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Nurs 228 Chapter 27

Health Assessment in Nursing: Chapter 27

QuestionAnswer
What could cause numbness/tingling? Damage to brain, spinal core, or peripheral nerves (basically nerve damage)
What could cause seizures? Epilepsy, metabolic disorders, head injuries, and/or high fevers
What might cause morning headaches that subside after arising? Increased intracranial pressure (e.g. brain tumor)
Dysfunction of what cranial nerve would diminish one's sense of smell? Cranial nerve I (olfactory)...could also be caused by a brain tumor--a common diagnosis the television drama House.
What would cause ring in one's ears, or hearing loss? Dysfunction of cranial nerve VIII (acoustic)
Dysfunction of which nerve(s) would cause changes in vision? Mostly cranial nerve II (optic); Damage to III (oculomotor), IV (trochlear), or VI (abducens) would cause double or blurred vision
Damage to which nerves would affect one's ability to swallow? IX (glossopharyngeal), X (vagus) or XII (hypoglossal)
Bowel and/or urinary control can be caused by damage to what? Um...the book just says spinal cord. Lame, I know.
What might cause one to have tremors? Degenerative neuro-disorders (think parkinson's), or cerebellar disease, or MS
What may cause loss of recent (24 hour) memory? Amnesia, Korsakoff's syndrome, delirium, and/or dementia.
What may cause loss of remote (think longer-term) memory? Cerebral cortex disorders.
What is a CVA? A cerebrovascular accident; a stroke
T/F Peripheral neuropathy can be caused by a vitamin deficiency. True: niacin, folic acid, vitamin B12 (all B-vitamins)
Which American minority is twice as likely to endure a CVA than caucasian? African Americans
Describe the scale used to report reflex response. 0 to 4+; 0 being no response, 2+ being normal, and 4+ being hyperactive
Describe the assessment of cranial nerve I (olfactory) Ask client to identify familiar smell (e.g. soap)
Describe the assessment of cranial nerve II (optic) Use the Snellen chart (bad vision/missing letters=bad); red-reflux with irregular margins (using opthalmoscope) may equal papilledema.
Describe examination of nerves III, IV, and VI Watch for droopy eyelid (think Paris Hilton); or uncoordinated motion of eye.
Describe the elements of a quick "nero check" LOC, pupillary, movement/strength of extremities, VS
Describe the muscle strength table Scale of 0-5 5: Active against full resistance (normal) 4: Active motion against some resistance (slight weakness) 3: Active against gravity (poor ROM) 1: Slight flicker (severe weakness) 0: No response (paralysis)
Why is it important to assess LOC first? LOC validates subjective information collected from client
How do you test for corneal reflex? (CN VII: facial) Touch the eye with a "fine wisp of cotton" - eyes should blink bilaterally
How do you assess for proper motor function of CN V (trigeminal) Ask client to clench teeth; palpate masseter muscles; both S/B clinched bilaterally.
What would you ask of a client to assess motor function of CN VII (facial)? Have them make faces; smile, frown, wrinkle forehead, etc.
What are normal findings of an assessment of motor function of the CNs IX (glossopharyngeal) and X (vagus)? Demonstrates unlabored swallowing, positive gag reflex, and rising of the uvula and soft palate on phonation (CN X only; say ahhhhh).
Describe the method for assessing the CN XI (spinal accessory) (hint: involves resistance) S/B able to shrug shoulders (otherwise: paralysis), and turn head (otherwise PN disease) against resistance.
What would an assessment of CN XII (hypoglossal) test for? Fasciculations/Arophy caused by PN disease. Watch for deviation of tongue to affected side.
What kind of tests would be appropriate when evaluating the function of CN VIII? (CNVIII=acoustic/vestibululocochlear nerve) Weber test (bilatteral hearing); Rinne test (vibratory senses); hearing (air conduction) should be 2Xs longer than vibratory conduction.
What does AAOx4 (or A&Ox4) mean? Alert, aware, and oriented X4 (person, place, time, situation)
T/F muscle atrophy is the result of inactivity, and is not a sign of neural defect. Fasle: neural defect can cause inactivity, and muscle atrophy (p. 581) Muscle atrophy can be a sign of lower neuron disorders.
Q. Elizabeth demonstrates bizarre face, tongue, jaw, and lip movements. What is likely to be the cause of Elizabeth's symptoms? A. Chronic psychosis, or prolonged use of psychotrophic drugs.
Q. Jason has slow movements in his lower extremities, as if he is trying to run while half submersed in a swimming pool. What is the cause? A. Cerebral palsy. (could also cause slow, twisting movements in his face...bummer)
Q. John presents with a wide-based, staggering, unsteady gate. He also demonstrates a positive Rhomberg's test. What is his diagnosis? John is presenting with cerebellar ataxia for one of two reasons: either John has cerebellar disease, or he is drunk. hopefully the latter.
Q. Jake presents with a shuffling gait. He turns in a very stiff manner, has a stooped-over posture with flexed hips and knees. What's Jakes problem? A. Jake is either doing an impression of Bill Cosby dancing, or he is presenting with Parkinsonian Gait. Either way it's painful to watch.
Q. Scott emerges from his low-rider with a flexed arm held close to his body. As he ambulates, you notice that he his dragging the toe of one leg behind him. WTF is up w/ Scott? A. Scott is suffering from one of two serious issues: either he is experiencing spastic hemiparesis, or he thinks he is a gangsta from the 2c. Either way, it's likely the result of a recent stroke. Poor Scott
What is Nystagmus, and what is it a S/S of? Rhythmic oscillation of the eyes; issues with CNIII, IV, and/or VI
What is paralytic strabismus, and what is it a S/S of? Paralysis of the CNs III, IV, and/or VI
Created by: scottheadrick