The Nerve of You
These are signs of sympathetic nervous system stimulation (identify at least two).
What are dilated pupils, increased HR, and immobilized digestion?
Fight or Flight!!!!
Multiple sclerosis is caused by the breakdown of this and causes this...
What is breakdown of the myelin sheath (demyelination) and causes interrupted impulse transmission?
A herniated nucleus pulposus is...
What is the central soft component of the invertebral disk that bulges or herniates outside the disk causing a significant inflammatory response?
This is inflammation of the meninges and this is inflammation of the brain...
What is meningitis and what is encephalitis?
The RN knows that after a cerebral angiogram, if active bleeding is noted, the RN should...
What is apply direct pressure, request immediate assistance, and notify physician?
A dementia pt may continue to make his/her own decisions if...
What are he/she can explain purpose of medications, can express consequences of treatment choices, and is oriented enough to understand information provided?
These are signs of parasympathetic nervous system stimulation.
What are constricted pupils, slowed HR, increased digestion?
Rest & Digest!!!
Recovery after stress
Multiple sclerosis is an autoimmune disease that attacks the _____ & ______.
What is the brain and the spinal cord?
With a herniated nucleus pulposus, if the nerve root is compressed, these s/s may be present...
What is numbness in the affected extremity with pain & weakness?
S/S of both may include...(name 3)
What are stiff neck, altered mental status, photophobia, confusion, seizures, phonophobia?
The RN knows the most sensitive and reliable indicator of neuro status is...
What is level of consciousness?
This is a common Alzheimer's med that can reduce s/s of moderate to severe Alzheimer's and this category of meds may help memory and cognition...
What is Memantine and what are cholinesterase inhibitors?
The autonomic nervous system controls these involuntary functions (name 3).
What are HR, RR, digestion, pupil response?
Symptom management for MS includes... (name at least 3)
What are avoid overheating, rest periods, high fiber diet, regular visits w neurologist, regular exercise and ROM, regular vision check ups due to potential for vision involvement?
If a patient has a spinal injury at this level, they will lose the inability to breathe and will be a quadriplegic...
What is C4?
Bacterial meningitis may be identified by...
A lumbar puncture with gram stain of CSF (result will be +) and increased WBCs in CSF (neutrophils because neutrophils are associated w bacterial infections), elevated protein, and glucose level lower than serum glucose?
The RN knows this, like with hypoxia, is an early sign of increased ICP (intracranial pressure)?
What is restlessness?
Common s/s of Alzheimer's include...
What are forgetting familiar words & locations, short term memory issues, agnosia (inability to interpret sensations), flat affect, and forgetfulness?
Autonomic dysreflexia is related to _____ at this level ___ and can be triggered by (name at least 3 causes).
What are spinal cord injuries at T6 or above and can be triggered by urological events (UTI, distention, blocked foley catheter), full bowel, tight clothing, shoes, DVT, GI issues, temperature extremes, minor injury, and/or sitting or laying on a hard surface?
Complications of MS may include... (name at least 3)
What are paralysis, particularly the legs; bladder, bowel, and sexual dysfunction; ALOC related to memory issues and concentration; depression, seizures?
If a spinal cord injury occurs at this level, the patient will be a paraplegic...
What is Thoracic?
These three signs are identified with Meningitis...
What are nuchal rigidity (stiff neck), Kernig's sign (knee won't bend straight) and Berzinski's sign (laying supine, when the neck is bent forward, the legs pull up towards the chest due to stiffness of spinal column related to inflammation of meninges)?
The RN knows, if a patient has a foley catheter, it is important to maintain the bag at this level to prevent reflux of urine and ensure the tubing remains...
What is the bag should stay below the level of the bladder and the tubing should remain free of kinks and obstruction, draining freely?
Nursing actions for seizure patients include...(name at least 3)
What is maintain pt safety by protecting pts head, turning pt on side if possible (preferably left side to reduce risk of reflux w consequent aspiration); O2; administer benzo (diazepam, lorazepam), check for additional med orders; loosen restrictive clothing, note time of onset and duration?
Autonomic dysreflexia may present with... (name at least 3)
What are piloerection (hair stands up; goosebumps); severe headache, HTN, bradycardia, tachycardia, diaphoresis, flushing ABOVE injury with pallor BELOW the injury, sense of impending doom; BP will often be 20 to 40 mm HG above baseline?
New s/s may be noted with each visit to the neurologist because of this...
What are new areas of demyelination?
If a patient experiences a spinal injury at the lumbar or sacral area, expected s/s include...
What are decreased control of legs; bowel, bladder, and sexual dysfunction?
When diagnosing meningitis, expect these 3 diagnostic tests...
What are CT of brain, lumbar puncture, CBC with differential?
If a presenting with neuro s/s, the first assessment an RN should complete is... (even if the pt has comorbidities like renal, DM, or resp disorders)
What is a neuro assessment?
The RN knows Carbamazepine is an anticonvulsant that contains these 4 black box warnings...
What are 1) skin issues like Steven Johnson Syndrome, 2) bleeding risks like aplastic anemia & agranulocytosis (decreased blood cell production); hyponatremia; suicidal ideations?
The enteric nervous system affects...
What is digestion by regulating gut motility, secretion, and absorption of nutrients, but also influences the gut-brain axis, impacting mental health and stress responses, and interacts with the gut microbiota and immune system?
Lifestyle management for multiple sclerosis includes...
What is keeping cool, periods of rest, continued exercise & ROM, healthy diet (avoid overeating), stress relievers?
If the patient has an injury at C4 or above, this intervention is immediately required...
What is vent support?
Aseptic meningitis refers to meningitis that is caused by...
What is NOT a bacteria?
The RN knows a neuro pt who is having difficulty swallowing is a priority due to risk of this...
What is risk for aspiration pneumonia?
For a pt in postcoital state after a seizure, the RN should take these actions...
What are side lying position to reduce risk of aspiration, monitor vitals, assess LOC, keep environment calm & quiet?