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Test 1 Flashcards

1
Q

What is myasthenia Gravis and what are medications to treat it?

A

An auto immune disease where body has inability to transmit nerve impulses to voluntary muscles.

Meds- mestinon (neotigmine bromide), prostigmin, and mytelase (ambenonium chloride) to increase acetylcholinesterase neuromuscular function

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2
Q

What is Glasgow’s coma scale?

Score of 15 indicates-

Score of 7 or less -

Score of 3 or less -

A

And objective tool used for assessing consciousness and clients

15- fully oriented person

7- consider state of coma

3- lowest possible score/deep coma (no response )

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3
Q

What to do for low Glasgow’s coma scale scores?

A

Physician must be notified immediately and measures taken to decrease intracranial pressure

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4
Q

Pulpillary reactions and how to get a response ?

A

Size (symmetry), equality, and rounded of pupils may change and are assessed

Measure in mm

React to light by shinning a penlight obliquely into clients eye from outer edge of eye toward the center of eye.

Reaction may be brisk, sluggish, consensual,or non reactive

PERRLA is used when reaction is normal

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5
Q

What is a TIA?

A

Mini strokes and frequently precede a stroke. Which is caused by temporary impairment of blood flow to the brain

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6
Q

Risk factors of TIAs?

A

HTN , diabetes, atherosclerosis, aneurysm, cardiac disease , high blood cholesterol, obesity, sedentary lifestyle, smoking, stress, drug abuse (cocaine) , use of oral contraceptives, ppl with more than one of these are at greater risk

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7
Q

Types of TIA strokes -

Occurs as a result of an obstruction with in a blood vessel supplying blood to the brain.

Occurs when weakened blood vessel ruptured and bleeds.

Caused by a temporary clot.

A

Ischemic (clots)

Hemorrhagic

Transient ischemic attack

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8
Q

What meal safety precautions one should take with Parkinson’s disease ? When taking levodopa

A

Avoid a high protein diet

Protein may interfere with the medication absorption of levodopa into the brain.

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9
Q

Diagnostic testing of meningitis and encephalitis (swelling of brain)

A

Lumbar puncture

CBC

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10
Q

Treatment of meningitis / encephalitis and nursing interventions

A

Give Fluids to rehydrate client

Place client in isolation to avoid spreading virus

Antibiotics or anti-infectives

Corticosteroids and diuretics given for cerebral edema

Anticonvulsants to prevent seizures

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11
Q

What to teach a pt about anticonvulsant medications ?

A

Used to control seizures

Start one at a time and gradually increase doses

When d/c gradually decrease

Abrupt withdrawal can cause status epilepticus which is a prolonged seizure lasting at least 30 min

Monitor blood level for therapeutic range

Monitor for side effects of drug toxicity

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12
Q

Head injuries include trauma to where ?

A

Scalp, skull, brain

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13
Q

Caused by injuries of accreditation such as Baseball bat, car fourth, rotational force or whiplash, bullet

A

Brain injuries

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14
Q

Type of injury ? Skull fractures and penetrating injuries : bleeding from nose, ears , mouth , eyes.

*fluid may leak from ears

A

Open head injury

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15
Q

These Injuries are caused by blunt force it to the head such as concussion and laceration

Hemorrhage in the brain, hematomas,Cerebral Adema

A

Closed head injury

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16
Q

Device used for draining and maintaining adequate O2 levels and perfusion in brain after head injury

A

ICP

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17
Q

Other treatment for head injury?

A

Surgical decompression - alllows excess drainage

Meds - corticosteroids, muscle relaxants, diuretics, antacids

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18
Q

Early warning signs of severe head injury?

A

Consciousness, abnormal eye movement , pupil changes, abnormal vital signs, abnormal pulse , muscle weakness, muscle twitching, nausea, vomiting, visual or hearing disturbances

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19
Q

Nursing interventions for head injury?

A

Monitor I &O

Elevate head 30-40 degrees

Maintain airway and O2

Fluid restrictions

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20
Q

What is the purpose of suctioning in severe head injury patients ? Risks?

A

To decrease pulmonary complications

Risks include possible sudden increase in intercranial pressure (icp) and may cause further cerebral damage

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21
Q

Repositioning after back surgery?

A

Reposition using log roll turning to prevent injury to vertebrae and spine

Avoid twisting and limit sitting and bending

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22
Q

Chronic progressive degenerative disease of central nervous system - loss of myelin

A

MS - multiple sclerosis

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23
Q

What causes MS ?

What can trigger it ?

A

Autoimmune disease -

inflammation in the CNS the inflammation damages myelin which decreases nerve impulses in the body.

Stress , infections , pregnancy , trauma , fatigue,hit bathes or strenuous activity

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24
Q

Goals of MS ?

A

Reduce flare ups by:

taking medications ,

eating healthy diet,

exercise and staying active and independence

reduce stress, infections, and fatigue

Proper fluid intake

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25
What kind of paralysis can spinal cord injuries cause?
Spinal shock Areflexia Flaccid paralysis Neurogenic shock Quadriplegia Autonomic dysreflexia
26
Cessation of motor , sensory, autonomic and reflex impulses
Spinal shock
27
Absence of reflexes
Areflexia
28
Hypotension situation resulting from loss of sympathetic control of vital functions from the brain such as loss of ability to sweat below injuried area - can occur after CNS damage
Neurogenic shock
29
Complete under motor neuron injury , paralysis of both arms , legs , bowel and bladder and all four limbs
Quadriplegia
30
Can cause hypertensive crisis , bradycardia , severe headache , stroke or seizures - spinal cord injury at or above the sixth thoracic vertebral level T6
Autonomic dysreflexia
31
What will help ADLs and assessment with spinal cord injuries
Immobilization of headband neck and vertebral column , spinal column Surgery : realignment of vertebral column Medications- nifedipine, nitroprusside sodium ROM and slow movements to prevent hypotension Turn client frequently Give calll light in reach Adequate nutrition and fluid intake Monitor vitals Implement bowel and bladder training regimen Assessment - Client input on pain , sensation and hx of accident Clients respiratory status, airway breathing, circulation, disability, exposure, bowel and bladder function , skin condition, neuro assesment
32
Nursing interventions for autonomic dysreflexia?
Client education on causes and symptoms Prevent bladder distention and fecal Impaction Observe for bradycardia , vasodilation, flushing, diaphoresis above site of injury Raise HOB and lower legs to reduce bp and remove constrictive clothing Asses urine for infection Monitor bp q few min
33
Chronic sensory deprivation can cause what?
Inability to concentrate Poor memory Impaired problem solving ability Confusion Irritability Mood swings Hallucinations Depression Boredom and apathy Drowsiness
34
A disorder that causes lens or its capsule to lose transparency and or become opaque Clouding develops in the eyes as well as visual impairmentsAnd is associated with aging and usually affects both eyes
Cataracts
35
What to avoid with cataracts
Avoid reaching for objects to maintain stability since depth perception is altered Heavy lifting , straining during defecation, vigorous coughing and sneezing
36
Drugs for glaucoma
Drugs that enhance pupillary constriction Miotics and choleinesterase inhibitors (cholinergic agonists) timolol maleate Pilocarpine hydrochloride Betagan, diamox, alphagan
37
What does a hearing aide do?
It amplifies sounds to make them louder in order for one to hear better Convert environmental sound and speech into electronic signals that are amplified and converted to acoustic signals
38
Nursing diagnosis of hearing loss
Social isolation related to hearing impairment
39
Nursing diagnosis of cataracts
Disturbed visual sensory perception Risk for injury - due to processing visual images and depth perception Home impaired maintenance- related to age limited vision or activity restrictions due to surgery
40
Interventions for hearing loss:
Hearing aids , surgical cochlear implant, how to mange such as using interpreter , writing notes, texting, computer, inform people who
41
Hearing loss caused by damage to the inner ear or the nerve from the ear to the brain.
Sensorineural hearing loss
42
occurs when there is a problem conducting sound waves anywhere along the route through the outer ear, tympanic membrane (eardrum), or middle ear (ossicles).
Conductive hearing loss
43
caused by a combination of conductive damage in the outer or middle ear and sensorineural damage in the inner ear (cochlea) or hearing/auditory nerve.
Mixed hearing loss
44
Also know as endolymphatic hydrops An inner ear disorder that causes episodes of vertigo (spinning, tinnitus , uninlateral fluctuating hearing loss)
Ménière’s disease
45
Delivers radioactive isotopes directly within the body by sealed or unsealed sources. To kill cancer in the body.
Internal radiation
46
Nursing interventions for internal radiation ?
Prepare pt outside of room Several nurses for lessened time Wear lead apron or shield device ??
47
What labs to look for with chemotherapy
Look at platelet levels count <50,000 or less indicates bone marrow dysfunction , wbc of <500 indicates neutropenia and RBC levels ?
48
A general state of ill health involving marked weight loss and muscle loss.
Cachexia
49
What foods to eat with cachexia ?
Small portions of complex carbohydrates High calorie diet , no sugar
50
How to treat pain with cancer ?
Non invasive techniques such as heat, cold pack, massage, relaxation techniques, imagery, and hypnosis. Drugs- Skin patches , slow release tablets, client controlled pumps Nonopiods are the first step in nonopiods for mild to moderate pain Morphine Neurosurgical procedures such as nerve blocks
51
Telepathy Or High energy radiation delivered on outpatient basis
External radiation
52
Side effects of external radiation
Skin reactions, G.I. discomfort abdominal cramping, diarrhea, loss of appetite, and fatigue
53
What is used to protect skin and main gain position in external radiation
Customized shielding blocks and immobilization device ??
54
Radioactive implants place under anesthesia using radiological guidance. Lower dose permanent implants typically used . For internal radiation
Brachytherapy
55
Risks for cancer ?
Smoking or tobacco use Family hx Age Hormones Over exposure to the sun and indoor tanning Unhealthy diet Not exercising Not getting tested /examinations Not getting enough sleep Unhealthy weight Unprotected sex Chronic inflammation Immunosuppression Alcohol Fair complexion
56
Foods that increase cancer risk?
High fat foods/ red meats and high fat meats Processed meat Salt, sugar , and oily foods Alcoholic beverages
57
How to decrease risk of cancer ?
Do not smoke , or use tobacco Avoid tanning beds and sun Healthy diet Exercise Physical examination Sleep Self exam Healthy weight Protected sex Safety in work place client
58
What to monitor with thrombocytopenia?
Signs of bleeding , labs (low platelet count, Hgb, Hct, prolonged bleeding time. Bowel movements/constipation, pain, vital signs, and mental status.
59
Low level | Of platelets in the blood
Thrombocytopenia
60
Abnormally low count of a type of white blood cells?
Neutropenia
61
What kinda of food to eat with neutropenia?
Nothing that could be undercooked. PasteriZed dairy Cooked veggies and fruit Starches Protein
62
Care for people who are terminally ill who are expected to die In 6 months or less woh dignity in the comfort of the persons choice surrounded by loved ones
Hospice
63
seizure that involves loss of consciousness and violent muscle contractions
Tonic clonic seizure
64
Nursing interventions for tonic clonic seizures?
Turn client to the side to allow secretions to drain from the airway. Prepare to suction oropharynx if necessary Asses skin color and respiratory rate and depth after seizure Give O2 PRN Do not insert anything into mouth Loosen restrictive clothing Observe for injuries After seizure , asses airway and turn to side Ease client to the floor when it begins in supine positions If I’m bed, use blankets or protective pads to line side rails Low stimulative environment Wear medical id tag Client teaching of safe environment
65
Prepares the body for intense physical activity (fight or flight response)
SNS
66
Relaxes the body and inhibits it slows high energy functions ? (Conserves and restores)
PNS
67
Response to stress and prepares the body to react to danger part of the autonomic nervous system. Maintains homeostasis
Fight or flight response
68
The loss of full control of bodily movements
Ataxia
69
Posture of abnormal posturing in which a person is stiff with bent arms, clenched fists , and legs held out straight. Arms are bent in torwards body and the wrists and fingers are bent and held on the chest. The posture is a sign of severe damage in the brain
Decorticate
70
A sensation perceived by a patient that proceeds a condition affecting the brain. It often occurs before a migraine or seizure. It may consist of flashing lights, a gleam of light, blurred vision, and order, the feeling of a breeze, numbness, weakness, or difficulty in speaking.
Aura
71
What may leak through ears in open head injury?
Cerebral fluid make leak through ears
72
What to do when some one has IV site pain?
Inspect site and remove needle if swelling
73
What causes diarrhea in ppl with cancer And what to eat and drink?
Chemo, Radiation, surgery, bone marrow stem cell transplant, Infections, stress and anxiety, cancer it’s self Drink clear liquids, eat low fiber foods, frequent small meals, foods that are high in potassium, probiotics, avoid foods that irritate your digestive tract
74
Earliest indicator in neurological status? Exam
Level of consciousness , motor function, eye movement, pupil size and reaction, protective reflexes and vital signs
75
What is mental status and What to look for in change of mental status?
Ones Orientation, Memory, calculation, and fund of knowledge Level of consciousness
76
What is an internally planted device falls out?
Do not touch , put into a radioactive container, inform radioactive officer
77
Seizure med side effects?
Drowsiness , diZzy, gastric distress, rash , blood dyscarsias, ataxia
78
Signs and symptoms of ICP?
Headache nausea vomiting confusion , increased bp, pupils don’t respond to light , coma, seizures,shallow breathing
79
Signs and symptoms of ICP?
Headache nausea vomiting confusion , increased bp, pupils don’t respond to light , coma, seizures,shallow breathing
80
Most important vital sign to take with stroke ?
Bp
81
Goal of cataracts for pts ?
20/20 vision Eyelashes, lids , conjunctiva and structures inside eye do not have defects
82
Affects only one limb and is associated with cerebral palsy
Monoplegia
83
Affects one arm and one leg on the same side of body
Hemiplagia
84
Paraplegia affects what?
Affects both legs
85
Affects both arms and legs
Quadriplegia
86
Assessment of spinal cord injury?
Neuro evaluation of motor and sensory function of extremities below herniated area Reflex testing ROM of affected area Clients knowledge about disease , treatment and pain management and surgery and post care Bowel and bladder elimination Note gait alterations and bending limits ``` Vitals Skin conditions O2 status B and B Immobility complications ```
87
_____ is the pressure exerted by a source. When light is hitting a surface it is also pushing down on the surface
Radiation pressure
88
is a mixture of electromagnetic waves ranging from infrared (IR) to ultraviolet rays (UV). It of course includes visible light, which is in between IR and UV in the electromagnetic spectrum
Radiation from the sun

PN3 (4 decks)

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