NUR 425 FINAL EXAM WITH ACTUAL QUESTIONS AND
VERIFIED DETAILED ANSWERS|FREQUENTLY TESTED
QUESTIONS AND SOLUTIONS|ALREADY GRADED A+|LATEST
2024|GUARANTEED PASS
what is the earliest indicator of change in neuro status?
change in LOC
what is the term for forgetfulness
confusion
what is the term for drowsy
lethargy
what is the term for arousable by stimulation
obtunded
what is the term for arousable by vigorous stimulation?
stuporours
what is the term for cannot arouse?
coma
what to assess in a neuro assessment?
vitals:
-changes in HR and BP are more important than certain directions or limits they should be in
(trends!)
-HR and BP and temp variable
-respirations altered?
-hypotension: decreases cerebral blood flow (less pressure)
-hypertension: increases cerebral blood flow (more pressure)
assess fontanels/sutures if less than 2 years old
-abnormal bulging
assess head circumference
assess pupils
-size and reactivity
-pinpoint: overdose
-bilateral fixed and dilated: brainstem herniation...could be caused by mydriatic drugs
what is cushing's reflex?
, decreased HR, increased BP, altered respirations
This is a late sign and uncommon in children
the breathing is an ominous sign
What is Cheyne-Stokes breathing?
apnea of 10-60 sec followed by increasing depth and frequency of breaths (occurs in DKA)
what conditions affect altered mental status?
-metabolism (hypoglycemia, DKA)
-infections (meningitis)
-toxins (alcohol, lead)
-trauma (traumatic brain injury, submersion injury)
-endocrine (hypothyroidism)
-neurological/neoplasm (seizure, myelomeningocele, tumor)
why is MAP important?
it is a better indicator of perfusion
it is the average blood pressure during one cardiac cycle
normal value for MAP in pediatrics?
should be above 50 (adults are 60-100)
what is cerebral perfusion pressure?
pressure needed to ensure adequate oxygen and nutrients are delivered to the brain
it is the difference between pressure of blood going to the brain (MAP) and the back pressure to this
flow (ICP)
What is intracranial pressure?
it is the force exerted by the three contents of the brain (csf, blood, tissue)
why must cpp must be maintained within narrow limits?
because too little pressure could cause ischemia and too much pressure could raise ICP
net gradient that drives oxygen to tissue
what is the relationship between ICP and CPP?
they work against each other
-if icp increases, then cpp decreases
what is the normal value of CPP in children?
40-60
VERIFIED DETAILED ANSWERS|FREQUENTLY TESTED
QUESTIONS AND SOLUTIONS|ALREADY GRADED A+|LATEST
2024|GUARANTEED PASS
what is the earliest indicator of change in neuro status?
change in LOC
what is the term for forgetfulness
confusion
what is the term for drowsy
lethargy
what is the term for arousable by stimulation
obtunded
what is the term for arousable by vigorous stimulation?
stuporours
what is the term for cannot arouse?
coma
what to assess in a neuro assessment?
vitals:
-changes in HR and BP are more important than certain directions or limits they should be in
(trends!)
-HR and BP and temp variable
-respirations altered?
-hypotension: decreases cerebral blood flow (less pressure)
-hypertension: increases cerebral blood flow (more pressure)
assess fontanels/sutures if less than 2 years old
-abnormal bulging
assess head circumference
assess pupils
-size and reactivity
-pinpoint: overdose
-bilateral fixed and dilated: brainstem herniation...could be caused by mydriatic drugs
what is cushing's reflex?
, decreased HR, increased BP, altered respirations
This is a late sign and uncommon in children
the breathing is an ominous sign
What is Cheyne-Stokes breathing?
apnea of 10-60 sec followed by increasing depth and frequency of breaths (occurs in DKA)
what conditions affect altered mental status?
-metabolism (hypoglycemia, DKA)
-infections (meningitis)
-toxins (alcohol, lead)
-trauma (traumatic brain injury, submersion injury)
-endocrine (hypothyroidism)
-neurological/neoplasm (seizure, myelomeningocele, tumor)
why is MAP important?
it is a better indicator of perfusion
it is the average blood pressure during one cardiac cycle
normal value for MAP in pediatrics?
should be above 50 (adults are 60-100)
what is cerebral perfusion pressure?
pressure needed to ensure adequate oxygen and nutrients are delivered to the brain
it is the difference between pressure of blood going to the brain (MAP) and the back pressure to this
flow (ICP)
What is intracranial pressure?
it is the force exerted by the three contents of the brain (csf, blood, tissue)
why must cpp must be maintained within narrow limits?
because too little pressure could cause ischemia and too much pressure could raise ICP
net gradient that drives oxygen to tissue
what is the relationship between ICP and CPP?
they work against each other
-if icp increases, then cpp decreases
what is the normal value of CPP in children?
40-60
