Cardiac

Question 1

Precautions with contrast for diagnostic testing

Answer 1

Informed consent
Any kidney damage
Allergies
Dehydration
NO on metformin or NSAIDS 24-48 hours before and after
Evaluate kidney fxn.
Provide adequate hydration before and after testing

Question 2

Assessment of migraine headaches

Answer 2

Aura develops 
Visual disturbances 
Vertigo 
Drowsiness 
N/V
Photophobia (light sensitivity)
Phonophobia (sound sensitivity )
Throbbing pain

Question 3

Factors that trigger migraine attacks

Answer 3

Alcoholic beverages 
Aged cheese
Caffeine 
Chocolate 
Fresh breads
MSG
Meats 
Anger
Fatigue
Hypoglycemia 
Hormonal fluctuations 
Stress
Different altitudes

Question 4

Cluster headache

Answer 4

30 minutes -2 hours intense unilateral pain that generally occurs in spring and fall without warning

Question 5

Assessment of cluster headaches

Answer 5

Sleep wake cycle 
Throbbing around eyes, forehead, temple or cheek 
Ipsilateral( tearing of eye)
Rhinorrhea (runny nose)
Ptosis (drooping eyelid)
Eyelid edema
Facial sweating
Miosis ( constriction of pupils)

Question 6

Health teaching for patient with epilepsy

Answer 6

Drug therapy information
Do not take any OTC drugs without talking to HCP
Wear a medical bracelet
Avoid alcohol and excessive fatigue

Question 7

Care of a patient during a tonic- clonic or complete partial seizure

Answer 7

Protect patient from injury 
Do not force anything down there throat 
Turn patient on side maintain airway 
Loosen any restrictive clothing
Maintain airway
Do not restrain or try and stop patients movements 
Record when the seizure began and ended

Question 8

At completion of seizure

Answer 8

Take patients VS
Perform neurologic checks
Keep patient on side
Allow patient to rest
Document seizure

Question 9

Nursing observations and documentation

Answer 9

Date, time, and duration 
Description of seizure 
if more than one type of seizure occurs
Where seizure began
Bod part first involved 
Changes in pupil size 
LOc
Presence of apnea 
Incontinence of bowel bladder
How long seizure lasts
When last seizure took place
Any aura 
What patient does after seizure 
How long it takes for patient to return to pre-seizure status

Question 10

Key features of meningitis

Answer 10

Decreased LOC
Disoriented to person, place, and thing
Photophobia
Nystagmus

Question 11

Seizure

Answer 11

Abnormal, sudden, excessive, uncontrolled electrical discharge of neurons within the brain
Change in LOC

Question 12

Epilepsy

Answer 12

2 or more seizures experienced by a person

Question 13

4 types of seizures

Answer 13

Generalized
Partial
Unclassified
Secondary seizures

Question 14

Generalized seizures

Answer 14

Both hemispheres

Question 15

Tonic-clonic phase of seizure

Answer 15

Lasting 2-5 minutes
Tonic: stiffening or rigidity of muscles and immediate loss of C
Clonic: jerking of all extremities; bit his tongue, or incontinintent

Question 16

Partial seizures

Answer 16

One cerebral hemispheres
Are less responsive to medical treatment
Complex partial seizure: black out for 1-3 minutes; unaware of environment

Question 17

Seizures may be caused by

Answer 17

Metabolic disorders
Acute alcohol withdrawal
Electrolyte disturbances 
Heart disease 
High fever
Stroke 
Substance abuse

Question 18

Preictal phase

Answer 18

Presence of an aura before seizure begins

Question 19

Postictal phase

Answer 19

After the seizure

Question 20

Seizure precautions

Answer 20

Oxygen
Suction equipment  
Airway
IV access
Side rails up and padded

Question 21

Seizure medications with women

Answer 21

Hormonal changes
Interaction with oral contraceptives
Teratogenicity with AED’s

Question 22

One thing that do not belong at the bedside

Answer 22

Padded tongue blades

NEVER be inserted

Question 23

Medication for tonic-clonic seizure activity

Answer 23

Ativan
Valium
Diastat
IV phenytoin

Question 24

Status epilepticus

Answer 24

Last more than 5 minutes or repeated seizures over course of 30 minutes
MEICAL EMERGENCY 
Airway
ABG's
IV push ativan, valium 
Rectal diazepam

Question 25

Causes of status epilepticus

Answer 25

Sudden withdrawal of AED's 
Infection
Acute alcohol or drug withdrawal 
Head trauma
Cerebral edema
Metabolic disturbances

Question 26

Carbamazepine drug therapy

Answer 26

Monitor headache, dizziness, blurred vision, N/V, leukopenia
CBC
Do not crush or chew

Question 27

Clonazepam drug therapy

Answer 27

monitor liver functions

Question 28

Divalproex drug therapy

Answer 28

Monitor hair loss, tremors, increased liver enzymes, bruising, N/V
CBC
PT
PTT
AST

Question 29

Lamotrigine

Answer 29

Watch for blurred vision, headaches, dizziness, drowsiness, ataxia, N/V, life-threatening rash when given with valproate acid

Question 30

Keppra drug therapy

Answer 30

Monitor renal function

Notify HCP for gait or coordination problems

Question 31

Drug therapy

Answer 31

Evaluate most current blood level of medication
Avoid grapefruit juices (citrus fruits)
Maintain therapeutic blood levels
Do not administer warafarin with phenytoin
Document and report adverse effects

Question 32

Patient and family education with seizures

Answer 32

Compliance with AED’s
Social services to assist with medication costs
Evaluation of employment (construction workers, operators of dangerous equipment, pilot)
Vocational rehab may be subsidized