Neurosurgical Nursing and Postoperative Care Flashcards

The nurse is caring for a patient with a lumbar drain placed for CSF diversion. The maximum recommended CSF drainage rate per hour is:

Answer: 10–15 mL/hour

Lumbar drains are typically set to drain 10–15 mL/hour; excessive drainage can cause intracranial hypotension and brainstem herniation.

After transsphenoidal surgery, the nurse instructs the patient to avoid which activity to prevent disruption of the surgical repair?

Answer: Blowing their nose forcefully

Forceful nose blowing increases intracranial pressure and can displace the sellar repair, causing CSF leak after transsphenoidal surgery.

The nurse is assessing a patient with a cervical laminectomy and notices sudden respiratory distress. The most likely cause is:

Answer: Epidural hematoma compressing the cervical cord

An epidural hematoma after cervical laminectomy can rapidly compress the spinal cord at the level of the phrenic nerve, causing acute respiratory failure.

Which test confirms the diagnosis of carpal tunnel syndrome and is considered the gold standard?

Answer: Nerve conduction study (NCS) and electromyography (EMG)

Nerve conduction studies (NCS) and EMG are the gold standard for diagnosing carpal tunnel syndrome by demonstrating slowed median nerve conduction across the wrist.

A patient is admitted for a craniotomy for resection of a right temporal lobe glioblastoma. Preoperatively, the nurse anticipates the patient may have deficits in:

Answer: Receptive language (Wernicke's aphasia) if dominant hemisphere

In most people, the left temporal lobe contains Wernicke's area; if the right hemisphere is dominant or if the dominant temporal lobe is affected, receptive aphasia may occur.

A patient with a VP shunt complains of a new severe headache with blurred vision. Non-contrast CT shows enlarged ventricles compared to prior imaging. The nurse recognizes this indicates:

Answer: Shunt malfunction with hydrocephalus

Enlarged ventricles on CT with headache and visual symptoms indicate VP shunt malfunction causing obstructive hydrocephalus requiring urgent intervention.