Neurology
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Questions and Answers

Respiratory failure can be caused by undermedication, stress, or ______.

infection

Cholinergic Crisis occurs when there is excessive ______ in the neuromuscular junction.

acetylcholine

A positive Tensilon test indicates worsening ______ symptoms.

myasthenia gravis

Amyotrophic Lateral Sclerosis (ALS) affects voluntary muscle ______, such as walking and talking.

<p>movements</p> Signup and view all the answers

In autonomic dysreflexia, patients may experience severe ______.

<p>hypertension</p> Signup and view all the answers

Increased ICP can lead to ______ which indicates severe pressure on the brain.

<p>Cushing's Triad</p> Signup and view all the answers

A bruise behind the ear, known as ______ sign, can indicate a basilar skull fracture.

<p>battle</p> Signup and view all the answers

Meningitis can be caused by viral, bacterial, or ______ infections.

<p>fungal</p> Signup and view all the answers

Wernicke's Encephalopathy is characterized by low levels of ______.

<p>thiamine</p> Signup and view all the answers

A common early warning sign of meningitis is ______, which is sensitivity to light.

<p>photophobia</p> Signup and view all the answers

A patient with a spinal cord injury at C1-C8 will likely experience ______.

<p>quadriplegia</p> Signup and view all the answers

Guillain Barre syndrome causes ______ paralysis as the immune system attacks the nerves.

<p>ascending</p> Signup and view all the answers

In an emergency, the head of bed should be elevated to ______ degrees for patients with autonomic dysreflexia.

<p>90</p> Signup and view all the answers

Multiple Sclerosis is a chronic disease that primarily affects ______ communication.

<p>neural</p> Signup and view all the answers

In Myasthenia Gravis, muscle weakness tends to improve with ______.

<p>rest</p> Signup and view all the answers

Patients with spinal cord injuries between T1 and L4 may experience ______.

<p>paraplegia</p> Signup and view all the answers

The presence of high protein and low glucose in the cerebrospinal fluid indicates ______.

<p>meningitis</p> Signup and view all the answers

People with Myasthenia Gravis may experience ______, which is double vision.

<p>diplopia</p> Signup and view all the answers

Increased intracranial pressure and Cushing's Triad can lead to ______.

<p>bradycardia</p> Signup and view all the answers

A Myasthenia Crisis is considered a medical ______ due to worsening muscle weakness.

<p>emergency</p> Signup and view all the answers

Decorticate positioning involves arms bent and legs ______

<p>straight</p> Signup and view all the answers

A patient experiencing slurred speech may be suffering from ______

<p>dysarthria</p> Signup and view all the answers

Status epilepticus is defined as a seizure lasting more than ______ minutes.

<p>5</p> Signup and view all the answers

In ischemic strokes, blood flow to the brain is blocked due to a ______.

<p>clot</p> Signup and view all the answers

Parkinson's Disease is caused by low levels of ______ in the brain.

<p>dopamine</p> Signup and view all the answers

In cases of hemorrhagic strokes, there is a ______ due to ruptured blood vessels.

<p>brain bleed</p> Signup and view all the answers

The postictal phase occurs after a seizure and ends when the patient returns to ______.

<p>baseline</p> Signup and view all the answers

A patient may show signs of ______, which includes communication loss after a stroke.

<p>dysphasia</p> Signup and view all the answers

Seizures can be categorized as convulsive or ______ seizures.

<p>nonconvulsive</p> Signup and view all the answers

Patients with an aneurysm may experience ______ changes as a symptom.

<p>vision</p> Signup and view all the answers

Study Notes

Neurology

  • Decorticate positioning: Arms bent, legs straight, stiff; damage to the cortex.
  • Decerebrate positioning: Arms and legs straight; severe damage to the cerebellum or brain stem.
  • Seizures:
    • Tonic: Stiffness followed by loss of consciousness.
    • Myoclonic: Quick muscle jerks.
    • Clonic: Body spasms.
    • Atonic: Sudden lack of muscle strength.
    • Postictal phase: Occurs after a seizure, when patient returns to baseline.
    • Status epilepticus: Seizures lasting more than 5 minutes or multiple seizures without regaining consciousness; convulsive (tonic-clonic) seizures are most dangerous.
  • Stroke:
    • Risk factors: Hypertension, atherosclerosis, history of stroke, diabetes, smoking.
    • Symptoms: Motor loss (hemiparesis or hemiplegia), communication loss (dysphasia, dysarthria, apraxia, aphasia), vision changes, decreased mental acuity.
    • Start rehabilitation when patient is stable.
    • Nursing interventions (NI): Control blood pressure, neurological assessment, position patient to decrease edema, bed rest, stool softeners.
    • Ischemic stroke: Blockage of blood flow to the brain due to a clot.
      • NI: Give tPA within 3-4 hours of symptoms.
    • Hemorrhagic stroke: Brain bleed due to ruptured blood vessels.
      • NI: Anticoagulation therapy is contraindicated.
  • Aneurysm: Bulge in a blood vessel that can lead to rupture (hemorrhagic stroke).
    • Symptoms: Vision changes, headache, nuchal rigidity, dizziness.
      • NI: Promote a calm environment, bed rest.
  • Parkinson's Disease: Central nervous system disorder; low dopamine levels.
    • Symptoms: Tremors, pill rolling movement, rigidity, stooped posture, bradykinesia, difficulties with gait.
    • NI: Promote patient safety, schedule activities later in the day, calm environment, soft diet, physical therapy.

Increased Intracranial Pressure (ICP)

  • Pressure builds in the skull; blocking brain circulation.
  • Signs: Cushing's Triad (changes in level of consciousness or pupil size, headache, blurry vision, vomiting).
  • NI: Elevate head of bed (HOB) 30 degrees, keep body midline, calm environment, stool softeners, avoid Val Salva maneuver.

Meningitis

  • Inflammation of the membranes surrounding the brain and spinal cord.
  • Caused by viruses, bacteria, or fungi.
  • Symptoms: Photophobia (light sensitivity), drowsiness, confusion; nuchal rigidity (stiff neck), Brudzinski's and Kernig's signs; fever, headache, muscle pain.
  • Diagnostic test: Cerebrospinal fluid (CSF) test.
  • NI: Antibiotics, droplet/contact precautions, neurological assessment, vital signs, dark and calm environment, seizure precautions.

Guillain-Barré Syndrome

  • Immune system attacks its own nerves, causing ascending paralysis.
  • Symptoms: Paresthesia (numbness and tingling), difficulty breathing, pain, vision changes.
  • NI: Assess respiratory status; mechanical ventilation may be needed.

Multiple Sclerosis

  • Chronic disease affecting the brain and spinal cord, more common in women.
  • Immune system attacks myelin sheath.
  • Symptoms: Numbness, vision problems, slurred speech, fatigue.
  • NI: Implement rest breaks; create voiding schedule; high-fiber diet, increased fluid intake.

Myasthenia Gravis

  • Muscle weakness and fatigue of voluntary muscles.
  • Symptoms: Diplopia (double vision), ptosis (drooping eyelids), weakness, and breathing issues.
  • NI: Assess respiratory status, trach kit at bedside, cholinergic meds, cluster care.

Myasthenia Crisis

  • Medical emergency due to worsening muscle weakness, causing respiratory failure.
  • Caused by insufficient medication or stress.
  • Symptoms: Worsening MG symptoms.

Cholinergic Crisis

  • Excessive acetylcholine (ACh) in the neuromuscular junction.
  • Caused by too much anticholinesterase medication.
  • Symptoms: Cramps, diaphoresis (sweating), diarrhea.
  • NI: Give antidote, atropine sulfate.

Amyotrophic Lateral Sclerosis (ALS)

  • Progressive muscular disease; nerve cell degeneration.
  • Affects voluntary muscle movements (walking, breathing, talking).
  • NI: Assess respiratory status, encourage physical therapy/occupational therapy/speech therapy.

Autonomic Dysreflexia

  • Medical emergency in spinal cord injury (T6 or higher).
  • Symptoms: Severe hypertension, bradycardia, sweating, anxiety, headache.
  • NI: Elevate HOB to 90 degrees, remove tight clothing, administer antihypertensive medications.

Basilar Skull Fracture

  • Fracture of one of the bones at the base of the skull.
  • Symptoms: Bruise behind the ear (battle sign), periorbital hematoma (raccoon eyes), halo sign, hearing loss.
  • NI: Assess ABCs, neurological exam, GCS, CT scan.

Wernicke's Encephalopathy

  • Disruption caused by low thiamine (Vitamin B1).
  • Symptoms: Confusion, ataxia (loss of motor control), abnormal eye movements.

Spinal Cord Injuries

  • Damage to the spinal cord.
  • Different levels of injury result in varying degrees of deficits (e.g., paraplegia- TI to L4; quadriplegia/tetraplegia- C1 to C8; C2 to C3 - typically fatal).
  • NI: Assess respiratory status, neuro checks; immobilize on a backboard; maintain body midline.

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Description

Test your knowledge on key concepts in neurology, including decorticate and decerebrate posturing, types of seizures, and stroke risk factors. This quiz covers essential nursing interventions and rehabilitation strategies for stroke patients. Perfect for students and professionals in the health sciences.

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