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aa Orgo > 409 Final 2 > Flashcards

409 Final 2 Flashcards

1
Q

MG is an acquired ___ disease

A

autoimmune

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2
Q

MG: main characteristics are ___ and ___

A

fatigue and weakness

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3
Q

MG: pattern

A

remission and flare up

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4
Q

MG: the body is attacking itself, specifically the

A

motor nerves

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5
Q

When you’re assessing the MG patient, an organ that could be abnormal is the

A

thymus

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6
Q

Usually the onset of MG is

A

insidious, but it’s possible to have a sudden onset

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7
Q

MG: anesthesia, pregnancy, infection can cause

A

a sudden onset of MG

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8
Q

MG: characteristics of the fatigue

A

gets worse with exercise, better with rest

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9
Q

MG: even though they have the drooping lids,

A

the pupil responses will be normal

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10
Q

MG: they could have malnutrition and dysphagia because of

A

drooping jaw

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11
Q

Fortunately 2 things that are usually not an issue in MG are

A

pain and LOC

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12
Q

You can immediately confirm the dx of MG if

A

they respond to cholinergic drugs

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13
Q

Tensilon Testing

A

If the patient responds with increased muscle strength, it means they have MG

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14
Q

consideration for Tensilon Testing

A

have the antidote (atropine) ready

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15
Q

the Interventions of MG include 2 broad categories

A

treat symptoms

induce remission

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16
Q

MG interventions: treating symptoms category:

A

Anticholinesterase aka cholinergic drugs

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17
Q

MG interventions: inducing remission category:

A

Steroids, PE, thymectomy

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18
Q

MG: because of the fatigue, when should you schedule activities

A

schedule for times that they have energy, like in the morning or right after tx

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19
Q

MG: the first line drugs are ____ which improve impulses

A

Anticholinesterase aka cholinergic drugs

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20
Q

MG: Anticholinesterase aka cholinergic dose consideration

A

might need it adjusted day-today depending on symptoms

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21
Q

MG: Anticholinesterase aka cholinergic drugs adverse effect

A

Cholinergic crisis, which means the drug is working to strong. Paradoxically this causes increased weakness

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22
Q

MG: Even though cholinergic crisis and myasthenic crisis are opposite,

A

they look pretty much the same

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23
Q

MG: cholinergic crisis and myasthenic crisis can be differentiated by

A

tensilon testing. If the tensilon allows the patient to improve, then it was a myasthenic crisis

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24
Q

MG: in a cholinergic crisis give

A

atropine

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25
Q

MG: the goal of immunosuppressive drugs is to

A

induce remission

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26
Q

MG patients can have weakness in the face which makes ___ difficulty

A

talking

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27
Q

MG: Not only do they have trouble with drooping eyes,

A

they also can’t totally close the eye (so you might need artificial tears and tape them closed at night)

28
Q

MG: double vision tx

A

give them an eye patch and switch it back and forth

29
Q

MG: the goal of thymectomy is to

A

induce remission

30
Q

MG: because you could have weakness, keep the drugs

A

and a glass of water at the bedside in case you can’t get OOB

31
Q

MG: the patient should avoid

A

heat (including sun)
and
big changes in sleeping habits

32
Q

MS: The body is attacking its own

A

myelin sheaths (like in GBS)

33
Q

Just like MG, MS has a pattern of

A

remission and flare up

34
Q

MS: after a long series of remission and flare up, the damage to the nerves becomes

A

permanent

35
Q

MS: they may have unusual reflexes like

A

Babinski

36
Q

MS: if the demyelination moves to the spine, they could have

A

bladder/bowel problems

sexual dysfunction

37
Q

MS: in the LATER part of the disease you could have

A

cognitive problems

38
Q

MS: The patient may need to give themselves injections via

A

SQ

39
Q

The MS patient may need b____, d___, or d___ for muscle tremors

A

baclofen
diazepam
dantrolene

40
Q

MS: nursing interventions for the cognitive problems

A

keep a calendar in the room

keep their belongings organized

41
Q

MS: you might need to teach the family discrete signs for

A

telling the patient they’re acting inappropriately

42
Q

The main feature of ALS is

A

progressive muscle weakness that eventually leads to paralysis

43
Q

ALS: can you have cognitive changes

A

yes

44
Q

The only drug for ALS

A

Riluzole, which extends survival time

45
Q

ALS: think about referring them to

A

hospice

46
Q

A sz happens when

A

all of a sudden there’s too much stimulation in the brain

47
Q

Epilepsy is when

A

someone has 2 or more szs

48
Q

General szs means

A

its in both hemispheres

49
Q

Response to drug therapy: partial vs general szs

A

partial tends to be less responsive to drugs

50
Q

Secondary sz means

A

it results from something specific (secondary to something else)

51
Q

The most common tx of primary epilepsy is

A

drug therapy

52
Q

Warfarin can’t be mixed with

A

pheny

53
Q

The risk of break through szs can be decreased by having (3 obvious things)

A

a balanced diet
rest
stress reduction

54
Q

Part of sz precautions is making sure you have ___ ____ in case you need to give meds immediately to stop a sz

A

IV access

55
Q

Tonic-clonic sz: if the patient turns blue

A

that’s not unusual, it tends to go away on its own

56
Q

Acute szing is when

A

the szs are worse than normal

57
Q

Status epilepticus is when

A

a sz is longer than 5 min

58
Q

A sz can be lethal if it lasts for

A

longer than 10 min

59
Q

In status epi there are metabolic changes, so the effects could be widespread, for example

A

kidney failure

60
Q

The drug of choice for status epi is

A

‘pams via IV push (then as prevention of it happening again you’ll give pheny)

61
Q

If drugs don’t manage the szs, they may need surgery, for example

A

VNS

62
Q

You can’t have VNS if you have

A

generalized szs

63
Q

PD: In addition to the classic signs you can have

A

hypotension because DA affects the sympathetic nerves

64
Q

PD: anticholinergic drugs should be avoided in

A

older adults

65
Q

PD: During drug therapy, they might need a holiday is

A

toxicity or tolerance begins

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