TEST REVIEW
1. 3 math, 1.25 points per question
NEURO
2. Review the slides on sympathetic and parasympathetic
○ Overactive sympathetic: (FIGHT OR FLIGHT)
● Tachycardic
● Dilated pupils
● Increased BP
● Overactive parasympathetic: (REST & DIGEST)
○ Bradycardia
○ Excessive GI motility
○ Constricted pupils
3. What would be your first action if you thought the person had an altered level of
consciousness
○ Assess airway, breathing, circulation (ABCs).
○ Check Glasgow Coma Scale, pupils, and vital signs
4. Glascoma scale
○ A numerical rating of eye opening (4), verbal response (5), and motor response(6)
● 9 to 15: Mild to moderate injury
● 3 to 8: Major injury
● A patient score of 8 or 9 indicates a moderate injury
● Moderate is still needs nursing care
5. Highest priority for patient who is unconscious
○ Maintain airway.
○ Prevent aspiration and injury
○ Place patient side-lying if needed.
6. Review definitions for lethargic, stuporous
○ Lethargy
■ Drowsy, awakens to stimulation -> sleepy but will answer to name
○ Obtunded
■ Difficult to arouse
■ Needs constant stimulation to follow a simple command; requires multiple
tries and repeating yourself to get attention
○ Stupor
■ Arouses to vigorous
■ Continuous stimulation; a sternal rub may be needed to keep them awake
7. Nursing intervention for patient with increased intracranial pressure
○ Position with head in neutral position, elevate HOB 0-60* to promote venous
drainage
○ Avoid: hip flexion, valsalva maneuver, or abdominal distention
, ○ Assess dressing and see if there are signs of CSF drainage (coming from the nose
or ears)
○ Use osmotic diuretics (Mannitol) to reduce cerebral edema
○ Low volume, low lights
○ Normal ICP 107-15 mmHg
8. Keep in mind patient with anything going on inside head you would to keep QUIET
○ What would you do to prevent straining?
■ Stool softers
○ Stimulation valsalva maneuver LOWERS BP
9. The difference between receptive and expressive asphagia
○ Aphasia-inability to express oneself or to understand language
■ Expressive- inability to express oneself; often associated with damage to
the left frontal lobe area
■ Receptive- inability to understand what someone else is saying; often
associated with damage to the temporal lobe area
10.Stroke
○ 5th leading cause of death
○ Right side stroke: affects LEFT side of body
○ Left side stroke: affects RIGHT side of body
11.Ischemia vs hemorrhagic stroke
○ Ischemic: caused by blockage; may treat with thrombolytics.
■ Symptoms depend on the location and size of the affected area
● Numbness or weakness of the face, arm, leg especially on one side
● Confusion or change in mental status
● Trouble speaking or understanding speech- AGNOSIA
● SUDDEN, severe headache
● Perceptual disturbances
■ Treatment: TPA- clot bluster (thrombolysis therapy)
● Must have the accurate weight PRIOR to administration
○ tPA is only given if criteria for ischemic stroke are met and
after ruling out hemorrhage.
● Must be administered with 3 hours of stroke onset
● S/E: potential bleeding
● Elevate HOB unless contraindicated, maintain airway and
ventilation
● Continue hemodynamic monitoring and neurologic assessment
○ NO HEPARIN FOR 24 HOURS
■ Confusion or change in mental status
■ Seizures are common early complications
■ Patient may remain conscious initially
■ Code STROKE: perceptual disturbances (ANYBODY CAN CALL)
, ■ *Get further screening if CAT scan is negative
○ Hemorrhagic: caused by bleeding; sudden severe headache; never give tPA.
■ Manifestations: SIMILAR to ischemic stroke, severe headache, EARLY
and SUDDEN changes in LOC, vomiting, bleeding
● Person with hemorrhagic stroke often develops seizures and loss of
conscious
■ intervention: tissue perfusion, nonstimulating environment (bedrest, head
elevated 30-45 degrees to promote venous drainage and decrease ICP),
avoid Valsalva maneuver (give stool softener), no rotation of the head and
neck, relieve anxiety, reteach for bladder learning (standing when peeing
for males)
■ Valsalva maneuver causes bradycardia- patient can pass out
■ Don’t keep the BP cuff too tight
12.Decerebrate vs decorticate
○ Decorticate (Flexion): Damage to cerebral hemispheres
■ Arms flexion towards the core, legs extended
○ Decerebrate (Extension): Brainstem injury; more severe
■ Arms & legs extend straight, wrist flex
EYES AND EAR
13.On eye and ear module, pay attention to different visual disorders
○ Glaucoma →increased intraocular pressure (IOP) causing optic nerve damage →
permanent vision loss.
■ Normal IOP: 10–20 mmHg, >21 mmHg = abnormal
■ Primary Open-Angle Glaucoma (POAG)
● Most common
● Slow, gradual increase in IOP
● Blockage of aqueous outflow
● Loss of peripheral vision (priority finding)
Halos around lights
1. 3 math, 1.25 points per question
NEURO
2. Review the slides on sympathetic and parasympathetic
○ Overactive sympathetic: (FIGHT OR FLIGHT)
● Tachycardic
● Dilated pupils
● Increased BP
● Overactive parasympathetic: (REST & DIGEST)
○ Bradycardia
○ Excessive GI motility
○ Constricted pupils
3. What would be your first action if you thought the person had an altered level of
consciousness
○ Assess airway, breathing, circulation (ABCs).
○ Check Glasgow Coma Scale, pupils, and vital signs
4. Glascoma scale
○ A numerical rating of eye opening (4), verbal response (5), and motor response(6)
● 9 to 15: Mild to moderate injury
● 3 to 8: Major injury
● A patient score of 8 or 9 indicates a moderate injury
● Moderate is still needs nursing care
5. Highest priority for patient who is unconscious
○ Maintain airway.
○ Prevent aspiration and injury
○ Place patient side-lying if needed.
6. Review definitions for lethargic, stuporous
○ Lethargy
■ Drowsy, awakens to stimulation -> sleepy but will answer to name
○ Obtunded
■ Difficult to arouse
■ Needs constant stimulation to follow a simple command; requires multiple
tries and repeating yourself to get attention
○ Stupor
■ Arouses to vigorous
■ Continuous stimulation; a sternal rub may be needed to keep them awake
7. Nursing intervention for patient with increased intracranial pressure
○ Position with head in neutral position, elevate HOB 0-60* to promote venous
drainage
○ Avoid: hip flexion, valsalva maneuver, or abdominal distention
, ○ Assess dressing and see if there are signs of CSF drainage (coming from the nose
or ears)
○ Use osmotic diuretics (Mannitol) to reduce cerebral edema
○ Low volume, low lights
○ Normal ICP 107-15 mmHg
8. Keep in mind patient with anything going on inside head you would to keep QUIET
○ What would you do to prevent straining?
■ Stool softers
○ Stimulation valsalva maneuver LOWERS BP
9. The difference between receptive and expressive asphagia
○ Aphasia-inability to express oneself or to understand language
■ Expressive- inability to express oneself; often associated with damage to
the left frontal lobe area
■ Receptive- inability to understand what someone else is saying; often
associated with damage to the temporal lobe area
10.Stroke
○ 5th leading cause of death
○ Right side stroke: affects LEFT side of body
○ Left side stroke: affects RIGHT side of body
11.Ischemia vs hemorrhagic stroke
○ Ischemic: caused by blockage; may treat with thrombolytics.
■ Symptoms depend on the location and size of the affected area
● Numbness or weakness of the face, arm, leg especially on one side
● Confusion or change in mental status
● Trouble speaking or understanding speech- AGNOSIA
● SUDDEN, severe headache
● Perceptual disturbances
■ Treatment: TPA- clot bluster (thrombolysis therapy)
● Must have the accurate weight PRIOR to administration
○ tPA is only given if criteria for ischemic stroke are met and
after ruling out hemorrhage.
● Must be administered with 3 hours of stroke onset
● S/E: potential bleeding
● Elevate HOB unless contraindicated, maintain airway and
ventilation
● Continue hemodynamic monitoring and neurologic assessment
○ NO HEPARIN FOR 24 HOURS
■ Confusion or change in mental status
■ Seizures are common early complications
■ Patient may remain conscious initially
■ Code STROKE: perceptual disturbances (ANYBODY CAN CALL)
, ■ *Get further screening if CAT scan is negative
○ Hemorrhagic: caused by bleeding; sudden severe headache; never give tPA.
■ Manifestations: SIMILAR to ischemic stroke, severe headache, EARLY
and SUDDEN changes in LOC, vomiting, bleeding
● Person with hemorrhagic stroke often develops seizures and loss of
conscious
■ intervention: tissue perfusion, nonstimulating environment (bedrest, head
elevated 30-45 degrees to promote venous drainage and decrease ICP),
avoid Valsalva maneuver (give stool softener), no rotation of the head and
neck, relieve anxiety, reteach for bladder learning (standing when peeing
for males)
■ Valsalva maneuver causes bradycardia- patient can pass out
■ Don’t keep the BP cuff too tight
12.Decerebrate vs decorticate
○ Decorticate (Flexion): Damage to cerebral hemispheres
■ Arms flexion towards the core, legs extended
○ Decerebrate (Extension): Brainstem injury; more severe
■ Arms & legs extend straight, wrist flex
EYES AND EAR
13.On eye and ear module, pay attention to different visual disorders
○ Glaucoma →increased intraocular pressure (IOP) causing optic nerve damage →
permanent vision loss.
■ Normal IOP: 10–20 mmHg, >21 mmHg = abnormal
■ Primary Open-Angle Glaucoma (POAG)
● Most common
● Slow, gradual increase in IOP
● Blockage of aqueous outflow
● Loss of peripheral vision (priority finding)
Halos around lights
