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NUR 425, Neuro Part 1 Review Questions and Correct Answers $8.99   Add to cart

Exam (elaborations)

NUR 425, Neuro Part 1 Review Questions and Correct Answers

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  • Course
  • NUR 425
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  • NUR 425

Autonomic nervous system and main neurotransmitters Sympathetic- norepinephrine Parasympathetic- acetylcholine First indicator that neurological functioning has declined Decreased LOC Levels of consciousness Alert: awake and responsive Lethargic: drowsy or sleepy but easily awakened (Obt...

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  • September 9, 2024
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  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NUR 425
  • NUR 425
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twishfrancis
NUR 425, Neuro Part 1 Review
Questions and Correct Answers
Autonomic nervous system and main neurotransmitters ✅Sympathetic- norepinephrine
Parasympathetic- acetylcholine

First indicator that neurological functioning has declined ✅Decreased LOC

Levels of consciousness ✅Alert: awake and responsive
Lethargic: drowsy or sleepy but easily awakened
(Obtunded: only stays awake when stimulation is actively occurring)
Stuporous: arousable only with vigorous or painful stimuli
Comatose: unconscious/cannot be aroused

Decorticate posturing ✅Everything drawn in toward the "core"; arms are drawn in
toward chest (flexed at elbows); late sign of brainstem dysfunction

Decerebrate posturing ✅Upper and lower extremities are extended, wrists are flexed,
and neck is extended (and toes fanned out?); late sign of brainstem dysfunction

GCS decrease ✅A decrease of 2 or more points is clinically significant and should be
communicated to the HCP immediately

Wherever a spinal cord injury is... ✅Anything below that level will be affected (function
may be altered or completely lost)

Cervical spine injury C4 or above ✅Risk for decreased spontaneous respiration

Complete vs incomplete spinal cord injury ✅Complete- loss of all voluntary movement
and sensation below level of injury (lesion damage entire diameter of cord is severed)
Incomplete- partial or varying losses below level of injury (lesion damage partial
diameter of cord)

Primary vs secondary mechanisms of injury ✅Primary- injury directly to the spinal cord
(hyperflexion, hyperextension, compression, rotation, penetrating trauma, etc.)
Secondary- injury occurred because of something else (hemorrhage, ischemia,
hypovolemia, edema)
-swelling, etc. makes the tissue not get enough blood flow

Primary intervention for spinal cord injury ✅Stabilize the site immediately (stabilize C-
spine)
-stabilize head with collar, hands, or sandbags; stabilize spine on a board

, -cannot take off devices until spine is cleared

Hold C-spine ✅Holding the patient's neck still so they can't move their head; put your
palms on their ears; if you need to turn them, do a log roll (would need at least 2 people
for this, as one person must hold the C-spine)
-don't try to talk to patients with potential spinal cord injuries unless you're directly above
them (they may try to turn and look at you)

Management of spinal cord injury ✅Respiratory issues are first priority, then
cardiovascular; also assess neurological functioning, sensory/motor ability, and GI/GU
systems

If anything at or above T6 is injured... ✅The chest wall muscles won't work as they
should
-breathing won't be as effective
-patient's body will fatigue quickly because only the diaphragm is working to breathe
-patient at risk for respiratory complications and pulmonary embolus during the first 5
days after injury

Desired blood pressure for perfusion ✅MAP of 60; systolic at or above 90

Proprioception ✅Knowing where your body parts are in space

Lack of impulses to bowel ✅Rectum loses its tone (becomes relaxed if it loses
innervation/impulses); may have bowel incontinence if there is fecal matter in the
rectum
-peristalsis will also stop, so patients are at risk for bowel obstruction (paralytic ileus) or
constipation

Lack of impulses to bladder ✅The bladder requires an impulse to empty, so it cannot
be emptied independently if it loses innervation/impulses; patients with spinal injuries
may have a permanent cath or may self-cath regularly

Priority drug for acute spinal cord injury ✅High doses of steroids as soon as possible
(specifically methylprednisolone)

Baclofen and tizanidine ✅Muscle relaxers; can cause drowsiness; can cause
psychosis (hallucinations) if withdrawn too quickly

Other medications for spinal cord injuries ✅Vasopressors (to increase BP), dextran (to
increase volume/BP), pain meds, DVT prophylaxis, stool softeners

Decompressive laminectomy ✅Removal of part of the laminae of the vertebrae, which
allows for swelling without compression of the spinal cord

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