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NRS 400 Exam 3 questions with Complete Solutions.
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NRS 400 Exam 3 questions with Complete Solutions.
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NRS 400 Exam 3 questions withComplete Solutions
What is hydrocephalus? - ANS-Hydrocephalus is the excessive accumulation of CSF that
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j increases intracranial pressure.
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-Blockage in flow of CSF through ventricles of brain or when cannot be absorbed by
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j arachnoid villi. j
What types of substances are able to directly cross the blood-brain barrier? - ANS-Lipophilic
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j substances are able to cross the blood-brain barrier directly and enter the brain.
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*Water crosses membrane by simple diffusion. Most nutrients cross blood brain barrier by
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j facilitated diffusion. j
Cerebral Autoregulation - ANS-Autoregulatory mechanisms fail: Loss of match between
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j oxygen supply and demand of tissues.
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Intracranial pressure: Pressure exerted by brain tissue, blood, and cerebrospinal fluid (the
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j contents of the cranium).
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Monro-Kellie hypothesis - ANS-If the volume of one component of intracranial pressure
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j increases slightly, it is offset by reduction in volume of the other two.
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,What are the risk factors for TIA/ stroke? - ANS-Nonmodifiable risk factors:
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-Age, family history, prior TIA/stroke, race, sex, sickle cell disease.
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Modifiable risk factors: j j
-CV disease, diabetes, excess weight, hypertension, hyperlipidemia, smoking, heavy drinking,
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j physical inactivity, poor nutrition, birth control.
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What are the manifestations of a TIA? - ANS-Clinical manifestations: Facial drooping, arm or
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j leg weakness on one side of body, speech difficulty, sudden trouble seeing in one or both
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j eyes, difficult walking with dizziness, lack of balance or coordination, severe headache.
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Treatment of TIA - ANS-Diagnosis and treatment- Seek Urgent Medical Attention
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- Exclusion of conditions that mimic TIA
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- Blood glucose and other blood tests
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- Electrocardiography
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- Noncontrast CT
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- MRI with diffusion-weighted imaging
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- CT angiography or magnetic resonance angiography
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- Carotid Doppler
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What are causes of Ischemic Stroke? - ANS--Partial or complete occlusion of cerebral blood
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j flow due to thrombus or embolus.
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,Most embolisms are of cardiac origin: Atherosclerosis, A-fib, Breakage of atherosclerotic
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j plaque form carotid artery.
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What is the most common location for a ischemic stroke? - ANS-Middle cerebral artery
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Interventions for Embolic stroke and Determining Timing and Appropriateness if use. - ANS-
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Treatment of ischemic stroke. j j j
Restoration of blood flow and reducing area of infarction.
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Penumbra: tissue surrounding infarction j j j
Know when the symptoms started
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-Supplemental oxygen j
-Glycemic control j
Fibrinolytic control j
-Antihypertensive therapy j
-Aspirin 325 mg j j
-Hypothermia
What are cause of hemorrhagic stroke? - ANS-- Thrombocytosis
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- Sickle cell disease
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- Hypercoagulable states- Medication
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What are the treatment/ Interventions for hemorrhagic stroke? - ANS-- Priority of care
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j depends on adequate ventilation and management of blood pressure.
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, Reverse Medications j
- Osmotic diuretics decrease intracranial pressure
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- Glucose is monitored and normoglycemia maintained.
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- Surgical treatment.
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Cerebral Edema: - ANS-Delayed cerebral ischemia (DCI): Clinical syndrome of focal
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j neurological deficits, cognitive deficits, or both: j j j j j
-Most important cause of morbidity and mortality in survivors aneurysmal subarachnoid
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j hemorrhage.
-Occurs in about 30% of patients in the first two weeks following hemorrhage.
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-Brain injury in first 72 hours leads to spontaneous waves of cerebral tissue depolarization
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j and profound hypoperfusion of the cortex.
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-Coagulation cascade activation impairs fibrinolytic cascade and causes microthrombosis
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A subdural hematoma of blood between which two membranes? - ANS-A subdural
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j hematoma is an accumulation of blood between the dura matter and arachnoid membrane.
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Manifestations of spinal cord hemorrhages? - ANS-Patient's typically present with sudden,
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j severe, localized back pain. Intramedullary, epidural, and subdural symptoms.
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-hemiparesis, paraparesis, quadriparesis, sensory loss below lesion, loss of sphincter control.
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-Subarachnoid symptoms: Headache, neck stiffness, and photosensitivity. j j j j j j
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