NEURO
A patient can follow commands, has spontaneous eye opening, but responds to questions with confused conversation. What GCS score should the nurse assign?
GCS 14
A patient arrives with sudden facial drooping, LUE weakness, and dysphagia. What about these assessments is concerning?
the SUDDEN & LOCAL neurological dysfunction, indicating a stroke
A patient with Parkinson's disease demonstrates tremor that is most noticeable when the affected extremity is at rest. What additional assessment findings would the nurse expect to see?
Rigidity, bradykinesia, postural instability
A client with epilepsy tells the nurse, "I can feel a seizure coming on because I get a strange sensation and then my right hand starts twitching." The client remains conscious during the episode. What type of seizure is most consistent with these findings?
focal seizure
A patient with Parkinson's disease asks which neurotransmitter is deficient in their disease process. What shoud the nurse explain
LOW DOPAMINE
A patient begins speaking fluently, but the words lack meaning. The patient also cannot understand the nurse's questions. The motor exam is normal. What area is most likely affected?
Wenicke's area
A patient experiences unilateral weakness that completely resolves after 15 minutes. The patient states, "Since everything is normal now, I don't need to worry." What should the nurse explain?
a TIA can be a warning sign of a future stroke and still requires eval
A patient with MG reports that their legs become progressively weaker while climbing stairs but improve after resting. Explain this patho
impaired acetylcholine receptor function at the neuromuscular junction causing weakness that is RELIEVED BY REST
A patient experiences a generalized tonic-clonic seizure lasting 6 minutes without regaining consciousness. what is this called & what should the nurse prioritize?
STATUS EPILEPTICUS, priority is to maintain airway and adequate oxygenation
A patient using a PCA tells the nurse, "My spouse presses the button for me whenever I say I'm hurting." What is wrong with this statement?
only the patient should activate the PCA
A patient has an injury involving the cerebellum. Which assessment finding would provide the strongest evidence that the injury is affecting cerebellar function?
A. Inability to produce meaningful speech
B. Loss of pain sensation on the opposite side
C. Unsteady gait with impaired coordination
D. Inability to recognize familiar objects
C (ataxia & impaired coordination is evidence that the cerebellar function has been affected, as it controls balance, coordination, and movement)
A patient with a severe TBI develops VS: BP 188/58, HR 46/min, RR irregular. What problem should the nurse associate with these findings?
increased ICP causing impaired cerebral perfusion and a compensatory rise in systemic blood pressure & wide pulse pressure. slow HR due to increased vagal tone in response to high ICP. irregular respirations due to brainstem compression/affect on respiratory center.
CUSHINGS TRIAD = late sign of high ICP/brainstem compression, including HTN w/ wide PP, bradycardia, slow/shallow/irregular breathing. REQUIRES URGENT INTERVENTION
A patient with multiple sclerosis reports severe fatigue that worsens later in the day. What nursing intervention supports energy concervation?
A. Encourage prolonged bed rest
B. Encourage high-intensity exercise during periods of fatigue
C. Schedule important activities during periods of greatest energy
D. Restrict fluids to reduce energy expenditure
C - schedule activity/PT/OT during times when energy is highest (MORNING)
A client sustains a L4 cord injury and later reports new urinary incontinence. The nurse recognizes that this finding is concerning because injury to the spinal cord can disrupt the neural pathways responsible for this function. What additional assessment should the nurse prioritize?
assessing bladder function and determining whether the client has urinary retention or loss of bladder control. can cause neurogenic bladder and loss of sensation in the perineal region
A patient receiving IV morphine has the following VS: BP 92/58, UOP 25 mL/hr, RR 8/min, difficult to arouse. Which finding is the highest priority?
RR 8/min (opioid induced respiratory depression)
A patient with a neurologic injury has increased muscle tone, exaggerated DTR, and spasticity. Which finding best explains the neuro pathway involved?
Upper motor neuron dysfunction
A patient with a subarachnoid hemorrhage suddenly develops a unilateral dilated pupil that reacts sluggishly to light. Why is this finding immediately concerning?
possible brain herniation from increasing ICP causing cranial nerve/pupillary compression
A patient with ALS has progressive weakness, fasciculations, and loss of voluntary motor function but does not have primary sensory loss. What is the patho behind this?
progressive degeneration of upper and lower motor neurons controlling voluntary skeletal muscle
A client with a TBI develops worsening neurologic findings. The nurse observes abnormal flexion of the upper extremities toward the chest with extension of the lower extremities. What does this finding indicate?
decorticate posturing, indicating significant brain injury above the brainstem
A client taking an antiseizure medication says, "I haven't had a seizure in several weeks, so I'm going to stop taking it today." what should the nurse say
antiseizure medications should not be stopped abruptly and should generally be tapered under the provider's direction. DUE TO RISK OF WHAT????
A patient has weakness and fasciculations accompanied by hyperreflexia and spasticity. The nurse recognizes that these findings cannot be explained by isolated lower motor neuron dysfunction alone. What combination of neurologic dysfunction best accounts for the assessment?
A patient with a severe brain injury has a GCS that decreases from 14 to 9 within 30 minutes. Why is this concerning?
a rapid deterioration in LOC indicates worsening neurologic function & possible increased ICP, requires immediate intervention!!! (notify provider, secure airway)
A patient with MG has ptosis and difficulty chewing. Several hours later, the patient develops dysphagia, a weak cough, and difficulty taking deep breaths. What should the nurse prioritize & why?
Respiratory interventions should be performed for decreased forced vital capacity. progression from skeletal muscle weakness to respiratory muscle involvement is an immediate threat to ventilation
A client sustains a brainstem injury and develops persistent tachycardia. The nurse recognizes that damage to a cranial nerve involved in parasympathetic regulation of the heart could contribute to this finding. What CN should the nurse associate w/ this problem?
CN X
The nurse is reviewing medications with a client who has newly diagnosed epilepsy. Which medications or medication classes should the nurse recognize as being used in antiseizure therapy? SATA
A. Hydantoins
B. Barbiturates
C. Triptans
D. Anticonvulsants
E. Phenothiazines
A hydantoins, B barbiturates, D anticonvulsants