Medsurg exam intracranial regulation

Brain does not store…

Glucose, glycogen, and oxygen

Monro-Kellie Hypothesis

There is only so much room inside of the skull. If tissue expands—> CSF decreases

Non-contrast CT is done for suspected…

stroke

Dont give contrast to stroke patients because…

It will flood the brain with iodine

Brain biopsy means…

something is growing

Ultrasound is

less invasive and used when the growth cant be determined

Fully conscious

alert

obtunded

yell to wake up

stuporous

painful stimuli to wake up

comatose

no response at all

Glasgow coma scale score of 3-8

severe

Glasgow coma scale score of 9-12

moderate

Glasgow coma scale score of 13-15

Mild

Cushings triad

Bradycardia, Irregular respirations, and widened pulse pressure (Increased systolic and Lower diastolic)

Decorticate posturing

Flexed posture, arms towards core, means problem in cervical spine or cerebral cortex

Is decorticate or decerebrate worse

Decerebrate

Extended posturing, arms extend away, problem in midbrain or pons

Focal onset seizure definition

One part of the brain

Focal awareness

Alert during seizures

Motor meaning

Shaking motions

Non-motor meaning

Smells, emotions, sounds

Generalized onset seizure definition

All over the brain

Tonic-clonic seizure

Stiff and jerking movements

Atonic seizure

Drop attacks

Myoclonic seizure

One muscle group is affected

Non-motor seizure

Staring out into space

Unknown onset of seizure definition

No idea what is happening

Impaired perfusion

Ischemic stroke, severe hypotension, cerebral vasospasm

Increased mass or volume

Brain tumors, hematomas, abscesses

ECG definition

Tracks brain signals and measures activity

ECG uses

Diagnosing epilepsy, evaluating conditions

Seizure precautions

Clear hazards, pad side rails, bed low and locked, find triggers and auras

How does menstrual cycle affect seizures

Hormones change the seizure threshold

Seizure emergency actions

Put pt on floor and protect head, position on side, clear environment

Meds used to stop an active seizure

Benzodiazepines (Ativan, valium)

Meds used to prevent seizures

Keppra, dilantin

What does vagus nerve stimulation do

Reduces seizure frequency

Dietary adjustments for seizures

Ketogenic diet

Emergency seizure triggers

Seizure lasting <5 mins, does not wake up, happens in water

Post-ictal stage

After seizure

Post-ictal care

Assess airway and vital signs, neuron assessment, check blood glucose, and document

Ischemic stroke

Blood clot

Two types of ischemic stroke

Thrombotic and embolic

Hemorrhage stroke

Brain bleed

Transient Ischemic Attack (TIA)

A mini stroke

BE FAST

Balance, Eyes, Face, Arms, Speech, Time

Intracranial pressure management

Elevate HB to 30 degrees, maintain seizure precautions, avoid restricted venous return

Ischemis ctroke- thrombolytic candidate

<185/110 mmHg

Expressive aphasia

Cant express themselves

Receptive aphasia

Cant understand what is being said

Homonymous hemianopsia

Lost vision on one side

Unilateral neglect

Stops using one side

Stroke rehab acute stage

0-7 days

Stroke rehab subacute stage

1-3 months

Stroke rehab chronic stage

3+ months