Show:
Stroke
Cranial Nerves
Neurodegenerative disease
Cancer
ICP
100

Name 3 modifiable risk factors for stroke

Heart disease: Atrial Fibrillation, DM

Hypertension

Metabolic syndrome 

Homocysteine (found in red meat, dairy)

B6, B12 & folic acid vitamins may be protective

Poor diet, heavy alcohol consumption

Drug abuse/Smoking

Sleep apnea

Physical inactivity, obesity

100

Which cranial nerve is associated with Bell's palsy?

CN VII

100

What medication is commonly used to treat Parkinson's disease?

Carbidopa-levodopa

100

Name one example of primary prevention

Preventing the cancer before it occurs by modifying risk factors such as avoiding implementing good diet, quitting smoking, etc

100

What is normal ICP?

5-15 mmHg

200

How are strokes assessed?

Bedside assessment (NIHSS)

CT - determine if hemorrhagic or ischemic

MRI - show areas of ischemia or other pathologic changes

200

Which cranial nerve is associated with trigeminal neuralgia?

CN V

200

Describe migraine aura

Positive and negative focal neurologic symptoms that precede or accompany an attack such as tingling in the face or spotty vision

200

Name 2 recommendations for a patient receiving radiation therapy

  • Cleanse skin with mild soap and lukewarm water

  • Apply moisturizing cream and medicated creams as directed. Some common ones you may see used are:


    • Topical corticosteroids

    • Topical 1% atorvastatin

    • Silver sulfadiazine 

    • Silicone-based creams

  • Avoid the use of heating pads and ice

  • Use paper tape to secure any bandages, if used.

200

What is Cushing's Triad?

Widening pulse pressure

Bradycardia

Decreased, irregular respirations 

300

What are the symptoms of stroke?

(Hint: BE FAST acronym)

B - balance

E - eyes
F - facial droop

A - arm weakness

S - slurred speech

T - time to call 911

300

What is CN III and how do you assess it?

Oculomotor

Use penlight to check for PERRLA

300

What are the stages of Alzheimer's disease?

  1. Asymptomatic preclinical phase

  2. Symptomatic predementia phase (mild impaired cognition)

  3. Dementia phase

300

Name 3 risk factors for prostate cancer

  • Age

  • Family history including first-degree relative with the disease

  • African-American race - risk of mortality 2x than any other group

  • Other factors may include diet (high saturated fat, low fiber) and exposure to environmental agents such as arsenic

300

What are late signs of increased ICP? (3 total)

Cushing's Triad (Widening pulse pressure, Bradycardia, Decreased/irregular respirations)

Pupillary changes

Vision abnormalities

400

What medications should be held 24 hours before a CT scan if possible?

Metformin

NSAIDS

(interfere with kidney perfusion)

400

What is CN VIII and how do you assess it?

Vestibulocochlear

Whisper test

Gait assessment

400

Name 3 goals of care for the patient with Parkinson's disease.

  • Improving mobility

  • Prevent falls

  • Encourage self-management of ADLs

  • Evaluate need for adaptive devices

  • Healthy sleeping patterns

  • Improve nutrition

  • Prevent aspiration

400

Name 5 risks for breast cancer

  • Female

  • Age

  • Genetic factors (BRCA1, BRCA2)

  • Hx of previous breast cancer

  • Family hx (two first-degree relatives with breast cancer)

  • Ionizing radiation to the chest

  • Breast density

  • Atypical hyperplasia

    • High postmenopausal bone density (high estrogen levels over time strengthen bone and ↑ breast cancer risk)

    • ETOH use (3-14 drinks/week increase) 

    • No or late child-bearing

    • Many years of menstruation

    • Recent OC use (slight increase – risk is removed with 10 years of no use)

    • HRT use.

    • Obesity

400

What are early signs of increased ICP? (5 total)

Headache

Decreased LOC

Nausea and vomiting

Restlessness

500

What are some nursing considerations for a patient with hemiplegia?

Mobility - fall risk

Skin - pressure ulcer/skin breakdown risk

Contractures - need to perform passive ROM

Inability to perform ADLs independently

Poor self image

500

What is CN XII and how do you assess it?

Hypoglossal

Ask patient to stick out tongue and move side to side

500

What are the 5 stages of Parkinson's disease?

  1. Initial stage

  2. Mild stage

  3. Moderate disease

  4. Severe disability

  5. Complete ADL dependence

500

What is the pancytopenic patient at risk for?

  • ↓ RBCs – fatigue, doe, headache, ↑ HR, palpitations; pallor on the conjunctiva, nail beds or palmar creases

  • ↓ WBCs – risk for infection, fever, dysuria, cough, enlarged spleen

  • ↓platelets – ecchymoses, petechial, bleeding gums, hematuria, joint pain

500

Name 3 interventions to decrease ICP

Fluid restriction]

Raise HOB

Refrain from coughing

Refrain from suctioning if able

Provide non-stimulating environment

Avoid neck/hip flexion

Therapeutic cooling