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NEURO A & P
NEURO ASSESSMENT
STROKE
GI
GI
100
These are known as Dura Mater, Arachnoid Mater and Pia Mater
What are meninges
100
Name two scales used to evaluate LOC
What is Glasgow Coma Scale and NIHSS
100
Name the two different types of stroke and the most common.
What is ischemic and hemorrhagic with ischemic being the most common.
100
This diagnostic test allows clinicians to evaluate the mucus lining of the GI tract visually and capture images to evaluate motility, identify lesions, masses, and sources of bleeding.
What is fiber optic endoscopy?
100
What can cause diminished abdominal wall compliance?
What is abdominal surgery, major trauma, major burns, prone positioning
200
This space is between the dura and arachnoid mater
What is subdural
200
What is a positive Babinski and Clonus reflex?
A Babinski is present when the great toe goes up and the other toes fan out with stroking rapidly from the heel across to the ball of the foot. Clonus is present when the ankle flexes and dorsiflexes repeatedly and rhythmically.
200
Name three exclusion criteria for tPA administration.
What is head trauma or stroke in last 3 months, recent intracranial or spinal surgery, history if ICH, AVM, or aneurysm, bp over 185/110, active internal bleeding, platelet less than 100,000, INR greater than 1.7 on anticoagulants, BS < 50, rapidly improving symptoms, major surgery or trauma in the last 14 days, pregnancy.
200
What are the top four/five priorities for a patient with an acute UGI bleed?
What is provide oxygen, large bore IV or CVC, IVF and blood products to stabilize hemodynamics, NGT
200
What is the impact of hypocalcemia on cardiac function and what does it mean in a patient with pancreatitis?
What is prolonged QT interval and increase the risk of Torsade's and it indicates that pancreatic enzymes are destroying the pancreas because calcium attaches to the fatty acids that are produced.
300
This develops when a normal flow of CSF is obstructed
What is hydrocephalus
300
How do you check cranial nerve II?
What is have the patient read the menu or clock
300
How do you assess cranial nerve III?
What is ask the patient to smile or puff out cheeks.
300
What is the purpose of lactulose?
What is to lower ammonia levels and treat constipation.
300
Explain where Cullen's and Grey Turners sign are found and what they mean.
What is bleeding around the umbilicus and flanks -- it means bleeding in the abdomen.
400
How does the body compensate with ICP?
What is shunting CSF into subarachnoid space, increased CSF absorption into the venous sinus, decreased CSF production in the choroid plexus of the ventricles, decreased blood volume by altering cerebral blood flow, and skull expansion in infants.
400
What is Cushing's Triad?
What is a specific set of vital signs that can occur if increased in ICP occur: increasing systolic pressure with a widening pulse pressure, bradycardia, and bradypnea.
400
Explain decerebrate and decorticate posturing.
What is decerebrate is adduction of upper arms, extension and pronation of lower arms and extension of lower extremities. Decorticate is adduction of upper arms, flexion of lower arms wrists, fingers and lower extremities extended.
400
What grade encephalopathy is this? The patient exhibits marked confusion, is sleeping but arouseable, speech is incoherent and the patient will have flexion in response to pain, the patient may not be able to follow directions to check for asterixis, and may exhibit bizarre behavior such as unprovoked rage.
What is Grade III encephalopathy
400
Your patient is a 73 year old female status post complete colectomy due to Chrohn's disease. Your residuals from your jejunal tube feeding are 400mls with marked abdominal distention and discomfort, and the patient has had 4 stools on your shift already. What do you do?
What is return the residual, hold the feeding, ask dietician to maybe change formulas, inform MD and check for c.diff.
500
This is known as "grand central station" of the nervous system
What is reticular activating system?
500
What is the Monroe-Kelli Hypothesis?
States that within the rigid compartment of the skull there are three components (brain, csf, and blood) that maintain a relatively constant volume in relationship with each other
500
What are the ischemic stroke core measures?
What is VTE prophylaxis and antithrombotic therapy by end of Day 2, stroke education, thrombolytic therapy (tPA) if no exclusion, anticoagulation therapy for a fib/flutter, discharged on statin and antithrombotic therapy, and assessed for Rehab.
500
Your patient has a large amount of ascites in his abdomen from liver failure, what are your patient care priorities?
What is high fowlers position, titrate oxygen greater than 90%, check ABG's for possible bipap/intubation
500
Your patient comes in with severe acute pancreatitis. How do you plan to feed him and explain why.
What is TPN because he is unable to receive enteral nutrition.