Neuro

Name that problem

100

Widening pulse pressure, bradycardia, low respiratory rate

Cushings triad

200

The TBI patient with headache, increased sensitivity to light, GCS 14, and amnesia about the injury has this type of TBI

Mild/concussion

300

The patient presents with fatigue, difficulty chewing and swallowing, and muscle weakness

Myasthenia gravis

400

The patient has ascending weakness

GBS

500

The patient experiencing this problem may be treated with plasmapheresis

GBS or MG

Position that patient

100

How we should position the patient at risk for increased ICP

HOB elevated, avoid flexion

200

The spinal cord injury patient is flushed, diaphoretic, and hypertensive. What is the first intervention?

Raise the HOB

300

The post-op craniotomy patient should be positioned with HOB raised at least to this level

30 degrees

400

These precautions must be used for a SCI patient

Spinal precautions 

500

This must remain on the SCI patient in the ED until the provider clears the patient (after radiology)

Cervical collar

Watch those numbers

100

Patients at risk for increased ICP should be kept normothermic to avoid this

Shivering

200

Abnormal levels of this electrolyte indicate a complication of craniotomy

Sodium

300

This is an appropriate amount of drainage in 8 hours from a craniotomy JP drain

30-50 mL

400

This is normal PaO2

80-100

500

CO2 levels outside this range place the head injury patient at risk for harmful vasodilation or vasoconstriction

40-45

Monitor that patient

100

This is an early sign of increased ICP

Irritability, restlessness 

200

The concussion patient should be instructed to return to the ED for these symptoms

Nausea and vomiting, decreased LOC, behavior changes, seizure activity

300

The post-op craniotomy patient is at risk for these pituitary gland problems affecting fluid balance

DI, SIADH

400

A neuro assessment that detects change in the size or reactivity of these should be immediately reported

Pupils

500

The nurse knows pyridostigmine has been effective when the patient reports increased this

Muscle strength, energy

Prioritize that situation

100

These two groups of people are most at risk for TBI

Geriatric patients, young men

200

This word (beginning with "l") describes a concerning level of consciousness that must be reported immediately

Lethargic

300

This is the nurse's first intervention upon suspecting the patient has meningitis

Institute droplet precautions

400

The priority focused assessment for a patient with a recent cervical spine injury is this

Respiratory

500

Before the newly admitted ALS, MG, or GBS patient eats, the nurse should do this

Swallow evaluation