Neuro Red Flags
A patient with suspected meningitis presents with photophobia, nuchal rigidity, and fever. What is a life-threatening complication you must monitor for?
Answer: What is increased intracranial pressure (ICP)?Rationale: Meningitis can cause cerebral edema and increased ICP, which can lead to brain herniation if not treated promptly.
A disease characterized by memory loss, poor judgment, and personality changes due to neurotransmitter decline.
Answer: What is Alzheimer’s disease?
Rationale: Alzheimer’s causes progressive cognitive decline linked to decreased acetylcholine.
What is the priority nursing assessment in a patient with suspected stroke?
Answer: What is performing a neurological exam?
Rationale: Rapid neuro assessment identifies deficits and guides immediate stroke interventions.
What is a key safety measure for a patient with a known seizure disorder?
Answer: What are padded side rails?
Rationale: Padded rails reduce injury during seizure episodes and are part of seizure precautions.
What medication is commonly used to treat Parkinson’s symptoms by increasing dopamine in the brain?
Answer: What is a dopamine-receptor agonist (e.g., carbidopa-levodopa)?
Rationale: Dopaminergic therapy helps restore the dopamine deficit in Parkinson’s disease.
A patient is experiencing new-onset bradykinesia, postural instability, and a resting tremor. These signs are red flags for which disease?
Answer: What is Parkinson’s disease?
Rationale: T.R.A.P (Tremor, Rigidity, Akinesia/bradykinesia, Postural instability) are hallmark signs of Parkinson’s disease.
Presents with ascending symmetrical weakness, paresthesia, and a history of recent viral illness.
Answer: What is Guillain-Barré Syndrome (GBS)?
Rationale: GBS often follows infections and is marked by rapid-onset ascending paralysis.
A patient with Parkinson’s disease is having difficulty swallowing. What is the nurse's first action?
Answer: What is assess for aspiration risk?
Rationale: Dysphagia can cause aspiration pneumonia; early recognition prevents complications.
For a patient with trigeminal neuralgia, what nursing intervention can reduce symptoms?
Answer: What is avoiding known triggers such as wind or facial stimulation?
Rationale: Trigger avoidance prevents painful episodes in trigeminal neuralgia.
What medication is used first-line in Myasthenia Gravis?
Answer: What is pyridostigmine?
Rationale: Pyridostigmine improves neuromuscular transmission by inhibiting acetylcholinesterase.
A patient with Myasthenia Gravis becomes increasingly weak and begins to exhibit respiratory distress. What crisis should be suspected?
Answer: What is myasthenic crisis?
Rationale: Myasthenic crisis is a medical emergency involving respiratory muscle weakness requiring mechanical ventilation.
Characterized by relapsing-remitting symptoms, vision changes, numbness, and fatigue due to demyelination.
Answer: What is Multiple Sclerosis (MS)?
Rationale: MS involves autoimmune demyelination affecting the CNS, causing varied neurological deficits.
A patient with MG is scheduled for meds. Why is timing crucial?
Answer: What is to prevent muscle weakness and crisis?
Rationale: Meds like pyridostigmine must be given on time to maintain acetylcholine activity and prevent crisis.
In patients with Alzheimer’s disease, what environment is best to reduce anxiety and confusion?
Answer: What is a calm, structured routine?
Rationale: Alzheimer’s patients benefit from consistency, familiar items, and minimal stimulation.
What collaborative referral is essential for a patient with dysphagia due to Huntington’s or ALS?
Answer: What is speech therapy?
Rationale: Speech therapists assess swallowing and communication strategies.
A patient reports sudden facial pain triggered by brushing their teeth and exposure to cold wind. Which condition is this indicative of?
Answer: What is trigeminal neuralgia?
Rationale: Trigeminal neuralgia causes severe, unilateral, electric shock-like facial pain triggered by minor stimuli.
Generalized or focal jerking, altered consciousness, and risk of postictal confusion are associated with this disorder.
Answer: What are seizures (epilepsy)?
Rationale: Seizures involve sudden abnormal neuronal firing and can vary by type and etiology.
Which patient should the nurse see first?
A) Stable MS with vision loss
B) ALS patient with O2 sat of 89%
C) Stroke patient eating dinner
D) Seizure patient with postictal confusion
Answer: Who is the ALS patient with O2 sat of 89%?
Rationale: ALS can cause respiratory failure. Oxygenation is a priority. The others are stable or expected.
What is a critical nursing intervention for a GBS patient with ascending paralysis?
Answer: What is monitor respiratory status and prepare for ventilation?
Rationale: GBS can impair diaphragm function. Early intervention prevents respiratory arrest.
What procedure might be done for a patient with ischemic stroke who is not a tPA candidate?
Answer: What is a mechanical thrombectomy?
Rationale: A thrombectomy removes the clot when tPA is contraindicated or ineffective.
A patient with ALS reports shortness of breath, poor cough effort, and difficulty clearing secretions. What late-stage complication should the nurse anticipate?
Answer: What is respiratory failure?
Rationale: In ALS, progressive muscle weakness eventually leads to respiratory muscle paralysis and failure.
Inherited disorder causing motor tics, poor coordination, depression, and shortened life expectancy.
Answer: What is Huntington’s disease?
Rationale: Huntington’s is genetic and involves neurodegeneration with motor, cognitive, and psychiatric features.
What is the priority action for a patient experiencing status epilepticus?
Answer: What is administer IV lorazepam?
Rationale: Status epilepticus is a medical emergency. Benzodiazepines stop prolonged seizure activity.
For a patient with MS experiencing fatigue and muscle spasticity, which nursing interventions are helpful? (Select all that apply)
A) Provide rest periods
B) Encourage passive ROM
C) Keep patient NPO
D) Use warm compresses on muscles
E) Initiate strict bed rest
Answer: What are A, B, and D?
Rationale: MS fatigue and spasticity are managed with rest, ROM, and warmth. NPO and strict bed rest are not standard.
What are key patient/family education points for managing Huntington’s disease at home? (Select all that apply)
A) Avoid public spaces
B) Use safety measures to prevent falls
C) Watch for depression and suicide risk
D) Encourage high-fat diet
E) Plan long-term care options
Answer: What are B, C, and E?
Rationale: Fall precautions, mental health monitoring, and long-term planning are essential in Huntington’s. Avoiding public spaces and high-fat diets are not indicated.