NSG 533 Exam 4 Study Guide
Tonsillar Herniation (Ans- cerebellum thru foramen magnum; kills by resp/cv depression
Meningitis (Ans- inflammation of the meninges covering brain and spinal cord
viral meningitis
(Ans- aseptic meningitis; lower mortality rate; 90% enteroviruses:
coxsackie virus, echo virus, fecal /oral route, respiratory: peak in summer
and fall months
Bacterial Meningitis (Ans- inflammation of the protective membranes covering the brain and spinal cord caused by various types of bacteria. Life threatening neurological emergency; patients can present in septic shock; endotoxin and inflammatory mediators initiate a CSF inflammatory response and edema formation; see increased ICP, reduction in cerebral perfusion and/or brain death
encephalitis (Ans- inflammation of the brain (usually by virus, herpes)
Myelitis (Ans- infection/inflammation of the spinal cord
ventriculitis (Ans- inflammation of the ventricles of the brain
Neisseria meningitidis (Ans- bacteria; common cause for meningitis in adults
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- influenzae
(Ans- bacteria; common cause for meningitis in neonates
Viral CSF (Ans- normal glucose, normal/high protein, few mononuclear cells
Bacterial CSF (Ans- low glucose, high protein, many mononuclear cells
Infectious Signs of Meningitis (Ans- Fever, tachycardia, chills
meningeal irritation signs (Ans- severe throbbing headache, severe photophobia, nuchal rigidity, positive kernigs/brudzinski signs
Neurologic signs of meningitis (Ans- Focal signs, ↓ in consciousness, CN palsies, seizures
seizure (Ans- sudden, transient disturbances in brain function resulting from an abnormal firing of nerve impulses d/t increased excitatory synaptic neurotransmitters (glutamate++, aspartate); Ionic excitation with inflow of Na, Ca+++ may or may not be associated with convulsion
Hippocampal sclerosis (Ans- temporal lobe epilepsy; loss of neurons in Ammon's horn of the hippocampus; unclear cause possibly related to birth or early childhood trauma or multiple seizures; elevated glutamate causes damage
temporal lobe epilepsy (Ans- seizures begin in the temporal lobe of the brain; refractory to treatment; due to HS, tumor, cortical dysplasia, vascular malformations or unable to determine
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simple partial seizure (Ans- a partial seizure, starting from a focus and remaining localized, that
does not produce loss of consciousness: motor or sensory
Simple complex seizure (Ans- partial seizure that may produce loss of consciousness; temporal lobe origin or causes secondary generalization
Generalized seizures (Ans- a seizure that affects both sides of the brain; tonic clonic, absence, myoclonic, infantile spasm, atonic, lennox gestaut syndrome
Ischemic Stroke (Ans- a type of stroke that occurs when the flow of blood to the brain is blocked; possibly from a blood clot in the brain; will immediately see brain tissue damage or death
Cardioembolic stroke (Ans- Ischemic stroke - Thrombus develops in heart - atrium, ventricle, or valve - detaches and embolizes May have multiple embolic events - affect multiple vessels Associated w/ atrial fibrillation, Risk of conversion to Ischemic Stroke Treatment - anticoagulants, prevent recurrent clot formation
hemorrhagic stroke (Ans- occurs when a blood vessel in the brain leaks or ruptures; also known as a bleed; hypertension related small vessel disease is number 1 cause
Normal pH PaCO2 PaO2 (Ans- 7.35-7.45; 35-45
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