Neurosensory And Musculoskeletal

Question 1

Osteoarthritis

Answer 1

Crepitus with joint movement
Decreased ROM
Joint pain resolved with rest

Question 2

Amyotrophic lateral sclerosis

Answer 2

1 monitor pulse ox

Frequent rest periods

Medicare for pain on regular schedule

Admin baclofen for spasticity

Question 3

Right hemispheric stroke

Answer 3

Impulsive behavior
Poor judgment
Lack of awareness
Neurological deficit on left side

Question 4

Left Hemispheric stroke

Answer 4

Inability to read

Aphasia

Question 5

Carbidopa-levodopa

Answer 5

Orthostatic hypotension
Avoid high protein foods
Expect dark colored secretions
Can take weeks-months to take effect

Question 6

Recombinant tissue plasminogen activator

Answer 6

Embolism stroke

Dissolves blood clot

Question 7

Med used for Hemophilia

Answer 7

Recombinant factor VIII

Question 8

Med used for Angina

Answer 8

Nitroglycerin

Question 9

Med used for ventricular dysrhythmias

Answer 9

Lidocaine

Question 10

Viral meningitis intervention

Answer 10

Check capillary refill every 4 hr

Vitals and neurological status every 4 hr

Reduce exposure to light

Question 11

Multiple sclerosis

Answer 11

Intention tremors

Hyperactive deep tendon reflexes

Question 12

Gillian Barre syndrome

Answer 12

Ascending paralysis

Question 13

Myasthenia gravis

Answer 13

Increased lacrimation

Tensilon test

Question 14

Manifestation of increased inter-cranial pressure

Answer 14

Restlessness

Question 15

Nursing intervention: status epilepticus

Answer 15

IV antiepileptic meds may be needed

Question 16

Administering alendronate for osteoporosis

Answer 16

8oz water

Remain upright 30 min after

Question 17

Bisphosohonates

Answer 17

Decrease serum calcium

Question 18

Rheumatoid arthritis

Answer 18

Bilateral

Ulnar deviation

Question 19

Osteoarthritis

Answer 19

Unilateral

Spine fracture

Question 20

Ménière’s disease

Answer 20

Move head of bed slowly

Avoid consuming foods high in salt -fluid retention

Question 21

Retinal detachment

Answer 21

Flashes of bright light

Question 22

Primary angle closure glaucoma

Answer 22

Admin osmotic diuretics IV bolus

Decrease intraocular pressure and prevent damage to eye

Question 23

Spastic bladder intervention

Answer 23

Stroke clients inner thigh

Question 24

SIADH?

Answer 24

Excessive secretion of ADH

Kidneys retain water
Urine is concentrated
Urine output decreases
Extracellular volume increase

Question 25

SAIDH lab values

Answer 25

ADH above (1-5) Low serum sodium High urine sodium Increased urine specific gravity above (1.010-1.025)

Question 26

Diabetes insipidous indicator

Answer 26

Water deprivation test (hold fluids 8-12 hr) IV access Monitor for dehydration (hypotension, tachycardia, dizziness )

Question 27

Diabetes insipidous interventions

Answer 27

Increase fluids Decrease sodium

Question 28

Propranolol

Answer 28

Check pulse Monitor BP ECG Hypoglycemia monitoring

Question 29

Rheumatoid arthritis labs

Answer 29

Positive Anti-CCP antibodies Increase in RF antibody (1:40-1:60) norm is 1:20 Elevated ESR Positive C-reactive protein Elevated WBCs

Question 30

PICC

Answer 30

Initial dressing change within 24 hr placement Assess every 8 hr Change tube and cap every 3 days Obtain blood samples Change transparent dressing every 7 days Cover when showering No BP in arm with PICC

Question 31

Symptomatic Bradycardia meds

Answer 31

Atropine Isoproterenol Electric: pacemaker

Question 32

A fib, SVT, ventricular tachycardia with pulse meds

Answer 32

Amiodarone Adenosine Verapamil Electric: synchronized cardioversion

Question 33

Ventricular tachycardia without pulse OR ventricular fibrillation meds

Answer 33

Amiodarone Lidocaine Epinephrine Electric: defibrillator

Question 34

Peritonitis

Answer 34

Micro organisms in peritoneum ``` Infection Fever Purulent drainage Redness or swelling Cloudy or discolored drained dialysate ```

Question 35

Ischemic attack

Answer 35

``` Visual disturbance Dizziness Slurred speech Weak extremity Temperature monitoring Vitals Electrocardiogram Elevate head 30 degrees ```

Question 36

Thyroidectomy post op

Answer 36

Thyroid hormone replacement therapy High-Fowler’s Check surgical dressing and back of neck for bleeding Humidify air, cough, deep breath Laryngeal nerve damage (speak post op and every 2 hr) Hypocalcemia Tetany

Question 37

Mechanical ventilation interventions

Answer 37

2 staff members to reposition or resecure tube Soft wrist restraints Suction for patent airway Resuscitation bag available Resp status every 1-2 hrs

Question 38

Hypokalemia s/s

Answer 38

``` Weak, irregular pulse Hypotension Muscle cramping Decreased muscle tone Hypoactive reflexes Premature ventricular contractions dysthymia Polyuria Metabolic alkalosis Constipation ```

Question 39

Hyperkalemia s/s

Answer 39

``` Hypotension Restlessness Flaccid paralysis Premature ventricular contractions, vfib, wide QRS Hyperactive bowels Oliguria Metabolic acidosis ```

Question 40

Digoxin

Answer 40

Count pulse 60 sec If less than 60 bpm or over 100 bpm call provider and don’t admin

Question 41

Digoxin toxicity

Answer 41

Fatigue Muscle weakness Confusion Loss of appetite

Question 42

Nitroglycerin

Answer 42

Headache is expected Sit and lie down slowly

Question 43

HIV/AIDS immunizations can receive

Answer 43

``` Hep B HPV Influenza Meningococcal Pneumococcal TDaP ```

Question 44

Chest pain interventions

Answer 44

ECG pain management Urine output ABGs Cardiac enzymes Electrolytes O2 2-4L IV access Energy conservation