exam 2 Flashcards

Question

risk factors for SLE

Answer 1

-gender-female -age: 20-40 year olds -race: African American, asian, Native American -environmental stimulus: infection, medications, sun exposure -genetic predisposition

Answer 2

-based on combination of clinical symptoms and lab findings -criteria consists of 11 key signs and lab tests, and a diagnosis is made if a patient meets at least 4 of them medical history and physical exam laboratory tests: -ANA test: most have positive, which indicates presence of autoantibodies -Anti-dsDNA and anti-smith antibodies: more specific for SLE. presence of anti-double-stranded DNA and anti-smith antibodies can help confirm the diagnosis -CBC: may cause anemia, low white blood cells (leukopenia), and low platelets (thrombocytopenia) -urinalysis: checks for protein and blood in urine, which may indicate kidney involvement (lupus nephritis) -complement levels (C3, C4): proteins are often low in active SLE because the immune system uses them up during inflammation.

Answer 3

-skin rashes: malar or butterfly rash on face -photosensitivity -lupus nephritis -fatigue -weakness -malaise -joint pain and swelling (arthritis) -fever -hair loss -mouth sores -anorexia, weight loss -palm erythema

Answer 4

-NSAIDs: for pain and inflammation in joints and muscles -antimalarials: to control skin symptoms and joint pain, and to prevent flares -corticosteroids: used to reduce inflammation during flare-ups but should be tapered and monitored for side effects -immunosuppressants: help control the immune response, but increase risk of infections adherence: stress importance of taking meds as prescribed, even when feeling well side effects: discuss potential side effects of medications like weight gain, increased risk of infections, bone thinning, and the importance of regular monitoring (blood tests for liver and kidney function)

Answer 5

-monitor for complications like renal failure -identify factors contributing to fatigue -diet: high vitamin and high iron, high protein if no evidence of kidney disease -administer medications as prescribed -monitor VS, Is and Os, daily weights for signs of fluid overload if corticosteroids are used -monitor for bruising, bleeding, and injury -monitor for signs of organ involvement such as pleuritis, nephritis, pericarditis, CAD, HTN, neuritis, anemia, and peritonitis -provide support therapy as major organs become affected -provide emotional support -provide information regarding support groups, and encourage the use of community resources

Answer 6

-recognizing and managing flares: early signs of flare, rest and energy conservation, when to seek help (CP, SOB, urinary symptoms) -preventing flares: sun protection, stress management, balanced diet, regular exercise, medication adherence -infection prevention: handwashing, masks, avoid crowds and sick people, stay up to date on vaccines -skin: clean skin with mild soap, avoiding harsh and perfumed substances -coping: mental health care, support groups -follow up care: emphasize the importance of regular medical checkups to monitor disease progression, medication effects, and organ function (kidneys, heart), may need to see multiple specialists

Answer 7

-metabolic disease -hyperuricemia (increased uric acid) and uric acid crystals in joints= tophi, and major organs (kidneys) causing organ dysfunction -caused by overproduction of uric acid, medications (thiazide diuretics, BBs), another disease (CKD)

Answer 8

-excruciating joint pain -erythema -swelling -tophi in great toe -low-grade fever -malaise -HA -pruritus: urate crystals in the skin -renal stones from elevated uric acid levels

Answer 9

-obesity -HTN -diet rich meat and seafood -use of thiazide diuretics -consuming large quantities of ETOH (beer)

Answer 10

-acute: acute onset of pain, redness, and swelling -intercortical: asymptomatic period between attacks -chronic: repeat attacks over many years causing the formation of tophi in the joints causing destruction

Answer 11

-uric acid level -synovial fluid exam and urate crystals -x-ray -CT scan

Answer 12

-medications: allopurinol for chronic, colchicine for acute -diet: avoid purine -weight management -limit ETOH -splint affected joint -monitor for kidney stones

Answer 13

-assess decreased ROM -assess intense joint pain, and tenderness, swelling, and warmth to affected joint -assess for presence of tophi -use ice packs -administer medications: NSAIDs, uric acid lowering agents, glucocorticoid therapy

Answer 14

-avoid purine rich foods: organ and red meat, shellfish, wine, aged cheese, lentils, asparagus, spinach, fructose drinks -increase urinary pH to above 6 by eating alkaline ash foods such as green beans or broccoli -avoid alcohol and starvation diets as these can cause attack -high fluid intake of 2000 mL/day to prevent stone formation -reduce stress -bed rest with affected extremity elevated -monitor joint ROM ability and appearance of joints -protect the affected joint from excessive movement (immobilize), direct contact with sheets or blankets, no weight bearing -provide cold to affected joint as prescribed -administer medications as prescribed

Answer 15

affect cognition, personality, mobility, and ADLs -chronic: primary headaches, seizure disorders, Parkinson's disease, Alzheimer's disease- require lifelong management and coping with exacerbations -emergency: primary or metastatic brain tumors, meningitis, and encephalitis- may be life-threatening emergencies

Answer 16

-occupies space within the skull -primary tumors: grow within the brain, benign or malignant, slow growing or aggressive -secondary tumors: metastasis spread from cancer in another area of the body effects of brain tumors are caused by inflammation, compression, and infiltration of tissue- cerebral edema, increased ICP, neurologic deficits, seizures, altered pituitary function

Answer 17

-CT -MRI -PET -biopsy -EEG -CSF analysis -toxicology to rule out substance use as cause

Answer 18

obtain patient and family history thorough neuro assessment symptoms vary with location of tumor, but some include: -HA -NV -new onset seizures -impaired sensory perceptions: facial numbness or tingling, visual changes (papilledema, loss of vision), hearing changes -cranial nerve palsy -loss of balance -ataxia -weakness or paralysis: one part or side of body (hemiparesis, hemiplagia) -abnormal redlexes -difficulty thinking, speaking, or articulating words-aphasia -changes in cognition, mentation, or personality

Answer 19

infiltrate any portion of the brain -most common type of brain tumor!

Answer 20

nonsurgical management -drug therapy: chemo, hormone suppressing meds, corticosteroids, osmotic diuretics, anticonvulsants, non-opioid analgesics -radiation therapy surgical management -biopsies -craniotomy -complication: increased ICP, bleeding, cerebral edema, seizures, VTE

Answer 21

goal= compensate for self-care deficits, improve nutrition, reduce anxiety, enhance coping skills, free of complications -frequent neuro and symptom assessments -VS: watch for cushing's triad- widened pulse pressure (HTN), bradycardia, irregular respirations: late increased ICP -treat headaches: analgesics, upright position -treat NV -treat fatigue: conserve energy, promote rest -treat pain -medication management: dexamethasone, antiepiletics -monitor elevtrolyes -Is and Os -urine specific gravity and osmolality -cognition: reorientation, orienting devices, assistance with self care, monitoring and intervention for prevention of injury -seizure precautions: educate on risk for seizures and prophylactic antiepileptics -emotional support

Answer 22

-encourage independence for as long as possible -measures to improve cognitive function -allow patient to participate in decision making and to express fears and concerns -presence of family, friends, spiritual advisor and health care personnel may be supportive -referral to counselor, social worker, home health care, support groups, PT/OT/ST -referral for hospice care -improve nutrition: oral hygiene before meals, plan meals for times when patient is comfortable and well rested, measures to make mealtimes as pleasant as possible, offer preferred foods, dietary supplements, daily weight, record daily intake.

Answer 23

pre-operatoin -treat anxiety: opening skull, head shaved, possible neuro deficits -provide reassurance -educate on post-op expectations post-operation: monitor for changes in status, prevent complications -VS and neuro checks q15-30 min for 4-6 hours, then q1 hour for first 24 hours -report immediately: decreased LOC, weakness or paralysis, aphasia, decreased sensory perception, sluggish pupil reaction to light, personality changes -periorbital edema and bruising around eyes- need cold compresses! -cardiac monitoring for potential dysrhythmias -monitor dressing for drainage- report immediately if dressing is saturated or drainage is >50mL in 8 hours -record Is and Os, with a fluid restriction if SIADH develops -treat electrolyte imbalance- Na! -manage airway, ventilator -medications as prescribed -standard post-op care: cough and deep breathing, incentive spirometers, SCDs

Answer 24

an acute inflammation of the protective membranes covering the brain and spinal cord, known as the meninges -an infectious organism crosses the BBB and enters the CSF, causing inflammation of the meninges -caused by bacterial, viral, fungal, or parasitic infections- bacterial being the most severe and life-threatening -early recognition and treatment are essential for reducing morbidity and mortality

Answer 25

-fever: high in bacterial meningitis -neck stiffness= nuchal rigidity -altered mental status -severe headache -photophobia -NV -seizures -rash: in meningococcal meningitis, petechial or purpuric -Kernig's sign: inability to straighten the leg when the hip is flexed at 90 degrees due to pain and stiffness -Brudzinski's sign: involuntary flexion of the knees when the neck is flexed toward the chest -signs in infants and older adults: infants-bulging fontanelle, irritability, poor feeding, lethargy, and a weak cry; older adults- atypical presentation like confusion, lethargy, and mild fever, dx more challenging

Answer 26

-lumbar puncture: GOLD STANDARD- increased WBC, elevated protein, decreased glucose in bacterial meningitis, presence of bacteria on gram stain and culture -blood cultures -CT or MRI scan prevention through vaccine!

Answer 27

-antibiotics: immediate empiric broad-spectrum antibiotics- 14 to 21 days of antibiotics, central line (PICC) -antiviral drugs for viral meningitis -anti-fungal therapy: fungal meningitis such as amphotericin B -corticosteroids: dexamethasone to reduce inflammation and risk of complications like hearing loss -supportive care: antipyretics for fever, anticonvulsants for seizures IVF for hydration complications= increased ICP, seizures, SIADH, DI

Answer 28

-neuro status -signs of meningeal irritation, such as nuchal rigidity, Brudzinski's sign, Kernig's sign -VS -fluid balance -HA -CSF results -daily weight -renal function -vascular assessments

Answer 29

-IVF -antibiotics -decrease stimuli -HOB 30 degrees -pain management -seizure precautions -bacterial meningitis-droplet precautions -maintain temperature: antipyretics, cooling bath, cooling blankets -educate on keeping follow up appointments and taking full course of abx

Answer 30

-disorders of the central and peripheral nervous system -deterioration of cells or function of the nervous system -slow onset of s/sx -Parkinson's disease -Huntington's disease -Amyotrophic lateral sclerosis= ALS

Answer 31

progressive neurodegenerative disease affecting movement, muscle control, and balance -causes muscle rigidity, akinesia, involuntary tremor, postural instability, disability -affects the dopaminergic neurons in the brain leading to a depletion of dopamine, which plays a key role in coordinating smooth, controlled movements -loss of dopamine and increase in acetylcholine leads to abnormal nerve function causing motor symptoms of Parkinson's -abnormal masses of protein develop inside neurons leads to characteristic PD, contributing to neuron dysfunction and death

Answer 32

-symptoms -rule out other neurological disease -levodopa trial -no specific diagnostic studies to confirm, so the presence of progressive decline in motor function accompanied by the tremors and rigidity is typically how the diagnosis is made

Answer 33

-history: when did symptoms start? -physical assessment: motor symptoms include bradykinesia leading to akinesia, tremors and pill rolling, muscle rigidity, postural instability, slow/shuffling gait -facial mask-like expression -drooling -dysphagia -psychosis, hallucinations, dementia -constipation, urinary incontinence -excessive perspiration -speech changes-slow and monotone -orthostatic hypotension

Answer 34

-levodopa: most effective drug, converted to dopamine in the brain, and often combined with carbidopa -dopamine agonists: mimic dopamine and stimulate dopamine receptors in the brain -MAO-B inhibitors: inhibit breakdown of dopamine in the brain -COMT inhibitors: prolongs the effect of levodopa by. blocking its breakdown -anticholinergics: reduce tremors by inhibiting the action of acetylcholine -amantadine: used in combination with levodopa to manage dyskinesia

Answer 35

-stage 1: mild symptoms- symptoms on one side of the body only; tremors, change in posture, facial expression, slowness of walking -stage 2: mild symptoms- symptoms on both sides of the body; tremors, rigidity, bradykinesia, walking difficulties, postural instability, loss of facial expressions -stage 3: moderate symptoms- loss of balance, slowness of movements, falls are more common -stage 4: severe symptoms- unable to stand without assistance, posture instability, bradykinesia, rigidity -stage 5: severe symptoms- stiffness in the legs may make it impossible to stand or walk, hallucinations and delusions occur

Answer 36

goal= promote mobility, manage cognitive dysfunction, maintain safety and quality of life safety: -gag reflex and swallowing: aspiration precautions, swallow evaluation and speech therapy, thickened liquids, modified texture diet, sit patient upright, have suction available -fall precautions -prevent constipation, pressure injuries, contractures mobility -progressive daily program of exercise -PT -walking techniques for safety and balance-stopping occasionally -frequent rest periods -proper shoes -use of assistive devices enhancing self-care activities -encourage, educate, and support independence -environmental modifications -use of assistive and adaptive devices -occupational therapy -allow patient extra time to perform ADLs and answer questions supporting coping abilities -set achievable, realistic goals -encourage social socialization, recreation, and independence -planned programs of activity -support groups and referral to supportive services: counselors, social workers, and home care medications -administer promptly on patient schedule for continuous therapeutic levels -prevent "off" periods (times when the medication isn't working effectively) home care preparation:case manager may be helpful self-management education: follow instructions for drug therapy, maintain or improve quality of life health care resources: national parkinson foundation

Answer 37

goal= control symptoms and maintain functional independence -no medical approach prevents disease progression -medications -deep brain stimulation -medical marijuana -non-traditional exercise like yoga or tai chi -SLP- sleep and dysphagia

Answer 38

progressive, genetic neurodegenerative disorder characterized by motor dysfunction, cognitive decline, and psychiatric disturbances -genetic disorder that results in degeneration of GABA neurons and increase dopamine in the cerebral cortex and basal ganglia -premature death of cells in the striatum of the basal ganglia (control of movement), and the cortex (thinking, memory, perception, judgment)

Answer 39

-genetic testing -family history -CT/MRI of brain

Answer 40

motor dysfunction: -chorea= rapid, jerky, involuntary, purposeless movements, during sleep and progresses to athetosis and uncontrollable movements of the entire body -athetosis= twisting and writhing movements -impaired gait- eventually bed bound cognitive impairment: -problems with attention and emotion recognition, psychosis, impaired judgment and memory, dementia behavioral features: apathy, blunted affect, fits of anger, suicidal depression -facial movements -emaciated -incontinence -speech: slurred, eventually unintelligible -chewing and swallowing difficulty

Answer 41

-no treatment stops disease progression -focus on quality of life -medication to treat chorea: tetrabenazine, benzodiazepines, neuroleptics -behavior management: SSRIs, tricyclic antidepressants, antipsychotics -psychotherapy -speech therapy: nutritional support when unable to eat (tube feed) -PT/OT -assistive services-home care, day care, respite, long term care -palliative care -end of life planning

Answer 42

assess: -movements, ambulation, balance -swallow, gag reflex, speech -mental status -oral intake actions: -aspiration precautions, position while eating -suction at bedside -pressure injury risk -administer medications -safety precautions-fall risk -consult PT/OT/SLP -involve family in care -end of life education: -fall prevention -aspiration precautions -suicide prevention -family: supportive care, facilitating favorite activities

Answer 43

neurodegenerative disease causing progressive muscle weakness and atrophy -no cognitive dysfunction! -graduation deterioration of the upper an lower motor neurons leads to loss of voluntary movement and muscle control

Answer 44

risk factors: -age -autoimmune disease -environmental exposure to toxins -family history -smoking -viral infections diagnosis: -symptoms -rule out other neurologic disorders -EMG -muscle biopsy -MRI

Answer 45

-fatigue -muscle atrophy, including tongue -progressive muscle weakness -twitching of face and tongue -muscle cramps -dysarthria -dysphagia -stiff, clumsy gait -spasticity-upper motor neuron damage -flaccidity- lower motor neuron damage -abnormal reflexes -emotional lability -respiratory paralysis within 3-5 years -death: infection, aspiration, respiratory insufficiency

Answer 46

goal= maintain or improve function, well-being, and quality of life. there is no cure -PT/OT -treat depression -palliative care, hospice -noninvasive positive-pressure ventilation -tracheostomy with mechanical ventilation -PEG tube with tube feed -medications: riluzole- first developed to slow disease progression edaravone- shown to reduce decline in daily functioning spasticity: baclofen, diazepam, dantrolene sodium fatigue: modafinil

Answer 47

-maintain patent airway, O2 saturation -monitor strength, ROM -ability to swallow -monitor for pneumonia and respiratory failure -manage non-invasive positive pressure ventilation -tracheostomy care -manage mechanical ventilator -medication management -emotional support -end of life care

Answer 48

chronic, progressive, immune-mediated disorder that affects the CNS -demyelination of nerve fibers, which disrupts the communication between the brain and other parts of the body -demyelination leads to the immune system mistakenly attacking the myeline sheath, and the protective covering of the nerve fibers -loss of myelin leads to the formation of hardened, scar-like areas (sclerotic plaques or lesions) in the brain and spinal cord types: -RRMS: relapsing-remitting MS -SPMS: secondary progressive MS -PPMS: primary progressive MS -PRMS: progressive-relapsing MS

Answer 49

-motor dysfunction: weakness in one or more limbs, spasticity (muscle stiffness or spasms), unsteady gait or coordination problems (ataxia) -sensory disturbances: numbness or tingling (paresthesia), pain, often described as burning or electric shock-like sensations (Lhermitte's sign) -vision problems: blurred or double vision (diplopia), optic neuritis (inflammation of the optic nerve, causing pain and vision loss) -fatigue: often the most disabling symptom, overwhelming physical or mental exhaustion -cognitive impairment: difficulty concentrating, with memory, or problem-solving -emotional changes: depression, anxiety, or mood swings -bladder and bowel dysfunction: urinary urgency, frequency, or incontinence, constipation or bowel incontinence -speech and swallowing difficulties: dysarthria (slurred speech), and dysphagia (difficulty swallowing) -heat sensitivity: worsening of symptoms in response to heat

Answer 50

diagnosis: difficult to diagnose because there is no one specific test, ruling out conditions with similar clinical presentations, h and p, rule out inflammatory or infectious diseases -MRI: identify brain lesions (plaques) -electrophysiological tests and evoked potentials to examine how quickly impulses are traveling through the nerves THE PATIENT MUST HAVE AT LEAST TWO SEPARATE SYMPTOMATIC EVENTS OF MRI CHANGES IN AT LEAST TWO SEPARATE LOCATIONS. there is no cure for MS.

Answer 51

managing symptoms, reducing the frequency of relapses, and slowing disease progression -adequate rest, healthy eating, exercise, staying cool, relieving stress, support groups -DMTs= disease modifying therapies -corticosteroids -symptomatic treatments -plasmapheresis= plasma exchange

Answer 52

assess: -neuromuscular function -vision/eye movement -skin integrity -ability to perform ADLs -bowel and bladder function actions: -encourage ROM exercises -administer medications -implement safety measures -PT and exercise to maintain strength and coordination -assistive devices to improve moility and reduce fall risk -scheduled voiding, high fluid intake, and a high-fiber diet to manage urinary and bowel dysfunction -teach intermittent catheterization if necessary -monitor for infections like UTIs teaching -disease process and prognosis -take meds as prescribed -importance of rest periods, preventing fatigue, and overheating -manifestations of exacerbation -maintain ideal body weight -safety: visual scanning, check water temp before entering shower/tub

Answer 53

-any damage to the spinal cord: direct damage or degenerative diseases -clinical manifestations depend on level of injury -diagnosis: history and physical, imaging tests -treatment: depends on level of injury, rehabilitation -nursing care: avoiding further injury, preventing complications

Answer 54

low-back pain often results from muscle strain, ligament injury, degenerative disc disease or herniation, spinal stenosis. these factors cause mechanical pressure on spinal nerves.

Answer 55

-localized or radiating pain -stiffness -limited mobility -muscle spasms -difficulty with ambulation -sciatica may occur with nerve root compression -acute pain: exacerbated by movement -muscle spams: limit mobility -nerve involvement: numbness/tingling

Answer 56

-history and examination -x ray -CT scan -MRI -electromyography (EMG) -myelogram

Answer 57

-non-pharmacological: PT, patient education on posture and lifting techniques, limit movement (brace, corset, belt), back strengthening exercise, heat, transcutaneous electrical nerve stimulation (TENS), interventional therapy like nerve blocks with local anesthetics, steroids, and narcotics injected into affected areas, massage, traction, acupuncture, meditation/yoga, weight reduction -pharmacological: acetaminophen, NSAIDs, muscle relaxations, opioids, corticosteroids, anti-seizure drug, antidepressants

Answer 58

for cases unresponsive to conservative treatment -spinal fusion -disectomy -laminectomy

Answer 59

normal part of aging, unless accompanied by pain! -osteoarthritis=OA -loss of fluid in the discs-lose elasticity, flexibility, shock absorbing abilities -discs become thin, shrink, and dry out- this limits ability to distribute pressure between vertebrae causing progressive destruction to disc -can cause disc herniation as disc weakens

Answer 60

"slipped disc" -most common sites: L4-5 and L5-S1, C5-6 and C6-7 -disc bulges outward between the vertebrae -degeneration, repeated stress, trauma, spinal stenosis -can press against these nerves "pinched nerve"- causes radiculopathy= radiating pain, numbness, tingling, decreased strength and ROM

Answer 61

Bundle of nerves at the end of the spinal cord that provides movement and sensation to the lower body

Answer 62

The nerves in the cauda equina are compressed, rare but serious condition that requires immediate surgery to prevent to prevent permanent nerve and muscle damage -weakness or numbness in the legs -numbness around the genitals, anus, or buttocks- saddle anesthesia -difficulty urinating or controlling urination -difficulty having a bowel movement or controlling bowel movements -loss of sexual sensation know the signs: S=saddle anesthesia P=pain I=incontinence N=numbness E=emergency!

Answer 63

cervical spine: -pain radiates to arms and hands -shoulder pain (rule out other causes) -weak or absent reflexes -weak hand grip lumbar: -low back pain: shooting or stabbing -radiculopathy: pain radiation, sciatica -straight leg test -depressed or absent reflexes -paresthesia: numbness, tingling -muscle weakness: limited ROM, inability to stand upright

Answer 64

assess: -VS -pain -mobility -numbness and tingling -bowel function -depression/SI actions: -administer meds as ordered: pain, anti-inflammatory, stool softener -range of motion exercises -increase fluid intake -William's position -avoiding painful positioning -emotional support -education -post-surgical care

Answer 65

-assess airway, breathing, circulation -frequent neuro assessments -check for bleeding and drainage at incision site -monitor VS -assess swallowing ability -monitor Is and Os -assess ability to void -manage pain -assist with ambulation -neck collar as ordered -education/discharge teaching: someone to stay with patient for few days, medications, incision care, walk everyday, wear color, call if pain numbness tingling worsening or swallowing becomes difficult, activity restriction- no lifting , driving, or strenuous activity

Answer 66

SCI results from trauma that damages the spinal cord, leading to partial or complete loss motor, sensory, and autonomic function below the injury site.

Answer 67

risk factors: -ages 16-18 -male gender -high-risk physical activity -driving under the influence of alcohol diagnosis: -neuro exam -xray -CT -MRI

Answer 68

acute management: -immobilization -maintain patent airway -corticosteroids to reduce inflammation -surgery to stabilize the spine-laminectomy, fusion rehabilitation: -physical therapy -OT -psychological support

Answer 69

-complete SCI: total loss of motor and sensory function below the injury level -incomplete SCI: varying degrees of motor and sensory loss depends on level of injury: autonomic dysreflexia!!! hypotension, bradycardia, bowel/bladder dysfunction, inability to breathe, paraplegia, loss of sexual function, chronic pain, impaired temperature control -higher the injury, greater loss of function

Answer 70

-autonomic dysreflexia: potentially life threatening condition that occurs in people with spinal cord injuries, typically at or above the level of T6. it is caused by an overreaction of the autonomic nervous system to a stimulus below the level of injury. the overreaction can lead to a dangerous increase in blood pressure. it is a medical emergency that requires immediate attention to prevent complications like stroke. -triggers= full bladder (maybe due to blocked catheter), full. bladder (constipation, impaction), skin irritation (like tight clothing or pressure sores) -s/sx: sudden, severe headache, flushed face, high blood pressure, bradycardia, sweating, cold, pale skin

Answer 71

assessments: -VS -respiratory function -motor function -sensory function -pain -bowel function -Is and Os -post op care/pin care if applicable actions: -maintain suction -facilitate cough -maintain spinal immobilization -passive ROM -reposition and maintain body alignment -perform routine pin care if halo in place post-op -teaching: s/sx of respiratory distress, autonomic dysreflexia, skin care/management

Answer 72

-PNS disease -chronic autoimmune disorder that affects nerve cell communication with muscles. the body produces antibodies that attack acetylcholine (ACh) receptors on the muscle surface necessary for muscle contraction. this leads to: -impaired transmission of nerve impulses to muscles -fluctuation muscle weakness, particularly with repetitive use -fatiguability that worsens with activity and improved rest

Answer 73

-muscle weakness: progressive weakness that worsens with activity and improves with rest -ocular muscles: ptosis=drooping eyelids, diplopia=double vision -facial and throat muscles: difficulty speaking=dysarthria, swallowing=dysphagia, and chewing -limb muscles: difficulty with lifting, climbing stairs, and performing repetitive movements -respiratory muscles: severe cases may cause respiratory weakness, leading to a myasthenic crisis (life threatening emergency!) -fatiguability: muscle weakness worsens with repetitive use, typically improving after periods of rest. symptoms can fluctuate throughout the day, often worsening in the evening.

Answer 74

a severe life-threatening exacerbation of muscle weakness that can involve respiratory failure due to diaphragm weakness. -triggers: infections, stress, surgery, or inadequate medications.

Answer 75

-acetylcholine receptor antibody test: measures the presence of anti-acetylcholine receptor antibodies, elevated in most MG patients -electromyography (EMG): evaluates electrical activity of muscles, reveals muscle weakness and abnormal fatigability -tensilon test= edrophonium test: short-acting acetylcholinesterase inhibitor (edrophonium) is administered to temporarily improve muscle strength, confirms MG -chest CT or MRI: detect a thymoma, tumor of thymus gland

Answer 76

-medications: anticholinesterase drugs, immunosuppressants, corticosteroids, azathioprine, or mycophenolate, intravenous immunoglobulin=IVIG -plasmapheresis -surgery: thymectomy= surgical removal of thymus gland, which can result in long-term improvement or remission in some patients -management of myasthenic crisis: mechanical ventilation, high-dose steroids, plasmapheresis, or IVIG

Answer 77

-muscle weakness, difficulty with chewing, swallowing, or vision problems -muscle strength, particularly in the ocular, facial, and respiratory muscles -signs of fatigue and weakness, particularly after repetitive activity -monitor respiratory function (rate, depth, and effort), pulse oximetry, especially during exacerbations

Answer 78

an acute, autoimmune disorder, in which the body's immune system attacks the peripheral nervous system, leading to inflammation and demyelination of the nerves. -results in impaired nerve signal transmission, primarily affecting motor function but can also involve sensory and autonomic nerves -the exact cause is unknown, but often triggered by a preceding infection, such as a respiratory or GI illness or viral infection.

Answer 79

-have emergency equipment available, like suction and ventilator -timely administration of anticholesterase drugs to optimize muscle strength throughout the day -support respiratory function with non-invasive or invasive ventilation -coughing, deep breathing exercises, use of an incentive spirometer -collaborate with speech therapy and dietitians to assess swallowing ability -provide small, frequent meals, with soft or pureed foods if needed to prevent choking -education: taking medications consistently, especially before meals to reduce aspiration risk, how to conserve energy and plan rest periods to avoid fatigue, recognizing signs of myasthenic crisis, infection prevention and management of stress, which can exacerbate symptoms

Answer 80

-lumbar puncture: increased protein levels in the CSF with a normal white blood cell count (albuminocytologic dissociation) is a key indicator -electromyography (EMG) and nerve conduction studies: confirms nerve dysfunction by showing delated or absent conduction -other: MRI to rule out other causes of weakness (spinal cord disorders), pulmonary function tests (PFTs) to assess respiratory involvement

Answer 81

-motor symptoms: ascending weakness starting in the legs and progressing to the upper limbs and face -reduced or absent deep tendon reflexes= areflexia -difficulty with ambulation, respiratory muscles involvement in severe cases -sensory symptoms: tingling or numbness in extremities= paresthesia -pain, which can be neuropathic in nature -autonomic dysfunction: blood pressure fluctuations, cardiac arrhythmias -bowel and bladder dysfunction

Answer 82

-motor function: progressive weakness, ascending paralysis -respiratory function: RR, depth, effort, signs of respiratory distress -cardiovascular status: autonomic instability, such as fluctuations in BP and HR -pain: evaluate for neuropathic pain -psychosocial status: signs of anxiety and depression

Answer 83

-non-invasive ventilation (like BiPAP) or mechanical ventilation -treat potential respiratory infection (such as pneumonia) -cardiac monitoring -gradual position changes to prevent orthostatic hypotension -mobility: ROM, PT, OT- prevent contractures and other complications -manage pain -plasmapheresis -administer IVIG -provide emotional support, encourage family involvement, and consider involving mental health services

Answer 84

sudden, usually unilateral, severe, brief, stabbing, recurrent pain the distribution of one or m ore branches of the trigeminal nerve (CN 5) -etiology is unknown! may be due to vascular compression, tumor, structural abnormality or the skull base, or MS -diagnosis: Hx, physical, MRI

Answer 85

-intense, sudden, sharp, stabbing, or electric shock-like facial pain -typically occurs unilaterally -triggered by stimuli like chewing, talking, smiling, brushing teeth, or light breeze -fear of triggering pain can cause the patient to avoid eating, speaking, or other daily activities

Answer 86

-medications: anticonvulsants, muscle relaxants, antidepressants, opioids, NSAIDs -nerve block injections, acupuncture, relaxation techniques -surgical options: microvascular decompression or nerve ablation for refractory cases

Answer 87

-obtain detailed history of the patient's pain: location, intensity, triggers, duration, and any associated symptoms -impact on daily activities and psychosocial status -evaluate medication history, effectiveness, and any side effects from current treatments

Answer 88

-administer meds: carbamazepine or baclofen as prescribed -educate the patient about recognizing and avoiding triggers -assist in planning meals and activities around times when pain is less likely to occur -provide psychological support to help manage anxiety and depression associated with chronic pain -consider referral to a mental health professional if needed -teach patient and family about condition, treatment options, and importance of medication adherence -inform them about potential side effects and when to seek medication attention (example- signs of drug toxicity)

Answer 89

an acute, unilateral paralysis or weakness of the facial muscles due to inflammation or compression of cranial nerve 7 (facial nerve), inflammation of the facial nerve leads to interruption of nerve signals, exact cause is unknown, but often associated with viral infections such as herpes simplex virus=HSV, varicella-zoster virus, epstein-barr virus, or lyme disease

Answer 90

-sudden onset over 48 hours -facial dropping -inability to close eye -inability to smile or raise eyebrow -difficulty speaking and eating -excessive tearing or dry eye

Answer 91

exam to rule out other causes of facial paralysis, like stroke, tumors, or lyme disease

Answer 92

-medications: corticosteroids, antivirals, analgesics -eye care: eye drops, protective patch, taping -physical therapy -speech therapy -emotional support

Answer 93

-understanding bell's palsy: educate patient a bout the condition, its likely causes, and the typical course of recovery -eye care at home: demonstrate how to apply artificial tears and protect the eye with patches or taping -medication adherence: stress the importance of completing the corticosteroid course and taking antivirals if prescribed -facial exercises: teach simple exercises, like smiling or frowning, to help improve muscle tone and recovery -recovery expectations: most patients see improvement within weeks to months, but some may experience residual weakness. reassure them that recovery is favorable, though full recovery may take time.

exam 2 Flashcards

Immune and connective tissue disorders, brain and spinal cord disorders, and PNS disorders