IT IS CRUCIAL!!
•Mental status
•LOC, Speech, Cognitive (Can write it out if intubated)
•Cranial nerves (Check ocular response, EOMS)
•Motor function (squeeze hands, wiggle feet)
•Sensory function (inflict pain to assess) - ANS-Initial baseline neuro assessment:
A change in LOC - ANS-What is the most basic and sensitive indicator of altered brain function?
Standardized tool developed for the purpose of assessing LOC
-Eye-opening
-Verbal response
-Motor response - ANS-Glasgow Coma Scale (GCS)
Motor response - ANS-What is the most powerful predictor of patient outcome?
arms flexed inward and bent in toward the body and the legs are extended
-to the core - ANS-Decorticate posturing
-"extensor posturing";
, -abduction of arms, elbow and wrist extension - ANS-Decerebrate posturing
Yes
-they may shake their head or write on a board or paper - ANS-Can we assess speech on an
intubated patient?
II, III, IV, VI - ANS-Which cranial nerves are more vulnerable to increasing ICP?
•Pupillary reflex
•"PERRLA, pupils 2+ B/L". - ANS-CN II & III
-EOMs
-"EOMs intact" - ANS-CN III, IV, & VI
patient stands up with feet together and arms out to see if they can balance
-tests for motor response
-(+)= loss of balance - ANS-Romberg's test
Mg+ - ANS-What electrolyte affects DTRs?
Decreased - ANS-If Mg+ is increased, DTRs are?
Increased - ANS-If Mg+ is decreased, DTRs are?
abnormal breathing pattern; periods of dyspnea and apnea
-rapid breathing followed by apnea - ANS-Cheyne stokes
Abnormal respiration marked by prolonged inspiration; accompanies damage to upper pons. -
ANS-Apneustic breathing
A cluster of breaths has a disordered sequence with irregular pauses between breaths. -
ANS-Cluster breathing
Irregular or unidentifiable pattern
May follow serious head injuries - ANS-Ataxic respirations
ischemia and hypoxia - ANS-As ICP rises, it compresses neural tissue and causes what?
Increases - ANS-Any increase in blood, brain, and CSF (Monro Killin Doctrine), decreases or
increases ICP?
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