NU431 Final Exam Guide With
Complete Solution
Changes in LOC - ANSWER most important indicator of neurologic decline
Dysarthia - ANSWER weakness or lack of coordination of muscles of speech
Richmond Agitation Sedation Scale - ANSWER scale ranging from -5 to 4 that
helps gauge level of sedation
decorticate - ANSWER flexion into the body; indicates damage to cerebral
hemispheres or thalamus
decerebrate - ANSWER extension away from the body; indicates damage to
the midbrain or pons
Romberg test - ANSWER assesses ability of vestibular apparatus in inner ear
to help maintain standing balance
oculomotor nerve (3) - ANSWER nerve that can impact pupil size and
reaction
trigeminal and facial nerves (5/7) - ANSWER nerves that impact corneal reflex
glossopharyngeal, vagus, and hypoglossal (9,10,12) - ANSWER nerves that
affect gag and cough reflexes
oculomotor, trochlear, and abducens - ANSWER nerves that affect
extraocular movements
disconjugate gaze - ANSWER eyes move independently of one another
,nystagmus - ANSWER jerking or rhythmical movement of one or both eyes
monroe kellie hypothesis - ANSWER if volume of one brain component rises,
the other two must compensate in some way
5 to 15 mmhg - ANSWER normal ICP range
vasodilation, increased CBF - ANSWER result of increased PaCO2
60 to 100 mmhg - ANSWER normal cerebral perfusion pressure
MAP minus ICP - ANSWER equation to determine CPP
less than 50 - ANSWER CPP that can result in permanent neurologic damage
less than 30 - ANSWER CPP that is incompatible with life
change in LOC, headache - ANSWER early signs of increased ICP
projectile vomiting, increased PP, bradycardia, changes in respiratory
pattern, blown out pupils - ANSWER late signs of increased ICP
when GCS is less than 8 and abnormal CT/MRI - ANSWER when ICP
monitoring should be initiated
ventriculostomy - ANSWER catheter inserted directly into the lateral
ventricle; allows for direct measurement of ventricular pressure,
removal/sampling of CSF, drug administration
level with tragus of ear - ANSWER where transducer of ventriculostomy must
be aligned to get correct reading
normal icp tracing - ANSWER has three phases; "staircasing,"
external ventricular darin - ANSWER allows controlling of the ICP by
removing CSF
, 20 to 30 ml/hr - ANSWER normal production rate of CSF
90 to 150 ml - ANSWER average volume of CSF
monitoring for 5 or more days, ventriculostomy, concurrent CSF leak, current
systemic infection - ANSWER conditions that increase the risk of infection
with ICP monitoring
mannitol, hypertonic saline, decadron, prophylactic seizure meds - ANSWER
medications that may be used to decreased ICP
CSF drainage, drug therapy, avoid fevers/shivering, treat agitation, elevate
HOB, keep neck midline - ANSWER methods to decrease ICP
avoid valsalva, avoid suctioning, decreased anxiety, maintain patent airway,
prevent seizures, low stimulation - ANSWER activities that will prevent an
increase of ICP
concussion - ANSWER sudden transient mechanical head injury with
disruption of neural activity; sudden change in LOC; may or may not lose
consciousness
contusion - ANSWER bruising of brain tissue within a focal area; may contain
areas of hemorrhage, infarction, necrosis, and edema frequently around
fracture site
coup contrecoup - ANSWER injury to both sign of the brain that occur from
rapid movement within skull
Racoon eyes, battle's sign - ANSWER signs of major head trauma
battle's sign - ANSWER bruising behind the ears, indicative of a basilar skull
fracture
Complete Solution
Changes in LOC - ANSWER most important indicator of neurologic decline
Dysarthia - ANSWER weakness or lack of coordination of muscles of speech
Richmond Agitation Sedation Scale - ANSWER scale ranging from -5 to 4 that
helps gauge level of sedation
decorticate - ANSWER flexion into the body; indicates damage to cerebral
hemispheres or thalamus
decerebrate - ANSWER extension away from the body; indicates damage to
the midbrain or pons
Romberg test - ANSWER assesses ability of vestibular apparatus in inner ear
to help maintain standing balance
oculomotor nerve (3) - ANSWER nerve that can impact pupil size and
reaction
trigeminal and facial nerves (5/7) - ANSWER nerves that impact corneal reflex
glossopharyngeal, vagus, and hypoglossal (9,10,12) - ANSWER nerves that
affect gag and cough reflexes
oculomotor, trochlear, and abducens - ANSWER nerves that affect
extraocular movements
disconjugate gaze - ANSWER eyes move independently of one another
,nystagmus - ANSWER jerking or rhythmical movement of one or both eyes
monroe kellie hypothesis - ANSWER if volume of one brain component rises,
the other two must compensate in some way
5 to 15 mmhg - ANSWER normal ICP range
vasodilation, increased CBF - ANSWER result of increased PaCO2
60 to 100 mmhg - ANSWER normal cerebral perfusion pressure
MAP minus ICP - ANSWER equation to determine CPP
less than 50 - ANSWER CPP that can result in permanent neurologic damage
less than 30 - ANSWER CPP that is incompatible with life
change in LOC, headache - ANSWER early signs of increased ICP
projectile vomiting, increased PP, bradycardia, changes in respiratory
pattern, blown out pupils - ANSWER late signs of increased ICP
when GCS is less than 8 and abnormal CT/MRI - ANSWER when ICP
monitoring should be initiated
ventriculostomy - ANSWER catheter inserted directly into the lateral
ventricle; allows for direct measurement of ventricular pressure,
removal/sampling of CSF, drug administration
level with tragus of ear - ANSWER where transducer of ventriculostomy must
be aligned to get correct reading
normal icp tracing - ANSWER has three phases; "staircasing,"
external ventricular darin - ANSWER allows controlling of the ICP by
removing CSF
, 20 to 30 ml/hr - ANSWER normal production rate of CSF
90 to 150 ml - ANSWER average volume of CSF
monitoring for 5 or more days, ventriculostomy, concurrent CSF leak, current
systemic infection - ANSWER conditions that increase the risk of infection
with ICP monitoring
mannitol, hypertonic saline, decadron, prophylactic seizure meds - ANSWER
medications that may be used to decreased ICP
CSF drainage, drug therapy, avoid fevers/shivering, treat agitation, elevate
HOB, keep neck midline - ANSWER methods to decrease ICP
avoid valsalva, avoid suctioning, decreased anxiety, maintain patent airway,
prevent seizures, low stimulation - ANSWER activities that will prevent an
increase of ICP
concussion - ANSWER sudden transient mechanical head injury with
disruption of neural activity; sudden change in LOC; may or may not lose
consciousness
contusion - ANSWER bruising of brain tissue within a focal area; may contain
areas of hemorrhage, infarction, necrosis, and edema frequently around
fracture site
coup contrecoup - ANSWER injury to both sign of the brain that occur from
rapid movement within skull
Racoon eyes, battle's sign - ANSWER signs of major head trauma
battle's sign - ANSWER bruising behind the ears, indicative of a basilar skull
fracture
