Certified Emergency Nurse Neurological System Practice Questions and Answers

Dementia An altered mental state, characterized by loss of cognitive function that can have many causes such as drug abuse, metabolic disorders, side effects from prescription medications, depression, and is most associated with alzheimers disease. History from family or caregiver is especially important to determine the cause. Multiple Sclerosis Is an autoimmune disorder of the CNS, characterized by damage to the myelin sheath, a tissue that surrounds the axon of the nerve. The damage results in a mylelin sheath that is scarred and inefficient in conducting nerve impulses. Symptoms mimic those of stroke, including loss of balance, coordination, slurring of speech, cognitive and vision impairment. Pain, bladder and bower dysfunction can occur as well. Symptoms can be relapsing, remitting, or progressive, or a combination thereof. Amyotrophic Lateral Sclerosis (ALF) A progressive, degenerative, neuro-muscular disease that results in the spasticity, hyperreflexive, weakening, and paralysis of skeletal and smooth muscle tissue, causing dysphagia, cramping, muscular atrophy, and respiratory arrest. Parkinson's Disease Parkinson's disease is a disorder of the motor movement system, resulting in extrapyramidal movements. It is caused by a decrease in Dopamine producing cells of the CNS. Typical symptoms include tremors of the face and extremities, rigidity, bradykinesia, akinisia, poor posture, lack of balance and coordination, poor mobility, poor speech, and decreased swallowing ability. ROM tests to DX, treated with dopaminergic drugs. Myasthenia Gravis An autoimmune disorder of the neuromuscular system, where acetylcholine receptors are damaged at the neural synaptic clefts, affecting receptor cells at the muscular site.. Muscles therefore fail to contract efectively, resulting in muscle weakness, flacidity, ptosis, diplopia. Myasthenic crisis can result in respiratory failure. DX with an edrophonium test to differentiate bw crisis and exacerbation of disease. Guillain Barret Syndrome (GBS) An autoimmune D/O of the motor nerves of the peripheral nervous system that originates at the most distal end of the lower extremities, eventually becoming generalized and effecting the nerves of face, up to even those involved in respiration/ventilation. Myelineated nerves of the periphery are damaged by immune system response to viral gastroenteritis and Campylobacter jejuni infection. Weakness, numbness, paresthesia, are symptoms of this disease. Treatment is supportive, pts are placed in observation and ventilatory support is administered if the need arise