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Stack #198318
Diagnostic Studies of the Nervous System: quiz 2
| Question | Answer |
|---|---|
| What is a lumbar puncture? | Most common nervous system diagnostic study in obtaining CSF for analysis. |
| When is a lumbar puncture contraindicated? | In the presence of increased ICP, or an infection at the site of injection. |
| Where is this procedure performed at? | Patients room |
| Description and Purpose(DP): CSF is aspirated by needle insertion in ___-___ or ___-___ to assess many CNS diseases | L3-4; L4-5 |
| Nursing Responsibilities(NR): Before the start of the procedure what do you check, to make sure the patient does not have? | Cerebral tumor. |
| What is the rationale for the contraindication of a cerebral tumor & LP | When a pt has a cerebral brain tumor the removal of CSF can result in herniation. |
| NR: What position due you make sure your pt assumes and maintains through out the procedure? | Lateral recumbent with knees flexed and chin to chest, with back at the very edge of the bed. |
| What should the patient due before the procedure. | Empty bladder |
| While the physician performs procedure what do you need to make sure is maintained? | Strict aseptic technique |
| Ensure proper labeling of CSF specimens in ___ ___. | Proper sequence. |
| Depending on the physicians preference the patient may have to lay flat for a few hours after the procedure, what is the reasoning? | To avoid spinal headache |
| Spinal Headache: | Result of leakage of CSF from puncture site |
| What position is effective in preventing CSF leakage? | Prone |
| HA intensity may also be reduced by: | Increasing fluid intake. |
| Needle is inserted, below what lumbar vertebra | 3rd |
| Inform patient may cause | Local discomfort |
| A patient may have pain radiating down leg or muscle twitching if needle irritates the spinal root. Inform pt | Assure them that it is temporary and they are not in danger of being paralyzed |
| A manometer is attached to the needle & CSF pressure is determined;When and why. | After the patient is asked to relax and extend the legs; If not relaxed pressure is appears abnormally high. |
| What S/S may develop in some patients after the procedure that they should be informed about. | Meningeal irritation (nuchal rigidity) or S/S of local trauma Ex; hematoma, pain |
| After procedure what is monitored | Neuro checks & VS |
| What is administered prn? | Analgesics as ordered |
| Radiologic study indicated when vascular lesions or tumors are suspected: | Cerebral Angiography |
| A catheter is inserted into what artery? | Femoral & sometimes brachial |
| Cerebral angiography: | serial x-ray visualization of intracrainal and extracrainal blood vessels to detect vascular lesions and brain tumors. |
| Is contrast medium used? | Yes |
| Since it is an invasive procedure what adverse reactions might occur? | Allergic reaction to the contrast medium |
| NR: Assess for stroke risk prior to procedure | Thrombi may be dislodged during procedure |
| Withhold | preceding meal |
| Patient teaching: (PT) Contrast medium | Feel hot, flushed in head and neck when contrast medium is injected. |
| PT/NR: Administer premedication | explain the need to stay absolutely still during procedure. |
| For the 1st 2 hours how often are the VSs and neuro checks performed | Every 15-30 minutes |
| How often for the next 6 hours | Every hour |
| Then they are checked every 2 hours for: | 24 hours |
| Report: | Any neuro changes |
| Maintain bed rest until: | Pt is alert and VS are stable. |
| Most common precaution nurse should take in caring for pt after the return to there room: | Observation for bleeding at puncture site usually groin |
| What is usually applied to the site to promote hemostasis and prevent swelling | Pressure dressing and ice |
| Computed tomography/CT: | Computer assisted x-ray of several levels or thin cross section of body parts. |
| This done to detect problems such as: | Cyst, Tumors, Edema, Hemorrhage, Brain atrophy, Infarction, and other brain abnormalities. C/T/E/H/B/I= Mnemonic (CT every humans brain instantly) |
| Why might contrast be used | Enhance visualization of brain structures. |
| NR: Assess pt for contraindications to contrast media | Including shellfish, iodine, dye allergy |
| PT: Explain | Procedure is noninvasive if no contrast is used |
| PT: Explain/Instruct | Explain appearance of scanner Instruct them to remain still during procedure |
| MRI: | Imaging of brain, spinal cord, spinal canal by means of magnetic energy |
| Used in the detection of: | Multiple Sclerosis, Tumors, Strokes, Trauma, Herniation, Seizures. M/T/S/T/H/S: Mnemonic (Magnetic therapy said to help some) |
| ____ contrast media may be used to enhance visualization. | Gadolinium |
| Does a MRI or CT have greater contrast in images of soft tissue structures? | MRI |
| NR: What contraindication should you assess the patient for? | Heart pacemaker |
| NR: Screen the patient for: | Metal parts in body |
| PT: Instruct | the need to lie very still for up to one hour. |
| When might sedation be required | If patient is claustrophobic. |
| What electrographic study measures electrical activity of the brain and is recorded by electrodes placed on the scalp? | EEG/ electroencephalography |
| involves the recording of the electrical activity of the surface __ __ of the brain by 8-16 electrodes placed on specific areas of the scalp? | Cortical neurons |
| Specific test may be done to evaluate the effects of | bright lights and loud noises on electrical activity |
| This test is done to evaluate not only cerebral disease but also the CNS effects | of many metabolic and systemic diseases , and to determine brain death |
| cerebral diseases assessed by EEG are; | seizure disorders, mass lesions, cerebrovascular lesions, and brain injury |
| Give 3 examples of a mass lesion | Hematoma, Abscess, Tumor "HAT" |
| Patients often have misconceptions on this test what should you tell them | Procedure is painless and without danger of electric shock. |
| What should be with held prior to the test, but can be resumed after | Stimulants |
| Determine if any other medications need to be with held for test such as; | tranquilizers and anti-seizure drugs |
| What should you assist patient with after test is complete | Washing paste out of hair |
Created by:
jsande02
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