Under Pressure
Level of consciousness
What is the earliest and most sensitive indicator of neurologic decline?
Protecting your patient from harm during a seizure.
What is one of your nursing priorities when a patient is having a seizure?
With any type of injury the nurse should monitor this.
Anterior Fontanelle
What fontanelle closes between 6-18 months?
Irritability, fever, and vomiting.
What are some presenting signs/symptoms for an infant with meningitis?
This is a common cause of a hemorrhagic stroke.
What is hypertension?
This is a medical emergency and is a seizure lasting more than 5 minutes OR multiple seizures within a 5 minute period.
What is status epilepticus?
This device is used for relieving ICP by draining CSF, obtaining CSF samples and monitoring ICP.
What is an EVD?
Intranasal Midazolam
What is one common seizure rescue medication?
The fluid that bathes and protects the brain and spinal cord.
What is CSF?
This group will have the best knowledge of your patient's baseline.
Who are family members/caregivers?
Institute droplet precautions in addition to standard precautions.
What type of isolation should be instituted on all patients with suspected meningitis?
This is a common cause of an ischemic stroke.
What is hypertension?
This area of the brain is associated with language comprehension.
What is the Wernicke's Area of the brain?
Enlargement of baby’s head, fontanel is full and tense when infant is upright and prominent scalp veins.
What are signs and symptoms of increased ICP in an infant?
You will have electrodes placed on your head (on the outside) with very strong smelling glue.
What is an EEG?
This diagnosis should be suspected in a 9 mo old with lethargy and concerns for non-accidental trauma.
What is an intracranial bleed?
Sodium and Glucose
What two electrolytes that can affect a neuro exam?
Preventative measures for meningitis.
What are vaccines? - bonus points if you can name 2
tissue plasminogen activator (t-PA)
What is given as soon as possible if a patient is having an ischemic stroke?
The brand name for Levetiracetam.
What is Keppra?
Decorticate posturing, changes in vital signs and fixed and dilated pupils.
What are late signs of increased ICP?
A 3 y/o presents following a generalized 10 min tonic clonic seizure, a fever of 104.9F, and a family history of “seizures as a child.”
What is a febrile seizure?
One of the three major spinal cord functions.
What is 1) Sends motor information from the brain 2) enables the "feeling" of sensory information 3) coordinates reflexes?
Eye opening, verbal response and motor response are all parts of what scoring system?
What is the Glasgow Coma Scale?
Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type B.
What are types of meningitis that are preventable with vaccines? Bonus - which type is common in AYA living in community settings such as dorms?
Immediate nursing treatment of a ischemic stroke.
What is start IV t-PA, monitor intracranial hemorrhage symptoms such as HTN, headache, n/v, and decreased neuro status.
This type of imaging technique can not travel through bone.
What is an Ultrasound?
This doctrine states that skull is a closed vault with 3 components: brain, blood and CSF. And any increase or decrease in one element must be compensated for by change in the others.
What is the Monro Kellie doctrine?
Loss of motor activity accompanied by a blank stare.
What is an absence seizure?
Your highest priority when moving a patient with a spinal cord injury.
What is the immobilization of the head, neck and spine?
Widening of pulse pressure (increasing systolic/decreasing diastolic), bradycardia and altered respiratory patterns - all must be present.
What is cushing's triad? - bonus if you can tell what this is indicative of.
Older children with meningitis complain of pain and stiffness in this part of their body.
What is their neck?
Blood flow is interrupted to brain for brief period and is often referred to as a precursor to a stroke
What is a TIA (transient ischemic attack)?
What is a generalized seizure?