Meningitis and Encephalopathy
This clinical sign is present when the patient's hips and knees involuntarily flex in response to the nurse flexing the patient's neck forward
Brudzinski's Sign
This "test" involves administering IV edrophonium; a temporary improvement in muscle strength indicates a positive diagnosis for myasthenia gravis
Tensilon Test
The nurse should educate the patient taking Carpidopa/ Levodopa to avoid high amounts of this macronutrient during the day to prevent decreased absorption of the drug
Protein
A patient with MS suddenly develops significantly worsening neurologic symptoms. The nurse should recognize this as potentially representing this
MS relapse/exacerbation
This medication is the first-line "drug of choice" for terminating Status Epilepticus due to its rapid ability to enhance GABA activity
Valium (Diazepam) drug of choice
contraindicated in narrow angle glaucoma
antidote: IV flumazenil
Administer slowly to prevent respiratory depression
This diagnostic test must be completed within 30 minutes of a suspected stroke patient's arrival to rule out a hemorrhagic stroke
CT scan!
This is the earliest and most sensitive indicator that a patient’s neurological status is deteriorating
change in Level of Consciousness (LOC)
After starting appropriate antibiotic therapy for bacterial meningitis, the nurse must maintain droplet precautions for this specific length of time
24 hours
To maximize drug efficacy and minimize the risk of aspiration during meals, the nurse should administer Pyridostigmine how long before allowing the client to eat
30-60 minutes
Initial choice for increasing muscle strength in MG
Medium acting
Antidote: Atropine Sulfate
Adverse Effects: cardiac dysrhythmias, COPD, HTN, bradycardia, seizures
Originally developed as an antiviral for influenza, this medication is used for Parkinson's to relieve symptoms for a limited amount of time
Amantadine HCL
side effects increase with other Parkinson's drugs.
Don't give to RENAL failure or dialysis
Increase oral hygiene, avoid alcohol caffeine and smoking, avoid heat extremes, glaucoma
This immunomodulator is considered a first-line treatment for MS
interferon beta-1a/b
as well as corticosteroids, anti-inflammatories, and muscle relaxants
Side effect of gingival hyperplasia, liver toxicity, agranulocytosis, hirsutism, SJS, and suicidal ideation are common from what medication?
Phenytoin (Hydrantoins)
thin therapeutic window (10-20 mcg/mL)
avoid anticoagulants, backup birth control, take with milk or food
A patient with damage to this side of the brain is likely to experience aphasia, impaired speech, and a slow, cautious behavioral style
Left side damage
This group of late-stage IICP symptoms includes widening pulse pressure (increased systolic BP), bradycardia, and irregular respirations
Cushing's Triad- (opposite symptoms as stroke)
Before a patient undergoes this diagnostic procedure to analyze CSF, the nurse must ensure a CT scan is performed first if increased intracranial pressure (IICP) is suspected
Lumbar puncture (spinal tap)
You may see orders for corticosteroids and broad spectrum antibiotics ordered to help reduce inflammation
If a patient experiences a cholingergic crisis (overdose) characterized by bradycardia and respiratory distress, the nurse should be prepared to administer this IV antidote
IV atropine sulfate
A nurse assessing a Parkinson's patient might observe this classic "pill-rolling" motion of the thumb and fingers
resting tremor
Patients starting interferon beta 1a/b should be prepared to feel what sort of side effects
Flu like symptoms
also be aware of adverse effects- teratogenic effects- avoid pregnancy, and myelosupression (risk for infection) and hepatotoxicity
For a patient taking Phenytoin, the nurse must monitor labs to ensure the medication stays within this therapeutic window.
10-20 mcg/mL. Anything over 30mcg/mL is TOXIC
While rt-PA can often be given up to 4.5 hours after the "last known normal," this age group is excluded if the window exceeds 3 hours
over the age of 80
This type of abnormal posturing, characterized by internal rotation and adduction of the arms, indicates damage to the corticospinal tract
Decorticate posturing
While meningitis is an inflammation of the membranes, this condition is an acute inflammation of the brain tissue itself, often caused by Herpes Simplex Virus
Encephalitis
Priority is to find out what started it** treat with antivirals and monitor labs
another manifestation is phonophobia and nuchal rigidity (neck can't bend forward)
This priority nursing assessment for a MG patient is essential because the disease could can lead to weakened diaphragm and intercostal muscles
Respiratory Status- difficulty breathing
The use of anticholinergic medications like Atropine to treat PD tremors is strictly contraindicated in patients with this specific eye condition
Narrow-angle glaucoma
The nurse should instruct the MS patient to avoid these triggers, which are known to cause exacerbations of the disease
temperature extremes (Heat and cold), stress, and infection
During a tonic-clonic seizure, the nurse should never attempt to do this to the patient's jaw or mouth
force the mouth open or ever stick anything in it
Before administering thrombolytics, the nurse must ensure the patient's blood pressure is below this specific systolic threshold
Systolic BP greater than 185
or Diastolic BP greater than 110
make sure to know exclusion criteria**
A nurse observing "extensor posturing" knows this indicates a more severe injury involving this specific part of the brain
Brain Stem
This assessment finding, characterized by pain or resistance when the nurse attempts to straighten the patient's leg while the hip is flexed at 90 degrees is a classic sign of meningeal irritation
Kernig's Sign
Too little acetylcholinesterase inhibitor medication can result in this type of crisis
Myasthenic Crisis
This term describes "mask-like" blank expression and slow, shuffling gait characteristic of advanced Parkinson's disease
Bradykinesia
This specific clinical manifestation of MS involves a sensation of an electric shock that travels down the spine when the patient moves their head.
Lhermitt's sign- (electric shock sensations)
This term refers to the period of confusion, fatigue, and headache that follows a generalized seizure
postictal state
If a patient receiving rt-PA begins to bleed uncontrollably, the nurse should have this specific hemostatic antidote ready for administration
Aminocaproic acid- stops bleeding
To promote venous drainage and help lower intracranial pressure, the nurse should do these early interventions
Elevate HOB, keep neck in neutral position, no neck or hip flexion