Scans: Assess blood flow, tissue composition, and brain function.

    • Cerebral Angiography: Uses contrast medium to visualize cerebral circulation and detect aneurysms or tumors, often accessing the femoral artery.

    • Lumbar Puncture (Spinal Tap): Involves inserting a needle into the subarachnoid space between the third and fifth lumbar vertebrae; useful for measuring cerebrospinal fluid (CSF) fluid or pressure or injecting a medication or contrast medium. Contraindicated with increased intracranial pressure.

    • Myelography: An X-ray of the spinal subarachnoid space after injecting a contrast agent; used to visualize the vertebral column and intervertebral disks.

    • Electroencephalogram (EEG): Measures electrical activity in the brain; used to diagnose and evaluate seizures, identify tumors or brain abscesses/infections, and confirm brain death.

    Laboratory Testing

    • Cerebrospinal Fluid (CSF) Analyses: Analyzing CSF can reveal normal findings, such as a pH of 7.35-7.45, specific gravity of 1.007, and a clear, colorless, odorless appearance. Additionally, minimal WBCs and no RBCs along with positive protein and glucose are normal findings.

    Nursing Management for Patients with Cervical Disc Prolapse

    • Immobilization: Immobilize/rest the cervical spine using methods like a cervical collar, cervical traction, and bed rest.
    • Muscle Spasm Control: Administer muscle relaxants to control muscle spasm.
    • Surgical Intervention: Prepare for surgical intervention if necessary, due to significant neurological deficit from nerve root compression.
    • Discharge planning: Teach patients to avoid extreme flexion, extension and rotation of the cervical spine during activity, keep the head in a neutral position while sleeping, avoid excessive automobile riding while experiencing acute phase symptoms.

    Nursing Management for Patients with Lumbar Disc Prolapse

    • Bed Rest: Encourage the patient to remain on bed rest.
    • Drug Therapy: Administer appropriate analgesic and anti-inflammatory drugs.
    • Heat and Massage: Utilize heat and massage treatments by a physiotherapist to relax muscles.
    • Neurological Deficit Monitoring: Watch for any neurological deficits, such as muscle weakness, atrophy, loss of sensory/motor function, or unrelieved acute pain.
    • Gradual Activity Increase: Have the patient increase activity gradually.
    • Surgical Intervention: Prepare for surgical intervention (laminectomy) when indicated, to remove the ruptured disc.
    • Discharge Planning & Health Teaching: Encourage patient to do lumbar flexion exercises. Advise the patient to sleep on side with knees and hips flexed. Encourage proper posture. Consider a lumbar support (corset).

    Management of Patients Following Laminectomy

    • Laminectomy: Removal of the lamina to expose the neural elements of the spinal canal. Allows for inspection, identification, and removal of pathology/compression from the spinal cord and roots.

    Post-Operative Nursing Management for Cervical Disc

    • Vital signs and neuro checks: Monitor vital signs and neurological status frequently.
    • Sore throat management: Be aware of sore throats as a common complaint and avoid throat numbing sprays.
    • Pulmonary secretions: Observe for pulmonary secretions.

    Nursing Process - Assessment (Pre-operative)

    • Past injury: Assess for past neck injury
    • Pain: Assess pain onset, location, radiation
    • Cervical spine area: Assess area around the cervical spine by palpation to assess muscle tone and tenderness
    • Range of motion: Assess range of motion in the neck and shoulders
    • Surgical info: Determine the patient's need for information about the planned operative procedure.

    Post-Operative Assessment

    • Vital signs monitoring: Monitor blood pressure (BP) and pulse.
    • Bleeding evaluation: Evaluate any bleeding.
    • Drainage inspection: Inspect the dressing for serosanguineous drainage.
    • Headache assessment: Assess for headaches.
    • Extremity weakness evaluation: Check for weakness in upper and lower extremities.

    Nursing Diagnoses

    • Pain: Pain related to surgical procedure.
      • Interventions: Keep the patient flat in bed for 12-24 hours. Administer analgesics as needed. Consider a soft diet if dysphagia is present.
    • Impaired Physical Mobility: Impaired physical mobility related to post-operative surgical regimen.
      • Interventions: Use of cervical collar. Teach patient to turn the body instead of the neck when looking from side to side. Encourage wearing shoes when ambulating.

    Patient Teaching & Home Health Care

    • Cervical collar use: The cervical collar is usually worn for 6 weeks.
    • Neck movement restrictions: caution against extreme neck movements (flexing, extending, rotating) during activities/exercises. Avoid the prone position while sleeping.
    • Symptom monitoring: Encourage monitoring of signs and symptoms, such as fever and wound drainage.
    • Positioning and activity: Avoid prolonged sitting or standing periods (more than 30 minutes). Alternate tasks that don't involve body movement.

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    Description

    Test your knowledge on the assessment and management of neurological disorders. This quiz covers various aspects such as the Glasgow Coma Scale, health history assessment, and postoperative care. Determine how well you understand the key concepts in neurology.

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