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Saturday, October 4, 2008

Nclex Medical Surgical: Neurosensory Disorder Nclex RN Review Course

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Vision changes, such as diplopia, nystagmus, and blurred vision are symptoms of multiple sclerosis. Deep tendon reflexes may be increased or hyperactive -- not absent.

Normal pressure in the anterior chamber of the eye remains relatively constant at 20 to 25 mm Hg.

subdural hematoma - A condition involving the collection of blood between the dura mater and the brain.

Lichtheim's sign is the inability to speark associated with subcortical aphasia.

An injury from C5 to C6 results in quadriplegia, with diaphragmatic and gross arm movemens.

transsphenoidal hypophysectomy - Microsurgery in which an incision is made at the junction of the gums and upper lip. A surgical microscope is advanced and a special surgical instrument is used to excise all or part of the pituitary gland.

polyneuritis - Degeneration of peripheral nerves primarily supplying the distal muscles of the extremities. It results in muscle weakness, with sensory loss and atrophy, and decreased or absent deep tendon reflexes.

Decerebrate posturing, characterized by abnormal extension in the response to painful stimuli, indicates damage to the midbrain.

With damage to the diencephalon or cortex, abnormal flexion (decorticate posturing) occurs when a painful stimulus is applied.

Damage to the medulla results in flacidity.

Receptive aphasia = damage to temporal lobe.

Damage to the parietal lobe affects the client's ability to identify special relationship with the environment.

Dames to the occipital lobe affects visual association.

PERRLA stands for "Pupils Equal, Round, Reactive to Light and Accommodation"

audiometry - Evaluation of hearing using an audiometer. Various audiometric tests identify the lowest intensity of sound at which a client can perceive an auditory stimulus, hear different frequencies, and differentiate speech sounds. Pure tone audiometry evaluates the ability to hear frequencies, usually ranging from 125 to 8,000 Hz, and can determine whether a hearing loss results from a problem in the middle ear, inner ear, or auditory nerve.

Myasthenia gravis is characterized by a weakness of muscles, especially in the face and throat, caused by a lower motor neuron lesion at the myoneural junction.

The nurse must dissolve crystallized mannitol before administering it. This is best doen by warming it in hot water and shaking the container vigorously, then allowing the solution to return to room temperature before administering it.

To prevent adverse reaction, which are commmon, I.V. diazepam should be administered no faster than 5 mg/minute in an adult and should be given over at least 3 minutes in children.

Presbycusis is progression hearing loss associated with aging.

A decreased acetylcholine level has been implicated as a cause of cognitive changes in healthy geriatric clients and in the severity of dementia.

A normal and stable ICP value is less than 15 mm Hg.

Chewing is a function of cranial nerve V (Trigeminal).

Swallowing is a motor function of cranial nerves IX and X.

epilepsy - A group of neurologic disorders marked by uncontrolled electrical discharge from the cerebral cortex and typically manifested by seizures with clouding of consciousness. Epilepsy is most commonly of unknown cause (idiopathic) but is sometimes associated with head trauma, intracranial infection, brain tumor, vascular disturbances, intoxication, or chemical imbalance.

cerebral contusion - A bruising of the brain tissue as a result of a severe blow to the head. A contusion disrupts normal nerve function in the bruised area and may cause loss of consciousness, hemorrhage, edema, and even death.

The catheter for measuring ICP is inserted through a burr hole into a lateral ventricle of the cerebrum, thereby creating a risk of infection.

Succinylcholine (Anectine) a depolarizing blocking agent, is the drug of choice when short-term muscle relaxation is desired -- for example during ECT or intubation.

Cones provide daylight color vision, and their stimulation is interpreted as color. Rods are sensitive to low levels of illumination but cants discriminate color.

The sweat chloride test is used to confirm cystic fibrosis. Edrophonium (Tensilon) test confirms the diagnosis of myasthenia gravis.

A helicopod gait is an abnormal gait in which the client's feet make a half circle with each step. In a steppage gait, the feet and toes rish high off the floor and then heel comes down heavily with each step.

When administering pilocarpine, the nurse should apply pressure on the inner canthus to prevent systemic absorption of the drug.

Nonfluent aphasia is characterized by telegraphic speech, failure to use conjunctions and pronouns and impared repetition and ability to read aloud.

In global aphasia, spontaneous speech is absent or limited to a few stereotyped words; comprehension is limited to the client's name or a few words.

In fluent aphasia, auditory comprehension is disturbed; speech lacks meaningful content, is unrelated to questions and includes paraphasias. The client with fluent aphasia seems unaware that speech doesnt make sense and that reading and writing are impared.

In anomic aphasia, the client can't name objects, has trouble finding words and may be unable to read or write.

A basilar skull fracture commonly causes only periorbital ecchymosis (racoon's eyes) and postmastoid ecchymosis (Battle's sign).

Atropine sulfate is a cholinergic blocker.

Lower brain stem dysfunction alters bulbar functions such as breathing, talking, swallowing and coughing.

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