STUDY GUIDE-EXAM 3

NEURO: What is the Monroe-Kelly doctrine? What is intracranial pressure? Know the
normal ICP reading. What is cerebral edema and how does it develop? What is auto
regulation and what happens when it fails? Describe the different types of ICP
monitoring. What are the complications associated with ICP monitoring? What
conditions increase ICP? Why is an elevated ICP a danger? Know and describe the
clinical manifestations of increased ICP: LOC, VS (Cushings response), pupil
changes, motor changes, breathing patterns, headache and vomiting. Know the
interventions for elevated ICP-prioritization of these. What medications are used to
control ICP?
CVA: What do we say CVA is a brain attack? What are the 2 types of CVA: describe
the differences and how these impact assessment and treatment: Ischemic CVAs
are broken down into thrombotic and embolic. Hemorrhagic is broken down into
intracerebral and subarachnoid. Know and understand the modifiable and nonmodifiable CVA risk factors. What pertinent history related to CVA? FAST is a
teachable assessment tool for patients. NIH is a thorough and diagnostic
assessment tool for CVA. Understand and be familiar with these two tools. What is a
TIA and why is it significant as it relates to CVA? What are the clinical manifestations
of CVA? What are the diagnostics for CVA: prioritize these diagnostics and
understand why. What are the treatments for ischemic CVA? Describe the
contraindications for these treatments. What are the treatments for hemorrhagic
CVA? What are the complications for the treatment of patients with CVA?
Head injury: Describe the 3 types of hematomas, diagnosis and treatment: epidural,
subdural and intracerebral. Which one is a medical emergency and why? Describe a
focused assessment and use of the Glasgow assessment tool.
What is meningitis and why can it be life-threatening? What are the signs and
symptoms of meningitis? What are the diagnostics and treatments for meningitis?
What are the nursing implications for patients with meningitis? Be familiar with
encephalitis: causes, treatments and nursing implications.
Understand the implications and treatments associated with brain tumors and brain
abscesses
Understand basics regarding cranial surgery and nursing implications
SAMPLE QUESTION:
The nurse will report and elevated urine output for a patient with increased ICP
because:
A. High urine output leads to dehydration
B. High urine output leads to hypokalemia
C. High urine output leads to increased confusion

D. High urine output indicates hyperparathyroidism

CORRECT ANWSER IS D. High urine output indicates development of diabetes
insipidus and worsening ICP.
SPINAL CORD:
Understand the basics of spinal cord pathophysiology, clinical manifestations
associated with each level of spinal cord injury: cervical, thoracic, lumbar.
Remember all areas of the body: CV, respiratory, urinary, GI, etc. Also included are
the incomplete injuries for example Brown-Sequard
Understand treatments and nursing implications associated with each level of injury
mentioned above. Know appropriate nursing assessments and precautions for these
as well.
Understand how autonomic dysreflexia works and know the appropriate nursing
implications associated with this problem
Understand how neurogenic shock is manifested and what nursing measures are
involved with a patient in neurogenic shock
Understand spinal tumor, its manifestations and nursing implications