Med Surg 3 Neuro Study Guide Graded A 2023

functions of nervous system - controls all motor sensory, autonomic, cognitive, behavioral activities parasympathetic nervous system - rest and digest : constricts the pupils altered LOC - most important indicator of pt condition cont from full alertness and full cognition to coma coma - unresponsive, unarousable, unresponsiveness assess of altered LOC - assess verbal response and orientation, alertness, motor response, respiratory status, eye signs, reflexes, postures, GCS, CN eye movement CN - 3, 4, 6 CN 5 - trigeminal (face sensation) CN 7 ` - facial, salivation CN 8 - Vestibulocochlear : hearing, balance CN 9 Glossopharyngeal - swallowing and gag reflex glasgow coma scale - motor: 6, verbal:5, eye opening: 4 coma: 8 or less Decordicate posturing - arms flexed and legs internally rotated Decerbrate - arms pronated Cerebral angiography (CT w contrast) - ident aneuy, vascular malformations, narrowed vessels cerebral angiography prep - lie flat, dye into femoral arterty (BUN/creat, hydration) post cerebral angiography - neuro assessment q 15-30 until vitals stable and site q 1 hour neurovascular assess keep flat 12-24 h, lumbar puncture - at L3-L4 into subarachnoid space lateral recumbent fetal position Transcranial doppler - cerebral blood flow can assess vasospasm, oculsive vessel syn, brain death post lumbar puncture - neuro checks q 15-30 mins flat for several hours PO fluids to 3000 ml oral pain meds for HA dressing for bleeding or drainage assess for HA when sitting upright after (CSF lesk) complications of lumbar puncture - brainstem herniation what test to do before lumbar puncture - CT scan to see if space occuying lescion present EEG test - records elect activity of the brain done by tech in quiet room hold tranq / stimulants (inc coffee) keep awake the night before test WASH HAIR AFTER CT scan - detects hemmorhage, infraction, abcess, tumor immobile during exam, flushing / warm during dye Myelogram test - visualizes spinal cord and subarach space NPO 4-6 hours before allergy hx(iodine / shellfish) if CSF leak = blood patch CNS depres held 48 hours before table moved to various positions and lie on back post myelogram - neuro assessment q 2-4 hours elevate HOB 30-45 degrees for 3 hours oral analestic for HA enourage fluids assess distended bladder inspect site important nursing intervention for neuro - assume total pt care bc loss of protective reflexes when do patients need to be intubated? - GSC less than 8