Definitions
PERRLA?
pupils equal round reactive to light and accommodating.
What cranial nerve is being assessed when the patient is being asked to smile, frown, close eyes tightly, and puff out the cheeks?
(name the name, number, and Motor/sensory)
CN VII (facial)
Motor and Sensory.
What are the type of strokes?
Ischemic and hemorrhagic.
What is the seizure that has 3 phases and can last up to 30-40 seconds to minutes?
Tonic Clonic seizures.
'triptan medications are used for what kind of conditions?
Migraine or cluster headaches.
Retrogenesis?
Aging backwards
How do you assess a patients trigeminal (CN V) nerve?
Touch a cotton ball to the face and lightly brush
A patient being admitted with a stroke has right-sided facial drooping and right-sided arm and leg paralysis. Which other finding would the nurse expect?
1. Impulsive behavior
2. Right-sided neglect
3. Hyperactive left-sided tendon reflexes
4. Difficulty understanding instructions.
Difficulty understanding instructions.
This type of seizure occurs in ages 4-8 years old?
Absence seizure.
What is the time frame that IV tPA can be given to a patient from when the onset of symptoms start?
Intraarterial tPA?
IV: 3-4.5 hours.
6 Hours.
Lhermittes sign
Temporary sensory symptom described as an electric shock going down the spine or the limbs with neck flexion.
VIII.
Whats the name? How do you test for it?
Vestibulocochlear.
Ask the patient to close or plug one either and whisper in the open to see if the patient can repeat the word for phase back.
Assess the gait as they walk in or have them walk in a short straight line.
A patient is being admitted with a possible stroke. Which information from the nursing assessment indicates that the patient is more likely to be having a hemorrhagic stroke than a thromboembolic stroke?
1. The patient has intermittent bouts of atrial fibrillation.
2. The patient has had brief episodes of right-sided hemiplegia.
3. The patient has a history of treatment for infective endocarditis.
4. The patient reports that the symptoms began with a severe headache.
The patient reports that the symptoms began with a severe headache.
What diagnostic test is ran on a patient who has a possible seizure disorder?
Electroencephalography (EEG)
What drug class or drug is the first line treatment to PREVENT a stroke in a patient who has a history of a TIA?
Antiplatelet.
Aspirin (most used), clopidogrel, ticlopidine.
Status epilepticus
A state of continuous seizure activity, lasting longer than 5 minutes or 2 occurring too close together to where the patient cannot recover.
When asking the patient to shrug their shoulders, what cranial nerve are you assessing?
XI spinal accessory.
A patient comes into the ER with left sided weakness that started an hour ago. What diagnostic test should be ran first?
Noncontrast CT
Focal seizures begin in where?
In one hemisphere of the brain in a localized region of the cortex.
These are the main drugs to treat tonic clonic and focal-onset seizures.
phenytoin, carbamazepine, and divalproex.
Decorticate posturing
Internal rotation, adduction, and flexion of the arms.
What are the cranial nerves to assess the eyes?
II Optic, III oculomotor, IV trochlear, VI abducens
This type of stroke is bleeding within the brain caused by a rupture of a vessel with a poor prognosis.
HINT. Hypertension is the most common cause.
Intracerebral hemorrhage
What are the phases of tonic-clonic seizures?
Tonic phase - body stiffing lasting 10-20seconds
Clonic phase - extremities jerking movements.
First line medications to help treat RLS?
Dopamine antagonist