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Neuro 260
Neuro Clinical Topics: Neuro Assessment Tool
Question | Answer |
---|---|
The Glasgow Coma scale is a 15 point scale that is used to measure neurological status, what does it measure responses to? | Eyes Open, Best Verbal Response, Best Motor Response |
What are the different point values given for the different Eyes Open responses? | Spontaneously - 4, To Speech - 3, To Pain - 2, None - 1 |
What are the different point values given for the different verbal responses on the Glasgow Coma Scale? | Oriented - 5, Confused - 4, Inappropriate Words - 3, Incomprehensible Sounds - 2, None - 1 |
What are the different point values given for the different Best Motor Responses on the Glasgow Coma Scale? | Obeys commands - 6, Localize Pain - 5, Flexion Withdrawal - 4, Abnormal Flexion - 3, Abnormal Extension - 2, Flaccid - 1 |
Patients with Glasgow Coma Scales of _____ or below are in very poor shape. | 8 |
Glasgow Coma Scales of _____ to _____ usually are comatose patients and there is a very high potential that they will remain in a permanent vegetative state. | 3 to 6 |
Sometimes you will see _______ responses from geriatric patients, the dementia patients, and the alzheimers patients where the answer to everything might be "NO" or "my shoes". | Automatistic |
In patients displaying automatistic cognitive functioning why is the answer to everything "NO"? | It is because they are not able to cognitively process the information because they have a breaking down of the neuro system.(similar to an immature system) |
For our brains to do math, what does it require? | A higher level of functioning. |
A person can lower their stress by focusing on what? | A much higher functioning part of your brain. |
When evaluating Alzheimer's patients we must remember that they are very good at doing what? | Hiding that they don't remember things. |
Women in menopause will experience a short term memory loss which is not neurologically related, instead it is related to what? | Flucuation of hormones. It is normal in menopause. |
When you have a patient that has a neurological disorder a change in affect(mood) occurs. Why? | Because of a void or empty space that the response runs into causing changes/inappropriate responses. |
Parkinsons patients tend to develop a very _____ affect. | flat |
What needs to be communicated to patients and family about the patients affect? | They cannot control their behavior, it is part of the disease process. |
When we look at thought content, what do we want to look at? | All the psych issues, delusional paranoia, obsessed with one idea, and appropriate and intact behavior. |
If you are doing a neuro assessment and it doesn't quite feel right, what should you do as a nurse? | You need to continue to probe. |
Changes in speech can ___ and ____. Why? | come and go, fatigue and stress will exacerbate a neuro problem and it takes alot of damage before these symptoms are cosistent. |
Describe what a person with Wernicke's aphasia would have difficulty doing. | They have compresion difficulties, and usually little difficulty talking. Example: A person may call a knife a gleeble. |
Describe Broca's aphasia. | Difficulty with forming complete sentences and the rules of grammar. People with Broca's aphasia often speak in short sentences like, "walk home". |
Describe the patient with Global aphasia. | These patients can barely speak or understand what is being said to them. In addition, they can no longer read or write. |
What nerve has to do with the sense of smell? | Cranial nerve 1 - Olafactory |
The location of the the olfactory nerve causes the nerve to be ________ easily. | damaged |
Many persons that have experienced a significant trauma may not have a | Sense of smell, they may never get it back, but they may also get some of it back. |
What nerve has to do with vision? | Cranial nerve 2 - Optic |
What do we do to check function of the optic nerve? | Field of vision, visual acuity and structures (external, internal, red reflex and optic disc.) |
What nerve has to do with the eyelids? | Cranial nerve 3 - Occulomotor |
What cranial nerve is responsible for facial sensations and clenched jaws? | Cranial nerve 5 - Trigeminal |
When doing a corneal reflex, we need to remember what key factor? | Age slows down the reflex. Contact lenses can effect the corneal reflex as well. |
Blue eyed people will have larger pupils than people with dark eyes. Why? | Because people with blue eyes will let more light in. |
Cranial nerves 3,4,5, and 6 have to do with what? | The eyes. |
Cranial nerve 7 comes out of the temple and runs all the way down to the corner of the mouth. Ifthere are problems with this nerve, what might we see? | Drooping of the corner of the mouth (Bell's Palsy) |
Sometimes you can see Bell's Palsy follow what event? | Childbirth |
How long does Bell's Palsy tend to last? | 12-14 days |
Persons with Bell's Palsy normally do not have any _____ effects once it is gone. | residual |
What is the 8th cranial nerve responsible for? | Acoustic |
When we look at the 9th and 10th cranial nerves, what is important to look at? | Gag reflex, swallowing, uvula symmetry, phonation, taste. |
A patient with uvula symmetry will develop an inability to do what? | Projecting their voice. |
The longest nerve in your body is the | vagus nerve |
Why is it important to watch the HR when a person is being intubated? | They can vasovagal down very quickly with just the stimulation from the laryngealscope. |
Cranial nerve 11 involves what area? | Neck and shoulder movement. |
When a person has a stroke and their cranial nerve 12 is affected, what will we see? | The persons tongue will protrude from the mouth. |
What is cerebellar functioning? | It is coordination. Rapid altenating movements. It controls your movements. |
As a disease progresses that affects cerebellar function, what happens? | They lose the ability control movements. |
When you have movement disorders you can's slow down, instead you | speed up |
In patients with movement disorders, what way do they move? | Side to side. |
Persons with Parkinsons will lose their balance mostly when they are walking and they start to _____ in their movement. | turn |
If a patient does have a movement disorder and they close their eyes, what will happen. | They will fall over. |
What are the characteristics of meningismus? | Meningismus consists of fever, clouding of consciousness, photophobia (bright light being painful to look at), nuchal rigidity, a positive Brudzinski's test, and possibly a positive Kernig's test. |