ECCO Caring For Patients With Neurologic Disorders
ECCO Caring for Patients with Neurologic Disorders
Exam (elaborations)
ECCO Caring for Patients with Neurologic Disorders: Part 1 exam questions and 100% correct answers
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ECCO Caring for Patients with Neurologic Disorders
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ECCO Caring For Patients With Neurologic Disorders
What vital sign assessments herald impending brainstem herniation? - correct answer Increased SBP w/widening pulse pressure, changes in respirations, and bradycardia
A patient is admitted after sustaining traumatic brain injury in a motorcycle crash. The patent's GCS score on admission is E 2, M...
ECCO Caring for Patients with Neurologic Disorders Part 1
What vital sign assessments herald impending brainstem herniation? - correct answer Increased SBP w/widening pulse pressure, changes in respirations, and bradycardia
A patient is admitted after sustaining traumatic brain injury in a motorcycle crash. The patent's GCS score
on admission is E 2, M 3, V 1T = 6T. Which of the following should the nurse perform to prepare the patient for ICP monitoring? - correct answer Prior to placement of an ICP monitoring catheter, a neurologic assessment is performed in order to have a baseline assessment to compare to the postinsertion assessment.
A patient is admitted following a drug overdose. The patient does not open eyes upon verbal request but
localizes to a trapezius muscle squeeze without opening eyes. The nurse should document the patient's mental status as: - correct answer Responsive to painful stimuli
You are caring for an unconscious patient with traumatic brain injury from a motor vehicle crash. His alcohol and toxicology screen are negative, he has no facial fractures, and he's not receiving pain or sedation medication. Vital signs: BP 100/70 (80), HR 86 sinus rhythm, SpO2 95% with endotracheal tube secured. Upon application of painful stimuli with supraorbital notch pressure, the patient clenches fists, holds legs straight out, and bends arms inward toward the body. Fingers are bent and held on the chest. The nurse should document this response as: - correct answer Abnormal flexor posturing
In a patient with a subarachnoid hemorrhage, what is the purpose of a transcranial Doppler (TCD) test? - correct answer Measure blood flow velocity to assess for vasospasm.
Transcranial Doppler (TCD) uses ultrasound technology to evaluate cerebral blood flow and arterial narrowing in the major cerebral vessels. If arterial passages have narrowed, as in vasospasm, blood flow velocity is increased.
Which of the following patients should the nurse anticipate as most likely to develop hyponatremia and hypo-osmolality? A patient: - correct answer Two days post severe traumatic brain injury A nurse finds that a patient does not move spontaneously or follow commands. To assess the patient's motor function, the nurse applies a central pain stimulus, without response. What is the nurse's next step? - correct answer Apply peripheral pain stimulus
In determining LOC, a nurse finds that a patient post multisystem trauma does not respond to loud questions, statements, or a light shoulder touch. What should be the nurse's next step? - correct answer Assess a central pain stimulus response
Which of the following may result in a decreased supply of oxygen to the brain? - correct answer Hypotension and hypoxia are the primary systemic causes of decreased oxygen supply.
In assessing an unconscious patient who is noted to have new-onset sluggish pupillary light reflex, deficits in what other cranial nerve reflexes can indicate brainstem compression? - correct answer Deficits in pupil reactivity to light and the basic protective reflexes (e.g., gag, cough, corneal) in an unconscious patient can indicate brainstem compression. Report new-onset or previously unknown deficits immediately to the provider.
Which of the following should the nurse perform immediately after insertion of the ICP monitoring device is completed? - correct answer Assess neurologic status and compare to assessment before insertion.
Which of the following central pain stimuli should the nurse use to assess motor function in a patient who is unconscious and who has facial fractures? - correct answer Use the trapezius squeeze as a central pain stimulus in patients who have facial injuries.
A patient is admitted after an unwitnessed cardiac arrest at home. Review the EMR. What criterion is anticipated as part of the decision-making process to support declaration of death by neurologic criteria?
- correct answer The PaCO2 increases to 68 when off ventilator for 8 minutes. During an apnea test, patients without brainstem function will remain apneic even when the PaCO2 reaches very high levels.
A patient with an EVD in place suddenly develops disorientation to place, and ICP suddenly increases from 15 to 22 mm Hg. EVD drainage system troubleshooting indicates no visible blockages and no CSF
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