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neuro disorders
common neuro disorders
| Question | Answer |
|---|---|
| sudden onset, lasts longer than 24 hours and results from a cerebrovascular disease | stroke |
| stroke | diagnosis with a non-contrast CT and the NIHHS scale |
| use if with in 3 hours of onset of a stroke | thrombolytics |
| collection of blood between the dura and the inner table of the skull | epidural hematoma |
| accumulation of blood below the dura and above the arachnoid covering of the brain | subdural hematoma |
| collection of blood within the brain tissue | intra-cerebral hematoma |
| epidural hematoma | treat by driling a hole in the skull to remove pressure on the brain by draining the blood off then get pt to a level one trauma center |
| subdural hematoma | open the brain and drain, this is a less complete recovery for the patient cause the brain has been irritated by the blood |
| hypervolemic expansion, hemodilution, induce hypertension | triple H therapy for aneurysm or SAH pts |
| give volume to push volume through the vessesl | hypovolemic expansion |
| reduce viscosity of blood | hemodilution |
| push blood flow through area of spasm with use of vasopressors until improve in LOC or systolic of >160 | induced hypertension |
| One the pressure/volume curve what does it mean when the pressure and volume are about the same | that the pressure/volume is compensated |
| what does it mean the pressure and volume on the pressure/volume curve start to rise | there is worsening compliance |
| what does it mean when the pressure and volume on the pressure/volume curve are higher than before | there is a lack of compliance, herniation is imminent because the brain is displaced and death can occur |
| confusion, drowsiness, sluggish, papillary response and abnormal respiratiory patterns, decreased LOC, resp pattern changes, cheyne stokes or neurogenic hyperventilation, dilated or non reactive pupils are all S&S of what | increse in ICP |
| most specific to measure pressure, cath is put down deep into the third ventricle and has drainage holes to drain CSF to relieve pressure, great risk of infection and limited mobilization for the patient | intraventricular measurement |
| less infection and more mobility for the patient, less specific in terms of pressure reading, directly in brain, tranducer right at the tip, zero device then put it brain to measure | parenchymal measurement |
| assess resp patterns and rate, suctiioning if needed, check vital and neuro signs, positioning the client, temp control, glycemic control | 1st tier therapies to decrease ICP |
| treat hypothermai aggressively, babiturate coma till EEG is flat, antihypertensive therapy want high to normal, decompress crainectomy- remove bone flap to allow for swelling and pressure to decrease | second tier therapies to decrease ICP |
| insensitivity to ADH or insufficient release of ADH, Kidneys excrete great quantities of dilute urine, massive water dieresis leading to dehydration and high serum osmolality. | Diabetes Insipidis (DI) |
| too much ADH, excessive water reabsorbed casuses are susally ead injury or cancer | SIADH |
| SIADH | treat with vasopressin, DDAVP nasal spray, Aqueous pitressin SQ |
Created by:
dnoyes
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