Neuro Detective
A client moves slowly, has increased muscle rigidity, and has difficulty getting started when walking.
What is Parkinson disease?
A hospitalized client has a known seizure disorder. This equipment should be readily available if respiratory support becomes necessary.
What are oxygen and suction?
This Parkinson medication works primarily by increasing the availability of dopamine in the brain.
What is carbidopa-levodopa?
Changes in this assessment finding can provide an important early clue that neurologic status is worsening.
What is level of consciousness?
Clients with Parkinson disease should generally be encouraged to maintain as much of this as safely possible.
What is independence?
A client begins having a seizure while out of bed. The immediate goal is to prevent this.
What is injury?
A client suddenly develops neurologic symptoms that disappear completely a short time later.
What is a transient ischemic attack (TIA)?
During a generalized seizure, the nurse should avoid doing this to the client's extremities.
What is restraining them?
A client taking an antiseizure medication develops significant changes involving the gums.
What is gingival hyperplasia?
This bed position generally promotes cerebral venous drainage when intracranial pressure is elevated.
What is head of bed elevated approximately 30 degrees?
A client has difficulty initiating a step. Rhythmic or deliberate movement strategies may help overcome this phenomenon.
What is freezing?
A client suddenly develops a new focal neurologic deficit. The nurse recognizes that rapid assessment matters because some treatments are highly dependent on this.
What is time?
A client presents with fever, severe headache, neck stiffness, and sensitivity to light.
What is meningitis?
A client with impaired mobility wants to walk to the bathroom independently despite being unsteady.
What is encourage use of prescribed assistance/assistive devices?
This IV medication may be used rapidly to stop prolonged seizure activity.
What is lorazepam?
The head and neck should generally be maintained this way when attempting to promote cerebral venous drainage.
What is neutral alignment?
The nurse communicates with a client who knows what they want to say but has difficulty producing the words. The nurse should provide plenty of this.
What is time to respond?
A client with a suspected CNS infection arrives on the unit. The nurse should implement appropriate precautions at this point rather than waiting for final test results.
What is immediately/upon suspicion?
A client has sudden difficulty producing words but appears to understand what the nurse is saying.
What is expressive aphasia?
Before giving food, fluids, or oral medications to a client with a new neurologic deficit, the nurse should consider this major safety risk.
What is aspiration?
A medication used to reduce cerebral edema may cause significant diuresis as fluid shifts out of cerebral tissue.
What is mannitol?
Repeated coughing, straining, and excessive stimulation can have this undesirable effect in a client with increased ICP.
What is further increasing intracranial pressure?
A stroke client repeatedly ignores the affected side. Teaching the client to intentionally look across the entire environment uses this compensatory technique.
What is visual scanning?
A client with a neurologic disorder suddenly begins coughing during oral intake. The nurse's priority is to evaluate this function.
What is swallowing/airway protection?
A neurologic client begins showing subtle changes in behavior, attention, and responsiveness.
What is possible neurologic deterioration/increasing intracranial pressure?
A client with suspected contagious neurologic infection arrives on the unit. Nursing care should prioritize protecting both the client and others from this.
What is transmission of infection?
A client taking long-term Parkinson medication develops new involuntary movements. The nurse suspects this medication-related complication.
What is dyskinesia?
A neurologic client develops a widening pulse pressure and slowing heart rate.
What is a concerning sign of worsening intracranial pressure/Cushing response?
A client with Parkinson disease develops difficulty chewing and swallowing. Maintaining nutrition must be balanced against prevention of this complication.
What is aspiration?
A client with an acute neurologic condition develops vomiting, worsening confusion, and increasing drowsiness. The nurse's priority is this.
What is immediate reassessment and intervention for neurologic deterioration?
A client consistently ignores objects and people located on one side of the environment.
What is unilateral neglect?
A client with neurologic impairment becomes increasingly difficult to awaken. The nurse should interpret this as this type of finding rather than an expected consequence of being hospitalized.
What is an acute neurologic change?
A client receiving a medication to dissolve an arterial clot develops an abrupt neurologic decline. The nurse should suspect this potentially catastrophic complication.
What is intracranial hemorrhage?
A client receiving treatment for cerebral edema becomes more alert and demonstrates stable neurologic findings.
What is evidence that therapy may be effective?
Doing everything for a neurologically impaired client may be faster, but it can interfere with this important rehabilitation goal.
What is maximizing functional independence?
The nurse must choose between four neurologic clients. The best general prioritization principle is to assess the client demonstrating this first.
What is a new or worsening neurologic change?