NSG4100: Exam Blueprint
💙🩺📚💪EXAM 4: FINAL💙🩺📚💪
Unit 8
Read: Drugs to Know:
Ch. 34 pg 1067-1078 Interferon Beta-1A
Ch. 61 pg. 1966-1991 Glatiramer acetate
Ch.62 pg. 2048-2053 Dexamethasone
Ch. 63 pg. 2055-2087 Ceftriaxone
Ch. 64 pg. 2088-2106 Acyclovir
Ch. 65 pg. 2112-2118, 2129-2132 Mannitol
Phenytoin
Complex Neurological Problems
GCS-Glasgow Coma Scaleknow how to calculate!
🎯 Exam Pearl:
A GCS of 13–15 = mild brain injury
A GCS of 9–12 = moderate brain injury
A GCS of 8 or less = severe brain injury/coma (think possible intubation)
,To help answer exam questions, just remember:
Eyes (4)
4 = Spontaneous
3 = Speech
2 = Pain
1 = None
Verbal (5)
5 = Oriented
4 = Confused
3 = Inappropriate words
2 = Incomprehensible sounds
1 = None
Motor (6)
6 = Obeys commands
5 = Localizes pain
4 = Withdraws from pain
3 = Decorticate (flexion)
Think towards the core
Arms flexed inward/hands towards chest
2 = Decerebrate (extension)
Think exstensor “worse”
Arms extended/wrists pronated/legs extended
Usually indicates damage to brainstem
1 = None
🧠Head Injuries- injury to skull does not mean brain damage
• Risk: #1 male, 0-4 yr old, 15-19 y.o and adults over 65.
• PREVENTION is keyex-helmets, think safety precautions
• Scalp head injuries can be serious due to the amount of bleeding
• Skull fracture—fracture to the base of skull is a basilar (bruising over the mastoid
bone and eyes occurscalled battle sign, may also have CSF leak (CSF leak makes pt
at high risk of meningitis) teacher mentioned this being on exam!!!
s/s-depends on location/damage
S/S-CSF from nose or ears, mental status changes , headache,
bruising over mastoid bone/around eyes
If pt has CSF leaking, they are at high risk of meningitis
TX-Neuro assessments-GCS
Complications: hematoma, concussion, contusion, hemorrhage
• 🧠 CLOSED HEAD INJURY
, Definition--Head injury where:✅ Skull remains intact❌ No skull penetration
Concussions
Contusions
fractures
Causes
Falls
MVCs
Sports injuries
Complications
Concussion
Contusion
Hematomas
Increased ICP
Nursing Priorities
Monitor for:
Change in LOC ⭐
Headache
Vomiting
Pupil changes
GCS changes
Lori Nugget
🚨 Earliest sign of deterioration = change in LOC
🧠 INTRACRANIAL HEMATOMAS
Blood accumulates inside the skull causing:⭐ Increased ICP ⭐ Brain compression
Three you'll need to know:
• Epidural
• Subdural
• Intracerebral
🧠 SUBDURAL HEMATOMA
⭐Blood collects between the dura and arachnoid
Causes:
Falls
MVC
Elderly
Anticoagulants
Vessel⭐ Venous bleed (slower)
Presentation
Can take: Hours, Days, Weeks to develop.
S/S
Headache
Confusion / Drowsiness
Personality changes
Progressive LOC decline
NCLEX/Lori ClueElderly patient falls. A week later family reports:"He's been acting different." Think:⭐
Subdural Hematoma
Treatment
Burr holes
Craniotomy
💙🩺📚💪EXAM 4: FINAL💙🩺📚💪
Unit 8
Read: Drugs to Know:
Ch. 34 pg 1067-1078 Interferon Beta-1A
Ch. 61 pg. 1966-1991 Glatiramer acetate
Ch.62 pg. 2048-2053 Dexamethasone
Ch. 63 pg. 2055-2087 Ceftriaxone
Ch. 64 pg. 2088-2106 Acyclovir
Ch. 65 pg. 2112-2118, 2129-2132 Mannitol
Phenytoin
Complex Neurological Problems
GCS-Glasgow Coma Scaleknow how to calculate!
🎯 Exam Pearl:
A GCS of 13–15 = mild brain injury
A GCS of 9–12 = moderate brain injury
A GCS of 8 or less = severe brain injury/coma (think possible intubation)
,To help answer exam questions, just remember:
Eyes (4)
4 = Spontaneous
3 = Speech
2 = Pain
1 = None
Verbal (5)
5 = Oriented
4 = Confused
3 = Inappropriate words
2 = Incomprehensible sounds
1 = None
Motor (6)
6 = Obeys commands
5 = Localizes pain
4 = Withdraws from pain
3 = Decorticate (flexion)
Think towards the core
Arms flexed inward/hands towards chest
2 = Decerebrate (extension)
Think exstensor “worse”
Arms extended/wrists pronated/legs extended
Usually indicates damage to brainstem
1 = None
🧠Head Injuries- injury to skull does not mean brain damage
• Risk: #1 male, 0-4 yr old, 15-19 y.o and adults over 65.
• PREVENTION is keyex-helmets, think safety precautions
• Scalp head injuries can be serious due to the amount of bleeding
• Skull fracture—fracture to the base of skull is a basilar (bruising over the mastoid
bone and eyes occurscalled battle sign, may also have CSF leak (CSF leak makes pt
at high risk of meningitis) teacher mentioned this being on exam!!!
s/s-depends on location/damage
S/S-CSF from nose or ears, mental status changes , headache,
bruising over mastoid bone/around eyes
If pt has CSF leaking, they are at high risk of meningitis
TX-Neuro assessments-GCS
Complications: hematoma, concussion, contusion, hemorrhage
• 🧠 CLOSED HEAD INJURY
, Definition--Head injury where:✅ Skull remains intact❌ No skull penetration
Concussions
Contusions
fractures
Causes
Falls
MVCs
Sports injuries
Complications
Concussion
Contusion
Hematomas
Increased ICP
Nursing Priorities
Monitor for:
Change in LOC ⭐
Headache
Vomiting
Pupil changes
GCS changes
Lori Nugget
🚨 Earliest sign of deterioration = change in LOC
🧠 INTRACRANIAL HEMATOMAS
Blood accumulates inside the skull causing:⭐ Increased ICP ⭐ Brain compression
Three you'll need to know:
• Epidural
• Subdural
• Intracerebral
🧠 SUBDURAL HEMATOMA
⭐Blood collects between the dura and arachnoid
Causes:
Falls
MVC
Elderly
Anticoagulants
Vessel⭐ Venous bleed (slower)
Presentation
Can take: Hours, Days, Weeks to develop.
S/S
Headache
Confusion / Drowsiness
Personality changes
Progressive LOC decline
NCLEX/Lori ClueElderly patient falls. A week later family reports:"He's been acting different." Think:⭐
Subdural Hematoma
Treatment
Burr holes
Craniotomy
