Sensory perception

What are the two primary components of the Central Nervous System (CNS)?

The brain and the spinal cord.

What is the primary function of the Peripheral Nervous System (PNS)?

To transmit signals between the Central Nervous System and the rest of the body.

What is Peripheral Neuropathy?

A global condition affecting peripheral nerves, leading to communication disruption between the brain and other body parts. causing inappropriate signals causing pain or no sensations

What is the most common cause of peripheral neuropathy globally?

Diabetes.

What can cause peripheral neuropathy?

meds, infection, trauma, diabetes

Name the three types of nerve damage categorized by the number of nerves affected.

Mononeuropathy (single nerve), Multiple Mononeuropathy (two or more separate nerves), and Polyneuropathy (widespread damage).

What is the function of sensory nerves?

They relay signals like pain and temperature from the skin and muscles to the brain.

What is the function of motor nerves?

They send signals from the brain to muscles to control movement and coordination.

What is the function of autonomic nerves?

They control involuntary functions such as digestion, blood pressure, and heart rate.

Can you fix autonomic nerve problems with meds

NO

In what pattern do polyneuropathy symptoms typically develop?

They usually begin at the most distal parts of the body (toes and fingers) and progress proximally.

What are common motor nerve symptoms in peripheral neuropathy?

Muscle weakness, fasciculations (twitching), and lack of coordination.

What are common sensory nerve symptoms in peripheral neuropathy?

Decreased sensation to touch and temperature. Neuropathic pain described as burning, tingling, or electric-like.

What are common autonomic nerve symptoms in peripheral neuropathy?

Excess sweating, heat intolerance, unstable blood pressure (orthostatic), and bowel or bladder dysfunction.

what are assistive devices used in neuropathy

Ankle-foot orthoses (AFOs), knee-anklefoot orthoses (KAFOs), and orthopedic shoe inserts help maintain function and prevent complications.

Can surgery fix neuropathy

Surgery may be indicated in specific cases, particularly for nerve compression syndromes.- carpal tunnel

What is Guillain-Barre Syndrome (GBS)?

An acute autoimmune inflammatory polyneuropathy that causes segmental demyelination of peripheral nerves. Affects adults and children.

What are triggers of GBS

Viral/bacterial infections, surgery, trauma, and rarely vaccinations

What is the cause of Guillain- Barre Syndrome

unknown

What is the typical clinical progression pattern of Guillain-Barre Syndrome?

Ascending muscle weakness starting in the legs, moving to the arms, and potentially affecting respiratory muscles.

How does the recovery phase of Guillain-Barre Syndrome occur?

Healing occurs in reverse order of onset, with proximal muscles improving before distal ones.

How does the immune system affect GBS

The immune system mistakenly attacks peripheral nerves, damaging myelin sheaths that insulate nerve fibers.

Why can peripheral nerves regenerate while CNS nerves cannot?

Peripheral nerves have the potential to regenerate if the axons remain intact, whereas the CNS does not possess this regenerative capacity.

How long after a triggering event does GBS start

1-3 weeks

What diagnostic test measures the speed of nerve transmission?

Nerve conduction velocity tests.

What is the purpose of an electromyography (EMG) in diagnosing neuropathy?

To evaluate muscle response to nerve stimulation.

What are the intial s/s of Guillain-Barré syndrome

Tingling, paresthesia and weakness typically begin in lower extremities. Is symmetrical. Symptoms progress upward from legs to arms, then potentially to respiratory muscles. Maximum deficit reached within 2-4 weeks of symptom onset.

How does GBS healing occur

Healing occurs in reverse order, with proximal muscles improving before distal. Starts feet up, reverses arms down

If left untreated, GBS will need what

mechanical ventilation

What are the autononmic effects of GBS

Dysautonomia can cause blood pressure fluctuations, cardiac arrhythmias, and other complications.

How do you diagnose Guillain- Barre syndrome

Lumbar puncture- CSF typically shows elevated protein with normal cell count (albuminocytologic dissociation), though may be normal early.

Within 2-4 weeks of intial s/s of GBS

Rapid progression of symptoms with maximum disability reached within 2-4 weeks. May require ICU care and ventilatory support depending on severity.

How long does recovery of GBS last

Gradual improvement as remyelination occurs. Can take months to years, with most significant recovery in first 6-12 months. Can still have neuropathy

How do you treat Guillain barre

Hospital

Plasmaphresis

IVIG

What is Immunoglobulin Therapy IVIG

IVIG infusion administered daily for 5 days. Must be started within first 2 weeks of symptom onset for maximum effectiveness. - most common treatment but depends on dr. s/s cant be longer than 2 weeks old or IVIG wont help.

What is plasmapheresis?

Plasma exchange therapy removes antibodies from blood to reinfuse healthy antibodies. Typically performed 5 times over 1-2 weeks.

What type of tubing is used in IVIG

Vented tubing

What is the rate for IVIG

- 0.3 ml/kg/hr for first 15 minutes- can run slower than protacals in scope but not faster

Max rate- 2 ml/kg/hr (final rate)

When should you stop IVIG

only stop if respiratory problems, will treat s/s of hives with meds, monitor for 72hrs after infusion

What is the primary risk factor for falls in patients with peripheral neuropathy?

Decreased sensation and proprioception.

What is Trigeminal Neuralgia?

A condition affecting the 5th cranial nerve, resulting in intense facial pain.

What is the peak severity timeline for Guillain-Barre Syndrome?

Maximum deficit is typically reached within 2 to 4 weeks of symptom onset.

What is the classic clinical presentation of Guillain-Barre Syndrome (GBS)?

Rapidly progressing, ascending weakness or paralysis, often preceded by numbness and tingling.

What are the three phases of Guillain-Barre Syndrome?

Acute phase (progression), plateau phase (stability), and recovery phase (remyelination).

What is the time window for starting IVIG therapy in GBS patients?

It must be started within the first 2 weeks of symptom onset for maximum effectiveness.

What is the purpose of plasmapheresis in GBS treatment?

To remove antibodies from the blood and reinfuse healthy antibodies.

What is the primary nursing priority for a patient with GBS?

Respiratory monitoring and management.

What are the criteria for ICU admission in GBS patients?

Autonomic dysfunction, bulbar weakness (dysphagia), cough insufficiency, respiratory compromise, or hemodynamic instability.

What is the typical duration of the recovery phase in GBS?

Months to years, with the most significant recovery occurring in the first 6-12 months.

What is the primary goal of nursing care regarding skin integrity in GBS?

Frequent repositioning and meticulous skin care to prevent pressure injuries during immobility.

What is another name for Trigeminal Neuralgia?

Tic douloureux.

Which cranial nerve is affected in Trigeminal Neuralgia?

The fifth cranial nerve (CN V).

What is the most common cause of Trigeminal Neuralgia?

Compression of the trigeminal nerve by a blood vessel near the brainstem.

How is the pain in Trigeminal Neuralgia typically described?

Unilateral, severe, and electric shock-like sensations.

What are 'trigger zones' in Trigeminal Neuralgia?

Specific facial areas that, when touched or stimulated (e.g., eating, wind), trigger an episode of pain.

What is the first-line pharmacological treatment for Trigeminal Neuralgia?

Carbamazepine (Tegretol).

What are the three branches of the trigeminal nerve?

Ophthalmic, maxillary, and mandibular.

What monitoring is required during an IVIG infusion?

Continuous cardiac telemetry, oxygen saturation, and vital signs before and after every rate change.

Why is early passive range of motion important in GBS care?

To prevent contractures during the period of immobility.

What is the significance of the 'cough insufficiency' criteria in GBS?

It indicates a decreased ability to clear secretions, increasing the risk of respiratory failure.

How long should a patient be monitored for delayed reactions after an IVIG infusion?

Up to 72 hours.

What is the primary mechanism of Gamma Knife Radiosurgery for trigeminal neuralgia?

It delivers highly focused radiation to the trigeminal nerve root to damage nerve fibers and disrupt pain signal transmission.

What is a key advantage of Gamma Knife Radiosurgery compared to traditional surgical procedures?

It is non-invasive, requires no surgical incision, and is performed as an outpatient procedure.

What is the primary goal of a rhizotomy procedure for trigeminal neuralgia?

To destroy nerve fibers to interrupt pain transmission.

What are three common methods used to destroy nerve tissue during a rhizotomy?

Surgical resection, thermocoagulation, and radiofrequency coagulation.

What immediate post-procedure care is required after a percutaneous radiofrequency rhizotomy?

Apply an ice pack to the jaw on the operative side for 3-5 hours and avoid chewing on that side until sensation returns.

Can rhizotomy Procedures cause facial numbness or motor weakness

yes!

What is considered the gold standard surgical treatment for trigeminal neuralgia?

Microvascular decompression (MVD).

What is the primary function of microvascular decompression (MVD)?

It places a cushion between the trigeminal nerve and the compressing blood vessel.

What activity restriction is required for 6 weeks following MVD surgery?

No strenuous activities or heavy lifting.

What is the clinical definition of a cataract?

An opacity of the lens that distorts the image projected onto the retina, caused by the lens losing water and increasing in density.

What is the first symptom often noticed by patients developing cataracts?

Blurred vision.

what is leading cause of blindness

cataracts

how does cataract lens form

protein fibers clump together, creating cloudy areas that block light.

Nuclear cataracts

middle of lens

cortical cataracts

on the edge of the lens nucleus

Posterior subcapsular cataracts

forms at the back of lens

What are three common visual symptoms associated with cataracts?

Blurred vision, increased glare sensitivity, and halos around lights.

Which medication class, when used long-term, is a known risk factor for developing cataracts or glaucoma?

Corticosteroids.

What is a key clinical indicator of congenital cataracts in infants?

The absence of a red reflex during a pediatric eye exam.

What is the most common surgical technique used to remove cataracts?

Phacoemulsification, which uses ultrasound to break up the cloudy lens.

What is the purpose of IOL implantation during cataract surgery?

To insert an artificial intraocular lens with specific focusing power to replace the natural lens.

What are four serious post-cataract surgery complications that require urgent attention?

Endophthalmitis, retinal detachment, secondary glaucoma, and cystoid macular edema.

What are the signs of endophthalmitis following cataract surgery?

Severe pain, redness, and vision loss.

How do you treat endophthalmitis

antibotics

What are the signs of retinal detachment following cataract surgery?

Flashes of light, floaters, and vision loss.

What type of eye discharge is considered normal after cataract surgery?

Creamy white discharge.

What does green or yellow discharge indicate after cataract surgery?

A possible infection.

What activity restrictions are typically placed on patients after cataract surgery?

Avoid eye rubbing, bending, heavy lifting (over 20 lbs), strenuous activities, swimming, and driving.

What should a patient do if they experience sharp, sudden pain in the operated eye after cataract surgery?

Seek immediate medical evaluation as this is not normal.

What protective measure should be taken by cataract patients while sleeping during the first week post-op?

Wear an eye shield.

What lifestyle modification can help slow the progression of cataracts?

Smoking cessation.

When should you seek medical attention postop cataract surgery

- acute pain

-vision changes

-infection signs like green discharge, redness or swelling

-bleeding

What are complementary pain management measure would be included for a pt with TN

-acupuncture

-yoga

-biofeedback

Which conditions are associated with a risk of TN

- MS

-Shingles

Which instructions would the nurse give that would help to maintain a proper nutritional status of a pt with TN

- consume food that is easy to chew

- eat foods that are rich in carbs and proteins

- eat small quantities of foods more frequently

a pt has undergone a percutaneous radiofrequency rhizotomy procedure which instructions are correct for this pt

- avoid eating hot foods or drinks

- protect the face from extreme temps

- check oral cavity after eating foods for any residual particles