Nervous System
Challenge Questions
Cerebrovascular Accident (CVA)
Challenge Questions
Challenge Questions and other Assist with ADLs.

Be patient with self-care and movement. Allow time for tasks. Offer rest periods.

Give resident time to communicate.

Prevent falls.

Help avoid stressful situations. Listen to residents.

Sy
100

The nervous system is a complex network of nerves and cells that transmit signals between different parts of the body. It is divided into two main parts

What is 

central nervous system (CNS) 

peripheral nervous system (PNS).

100

NAs can help their residents with nervous system and related conditions

What is 

Suggesting residents make lists or write notes about things they want to remember

Placing a calendar where the resident can see it

Taking an interest in residents’ past by asking to see photos or hear stories

Allowing time for decision-making and avoiding sudden changes in schedule

Allowing plenty of time for movement

Encouraging reading, thinking, and other mental activities


100

NAs should know these facts about CVA:

What is 

CVA occurs when blood supply to a part of the brain is blocked or a blood vessel leaks or ruptures within the brain.

Results in lack of oxygen to tissues, causing cells to die.

Swelling, leaking blood, and clots affect surrounding healthy brain tissue.

Weakness occurs opposite affected side of brain.

Mild stroke may result in few, if any, complications.

100

It is a progressive, degenerative disease

Causes stiff muscles, stooped posture, shuffling gait, pill-rolling, tremors, and mask-like facial expression

Tremors can make ADLs difficult

What is 

Parkinson’s disease

100

Other issues that MS may cause if not discussed already

What is

MS can cause blindness, contractures, and loss of function in arms and legs

200

Central Nervous System (CNS) is composed of the following

What is 

  • The CNS consists of the brain and the spinal cord.

  • The brain is the control center of the body, responsible for processing sensory information, initiating voluntary movements, regulating bodily functions, and more.

  • The spinal cord is a long, tubular structure that runs from the base of the brain down through the vertebral column. It serves as a pathway for nerve impulses to travel between the brain and the rest of the body.

200

It is important to observe for and report the following

What is 

Fatigue or pain with movement

Shaking or trembling

Inability to move one side of body

Difficulty speaking or slurring of speech

Numbness or tingling

Disturbance or change in vision or hearing

Dizziness or loss of balance




200

The following are examples of what

Assist with ROM exercises or leg exercises to improve circulation as ordered, keeping safety in mind.

Use terms weaker or involved to refer to the affected side, not bad. 

Assist with speech therapy as needed. 

Use verbal and nonverbal communication to express a positive attitude.

Residents may experience confusion, memory loss, and heightened emotions. Be patient and understanding.

Encourage independence and self-esteem. 

Always check on resident’s body alignment.

Pay special attention to skin care.

If residents have lost sense of touch or sensation, be aware of potentially harmful situations, such as proximity to heat and sharp objects.

Adapt procedures when caring for residents with one-sided paralysis or weakness.

What is 

how to care for a resident who has had a CVA

200

Care Guidelines for Parkinson’s Disease


What is

Protect residents from falls. 

Help with ADLs as needed. 

Assist with ROM exercises as ordered. 

Observe for any swallowing problems and report them to the nurse.

Encourage self-care and be pa

200

Below are examples of 

Assist with ADLs,

Be patient with self-care and movement. Allow time for tasks. Offer rest periods.

Give resident time to communicate. 

Prevent falls. 

Help avoid stressful situations. Listen to residents. 

Symptoms of MS can change daily, Adapt care to symptoms reported.

Encourage a healthy diet with plenty of fluids. 

Give regular skin care.

Assist with ROM exercises.

What is Care Guidelines for Multiple Sclerosis

300

Peripheral Nervous System (PNS) is composed of the following

What is

  • The PNS includes all the nerves outside the brain and spinal cord.

  • It is further divided into the somatic nervous system and the autonomic nervous system.

  • The somatic nervous system controls voluntary movements and transmits sensory information to the CNS.

  • The autonomic nervous system regulates involuntary bodily functions such as heart rate, digestion, and respiration.

300

Other changes not mentioned that CNA need to report

What is 

Changes in eating or fluid intake

Difficulty swallowing

Bowel or bladder changes

Depression or mood changes

Memory loss or confusion

Violent behavior

Unusual or unexplained change in behavior

Decreased ability to perform ADLs


300

Care Guidelines for CVA 

For transfers

What is 

Always use a transfer belt.

Stand on and support the weaker side.

Lead with stronger side

300

The disease multiple sclerosis (MS)

What is 

MS is a progressive disease affecting the central nervous system.

Protective sheath breaks down over time and nerves cannot send messages properly.

300

The following are examples of


paraplegia-loss of function of lower body and legs. 

quadriplegia-loss of function of legs, trunk, and arms.


What is spinal cord in injury


400

The jobs of the nervous system

What is 

Control and message center of body

Controls and coordinates all body functions

Senses information from outside the body

Two main parts: central nervous system (brain) and peripheral nervous system (nerves)



400

Dementia and Alzheimer’s disease, which are common disorders of the nervous system, T or F

What is 

T=True

400

Care Guidelines for CVA 

For assisting with dressing

What is

Dress weaker side first. 

Undress stronger side first.

Use assistive equipment to help resident dress himself. 


400

With MS residents will have the same abilities (T or False)


What is F = False

Residents will have varying abilities

400

NAs should know these facts about head and spinal cord injuries

What is 

May result from diving, sports injuries, falls, car and motorcycle accidents, industrial accidents, war, and criminal violence

Can cause permanent brain damage, intellectual disability, personality changes, trouble breathing, seizures, coma, memory loss, loss of consciousness, paresis, paralysis

Effects of spinal cord injuries depend on force of impact and where spine is injured.

May cause paraplegia or quadriplegia

Rehabilitation is needed.

Emotional support is important.



500

Normal changes of aging to the nervous system include the following


What is

Slower responses and reflexes

Decrease in sensitivity of nerve endings in skin

Some memory loss, more often with short-term memory


500

REMEMBER

the difference between signs and symptoms

What is 

Signs are what the NA actually sees, hears, feels, or smells. 

Symptoms are not directly seen by the NA, but are reported by the resident who experiences them. 


500

Care Guidelines for CVA 

For assisting with eating

What is 

Place food in the resident’s field of vision.

Use assistive devices.

Watch for signs of choking.

Serve soft foods if swallowing is difficult.

Always place food in the unaffected side of mouth. Make sure food is swallowed.


500

Residents with MS may have symptoms such as

What is

Symptoms can include blurred vision, fatigue, tremors, poor balance, trouble walking, weakness, numbness, tingling, incontinence, and behavior changes.

500

Care Guidelines for Head and Spinal Cord Injuries


What is 

Give emotional support, as well as physical help. 

Prevent falls and burns. 

Be patient with self-care.

Give careful skin care to prevent pressure injuries. 

Assist with position changes at least every two hours. 

Perform ROM exercises as ordered. 

Encourage fluids and a high-fiber diet to prevent constipation. 

Give extra catheter care as needed. 

Offer rest periods as needed for fatigue. Use special stockings as ordered to aid circulation. 

Encourage deep breathing exercises as ordered. 

Provide for privacy if involuntary erections occur. 

Assist with bowel and bladder training.

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