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N3
Unit 14: Safe Environment - Alt Levels of Awareness/ Neurologically Impaired or
| Question | Answer |
|---|---|
| Identify the parts of the neurological examination. | 6 Components of AssessmentMental StatusCranial NervesMotor functionReflexesSensory functionCerebellar Function |
| Evaluate pupil size and reaction | Pupillary Reaction CNIII (oculomotor)Direct ResponseConsensual ResponseAccommodation |
| Consciousness | Being awake and aware - responsive to the environment |
| Describe assessment of limb movement | (blank) |
| Explain the purpose and parts of the Glasgow coma scale. | The scale comprises three tests: eye, verbal and motor responses. The three values separately as well as their sum are considered. The lowest possible GCS (the sum) is 3 (deep coma or death), while the highest is 15 (fully awake person). |
| Discuss the importance of measuring vital signs. | • Autoregulation is frequently impairedwith the traumatized brain• Cerebral blood flow will fluctuate withblood pressure• Injury may damage respiratory control center |
| Describe abnormal respirations. | (blank) |
| Explain different methods used to elicit a response in the unconscious patient. | Painful Stimuli: Nailbed pressure-to assessnonmoving extremity•Sternal rub•Supraorbital pressure•Pinch trapezius muscle |
| Describe application of painful or noxious stimuli. | (blank) |
| Differentiate between various eye movements. | (blank) |
| Identify conjugate eye movement. | Track together |
| Identify disconjugate eye movement. | Roving eyes, bobbing,nystagmus |
| Identify the oculocephalic reflex. | Doll’s eyes |
| Identify the oculovestibular reflex. | Cold calorics |
| Summarize abnormal and pathological reflexes. | (blank) |
| Unconsciousness | A dramatic alteration of mental state that involves complete or near-complete lack of responsiveness to people and other environmental stimuli. |
| Summarize the purpose for and nursing implications of diagnostic tests used to evaluate the unconscious patient. | (blank) |
| (blank) | |
| Discuss the use of radiological exams. | Skull x-rays – ID fractures |
| Discuss the use of PET scans. | PET-Positron Emission Tomography.Provides info @ the function of the brain in color. Noninvasive, 3-D. Nursing – Client is injected with deoxiglucose tagged with an isotope. The more active parts of the brain show more glucose uptake. Less radiation tha |
| Discuss the use of EEG. | EEG - View electrical activity of cerebral hemispheres - Nursing – No CNS depressants for 24 hrs. |
| Discuss the use of lumbar puncture. | Lumbar puncture/spinal tap-to obtain CSF for analysis. Nursing –Pre procedure carePost procedure careComplications – CSF leak, infection,intervertebral disc damage. |
| Discuss the use of MRIs. | MRI – picture of proton energyMagnetic field images are clear forall density of tissue includingvessels. Can use to diagnose MS.Nursing – pre procedure carepost procedure care |
| Discuss the use of cerebral angiography. | Cerebral Angiography – Ateriography,done under luoroscopy. Inject contrastmedium into artery, sequential x-rays.Visualize carotid and vertebral circulation.Nursing –Pre procedurePost procedure |
| Discuss the use of duplex studies. | Duplex Studies/Scans AKA TranscranialDoppler sonography – provide a visualrepresentation of moving blood. Evaluatearterial flow in Circle of Willis. Look forvascular abnormalities. Evaluate carotidartery patency. |
| Explain the assessment and care of a patient with seizure activity. | (blank) |
| Define terminology used for the stages of a seizure. | (blank) |
| Identify terminology to describe different types of seizures. | (blank) |
| Explain physiological reasons for seizure activity. | (blank) |
| Summarize nursing care of the patient during and following a seizure. | (blank) |
| Differentiate status epilepticus and collaborative care for this complication. | (blank) |
| Create a nursing care plan for an unconscious or neurologically impaired patient. | (blank) |
| Explain priority needs of the patient and their family. | (blank) |
| Summarize desired outcomes. | (blank) |
| Evaluate the nursing care given to a patient who is unconscious or neurologically impaired. | (blank) |
| (blank) | |
| Discuss educational needs for the patient who is neurologically impaired,including their significant others. | (blank) |
| (blank) | |
| Discuss patient needs regarding continued care or follow up. | (blank) |
| (blank) | |
| Identify action, indications and nursing implications of medications used to treat seizures. | (blank) |
| (blank) | |
| Anticonvulsant/Hydantoin | (blank) |
| Prototype: phenytoin (Dilantin) | (blank) |
| Fosphenytoin (Cerebyx) | (blank) |
| Anticonvulsant/Iminostilbene | (blank) |
| Prototype: carbamazepine (Tegretol) | (blank) |
| Anticonvulsant, sedative/barbiturate | (blank) |
| Phenobarbital (Luminal) | (blank) |
| Anticonvulsant/valproate | (blank) |
| Prototype: valproic acid (Dapkene) | (blank) |
| Divalproex (Depakote) | (blank) |
| Anticonvulsant/benzodiazepine | (blank) |
| Prototype: clonazepam (Klonopin) | (blank) |
| Anticonvulsant/analgesic | (blank) |
| Prototype: gabapentin/(Neurontin) | (blank) |
| Conjugate | track together |
| Disconjugate | Roving eyes, bobbing,nystagmus |
| Doll’s eyes | oculocephalic response |
| cold calorics | oculovestibular response |
| Motor Response | •Drift•Posturing•Decorticate•Decerebrate•Flaccidity |
| CN IX, X | Gag reflex |
| CN V, VII | Corneal reflex |
| Pathologic Reflexes | BabinskiSnoutChewingGraspSucking |
Created by:
littlemina
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