Neuro
What does the abbreviation PERRLA stand for?
Pupils, Equal, Round, and Reactive, to Light and Accommodation
What are some behaviors that increase risk of head and neck cancer? (list two)
smoking and alcohol consumption
True or false: the older adult is at a higher risk of falls with associated fractures when admitted to the hospital.
True. The client is in an unfamiliar setting taking multiple medications. They are also at an increased risk of medication interactions and delirium
When should a client be evaluated for domestic violence risk?
At every medical encounter.
What is CNII and how do we test it?
Optic nerve; visual acuity; snellen eye chart
What are the two forms of aphasia?
Expressive and Receptive aphasia
This is the main blood supply to the anterior nose.
Kisselbach Plexus
What types of assessment are utilized in the hospital setting?
Comprehensive, focused, urgent, emergent
What are risk factors associated with mental health disorders?
medical history, psychiatric history, family history, drug and alcohol use, violence in the environment
What are CNIII, IV, and VI? What are they responsible for?
Oculomotor, Trochlear, and Abducens. Pupillary light reflex and eye movement
This is only considered normal in newborn infants. To elicit it, the nurse would lightly scrape the sole of the foot from heel to toe in a "J" shape. What reflex is this?
Babinski reflex
What is considered a normal assessment finding during lymph node assessment?
Non-palpable, cannot be felt
What are some non-modifiable risk factors for disease?
gender, ethnic background, family history of disease, age
What is the CAGE screening tool and what does CAGE stand for?
Alcohol use screening tool.
Cut down, Annoyed, Guilt, Eye-opener
What is CNV and what is it responsible for?
Trigeminal nerve, Facial sensation, chewing, and a portion of pupillary dilation
What do Rapid Alternating Movement tests assess?
Coordination of skilled movement
True or False: It is considered normal for the older adult to experience clear nasal drainage (runny nose) when smelling or eating food.
True: this is called Gustatory Rhinitis
The nurse is caring for a client who is acutely hypotensive to a BP of 70/30, diaphoretic, and tachycardic to a HR of 190. The client is minimally responsive. What action should the nurse take next?
Call a rapid response team
When should a client be evaluated for their risk of self harm or suicide?
At every medical encounter. This is considered an urgent assessment
What is CNVII and what is it responsible for?
Facial nerve, movement of the facial structures
List of the signs and symptoms of a stroke.
Facial drooping, weakness or numbness to one side of the body, altered speech or inability to speak, disturbed balance and coordination
This is the name of the point of intersection for the facial sinuses.
Osteomeatal complex
This is a term for an emergency situation where the client is found pulseless. What do we "call" in the hospital setting?
Code blue
What factors put a client at risk for elder abuse?
cognitive decline, poor mental or physical health of either the caregiver or the client, financial instability, dependency
What is CNXI and what is it responsible for?
Accessory nerve; head turning side to side and shoulder shrug