N244 Unit 1 Neuro Cue Cards

Frontal lobe

Associated with personality and behavior, judgment, impulse control, and motor function.

Occipital lobe

Primary area for visual processing.

Temporal lobe

Associated with hearing, memory, language comprehension, and emotion.

Parietal lobe

Associated with sensory processing and interpretation of body sensations.

Subdural hematoma

Bleeding between the dura and arachnoid; often associated with slower neurologic deterioration than an epidural hematoma.

Epidural hematoma

Bleeding between the skull and dura; may have a brief loss of consciousness followed by a lucid interval and then rapid deterioration.

Basilar skull fracture

May present with CSF leakage from the nose or ear or bruising around the eyes or behind the ear; avoid inserting objects into the ear or nose.

Subarachnoid hemorrhage

Bleeding between the arachnoid and pia mater, where CSF circulates. Commonly associated with a ruptured aneurysm and a sudden severe headache.

Hemorrhagic stroke

Stroke caused by bleeding into or around the brain; increased ICP and rapid neurologic deterioration are major concerns.

Thrombotic stroke

Ischemic stroke caused by a thrombus forming in a cerebral blood vessel, often associated with atherosclerotic disease.

Embolic stroke

Ischemic stroke caused by an embolus traveling to and occluding a cerebral vessel; onset is often sudden.

Neurogenic shock

Loss of sympathetic tone after spinal cord injury causing vasodilation and hypotension; bradycardia may also occur.

Autonomic dysreflexia — common triggers

Bladder distention or urinary retention, bowel impaction, pain, skin irritation, or other noxious stimuli below the level of injury.

Autonomic dysreflexia

Sudden/severe HIGH BP from an uncontrolled sympathetic response d/t SCI, often presents with headache

Neurogenic shock

LOW BP and bradycardia caused by loss of sympathetic tone d/t SCI

Concussion

A mild traumatic brain injury; monitor for headache, confusion, dizziness, nausea/vomiting, and changes in LOC.

Coup-contrecoup injury

Brain injury caused by the brain striking the skull at the site of impact and/or opposite side.

Brain contusion

Bruising of brain tissue that can produce edema, bleeding, increased ICP, and neurologic deterioration.

Increased ICP — common cues

Decreased LOC, headache, vomiting, pupillary changes, seizures, and neurologic deterioration.

Normal ICP

Approximately 5–15 mm Hg.

MAP–ICP–CPP relationship

If ICP rises, cerebral perfusion pressure falls unless MAP increases.

Normal CPP

Approximately 60–100 mm Hg.

Cushing triad

Hypertension with widening pulse pressure, bradycardia, and irregular respirations; a late sign of increased ICP.

Nursing care for increased ICP

Maintain airway and oxygenation, elevate HOB as ordered, avoid activities that increase ICP, monitor neurologic status, and minimize unnecessary stimulation.

IICP - prevention

Straining, coughing, vomiting, and other Valsalva-type activities can increase intrathoracic pressure and raise ICP.

Vasogenic edema

Edema caused by disruption of the blood-brain barrier, allowing fluid to accumulate in extracellular brain tissue.

Brain abscess

A localized collection of infected material in brain tissue; can cause headache, vomiting, seizures, focal deficits, and increased ICP.

Meningitis — priority cues

Fever, severe headache, nuchal rigidity, altered LOC, and possible seizures; acute neurologic deterioration is a priority.

Meningitis — fever management

Control fever because hyperthermia increases cerebral metabolic demand and can worsen neurologic stress and seizure risk.

Encephalitis

Inflammation of brain tissue, often associated with fever, headache, altered LOC, seizures, and focal neurologic findings.

Seizure — nursing priority

Protect the patient from injury, maintain airway and oxygenation, and time the seizure; do not restrain the patient or place anything in the mouth.

Status epilepticus

A prolonged or recurrent seizure state requiring immediate treatment because ongoing seizure activity can cause hypoxia and neurologic injury.

Postictal state

The period after a seizure characterized by temporary confusion, drowsiness, headache, and/or other neurologic changes.

CVA / stroke — initial diagnostic test

Noncontrast head CT is the initial imaging study used to identify intracranial hemorrhage and help guide treatment.

Stroke — nursing priority

Determine the exact time the patient was last known well or symptom onset because treatment eligibility is time dependent.

TIA

A transient episode of neurologic dysfunction caused by focal brain ischemia without persistent infarction; it is a warning sign for future stroke.

Aneurysm

A weakened area of a blood vessel that can enlarge and rupture, potentially causing subarachnoid hemorrhage.

SCI — flexion/rotation mechanism

A spinal cord injury mechanism associated with severe neurologic deficits.

Spinal cord tumor — early symptom

Back pain that may worsen with activity can be an early symptom; neurologic deficits can progress

C7 SCI — severe headache/nausea

Suspect autonomic dysreflexia; check blood pressure immediately and look for a trigger such as bladder or bowel distention.

C3–C5 respiratory reminder

The phrenic nerve arises from C3–C5; higher cervical spinal cord injuries can threaten diaphragmatic function and ventilation.

Spinal cord injury — respiratory priority

Assess airway, breathing, oxygenation, and the level of injury; cervical injuries can compromise respiratory function.

Brachial plexus injury

Can cause weakness, sensory changes, or loss of motor function in the affected upper extremity depending on the structures involved.

CSF leak

Clear drainage from the nose or ear after head injury may indicate cerebrospinal fluid leakage; report and assess for associated neurologic changes.