Exam 3 Flashcards
A patient develops Bell’s palsy weeks after being diagnosed with a middle ear infection. What explanation should the nurse give when asked about the cause of the condition?
Bell’s palsy, or peripheral facial paralysis, causes mouth droop and the inability to close the eyelid, usually on one side. A viral infection is thought to cause inflammation and eventually demyelination of the nerve. Most patients recover fully with treatment within three to six months. Facial weakness, which occurs with a stroke, is caused by a blood clot stopping blood flow to the area of the brain. An inflamed eustachian tube can block drainage from the middle ear, leading to otitis media, a middle ear infection. The flow of CSF is normally blocked temporarily whenever there is an increase in intraabdominal pressure, as with coughing
Bell’s palsy treatment at home
Hot wet packs are applied to reduce the discomfort.
A 68-year-old patient with a spinal cord injury has a neurogenic bowel. Beyond the use of bisacodyl (Dulcolax) suppositories and digital stimulation, which measures should the nurse teach the patient and the caregiver about to assist the patient with bowel evacuation?
20-30g of fiber
1800-2800ml of liquid
NO oral laxatives at night
NO bowel eval at bedtime- 30 min after breakfast
stiffness of the jaw is
trismus
The nurse is assessing an infant in the emergency department. The nurse suspects that the infant has botulism. Which clinical manifestation supports the nurse’s suspicion?
descending paralysis- not areflexia
Botulism is caused by gastrointestinal absorption of the neurotoxin produced by Clostridium botulinum. It can occur in infants who are fed honey. Descending paralysis with muscle incoordination and weakness are manifestations of the disease.
Areflexia occurs with
Guillain-Barré syndrome.
extreme arching of the back and retraction of the head is called.
Opisthotonos
Seizures occur with neurosyphilis, which is caused by the bacterium ??
Treponema pallidum.
The arterial blood gas (ABG) report of a patient with a spinal cord injury reveals that the patient is in respiratory distress. Which nursing interventions, if prescribed, are appropriate for this patient? Select all that apply.
admin O2
assisted coughing techniques
trach suctioning
o maintain adequate ventilation, the nurse should administer oxygen until ABGs stabilize. Assisted (augmented) coughing simulates the action of the ineffective abdominal muscles during the expiratory phase of a cough, therefore facilitating the removal of secretions. Tracheal suctioning is performed if crackles or rhonchi are present, indicated by mucus stuck to the airways. Presence of an infection cannot be revealed by an ABG report; therefore, it is not appropriate to administer antibiotics. ABG does not reveal any presence of inflammatory process; therefore, it is inappropriate to administer steroids in this patient.
The nurse is performing a physical assessment of a patient with Bell’s palsy. What clinical manifestations is the nurse likely to find?
Placid side of face
drooping and drooling
flattening of the nasolabial fold
NO grimacing or frequent blinking
The nurse is providing care to a patient with trigeminal neuralgia. Which first-line drug prescribed to this patient does the nurse prepare to administer?
Topiramate
Topiramate is a first-line drug used in the treatment of trigeminal neuralgia. It is an anticonvulsant.
Baclofen is a γ-aminobutyric acid receptor agonist used in combination with antiseizure drugs if a single agent is not effective. Amitriptyline is a tricyclic antidepressant that is used to treat constant burning or aching pain, which are manifestations of trigeminal neuralgia. Gabapentin is used as an anticonvulsant and analgesic. It is also used in combination with antiseizure drugs if a single drug is not effective.
A patient who presented to the hospital two days ago is diagnosed with Guillain Barré syndrome. Plasmapheresis is planned to treat the condition. What criteria are used to determine if this treatment is effective?
Stabilization of bp
lung vital cap and ABGs are stable
Sx of paralysis stop progressing and abate
Guillain Barré syndrome is a polyneuropathic condition resulting from an immune response following some type of infection. Symptoms include paresthesia with ascending bilateral paralysis as demyelination of the nerves occurs. The paralysis starts in the extremities and can advance to the thoracic area, resulting in respiratory failure. Disturbance in the autonomic nervous system causes episodes of hypotension, hypertension, and bradycardia. Treatment is successful with the halt of paralysis and stabilization of cardiovascular function and respiratory status. BUN and creatinine levels and urinary output are measures of renal function.
A nurse has to explain to a patient having Bell’s palsy the reason why oral hygiene and nutrition are affected in this condition. What points should the nurse emphasize while explaining? Select all that apply.
There is pain around the jaw, which prevents the proper chewing of food
There is accumulation of food on one side of the mouth.
The taste sensation is impaired.
Bell’s palsy is a lower motor neuron facial paralysis of unknown etiology. Malnutrition in Bell’s palsy may occur due to inability to chew food and loss of taste sensation because of pain around the jaw. Oral hygiene is affected due to accumulation of food in one side of the mouth. Facial nerves do not supply muscles of mastication; sensation inside the mouth is not affected, as it is carried by the trigeminal nerve.
Violet-colored erythematous papules are the characteristic of
dermatomyositis. These papules may be caused by the destruction of the muscle vasculature, seen as violet-colored papules under the skin.
In Stage? severe RA, there may be extraarticular soft tissue lesions or nodules present and there is subluxation without fibrous or bony ankylosis. The muscle strength is decreased because there is extensive muscle atrophy. The manifestations are systemic, not localized.
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