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what is normal ICP

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what is normal ICP

0-15

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what factors influence ICP

brain tissue, blood, CSF

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how does CO2 affect ICP

it is a vasodilator so it increases ICP

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how does a brain tumor affect ICP

it occupies space so it increases ICP

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what does untreated increased ICP lead to

brain herniation and death

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what are the S/S of increased ICP

change in LOC, cushings triad, decreased eye reflexes, hemiparesis and hemiplegia, HA, projectile vomiting without nausea

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what are some nursing interventions for increased ICP

elevate HOB, hyperventilation, suctioning, NG tube

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how does mannitol work

hypertonic fluid/osmotic diuretic for plasma expansion and pulling fluid out of cells to decrease ICP

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how dose lasix work

reduces blood volume and rate of CSF production

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if a patient is experiencing increased ICP due to increased CO2, what nursing action can be taken

hyperventilate the patient

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how does O2 affect ICP

decreases ICP

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what does a glasgow coma score of 3 indicate

brain dead

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what does a glasgow coma score of 8 or less indicate

coma

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what nursing interventions are required for a patient with a glasgow coma score less than 8

monitor ICP

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what does a glasgow coma score of 15 indicate

normal

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what areas are assessed with the glasgow coma scale

verbal, motor, and eye-opening response

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what is decadron

corticosteroid used to treat arthritis and test for cushings syndrome

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what is excedrin used to treat

headaches and migraines

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what is levadopa used to treat

parkinsons

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how does levadopa treat parkinsons

increases dopamine in the brain

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what is meningitis

inflammation of the brain and spinal cord that increases CSF production and increased ICP

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what is the cause of meningitis

bacterial or viral upper respiratory infection

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what are the early S/S of meningitis

fever, nuchal rigidity, HA

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what are the severe S/S of meningitis

change in LOC, hemiparesis, abscess, hydrocephalus, waterhouse-friderichsen syndrome

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what is waterhouse-friderichsen syndrome

petechiae, PIC, adrenal hemorrhage

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what diagnostic test is used to diagnose meningitis

lumbar puncture

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what are the nursing interventions for meningitis

low stimulating environment, high protein and calorie diet, ROM, warm baths, monitor vitals and ICP

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what is a brain abscess

accumulation of pus in the brain

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what diagnostics are used for a brain abscess

CT, MRI

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what is the treatment for a brain abscess

antibiotics, incisions/drainage or removal of abscess

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what are the S/S of a tension headache

bilateral pressure/tightness, mild-to-moderate severity, photophobia and phonophobia

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what is the treatment for tension headaches

ASA, tylenol, ibuprofen

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what are the S/S of a migraine

recurring, unilateral, trobbing, worsended with activity, associated with aura

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what is the treatment for migraines and cluster headaches

imitrex, ergotamine, midrin, corticosteroids

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what are the S/S of a cluster headache

severe, unilateral, abrupt onset, repeated over 2-3 months, facial swelling, lacrimation, rhinnorhea, ptosis

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what nursing interventions should be completed after the tonic-clonic phase and during the post ictal phase

turn the patient on their side

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when does suctioning and oxygen therapy begin

post-ictal phase

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what should you not do for a patient having a seizure

restrain or put anything in the patients mouth

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what is the primary seizure medication

tensilon

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what is the therapeutic blood level for tensilon

10-20 mcg/ml

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how does one monitor tensilon levels

monitor with blood draws prior to morning med

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how do you administer tensilon through an IV

dilute and give slowly to prevent hypotension and cardiac dysrhythmias

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what are the side effects of tensilon

gingival hyperplasia, slurred speech, confusion, blood dycrasias, hyperglycemia, alopecia, hirsutism

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what patient education should be provided to a patient on tensilon

perform good oral hygeine

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what is an important assessment question for a patient who arrives to the ER with stroke S/S

when was the patient last seen normal

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what is the priority action for a pt with stroke S/S

stat CT to determine if its ischemic or hemorrhage

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what is a hemorrhagic stroke

bleeding caused by rupture of a blood vessel resulting in the death of cells

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what are the causes of hemorrhagic stroke

HTN and aneurysms

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what is the tell-tale sign of a hemorrhagic stroke

worst headache of my life

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what is an ischemic stroke

inadequate blood flow to part of the brain from an occlusion of an artery

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what is a thrombotic stroke

clot formation due to narrowing of the arteries from plaque

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what is an embolic stroke

clot comes from somewhere else in the body and gets stuck in an artery that is too small

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what is the cause of an embolic stroke

a-fib

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what is the treatment for an ischemic stroke

tPa

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what is the treatment for transient ischemic attacks

plavix, aspirin (ASA), and coumadin

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how do plavix and aspirin work

prevent platelet aggregation

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what is the action of coumadin

anticoagulant

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primary nursing diagnosis for tPa use

risk for bleeding

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what are surgical interventions to prevent hemmorhagic strokes

clipping or coiling of an aneurysm, endartectomy

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S/S of right sided stroke

reckless, impulsive, moves quickly

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what are the S/S of a left sided stroke

language skills deficit, very cautious

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what occurs in a wernicke deficit

receptive aphasia resulting in difficulty understanding

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what occurs in a brocas deficit

expressive aphasia resulting in difficulty speaking and writing

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what is the patho of parkinsons

deterioration of the basal ganglia

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what are the S/S of parkinsons

tremors, pin-rolling, rigidity, bradykinesia

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what is the treatment of parkinsons

levodopa

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what are the S/S of levodopa overdose

akinesia (freezing and slow) and athetosis (writhing movement of the neck

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what are nursing interventions for parkinsons

small frequent meals, declutter environment, simplify clothing

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what is the patho of myasthenia gravis

autoimmune disease that attacks acetylcholine receptors

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what are the S/S of myasthenia gravis

progressive weakness, ptosis, voice fading, respiratory problems

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what are the causes of myasthenia gravis

stress, infection, extreme temps, hypokalemia

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what is the treatment of myasthenia gravis

tensilon, neostigmine, atropine

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what is the action of tensilon and neostigmine

cholinesterase inhibitor which increases acetylcholine

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what is the action of atropine

blocks acetylcholine

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what are the nursing interventions for myasthenia gravis

respiratory support, mechanical soft diet

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what is the patho of multiple sclerosis

deterioration of the myelin sheath

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what are the S/S of multiple sclerosis

muscle spasticity and stiffness, weakness and paralysis, diplopia, tinnitus, hermits sign (electric shock)

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what is the treatment for multiple sclerosis

corticosteroids, immunomodulators, megavitamin therapy, baclofen pump

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what is the patho of huntingtons disease

excess of dopamine

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what are the S/S of huntingtons disease

involuntary movements (chorea), impaired speech and swallowing, deteriorating gait, intellectual decline

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what are the nursing interventions of huntingtons disease

high calorie diet to accommodate chorea

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what is the patho of ALS

progressive loss of motor neurons

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what are the S/S of ALS

weakness of extremities, dysarthria, dysphagia, respiratory dysfunction

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what is the prognosis of ALS

death in 2-6 years from respiratory infection secondary to compromised respiratory function

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