Neurosurgical Nursing and Postoperative Care Flashcards
6 cards from real CNRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Neurosurgical Nursing and Postoperative Care flashcards as text
After a craniotomy, the nurse assesses the patient and finds clear fluid draining from the nose. To determine if this is CSF, the nurse should:
Answer: Test for beta-2 transferrin and check for a halo sign on filter paper
Beta-2 transferrin is the most specific test for CSF; the halo (ring) sign on filter paper — a clear ring around a bloody center — also suggests CSF.
A patient who had a transsphenoidal hypophysectomy for pituitary adenoma develops polyuria (output 500 mL/hour) and hypernatremia. The nurse suspects:
Answer: Diabetes insipidus (DI)
Diabetes insipidus after pituitary surgery results from ADH deficiency, causing large volumes of dilute urine and hypernatremia.
Which medication is used to treat central diabetes insipidus after pituitary surgery?
Answer: Desmopressin (DDAVP)
Desmopressin (DDAVP) is a synthetic analog of ADH used to treat central diabetes insipidus by reducing urine output.
After lumbar spinal fusion surgery, the nurse assesses the surgical site and notes a bulge under the wound. The patient reports headache when upright that resolves when lying flat. The nurse suspects:
Answer: CSF leak with pseudomeningocele
A postural headache (worse upright, better supine) with a bulge under the wound after spinal surgery suggests a CSF leak and pseudomeningocele formation.
A patient with a ventriculoperitoneal (VP) shunt develops fever, headache, and stiff neck. The priority nursing intervention is to:
Answer: Notify the neurosurgeon immediately for suspected shunt infection
Fever, headache, and nuchal rigidity in a VP shunt patient suggests shunt infection/meningitis, a neurosurgical emergency requiring immediate notification.
The nurse is monitoring a patient's external ventricular drain (EVD). The drain is set to drain at 10 cmH₂O. The nurse should position the drip chamber reference point at:
Answer: The level of the tragus of the ear (foramen of Monro)
The EVD reference point (zero level) is placed at the tragus of the ear, which corresponds to the level of the foramen of Monro for accurate ICP measurement.