CEN Neurological Emergencies

CEN Neurological Emergencies To quickly evaluate a child's neurological status, all of the following standard evaluations can be used EXCEPT: a. The Epworth Scale. b. The AVPU scale. c. The Glasgow Coma Scale. d. Pupillary responses to light. ️️A. The Epworth Scale is a measure of sleepiness and is not part of the standard evaluation of a child's neurological exam. The AVPU and Glasgow Coma scales can be used to evaluate a child's neuro status. Pupillary size and response should also be checked. **Neurological Emergency CEN Questions and Answers** What is the first intervention for a patient with suspected acute ischemic stroke? The first intervention is to assess the patient's eligibility for thrombolytic therapy (e.g., tPA) within the therapeutic window, initiate a non-contrast CT scan or MRI to confirm the diagnosis, and ensure airway and oxygenation are adequate. ️️ How should you manage a patient with a suspected subarachnoid hemorrhage? Management includes ensuring airway protection, providing oxygen, and obtaining a CT scan or lumbar puncture to confirm the diagnosis. If subarachnoid hemorrhage is confirmed, the patient may require surgical intervention and blood pressure control. ️️ What are the signs and symptoms of increased intracranial pressure (ICP)? Signs include headache, vomiting, altered mental status, papilledema (swelling of the optic disc), bradycardia, hypertension, and irregular respiratory patterns (Cheyne-Stokes breathing). Immediate management focuses on reducing ICP. ️️ What is the first priority in managing a patient with a seizure? The first priority is ensuring safety by protecting the patient from injury, maintaining airway patency (positioning the patient on their side), and administering anticonvulsants (e.g., lorazepam or diazepam) as ordered. ️️ How should a nurse assess a patient with a suspected spinal cord injury? The nurse should assess for signs of neurological deficits, including loss of sensation or motor function below the injury level, and immobilize the spine using a backboard or cervical collar to prevent further injury. ️️ What is the most common cause of status epilepticus? The most common causes of status epilepticus include anticonvulsant non-compliance, alcohol withdrawal, infections (especially in children), and metabolic disturbances like hypoglycemia. Immediate benzodiazepine administration is required to stop the seizures. ️️ What is the first step in managing a patient with a suspected brain herniation? The first step is to ensure adequate airway management and provide oxygen, followed by elevating the head of the bed to 30 degrees to reduce ICP and preparing for potential surgical intervention. Medications like mannitol may be administered to reduce cerebral edema. ️️ What is the priority intervention for a patient with a traumatic brain injury and Glasgow Coma Scale (GCS) score of 7? The priority intervention is to secure the airway (via intubation if necessary) and provide ventilation support, followed by continuous monitoring of vital signs, and preparation for further imaging or surgical intervention to prevent secondary brain injury. ️️ How should a nurse manage a patient with a suspected epidural hematoma? Management includes ensuring airway protection, obtaining urgent CT imaging to confirm the diagnosis, and preparing for surgical intervention (e.g., craniotomy) to evacuate the hematoma and prevent further brain injury. ️️ What is the first priority in managing a patient with a suspected cerebral hemorrhage? The first priority is to maintain airway patency, monitor vital signs, especially blood pressure, and prepare for rapid imaging (CT scan) and surgical intervention (e.g., craniotomy) to evacuate the blood and relieve pressure on the brain. ️️ How should a nurse assess a patient with suspected meningitis? The nurse should assess for signs such as fever, headache, stiff neck, photophobia, and altered mental status. A lumbar puncture is required to confirm the diagnosis and evaluate cerebrospinal fluid (CSF) for signs of infection. ️️ What is the priority intervention for a patient with a sudden onset of severe headache and neck stiffness? The priority is to evaluate the patient for possible meningitis or subarachnoid hemorrhage. Immediate diagnostic imaging (CT or lumbar puncture) and appropriate antimicrobial or surgical intervention are crucial based on the findings. ️️ What is the first step in managing a patient with suspected Guillain-Barré syndrome (GBS)? The first step is to assess respiratory function, as GBS can lead to respiratory failure. The patient should be monitored closely, with early intervention such as plasmapheresis or intravenous immunoglobulin (IVIG) therapy to reduce the immune attack on the peripheral nervous system. ️️ What is the most common cause of acute peripheral facial nerve paral