NUR 2063 PATHOPHYSIOLOGY FINAL EXAM 2024-2025 QUESTIONS WITH VERIFIED COMPLETE SOLUTIONS., Exams of Nursing

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NUR 2063 PATHOPHYSIOLOGY FINAL EXAM 2024-

2025 QUESTIONS WITH VERIFIED COMPLETE

SOLUTIONS

Explain primary prevention - ANSWER -Preventing"; altering susceptibility or reducing exposure of disease for people Explain secondary prevention - ANSWER -"Screening"; early detection, screening, and management of disease to catch disease early before it spreads Explain tertiary prevention - ANSWER -"Treating" and preventing further complications from a disorder or disease after the person has the condition What are examples of primary prevention? - ANSWER -Vaccinations and Handwashing What are examples of secondary prevention? - ANSWER -PAP smears for STDs, lab work for HBA1C check, mammogram What are examples of tertiary prevention? - ANSWER -Rehab for hip surgery, relearning ADL's after amputation, Wound care after stroke to prevent pressure ulcer What happens to the body during the sympathetic phase of the flight or fight response? - ANSWER -Pupils dilate, salivation inhibited, increase in HR, bronchodilation of airway, increased respirations, glucose release, inhibit GI/GU.

What happens to the body during the parasympathetic phase of the flight or light response? - ANSWER -Rest and Digest. Pupils constrict, salivation occurs, decreased HR, bronchoconstriction,decreased respiration, GI/GU systems resume action Explain the role of the nucleus - ANSWER -control center of the cell, where DNA and genes are stored, produces mRNA to help build body proteins Explain the role of the mitochondria - ANSWER -Powerhouse of the cell. Provides energy in ATP, and has its own set of DNA Explain the role of the ribosome - ANSWER -produces RNA to produce proteins through transcriptions of DNA and translation of RNA into a protein Explain the role of the lysosomes - ANSWER -helps breakdown and digest dead cells, organelles, or tissues Explain the role of the rough ER - ANSWER -folded membranes that move proteins around the cell. Has ribosomes attached to it and helps produce proteins for the cell membrane Explain the role of the smooth ER - ANSWER -helps the Liver and kidney cells to detoxify, lipid metabolism, synthesis of hormones, and calcium storage Explain the role of the peroxisome - ANSWER -membrane cells that contain oxidase and catalase to detoxify harmful chemicals, breakdown hydrogen peroxide and filter metabolic wastes

Explain the role of the Golgi body - ANSWER -stacked membranes that act as the sorter and packager for proteins from the ER. Helps move things in and out of cell Explain passive immunity - ANSWER -the transfer of preformed antibodies against specific antigens from a protected or immunized individual to an unprotected or non immunized person. Provides immediate and short term protection. No memory cells are produced. IgA and IgE. Passes protection What are examples of passive immunity? - ANSWER -mom to fetus through placenta or mom to infant through breast milk. Serotherapy Explain active immunity - ANSWER -a protective state owing to the immune system response as a result of active infection or immunization. It has to be activated in the body and the body has to fight it to have long term immunity What are examples of active immunity? - ANSWER -Vaccinations Explain what edema is - ANSWER -accumulation of fluid in the interstitial space. Leads to tissue swelling What are some causes of edema? - ANSWER -increase in the forces that move fluid from capillaries to interstitial compartments or decrease in the opposite. What are factors that contribute to edema? - ANSWER -Increase in hydrostatic forces in the capillaries that increases the blood volume, increased capillary permeability, CHF, HYPTN, decrease in plasma proteins like albumin (causes liver to hold onto more water- ascites, cirrhosis), blockage of lymph drainage

What is a hypersensitivity? - ANSWER -an overreaction to antigens or allergens that is beyond the normal range, leading to damage What is a type 1 hypersensitivity? - ANSWER -anaphylactic. Occurs within 2- 30mins of exposure. Can be systemic or localized. Binds to IgE and mast cells that release histamine, leukotrienes, and prostaglandins to create inflammation Mediating Factor for type 1 hypersensitivity - ANSWER -IgE Examples of type 1 hypersensitivity - ANSWER -allergic reaction to dust. someone eats peanuts and breaks out in hives and runny nose How do we treat type 1 hypersensitivity reactions? - ANSWER -antihistamines to block histamine, beta adrenergics to bronchodilator , corticosteroids, to decrease inflammation. IgE therapy, epinephrine given during anaphylaxis through IV or through IM in epipens What are signs and symptoms of a type 1 hypersensitivity reaction? - ANSWER - hives, runny nose, eczema, throat constriction, ,localized edema, wheezing, tachycardia, anaphylaxis. Explain Type 2 Hypersensitivity - ANSWER -The cells attack healthy organs and blood, causing symptoms Mediating factor for type 2 hypersensitivity - ANSWER -cytotoxic- IgM/ IgG Examples of type 2 hypersensitivity - ANSWER -Blood transfusions when wrong blood given, hemolytic disease of newborn, grans disease, myasthenia gravis

What is type 3 hypersensitivity? - ANSWER -The igG antibodies are stuck beneath the membranes of cells. Can activate immune responses that can damage tissues. Immune complex Mediating factor type 3 hypersensitivity - ANSWER -immune complexes Examples type 3 hypersensitivity - ANSWER -RA, lupus What is type 4 hypersensitivity? - ANSWER -there is a delayed cell reaction caused by the T cells. Antigens are phagocytized and are sensitized to receptors on the t cell. Reexposure causes the memory cells to release destructive cytokines. Mediating factor type 4 hypersensitivity - ANSWER -delayed cell mediated Examples type 4 hypersensitivity - ANSWER -TB test, contact dermatitis Characteristics of benign tumors - ANSWER -Localized growth that is curable. They more closely resemble the original tissue type, they grow slowly, have little vascularity, rarely necrotic, and usually have similar function to the original cells. Can be fatal depending on the location (brain, heart,etc), usually grows at the original areas of the body. Encapsulated Characteristics of malignant tumors - ANSWER -usually cancerous. They ignore growth controlling signals and replicate despite signals from the environment. They can escape signals and can die. they can also display different functions poorly or not at all related to the tissue. Greater degree of differentiation means

that it is more aggressive. Can move around with a poor prognosis. Anaplasia, metastasis S/S of peptic ulcer disease - ANSWER -epigastric burning pain that is usually relieved by food or antacids (gastric ulcers present on empty stomach but can be after food, duodenal ulcers present 2-3 hours after food and is relieved by food). Can also be life threatening as GI bleeding can occur without warning and cause a drop in H/H and dark tarry stools and hematemesis What is H.pylori? - ANSWER -has a key role in promoting both gastric and duodenal ulcer formation and thrives in acidic areas. It slows down ulcer healing and can reoccur frequently, and taking it away can help ulcers heal What is a functional bowel obstruction? - ANSWER -problem with the act of the bowel actually moving, such as things that inhibit movement from surgery, medications, opioids, low fiber diets that can slow motility or shut off the GI system from the SNS stimulation What is a mechanical bowel obstruction? - ANSWER -blockage of the bowel inhibiting movement. adhesions, hernia, tumors, impacted feces, volvus or twisting of the intestines, intussusception adhesions - ANSWER -bands of scar tissue joining two surfaces that are normally separated in the bowel hernia - ANSWER -Protrusion of bowel through the wall of the cavity that normally contains it volvus - ANSWER -twisting of the bowel

Intusseption - ANSWER -telescoping of the intestines S/S of appendicitis - ANSWER -Periumbilical pain, RLQ pain, presence of a positive McBurneys point and rebound tenderness when one presses on the belly button and hip region and when the pressure is removed, the client has pain, nausea, vomiting, fever, diarrhea, RLQ tenderness, systemic signs of infection. how to assess appendicitis - ANSWER -McBurney's point technique when pressing on the belly button and RLQ hip region and removing the pressure causes intense pain, indicates positive appendicitis. Rebound tenderness= positive rebound tenderness - ANSWER -pain that increases when pressure (as from a hand) is removed-in appendicitis S/S of liver disease - ANSWER -hepatocellular failure (jaundice, decreased clotting, hypoalbuminemia, decreased vitamin D and K) and portal hypertension (GI congestion due to blockage of blood, more esophageal or gastric varies, hemorrhoids, enlarged spleen,) what is jaundice? - ANSWER -green yellow staining of tissues from increased level of bilirubin as the liver cannot metabolize extra bilirubin. Found on eyes, skin, and mouth. present with liver disease What is ascites? - ANSWER -pathological accumulation of fluid in the peritoneal cavity due to the loss of albumin in the liver, causing fluid to be free amongst the cells. It can cause a lot of pain in the abdomen, and it must be drained with a parenthesis

What is hepatic encephalopathy? - ANSWER -neuropsychiatric syndrome from too much ammonia in the blood as the liver cannot break it down. Dementia=ammonia and psychotic symptoms common along with jerking What is portal hypertension? - ANSWER -Increased pressure in the portal venous system from a build-up of portal vein pressure due to progressive hepatic fibrosis which increases hepatic resistance What is esophageal varices? - ANSWER -a complication of portal hypertension resulting from alcoholism or hepatitis. Causes the vessels in the esophagus to become dilated and bleed, and the rupturing can be forceful enough for one to bleed out How do we treat esophageal varices? - ANSWER -reduce the hypertension, banding the varices to prevent rupturing and bleeding by cutting of the flow with a band What role does albumin play in the blood? - ANSWER -Albumin helps keep fluid in the blood stream and in cells so it does not leak into other tissues. It can also carry other substances in the body What happens to albumin during liver failure? - ANSWER -leads to low albumin levels, causing edema in the extremities and buildup of fluid in abdomen called ascites from fluid leaking through the cells and vessels into the tissues Three functions of the kidneys - ANSWER -elimination, excretion, regulation Explain elimination - ANSWER -discharge of waste (urine) from the body

Explain Excretion - ANSWER -removal of organic wastes from the blood Explain regulation - ANSWER -regulating blood volume, ion concentration, blood pH and nutrients Manifestations of renal disorders - ANSWER -Pain: usually in the back-flank area, felt at the CVA angle when one palpates with a closed fist and it causes the client tenderness. Pain upon micturition What are abnormal urinalysis findings? - ANSWER -dark, strong smelling urine could denote decreased renal function, infection or dehydration, cloudy urine could denote infection or high WBC count. Ketones or glucose suggest diabetes, and proteinuria Normal GFR - ANSWER -125 mL/min Normal urine output per hour - ANSWER -30 mL/hr What is polycystic kidney disease? - ANSWER -a congenital abnormality of the kidney that is genetically transmitted, and it results in fluid filled cysts on one or both kidneys that can lead to renal failure, needing dialysis, or kidney transplantation What causes polycystic kidney disease? - ANSWER -genetics

Explain nephron - ANSWER -in the kidney and helps to filter blood and remove waste products. The kidney has 1-2 million of them Explain hematuria - ANSWER -blood found in the urine not due to menstruation Explain proteinuria - ANSWER -protein found in the urine What is nephrolithiasis? - ANSWER -kidney stones that obstruct the ureters and kidneys. Usually made of calcium and can cause urinary stasis and pain What is pyleonephritis? - ANSWER -infected and inflamed kidney, usually caused by e.coli from the lower urinary tract that ascends Explain how to assess for pyelonephritis - ANSWER -Percussion at the CVA noting tenderness, pain when urinating, low GFR, concentrated urine with things in urine s/s of pyelonephritis - ANSWER -CVA tenderness most common, fever, chills, N/V, anorexia or not willing to eat, flank pain What is cystitis? - ANSWER -inflammation of the bladder (UTI) How to prevent pyelonephritis - ANSWER -remove catheters as early as possible to prevent infection as it can spread s/s of acute kidney injury (AKI) - ANSWER -low urine output, concentrated urine, low GFR, high BUN/CRE, sudden reduction in kidney function

3 Causes of AKI - ANSWER -Prerenal, intrarenal, postrenal explain pre renal causes of AKI - ANSWER -disruption in renal perfusion and blood flow. It can cause low blood pressure, low blood volume, heart failure, renal artery obstruction, fever, vomiting, diarrhea, burns that lead to dehydration, Drugs such as ACE inhibitors or angiotensin 2 blockers, NSAIDs that can drop the blood pressure or cause bleeding Explain intrarenal causes of AKI - ANSWER -damage or disruptions within the kidney blood vessels, tubules, or glomeruli. It can cause reduced blood supply within the kidneys, toxic injury with medications, chemo, and contrast medias, renal inflammation, or prolonged prostate/ stones/ in the post renal stage Explain postrenal causes of AKI - ANSWER -caused by an obstruction in the urinary collecting system, urethra, bladder, or ureters due to stone, tumor, or enlarged prostate that results in elevated pressure in the Bowman's capsule that impedes glomerular filtration. Prolonged injury can lead to intrinsic injury and irreversible damage Examples of prerenal causes of AKI - ANSWER -low BP, hypovolemia, heart failure, renal artery occlusion, fever, vomiting, diarrhea, burns leading to dehydration, NSAIDs, and antihypertensives that drop the BP Examples of intrarenal causes of AKI - ANSWER -chemo, contrast dye, prolonged kidney stones in the post renal stage Examples of postrenal causes of AKI - ANSWER -renal stones, enlarged prostate, tumor in the urethra

What is compartment syndrome? - ANSWER -Damage to nerves and vasculature of an extremity due to compression. if untreated it can cause edema, increased pressure, reduced capillary flow, ischemia and necrosis What must be done in compartment syndrome? - ANSWER -fasciotomy to reduce pressure in the area What are the 5 P's for compartment syndrome? - ANSWER -Pain paralysis paresthesia pallor pulselessness What are pressure ulcers? - ANSWER -localized area of cellular necrosis resulting from pressure between any boney prominence and with an external object Which populations are most likely to have a pressure ulcer? - ANSWER -elderly, bedridden patients, incontinent patients, those who are malnourished, bad hygiene, those with paralysis Risk factors for pressure ulcers - ANSWER -poor nutrition, aging, immobility, sensory loss, bowel and bladder incontinence Most common places to find pressure ulcers - ANSWER -buttocks, coccyx, heels, elbows, back of head, shoulders stage 1 pressure ulcer - ANSWER -Intact skin with non blanching redness

stage 2 pressure ulcer - ANSWER -partial thickness skin loss involving the epidermis or dermis or both stage 3 pressure ulcer - ANSWER -full thickness tissue loss with visible fat stage 4 pressure ulcer - ANSWER -full thickness tissue loss with exposed bone, muscle or tendon How can we prevent pressure ulcers - ANSWER -turning patients every 2 hours who are bedridden. Appropriate nutrition and hydration. float heels off bed, clean linens, doing incontinence care, movement of patients What are electrolyte reservoirs? - ANSWER -where electrolytes are found at an abundance, usually in the bones Which electrolytes are stored in the bones? - ANSWER -calcium, phosphate, magnesium What is osteomyelitis? - ANSWER -severe pyogenic infection of bone and local tissues. the organism reaches the blood adjacent to soft tissue or directly into it. if not managed, necrotic bone can separate the bone into dead segments Causes of osteomyelitis - ANSWER -burns, sinus disease, trauma, tumors, periodontal infection and pressure ulcers, open fractures, penetration of wounds, surgical contamination or use of metal screws What is osteoporosis? - ANSWER -occurs when the rate of bone resorption is greater than bone formation. The bones end up becoming fragile and light

Who is most likely to get osteoporosis? - ANSWER -women age 60-80 that are caucasian What are the causes of osteoporosis? - ANSWER -estrogen deficiency, poor calcium intake and disuse of supplements S/S of osteoporosis - ANSWER -short stature, muscle wasting, back spasms and difficulty bending. bones will be porous and have holes in them, more fragile How do we diagnoses osteoporosis? - ANSWER -bone mineral density scan with levels being -1.0 to -2. How do we treat osteoporosis? - ANSWER -calcium and vitamin D supplements, exercise, human parathyroid hormone, supplemental estrogen What is rickets? - ANSWER -defective mineralization of both bone and growth plate cartilage in children What causes rickets? - ANSWER -Vitamin D deficiency Which population is affected by rickets? - ANSWER -children S/S of Rickets - ANSWER -bowleg, knock kneed, beading of ribs, improper formation of teeth, long ends of the bones, pelvis deformities

What is osteomalacia? - ANSWER -a rare condition of the adult bone associated with vitamin D deficiency, resulting in decalcification and softening of bone. Which population is affected with osteomalacia? - ANSWER -adults What causes osteomalacia? - ANSWER -Low vitamin D in adults What is osteoarthritis? - ANSWER -local degenerative disorder associated with aging and wear and tear from repetitive stress. Characterized by loss of articular cartilage, calcification, wear of bone and bone spurs. Non inflammatory, and the weight bearing joints are affected What causes osteoarthritis? - ANSWER -long-term or excessive wear and tear on joints, aging, genetics s/s of osteoarthritis - ANSWER -pain, stiffness, enlargement, tenderness, limited range of motion and deformity, crepitus What are Heberden's and Bouchard's nodes? - ANSWER -boney bumps on fingers and joints caused by joint inflammation in osteoarthritis and RA What is rheumatoid arthritis? - ANSWER -a chronic progressive inflammatory disease causing inflammation in the joints and resulting in painful deformity and immobility, especially in the fingers, wrists, feet, and ankles. What causes rheumatoid arthritis? - ANSWER -autoimmune disorder

s/s of rheumatoid arthritis - ANSWER -s/s similar to osteoarthritis, malaise and fatigue. What is psoriatic arthritis? - ANSWER -inflammation of the joint cavities associated with psoriasis What is psoriatic arthritis associated with? - ANSWER -psoriasis What causes psoriatic arthritis? - ANSWER -automimmune disorder where cells attack the joints if not corrected earlier s/s of psoriatic arthritis - ANSWER -similar to RA, but secondary to psoriasis. oligoarthritis, combined soft tissue and peripheral joint disease What is gout? - ANSWER -disorder in which the disturbance of uric acid metabolism leads to deposition of uric acid crystals in the joints What is associated with gout? - ANSWER -uric acid and uric acid crystals What causes gout? - ANSWER -hyperuricemia s/s of gout - ANSWER -Severe pain in a peripheral joint, often great toe Swelling of joint, redness Trophi in lower extremities (small, white nodules visible through the skin) Renal stones

What is gigantism? - ANSWER -occurs in childhood as a result of too much growth hormone. Occurs before skeletal plates fuse at the ends of bones. Leaves client with increased risk for cardiac problems Which population is affected by gigantism? - ANSWER -children What is dwarfism? - ANSWER -occurs when there is too little growth hormone. It causes short stature, hypoglycemia, delayed dental eruption, thin hair, poor nail growth, greater fat mass, decreased muscle mass, and delayed bone formation and puberty. Often is congenital or idiopathic. What is acromegaly? - ANSWER -occurs in adults as a result of too much growth hormone. Occurs when the cells grow width wise amongst the bones. Which population is affected by acromegaly? - ANSWER -adults How do the bones grow in gigantism? - ANSWER -vertically or horizontally from the ends of bone. How do the bones grow in acromegaly? - ANSWER -width wise What is diabetes insipidus caused by? - ANSWER -lack of ADH What does diabetes insipidous result in? - ANSWER -Results in the kidneys being unable to retain water in the body and a lot of urine output that is dilute. Extreme thirst. Lack of water leads to dehydration.

s/s of diabetes insipidus - ANSWER -dizziness, disorientation, nausea, tachycardia, headaches, low blood pressure, hypovolemia, high electrolytes in the blood- sodium, large volumes of dilute urine/ fluid are excreted, weight loss What are patient with diabetes insipidus at high risk for developing? - ANSWER - hypovolemic shock What is SIADH? - ANSWER -too much ADH in the body. Causes the body to retain too much water S/S of SIADH - ANSWER -low urine output, high osmolarity, electrolytes are at a lower concentration, edema, weight gain, hyponatremia, cereal edema, seizures, confusion, coma What are patients with SIADH at risk of developing? - ANSWER -cerebral edema What organism causes pelvic inflammatory disease - ANSWER -Neisseria gonorrhoeae, chlamydia trachomatis What organism causes cervical cancer - ANSWER -human papillomavirus or HPV What organism causes UTI - ANSWER -e.coli What organism causes herpes - ANSWER -herpes simplex 1/ 2 virus (depending on area of body) What organism causes syphillis - ANSWER -Treponema pallidum

What is parathyroid hormone? - ANSWER -increases the calcium levels in the blood to be released from bone reservoirs by activating osteoclasts. It increases Ca absorption in the intestine and decreases Ca excretion in the urine What is calcitonin? - ANSWER -decreases calcium levels in the blood and increases calcium levels in the bone. puts calcium back into the bones. What electrolyte is affected by parathyroid hormone and calcitonin? - ANSWER - calcium What is Cushing's disease? - ANSWER -caused by excessive glucocorticoids from either a pituitary tumor or tumor or adrenal cortex or secondary to prescribed glucocorticoids S/S of Cushing's Disease - ANSWER -hyperglycemia, loss of muscle and bone, excess water and salt retention, weight gain, edema, hypernatremia, characteristic signs: moon face and the buffalo hump due to swelling and redistribution of fat, high BP and blood volume What is Addison's disease? - ANSWER -caused by adrenocortical insuffiency from not having enough steroids or glucocorticoids. Primarily from autoimmune conditions or removal of the adrenals, secondary to removal of corticosteroid therapy S/S of Addison's disease - ANSWER -weight loss, salt wasting of fluids, weakness, malaise, hyperpigmentation or bronzing of skin, hypoglycemia, and hyperkalemia. Reduced cardiac output, inadequate blood volume, low blood pressure

Hypothyroidism causes - ANSWER -caused by cells attacking the thyroid gland or surgical removal of tissues, iodine deficiency. Leads to a lack of T3/T4 and too much of TSH. The TSH recognizes the lack of the T3/T4 so more is pushed into it yet the thyroid cannot produce it. Lab values for hypothyroidism - ANSWER -elevated TSH, low T3/T S/S hypothyroidism - ANSWER -low metabolism, weakness, lethargy, cold intolerance, low appetite, bradycardia, weight gain, dry skin, constipation, depression, difficulty concentrating, menstrual problems Hyperthyroidism causes - ANSWER -excessive iodine, Graves' disease, nonmalignant thyroid tumors, thyroid inflammation, and taking large amounts of thyroid hormone replacement Lab values for hyperthyroidism - ANSWER -High T3/T4 levels, low TSH S/S of hyperthyroidism - ANSWER -exophthalmos or eye budging, lid lag, vision changes, light sensitivity, high metabolism, rapid weight loss, insomnia, restlessness, cannot concentrate, tremors and irritability, palpitations, heat intolerance, diaphoresis, diarrhea, amenorrhea type 1 diabetes mellitus patho - ANSWER -the inability for one to produce insulin needed to transport glucose into cells. They are insulin dependent. The beta cells in the pancreas are destroyed or not present. No insulin to stimulate production of glucagon, causing glucose levels to rise. What must type 1 diabetes do with their condition? - ANSWER -take lifelong insulin

type 2 diabetes mellitus - ANSWER -caused by the cells of the pancreas becoming resistant ot insulin, and decrease of receptors on the target cells. They lose the ability to respond to cells. Results in decreased insulin production. What must type 2 diabetics do with their condition? - ANSWER -take insulin or oral diabetic agents. can have a low sodium diet and exercise regularly to keep stress levels low, keep their blood pressure low and weight gain at a minimum Normal blood sugar range - ANSWER -60-120 Hypoglycemia blood sugar levels - ANSWER -lower than 60 Hyperglycemia blood sugar levels - ANSWER -above 120 How do we diagnose diabetes? - ANSWER -random sampling of blood glucose over 200 mg, fasting blood glucose level of 126, or and Hgba1C over 6.5 Normal A1C level - ANSWER -4-6 Diabetic A1c level - ANSWER -above 6.5 Where should any diabetic aim their A1C level to be at? - ANSWER -less than 7 S/S of hyperglycemia - ANSWER -Dry mouth, increased thirst, blurry vision, weakness, headache, frequent urination "sugar high"

S/S of hypoglycemia - ANSWER -cold, pale, sweating, sleepy, lack of coordination, irritability, hunger Which takes priority: hyperglycemia or hypoglycemia? - ANSWER -hypoglycemia What do we need to do to treat hypoglycemia? - ANSWER -by giving 15g of carbs or D50 over time and rechecking the sugar every 15 minutes What are the 3 P's of diabetes? - ANSWER -polyuria, polydipsia, polyphagia Explain polyuria - ANSWER -increased urination Explain polydipsia - ANSWER -increased thirst Explain polyphagia - ANSWER -increased hunger Primary Brain Injury - ANSWER -occurs as a direct result of the initial insult to the brain Examples primary brain injury - ANSWER -stroke, concussion, trauma Secondary Brain injury - ANSWER -occurs as the response to the initial impact or trauma. Can be progressive damage resulting from the body's response to the initial insult

Examples of secondary brain injury - ANSWER -brain swelling secondary to stroke or trauma What is intracranial pressure? - ANSWER -the volume of the craniums brain tissue, CSF, and blood, overall pressure in the skull and spinal cord What is increased ICP? - ANSWER -occurs when there is a rise in pressure from trauma, stroke, swelling, tumor, obstruction, etc. There is often compression occurring from the skull that does not allow the brain to expand, adding to the pressure becoming high Result of increased ICP - ANSWER -cutting off of the blood supply, tissue damage, ischemia, hypoxia and eventually necrosis. brain cannot expand Normal ICP range - ANSWER -0-15 mmHg Increased ICP range - ANSWER -above 15 mmHg S/S of increased ICP - ANSWER -LOC changes, headache, vomiting, drowsiness, impaired speech, low arousal, blurry vision, impaired pupil responsiveness to light reflex, unequal pupil size, fixed and dilated pupils, altered respiratory pattern, lack of movement Explain the Glasgow Coma Scale - ANSWER -A scale that measures the degree or level of consciousness (LOC is always number #1 with neurological assessment) What 3 categories is the Glasgow coma scale based on? - ANSWER -eye opening, verbal utterances, and motor reactions

Mild Range Glascow coma scores - ANSWER -Above 12 Moderate Range Glascow coma scores - ANSWER -9-12 Severe Range Glascow coma scores - ANSWER -less than 8 What score does it mean a patient is dead on the Glasgow coma scale? - ANSWER -3 or less What is the most powerful predictor of outcome according to the Glasgow coma scale? - ANSWER -motor response Explain decorticate posturing - ANSWER -abnormal flexion towards the core of the body Explain decerebrate posturing - ANSWER -abnormal extension away from the body What is an ischemic stroke? - ANSWER -From a sudden blockage of the cerebral artery secondary to a clot or emboli formation. Associated with atherosclerosis and clotting disorders and cardiac conditions that can push the clot to the brain. Most common type of stroke is? - ANSWER -ischemic stroke

S/S of ischemic stroke - ANSWER -contralateral paralysis (Right brain controls left side, left brain controls right side) on one side of the body, facial drooping, ptosis, hemi-sensory loss, contralateral visual blindness, aphasia or speech difficulty What is a hemorrhagic stroke? - ANSWER -results from a bleed within the brain. From secondary to severe and chronic hypertension, severe head trauma, aneurysm, weakness or rupture of a vessel, anticoagulant use, or arteriovenous malformation. S/S of hemorrhagic stroke - ANSWER -one sided weakness, someone with right sided weakness - has a problem on the left side of the brain, drop on face, headache caused by bleeding, difficult to communicate, high blood pressure, impaired vision, nausea, seizures, unequal pupils, difficult respiration How do we diagnose a stroke (type and location)? - ANSWER -Brain CT scan Explain meningitis - ANSWER -inflammation of the meninges of the brain Causes of meningitis - ANSWER -strep pneumonia, meningococcus, hemophilic influenza or can be viral. it reaches the person through the ears S/S of meningitis - ANSWER -headache, fever, stiff neck (patient cannot touch chin to chest without pain), photophobia, purple rash, confusion delirium Explain encephalitis - ANSWER -inflammation of the brain with swelling Causes of encephalitis - ANSWER -west nile virus, HSV, equine cephalitis