N244 Master Study Flashcards Set

Diffuse Axonal Injury & Nutrition

Early enteral feeding within three days improves outcomes and prevents continued cerebral edema

Hyperthermia & Brain Injury

A body temperature of 103°F (39.4°C) after a head injury indicates injury to the hypothalamus

Cushing Triad

Bradycardia, systolic hypertension, and a widening pulse pressure

ICP Monitoring Duration

Should not exceed five days to prevent severe infection

Glasgow Coma Scale (GCS) Moderate Range

A score of 9 to 12

CSF Leak Halo Test

Blood coalesces in the center with a yellowish ring of CSF encircling it on a white pad

Gastric Tube Insertion

Oral gastric insertion is preferred in patients with skull fractures to avoid inadvertent intracranial placement of an NG tube

Cranial Nerve III Compression

Paralyzes muscles controlling pupillary size and shape due to midline brain shift.

Stroke Extent of Damage Factor

The degree of collateral circulation.

Initial Stroke Diagnostic Test

Noncontrast head CT.

Most Critical Stroke Information

The exact time at which stroke symptoms first appeared

Carotid Endarterectomy Purpose

To prevent a stroke by removing atherosclerotic plaques blocking cerebral blood flow.

Neurogenic Shock Characteristics

Hypotension and bradycardia due to sympathetic nervous system dysfunction.

Autonomic Dysreflexia Priority (C7 Injury)

Measure the patient's blood pressure immediately when severe headache and nausea occur.

Early Spinal Cord Tumor Symptom

Back pain that worsens with activity.

Guillain-Barré Respiratory Distress Cause

Paralysis ascending to the nerves that stimulate the thoracic area.

Primary Hypothyroidism Lab Findings

An elevated TSH level.

Parathyroid Damage Sign After Thyroid Surgery

Laryngospasms and tingling in the hands and feet.

Addison Disease Teaching Error

Decreasing prednisone during illness like influenza (it must be increased).

SIADH Characteristics

Fluid retention, serum hypoosmolality, and dilutional hyponatremia.

Diabetes Insipidus Characteristics

Polydipsia, polyuria, and dilute urine with a specific gravity under 1.005.

Optic Nerve (CN II)

Sensory nerve

Oculomotor Nerve (CN III)

Motor and parasympathetic nerve

Cerebral Edema

Swelling of brain tissue from abnormal fluid accumulation, increasing ICP. Normal Intracranial Pressure (ICP)

Hypertonic Saline

Concentrated sodium solution that draws water from cells to reduce cerebral edema and ICP.

calculated as MAP minus ICP (normal 60-100 mmHg). Spinal Shock

Temporary loss of motor, sensory, reflex, and autonomic function below a spinal injury. Autonomic Dysreflexia

often causes a lucid interval before rapid decline. Subdural Hemorrhage (SDH)

Slow-bleeding between the dura and arachnoid mater, often from torn veins in older adults. Subarachnoid Hemorrhage (SAH)

famous for a sudden, extreme thunderclap headache. Monro-Kellie Doctrine

The skull contains brain tissue, blood, and CSF

an increase in one requires a decrease in others. Actions that Increase ICP

Valsalva maneuver, coughing, straining, and bearing down. Three Buckets of IICP Causes

Transsphenoidal Hypophysectomy Monitoring

Monitor for CSF leakage via nasal drip and watch for DI versus SIADH.

monitor LFTs and albumin. Status Epilepticus Drug of Choice

Benzodiazepines (e.g., diazepam, lorazepam)

Mannitol Purpose

Osmotic diuretic administered IV to pull fluid out of brain tissue and decrease ICP.

Phenytoin (Dilantin) Therapeutic Range

10 to 20 mcg/mL.

hold and notify provider if level is 25 mcg/mL or higher.

Phenytoin capacity-limited metabolism

IV form of Phenytoin

half-life extends to 24 to 42 hours in overdose.

Phenytoin Adverse Effect: Gingival Hyperplasia

Swollen, bleeding gums that must be reported to evaluate progression; impairment reduces clearance and elevates toxicity risk.

Phenytoin Hypersensitivity Warning

Report new-onset fever or skin rash immediately to rule out Stevens-Johnson Syndrome.

Gabapentin (Neurontin)

Mimics GABA to inhibit hyperactive neurons; carries low risk of liver toxicity.

Phenobarbital (Barbituates)

Used for seizures and chronic neuropathy; Commonly dosed at 15 to 40 mcg/mL.

Acetazolamide (Diamox) Uses

Decreases cerebrospinal fluid production in the choroid plexus to manage hydrocephalus; Withhold if greater than 320 mOsm/kg.