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| 2545266226 | What is a cerebral angiogram? | provides visualization of the cerebral blood vessels. | 0 | |
| 2545275926 | What is digital subtraction angiography? | substracts the bones and tissues from the images, providing x-ray with only the vessels apparent.The procedure is performed within the department, because x-ray images provide documentation of blood vessel integrity. | 1 | |
| 2545294344 | What is cerebral angiogram used for? | To assess blood flow to and within the brain, To identify aneurysms To define vascularity of tumors (for surgery). Also used in therapy to inject medications that treat blood clots or to administer chemotherapy. | 2 | |
| 2545312658 | How is impaired blood flow translated in the angiogram? | blockages in the arteries or veins in the head and neck | 3 | |
| 2545321420 | What is indicated to open blockage in arteries and veins of the head and neck? | Surgical procedure | 4 | |
| 2545330528 | Why are risks to the fetus versus the benefits of the information obtained prior to cerebral angiogram for a pregnant women? | Radiation may endanger the fetus | 5 | |
| 2545336948 | What are nursing actions for patient going for an angiogram? | 1. Pt is NPO 4-8hr before procedure 2. check for allergy to shellfish or iodine (if yes, different contrast used) 3. check for history of bleeding 4. ensure that no jewelry are worn 5. give a mild sedative prior to procedure 6. monitor VS continuously during the procedure | 6 | |
| 2545349660 | What does the nurse teach the patient going for a cerebral angiogram? | Tell client to not move during the procedure, and to keep the head immobilized. | 7 | |
| 2545361159 | Where is the catheter inserted during the cerebral angiogram? | Catheter is placed into an artery usually the groin or the neck, dye is injected, x-rays images are taken. Catheter is removed once pictures are taken. | 8 | |
| 2545377642 | What are postprocedure nursing actions for a cerebral angiogram? | closely monitor the site to assure that clotting occurs restrict movements for 8-12 hr to prevent rebleeding at the catheter site. | 9 | |
| 2581017664 | What are complications related to a cerebral angiogram? | Risk for bleeding at the entry site | 10 | |
| 2581024407 | What should the nurse do if bleeding occur? | Reinforce dressings without removing, apply pressure and notify the prescriber. | 11 | |
| 2581028949 | What is a CT scan? | A Ct scan provides cross-sectional images of the cranial cavity. Sometimes a contrast media is used to enhance the images. | 12 | |
| 2581047289 | When is a CT scan indicated? | to identify tumors and infarctions to detect abnormalities to monitor response to treatment to guide needles use for biopsies | 13 | |
| 2581054412 | How are findings of the CT scan interpreted? | A surgical procedure may be indicated if a tumor or vascular abnormality is identified. | 14 | |
| 2581059386 | What are Preprocedure for a CT scan? | 1. If client is pregnant risk need to be outweigh 2. If contrast media is used and or sedation, tell patient to remain NPO 4-8hr before the procedure; check for allergy to shellfish or iodine, which would require the use of a different contrast media;check renal function (BUN), because contrast media is excreted by the kidneys. 3. Place a pillow in the small of the client's back to prevent back pain because patient must be supine for procedure. 4. secure client's head to prevent unnecessary movement during the procedure 5. Ensure that client is not wearing jewelry. | 15 | |
| 2581091883 | What are intraprocedure for a CT scan? | client must remain supine with the head stabilized during the procedure, although painless, a sedative may be provided for a CT scan. | 16 | |
| 2581096247 | What are postprocedure nursing actions for a CT scan? | 1. No follow up care is necessary 2. if contrast media was used, monitor site to assure that clotting has occured. 3. if client was sedated, monitor until stable | 17 | |
| 2581101566 | What is an EEG? | An EEG is a non invasive procedure that assesses the electrical activity of the brain and is used to determine if there are abnormalities in brain wave patterns. | 18 | |
| 2581106593 | When is an EEG indicated? | to identify and determine seizure activity to detect sleep disorders and behavioral changes | 19 | |
| 2581138130 | How are findings interpreted in the EEG? | Location of abnormal wave patterns may indicate site of brain that is stimulating seizure activity. | 20 | |
| 2581143164 | What are nursing actions preprocedure for an EEG? | 1. review medications with the provider to determine if they should be discontinued prior to the test 2. instruct client to withhold caffeine the day of the test 3. instruct client to wash hair before the test and not use oil or sprays on the hair 4. instruct client to wash hair after the test to remove electrode glue 5. if prescribed, instruct the client to induce sleep deprivation the night before the procedure by awakening at 2 am-3 am and stay awake for the rest of the night 6. instruct the client to withhold medications that are CNS stimulants or CNS depressants and antiepileptic medications, if instructed by provider. 7. inform client that they may be asked to take deep breaths and/ or will be exposed to flashes of light during the procedure. 8. Reassure client that test is not painful | 21 | |
| 2581196755 | What are intraprocedure for an EEG? | The test takes about 1 hour and there is no risks associated with it Small electrodes are placed on scalp and connected to a brain wave machine or computer while client rest in a chair or lying in bed. Sedation may be given by IV to induce sleep electrical signals produced by the brain are recorded by the machine or computer in the form of wavy lines which documents brain activity notations are made when stimuli are presented or when sleep occurs. (flashes of light or pictures may be used to assess client's response to stimuli) | 22 | |
| 2581221326 | What are postprocedure nursing actions for an EEG? | Instruct client that normal activities can be resumed. | 23 | |
| 2581225608 | What is GCS (Glasgow Coma Scale)? | assessment that focuses on neurologic function to determine level of consciousness and monitor response to treatment. | 24 | |
| 2581274469 | How is the GCS reported? | As a number, which allows providers to immediately determine if neurologic changes have occurred. | 25 | |
| 2581281590 | When is GCS indicated? | to determine changes in the level of consciousness for clients with head injuries, space occupying lesions, cerebral infarctions, and encephalitis. | 26 | |
| 2581290265 | How are findings in the GCS interpreted? | The GCS score correlate with the degree or level of coma The best score is 15 = no injury < 8 is severe head injury or coma 9 to 12 is moderate head injury > 13 is minor trauma | 27 | |
| 2581306148 | Explain the GCS procedure? | GCS is calculated by using appropriate stimuli (a painful one may be necessary) and client's response in 3 areas is assessed: eye opening, verbal response, motor response Eye opening: Total score 4 to 1 4= spontaneous eye opening 3= eye open when client hears a voice 2= eyes open when client is subject to pain 1= eyes do not open Verbal response: Total score 5 to 1 5= conversation is coherent 4= conversation is incoherent and disoriented 3= words are spoken but inappropriately 2= sounds are made, but no words 1= vocalization does not occur Motor response: Total score 6 to 1 6= follows command 5= local reaction to pain 4= general withdrawal to pain 3= decorticate posture (adduction of arms, flexion of elbows and wrists present) 2=decerebrate posture (abduction of arms, extensionof elbows and wrists present) |  | 28 |
| 2581376780 | How can a GCS be reported sometimes? | In critical situations, where head injury is present and close monitoring is required, subscale results may also be documented. A GCS may be reported as a single number, indicating the sum of the subscales (3 to 15), or as 3 numbers, one from each subscale result, and the total (E3 V3 M4=GCS 13. This allows provider to determine specific neurologic function. | 29 | |
| 2581392231 | What is a lumbar puncture (Spinal tap)? | A lumbar puncture is a procedure in which a small amount of cerebrospinal fluid is withdrawn from the spinal canal and then analyzed to determine its constituents. | 30 | |
| 2581398428 | When is a lumbar puncture indicated? | to detect presence of certain diseases like in multiple sclerosis, syphillis, infection and malignancies to administer medication or chemotherapy directly to spinal fluid | 31 | |
| 2581405913 | How are lumbar puncture findings interpreted? | Presence of red or white blood cells in CSF indicates an intracranial bleed or other vascular pathological process in the brain. Elevated CSF readings can also indicate increased intracranial pressure | 32 | |
| 2581414667 | What are preprocedure for a lumbar puncture? | Risks should be outweigh with patient before procedure -lumbar puncture has severe complications specially if done with presence of increased intracranial pressure (brain herniation) - lumbar punctures for clients with bleeding disorders or those taking anticoagulants may result in bleeding that compresses the spinal cord | 33 | |
| 2581428887 | What are nursing actions for the lumbar puncture procedure? | make sure the client is not wearing jewelry only hospital gown tell patient to void prior to the procedure position client to stretch the spinal canal (like a cannonball while on one side) or over an overbed table if sitting is preferred. | 34 | |
| 2581591127 | What are intraprocedures for the lumbar puncture? | area of the needle insertion is cleansed and a local anesthesia is injected. not a painful procedure; should be little need for pain or relaxing med other than the local anesthesia needle is inserted and the CSF is withdrawn, after which needle is withdrawn a manometer may be used to determine the opening pressure of the spinal cord,which is useful if increased pressure is a consideration | 35 | |
| 2581618413 | What are postprocedure for the lumbar puncture? | CSF is sent to pathology Monitor puncture site Have client lie for several hours to ensure that the site clots Once stable, advice client to resume activities | 36 | |
| 2581626229 | What are some complications of CSF leakage? | If clotting does not occur, CSF may leak, resulting in a headache and increasing the potential for infection | 37 | |
| 2581631979 | What is an MRI Scan? | An MRI scan provides cross-sectional images of the cranial cavity. A contrast media may be used to enhance images. MRI images are obtained using magnets compared to CT scans, thus radiation is avoided making it safer from pregnant women. | 38 | |
| 2581654334 | What clients should avoid MRI? | clients with pacemakers clients with surgical clips clients with IV access ports (shielding may be done to prevent injury) | 39 | |
| 2581675540 | What is equipment must be used to monitor patient while having an MRI? | MRI approved equipment to monitor vital signs provide ventilation/oxygen assistance | 40 | |
| 2581682248 | When is MRI indicated? | used to detect abnormalities monitor response to treatment guide needles used for biopsies | 41 | |
| 2581690166 | What are MRIs capable of? | discriminating soft tissue from tumor or bone (so more effective to determine tumor size and blood vessel location) | 42 | |
| 2581698017 | How are findings of the MRI interpreted? | detailed 3 dimensional pictures provide location and size of cranial pathology, such as tumors, arteriovenous malformations, other vascular disorders. | 43 | |
| 2581713396 | What are nursing actions preprocedure for an MRI? | Ensure that client is not wearing jewelry If client is to be sedated, NPO 4-8hr prior to procedure determine if client is claustrophobic and explain the tight space and noise providers and family members who are in proximity while patient is being scanned should remove jewelry, pagers, phones to prevent damage to themselves or the magnet place a pillow in the small of the client back to prevent back pain because patient will be supine during the test secure client head to prevent unnecessary movement. | 44 | |
| 2581731545 | What are intraprocedure for the MRI | Client must stay supine with the head stabilized The scan is noisy and earplugs or sedation may be provided | 45 | |
| 2581739156 | What are postprocedure nursing actions for the MRI? | No follow up care is required if contrast media was injected, monitor the site to assure that it had clotted if client was sedated, monitor until stable` | 46 | |
| 2581746861 | What is a PET and SPECT Scans? | They are nuclear medicine procedures that produce 3 dimensional images of the head. These images can be static (depicting vessels) or functional (depicting brain activity) | 47 | |
| 2581755678 | What is done during a PET and SPECT scan? | A glucose based tracer is injected into the blood stream which initiates regional metabolic activity and thus documented by the PET/SPECT scanner | 48 | |
| 2581762035 | What may be done after a PET/SPECT scan? | a CT scan because it may provide information regarding brain activity and pathological location | 49 | |
| 2581766849 | When is a PET/SPECT scan indicated? | to capture regional metabolic activity and is most useful in determining tumor activity and /or response to treatment. to determine the presence of dementia, indicated by the inability of the brain to respond to the tracer. | 50 | |
| 2581779159 | How are finding of the PET/SPECT interpreted? | PET/SPECT scans are able to determine the areas of the brain that are and aren't functioning. This tool can help provide diagnostic evidence of dementia. | 51 | |
| 2581789464 | What are preprocedure for the PET/SPECT scan? | PET/SPECT scans use radiation, thus the risk/benefit consequences for a pregnant mus be discussed. check for a history of diabetes mellitus because if client is diabetic, his medications may need to be altered to prevent hyperglycemia or hypoglycemia before and after the procedure. | 52 | |
| 2581804452 | What are intraprocedure for the PET/SPECT scan? | While the pictures are being obtained, client must remain flat with the head restrained. Procedure is not painful and sedation is rarely used. | 53 | |
| 2581811633 | What are nursing actions for the PET/SPECT scan procedure? | No follow up care after a PET/SPECT tracer glucose is short acting (< 2hr), broken down in the body, it is not excreted. | 54 | |
| 2581817175 | What is an X-Ray? | An x-ray uses electromagnetic radiation to capture images of the internal structures of an individual | 55 | |
| 2581822743 | How are the structure images on x-rays? | A structure's image is light or dark relative to the amount of radiation the tissue absorbs. The image is recorded on a radiograph, which is black and white image that is held to a light for visualization. Some are digital and immediately available. Interpretations are made by a radiologist. | 56 | |
| 2581833815 | When are x rays indicated? | to diagnose possible skull or spinal fractures to determine cause of paralysis or paresthesia and increasing neurological deficits. | 57 | |
| 2581838857 | How are findings of x rays interpreted? | x rays of the skull, spine, can reveal fractures, curvatures, bone erosion, dislocation, possible soft tissue calcification all of which can damage the nervous system. | 58 | |
| 2581849640 | What are nursing actions for the preprocedure of x-rays? | no special x-ray preprocedure protocol if contrast is not used. x rays are first diagnostic tool used after an injury to rule out cervical spine fracture in head trauma. They are done without any special preparation. However, pregnancy must be determined, jewelry must be removed, clothing should not cover the area to be x-rayed. explain to patient that the amount of radiation used in contemporary x ray machines is relatively very small. | 59 | |
| 2581860374 | How are intraprocedure of x-ray done? | instruct client to remain still during the procedure | 60 | |
| 2581874510 | What are nursing actions for the post procedure of x-rays? | no postprocedure care is required, just tell client when result will be available | 61 | |
| 2581885975 | A nurse is caring for a client scheduled for a cerebral angiogram with contrast dye. Which of the following client responses should the nurse communicate to the provider? (select all that apply) | 1. I may be pregnant. 2. I take coumadin 3. I am on an antihypertensive 4. I am allergic to shellfish 5. I am allergic to latex Answer: 1,2,4 Rationale:the provider should be notified of clients who are or could be pregnant due to the risks to the fetus secondary to exposure of radiation. Allergies to shellfish or iodine are also contraindications to contrast dye. A client taking warfarin (Coumadin) should also be reported to the provider due to the potential for bleeding postprocedure. There are no contraindications to contrast dye in clients who are on antihypertensives or are allergic to latex. | 62 | |
| 2581945966 | A nurse is providing education to a client who is to undergo and electroencephalogram (EEG) the next day. Which of the following should the nurse include? | 1. Do not wash hair the morning of the procedure 2. You will be given an analgesic prior to the test 3. The procedure will take approximately 15 min 4. You will need to lie flat for 4 hr after the procedure Answer: 2 Rationlale: This test is non invasive and does not cause any pain. There is no indication for pain medication prior to the test. The client may be given sedation for IV infusion to induce sleep. The client should be instructed to wash hair prior to the procedure. An EEG usually takes approximately 1 hour and there are no activity restrictions post procedure. | 63 | |
| 2581989268 | A nurse is collecting data from a client who was admitted to the medical surgical unit 12 hours ago after falling off a ladder and hitting his head. The client is drowsy, but responds to verbal commands, and opens his eyes when the nurse calls his name. He is oriented to time, place, and person. The nurse should document that the client's GCS score is which of the following? | 1. 15 2. 14 3. 13 4. 12 Answer: 14 Rationale: The client's GCS score is 14. Eye opening response is 3 (secondary to voice); verbal response is 5 (coherent and oriented to conversation); motor response is 6 (follow commands) 3+5+6=14 | 64 |
