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NRSG 110: Med Surg 2 > [Exam 4] Chapter 69: Management of Patients with Neurologic Infections, Autoimmune Disorders, and Neuropathies ( Page 2065-2068, 2069-2089 ) > Flashcards

[Exam 4] Chapter 69: Management of Patients with Neurologic Infections, Autoimmune Disorders, and Neuropathies ( Page 2065-2068, 2069-2089 ) Flashcards

1
Q

What are the Infectious Neurologic Disorders?

A

Meningitis

Encephalitis

Creutzfeldt-Jakob Disease and Variant Creutzfeldt-Jakob Disease

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2
Q

Meningitis: What is this?

A

Inflammation of the membranes and the fluid space surrounding the brain and spinal cord

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3
Q

Meningitis: What are the two types?

A

Bacterial

Viral

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4
Q

Meningitis: What do we do with Viral version?

A

Its Aseptic

Usually benign and does not require intervention

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5
Q

Meningitis: What can cause Aseptic Meningitis?

A

Viral infection, Lymphoma, Leukemia, or Brain Abscess

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6
Q

Meningitis: What causes septic meningitis?

A

Bacteria S. Pneumoniae or Neisseria Meningitidis.

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7
Q

Meningitis: How does bacterial version occur?

A

Aerosol and secretion transmission

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8
Q

Meningitis: What does bacterial version require?

A

Intervention

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9
Q

Meningitis: N. Meningitidis transmitted by?

A

Secretions or aerosol contamination, and infection is most likely in dense community groups such as college campuses

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10
Q

Meningitis: Manifestations of this includes

A

severee headache, fever, change in LOC, behavioral changes, nuchal rigidity (Stiff neck, painful), positive Kernig’s/Brudzinski’s sign, and photophobia

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11
Q

Meningitis: What is required for those living in close quarters?

A

A vaccine for bacterial meningitis.

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12
Q

Meningitis: Which one is the most contagious?

A

Bacterial, requires hospital care

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13
Q

Meningitis: What is Kernig’s Sign?

A

Patient is laying flat on back. Hip brought up to 90 degree angle. If knee at 90 degree angle as well and tried to straighten the knee, they won’t be able to. Hamstrings are very tight.

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14
Q

Meningitis: What is Brudzinski’s Sign?

A

Patient lying supine. If head flexed , chin to chest, will cause pain and will reflexively bring the knees up as well.

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15
Q

Meningitis: Medical Management for Bacterial Meningitis?

A

Vaccination for all children and at-risk adults.

Prevention by meningococcal vaccination for adolescents and high-risk groups

Early administration of IV antibiotics for bacterial

Dexamethasone

Treat dehydration(bc of high fever), shock, seizures

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16
Q

Meningitis: Nursing Management for this? (6)

A

Freq Assess including VS/LOC, motor movement, eye movement, speech

Protect pt from injury related to seizure or altered LOC

Prevent comps associated with immobility (ROM for them)

infection control precautions (high fever, so provide hydration)

supportive care

measures to facilitate coping with pt/fam

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17
Q

Meningitis: Nursing management, what will you monitor?

A

Daily weight, serum electrolytes, urine volume, specific gravity, and osmolality

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18
Q

Encephalitis: What is this?

A

Acute, inflammatory process of the brain tissue typically caused by a viral infections(herpes), vector-borne viral infection (west nile, st louis) can also be fungal

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19
Q

Encephalitis: Signs of this includes

A

headache, fever, confusion, changes in LOC

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20
Q

Encephalitis: Vector Borne signs? (West Nile, St. Louis)

A

Rash, Flaccid Paralysis, Parkinson-Like Movements

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21
Q

Encephalitis: Herpes Encephalitis treatment

A

Acyclovir IV

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22
Q

Encephalitis: Fungal Encephalitis treatment

A

Amphotericin

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23
Q

Encephalitis: West Nile Encephalitis treatment

A

No actual medication to treat virus. Dexamethasone can decrease inflammation

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24
Q

Encephalitis: Nursing Management for this?

A

Frequent, and ongoing assessment

Supportive Care

Antibacterial if by bacteria, run course if viral.

Seizure Precautions

Treat fever, watch hydration

Administer Dexamethasone.

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25
Q

Creutzfeldt-Jakob Disease: What is this?

A

Rare, degenerative infectious, transmissible spongiform encephalopathy. (TSEs)

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26
Q

Creutzfeldt-Jakob Disease: How does someone get this?

A

Body is exposed to prions (small proteinaceous particles that are smaller than a virus and resistant to sterilization)

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27
Q

Creutzfeldt-Jakob Disease: What is this known as to the public?

A

Mad cow disease

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28
Q

Creutzfeldt-Jakob Disease: How is this spread?

A

No contact. By indigestion of infected beef (vCJD) or by surgical tools used in eye or brain surgery. Brain or spinal fluids, tissue.

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29
Q

Creutzfeldt-Jakob Disease: Lifespan for someone with this?

A

One year

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30
Q

Creutzfeldt-Jakob Disease: Treatment?

A

No treatment, progressive and fatal

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31
Q

Creutzfeldt-Jakob Disease: Diagnostic test of choice?

A

EEG. Electrodes watch on brain.

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32
Q

Creutzfeldt-Jakob Disease: How can CJD differ from vCJD?

A

It can be genetic, or spontaneously occurs.

vJCD is from eating infected beef.

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33
Q

Creutzfeldt-Jakob Disease: Sigins of this?

A

Affective (behavioral changes, limb pain, sensory disturbance, muscle spasms, rigidity and cognitive impairments

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34
Q

Creutzfeldt-Jakob Disease: Nursing Management?

A

Prevention of disease transmission, blood and body fluid precautions, supportive care

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35
Q

Risk Factors for Bacterial Meningitis

A

Living in dense communities

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36
Q

Risk Factors for Cruetzfeldt-Jakob

A

Eye or any CNS Infected Exposure

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37
Q

Infectious Neurologic Disorders: Complications include

A

ICP

Skin Breakdown

Seizures

Dehydration

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38
Q

How to prevent bacterial meningitis?

A

Vaccination

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39
Q

How to prevent Crutzfeldt-Jakob?

A

Improved screening of tissues

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40
Q

Infectious Neurologic Disorders: Labs and Diagnostic Tests?

A

Serum Electrolytes and Hydration

Urine Volume and SpG

CVJ Diseased Diagnosed by EEG

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41
Q

Infectious Neurologic Disorders: Nursing Diagnosis?

A

Ineffective Protection

RF Imbalanced Fluid Balance

RF Imbalanced Temp

RF Injury-Seizures

Confusion

Altered LOC

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42
Q

Infectious Neurologic Disorders: Goals for this?

A

Avoidance of complications

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43
Q

Infectious Neurologic Disorders: Education to patient for this?

A

Prevention

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44
Q

What are some Autoimmune Neurologic Disorders?

A

Multiple Sclerosis (MS)

Myasthenia Gravis

Gullian-Barre Syndrome

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45
Q

Multiple Sclerosis: What is this?

A

A PROGRESSIVE immune-related demyelination disease of the CNS

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46
Q

Multiple Sclerosis: Body produces T Cell antibodies against what?

A

myelin sheath of the axon

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47
Q

Multiple Sclerosis: What do the T Cells cause in the body?

A

Demyelination of the sheath. Nerve impulses unable to travel to target tissues.

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48
Q

Multiple Sclerosis: Inflammation along the pathway can cause what?

A

Pain along the nerve pathways. Causing exacerbation’s and remissions

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49
Q

Multiple Sclerosis: Frequeuntly the disease is relapsing and remitting, has exacerbations and recurrences of symptoms including

A

fatigue, weakness, numbness, difficulty in coordination, loss of balance, pain with muscle spasms, and visual disturbances

Loss of bowel and bladder control

Gait

Swallowing

Skin Breakdown

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50
Q

Multiple Sclerosis: Cure for this?

A

No. Progressive for this

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51
Q

Multiple Sclerosis: Medical Management for this?

A

Disease Modifying Therapies: Interferon B-1a and Interferon B-1b (Increase neuron surivival, decrease inflammatory rsponse) glatiramer acetate (Copaxone, blocks myelin damaging T Cells) and Iv Methyprednisolone (Steroid to decrease inflammation, suppresses immune system)

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52
Q

Multiple Sclerosis: Symptom management of what symptoms?

A

Muscle spasms, fatigue, Ataxia, Bowel and Bladder Control

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53
Q

Multiple Sclerosis: Assessment that needs to be done include

A

Neurologic Deficits

Secondary Comps: UTI (Weak Muscles), Pain, Falls, Aspiration

Impact of disease on physical, social, and emotional function and lifestyle

Patient and Family Coping

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54
Q

Multiple Sclerosis: Nursing Diagnosis? (8)

A

Impaired Physical Mobility

RF Injury

Impaired Bowel/Bladder

Impaired Verbal Communication

Disturbed Thought Process

Ineffective Coping

Impaired Home Maintenance

Potential Sexual Dysfunction

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55
Q

Multiple Sclerosis: Goals for this? (6)

A

Promotion of Physical Mobility

Adapation to Sexual Function

Avoidance of Injury

Achievement of Bowel/Bladder Continence

Promote Speech and Swallowing

Improved Cognitive Function

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56
Q

Multiple Sclerosis: Interventions with multiple professions include what?

A

Collaborative approach in healthcare

Coordinate and refer as needed to health care services: social services, speech therapy, PT, counseling, Home Care

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57
Q

Multiple Sclerosis: Interventions with Activity and Rest includes what?

A

Program of activity and daily exercise

Relaxation , coordination exercises, walking, muscle stretching

Avoid Strenuous activity and extreme fatigue

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58
Q

Multiple Sclerosis: Interventions for bowel and bladder control?

A

Instruction or administration of prescribed meds

Voiding Schedule

Bowel Training Program

Adequate fluid and fiber to prevent constipation

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59
Q

Multiple Sclerosis: Reinforce and encourage

A

swallowign instructions, with strategies to reduce risk of aspiration

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60
Q

Multiple Sclerosis: What can be done to enhance cognitive function?

A

Memory aides, structured environment, and daily routine

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61
Q

Multiple Sclerosis & Interventions: What daily exercise should be done?

A

Stretching technique and ROM

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62
Q

Multiple Sclerosis & Interventions: What does their diet look like?

A

Fluid and Fiber

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63
Q

Multiple Sclerosis & Interventions: How do they drink/eat?

A

Chin tucked swallowing and no straws. HOB is kept up

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64
Q

Multiple Sclerosis & Interventions: What assistive devices would help?

A

Walkers, Velcro

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65
Q

Multiple Sclerosis & Interventions: You should support what worries?

A

Allow expression of worries of LTC placement or burden of family. Support the coping

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66
Q

Multiple Sclerosis: What patient education would be given?

A

Avoid Fatigue/Stress/Strenous Activity

Avoid Extreme Temp

Memory Aids like calendars, pillboxes

No Rugs

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67
Q

Multiple Sclerosis: Risk factors for this?

A

caucasian Women b/w 15-60

Family History

Epstein-Barr Virus

Pts with DM1 or inflammatory bowel disease

Smoking

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68
Q

Multiple Sclerosis: Labs to test for this?

A

MRI

Lumbar Puncture

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69
Q

Multiple Sclerosis: How to prevent this?

A

No smoking

Good , general health

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70
Q

Multiple Sclerosis: What complications can this lead to?

A

Muscle Stiff/Spasms

Paralysis in legs

Problems with bladder, bowel, or sexual function

Mental Changes such as forgetfulness or mood swings.

Depression

Epilepsy

UTI

Aspiration

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71
Q

Myasthenia Gravis: What is this?

A

Autoimmune disorder affecting the myoneural junction, characterize by varying degrees of weakness of the voluntary muscles

72
Q

Myasthenia Gravis: When does the thymus typically stop producing antibodies?

A

After Puberty

73
Q

Myasthenia Gravis: What does the Thymus do in these patients?

A

Thymus continues to produce antibodies for unknown reasons.

74
Q

Myasthenia Gravis: what do the antibodies do here?

A

Attack the acetylcholine receptor sites at the myoneural junction which impairs transmission of impulses

75
Q

Myasthenia Gravis: First symptoms are seen in what area?

A

Motor disorders

76
Q

Myasthenia Gravis: Initial symptoms involve

A

ocular muscles : Diplopia (Perception of two images of a single object) and Ptosis (Drooling or falling of upper eyelid)

77
Q

Myasthenia Gravis: Patient will visit a physician which will perform what test?

A

Tensolin Test: Given to patient . Within 30 seconds, ptosis and facial weakness should be regained. Lasts for 5 minutes. Half Life is very short.

78
Q

Myasthenia Gravis: What are some of the symptoms that patients could have?

A

Weakness of Facial Muscles

Swallowing (Aspiration)

Dysphonia (Voice Impairment)

Generalized Muscle Weakness

79
Q

Myasthenia Gravis: Risk factors for thiss?

A

Over 60 years old

Family History

80
Q

Myasthenia Gravis: How to prevent this?

A

Stress, illness, and fatigue can cause exacerbation bout

81
Q

Myasthenia Gravis: Labs for this?

A

Anti-Acetylcholine receptor Antibody

82
Q

Myasthenia Gravis: Is there a cure for this?

A

No, its a progressive disease

83
Q

Myasthenia Gravis: What should you do for a patient with this?

A

Focus on patient

Medication education/manage

Energy Conservation

Strategies to help with ocular manifestations

Prevent comps/crisis

Reduce RF Aspiration

Avoid stress, infection, vigorous physical activity, some meds, and high environmental temps

84
Q

Myasthenia Gravis & Medical Management: Therapy effective when..

A

there is improvement in symptoms

85
Q

Myasthenia Gravis & Medical Management: When should meds be given?

A

30 mins prior to meals to help with swallowing

86
Q

Myasthenia Gravis & Medical Management: What meds would be given?

A

Cholinesterase Inhibitor (Pyrostigmine Bromide (Mestinon): Has to be taken at same time everyday. No leeway with it.

Immunomodulating Therapy (Suppress immune system)

87
Q

Myasthenia Gravis & Medical Management: What other therapeutic effects can be done?

A

Plasmapheresis : Run blood through dialysis machine to remove antibodies

Thymectomy: Remove part of Thymus or all of it.

88
Q

Myasthenia Gravis: What are two major comps that can occur?

A

Myasthenic Crisis

Cholinergic Crisis

89
Q

Myasthenia Gravis: What is a Myasthenic Crisis a result of?

A

Disease exacerbation or precipitating event, most commonly a respiratory infection. Can also occur is med is missed or late.

90
Q

Myasthenia Gravis: What happens with a Myasthenic Crisis?

A

Severe generalized weakness with respiratory complications / failure

91
Q

Myasthenia Gravis: What may patient develop in Myasthenic Crisis?

A

Respiratory compromise failure. Patient can no longer breathe

92
Q

Myasthenia Gravis: What is Cholinergic Crisis caused by?

A

Overmedication

93
Q

Myasthenia Gravis: Signs of Cholinergic Crisis?

A

Severe muscle weakness with respiratory weakness

94
Q

Myasthenia Gravis: What may patients develop in Cholinergic Crisis?

A

Respiratory compromise and failure

95
Q

Myasthenia Gravis: Difference between Cholinergic Crisis and Myasthenic Crisis?

A

The difference in level of acetylcholine. Both still cause respiratory failure

96
Q

Myasthenia Gravis: What happens if you miss Mestinon too early, or miss it?

A

Miss it: Myasthenic Crisis

Too Early: Cholinergic Crisis

97
Q

Myasthenia Gravis: What complications can occur with this?

A

Pneumonia

Aspirations

Myasthenic Crisis

Cholinergic Crisis

98
Q

Myasthenia Gravis: What are signs of someone with this?

A

Motor symptoms (generalized weakness)

Initial symptoms with ocular msucles (diplopia and ptosis)

Facial weakness

Swallowing impairment

Dysphonia (voice impariemtn)

Luung sounds checked

99
Q

Myasthenia Gravis: Patient education includes what?

A

Meds taken at same time

Reduce Stress
Avoid Extreme Temp.Fatigue

Avoid Vigorous Exercise

Signs of Myasthenic/Cholinergic Crisis

Teach family Heimlich

100
Q

Myasthenia Gravis: What may be needed to ensure adequate ventilation?

A

Intubation and Mechanical Ventilation

101
Q

Myasthenia Gravis: What supporitive measures should be done?

A

Measure airway/respiratory support

If patient cannow swallow, NG feeding may be required

Avoid sedatives and transquilizers

102
Q

Myasthenia Gravis: What labs checked?

A

ABGs, Serum Electrolytes, I/O, Daily Weight

103
Q

Myasthenia Gravis: Nursing Diagnosis for this?

A

RF Aspiration

Self-Care Deficit

Impaired Communication

Impaired Nutrition

RF Skin Breakdown

Ineffective Airway Clearance

104
Q

Myasthenia Gravis: What interventions will be performed?

A

Energy conservation

Aspiration Precautions

Turn Q2H

Cough and Deep Breath, CPT, IS, Semi Fowlers

Humidification

105
Q

Myasthenia Gravis: How much fluid will someone consume?

A

2500 mL to thin secretions

106
Q

Guillain-Barre Syndrome: What is this?

A

Autoimmune disorder with acute attack of peripheral nerve myelin

107
Q

Guillain-Barre Syndrome: What do the antibodies do here?

A

Attack the myelin sheath causing a RAPID demyelination

108
Q

Guillain-Barre Syndrome: What does the demyelination possibly cause symptom wise?

A

Respiratory failure and autonomic nervous system dysfunction.

109
Q

Guillain-Barre Syndrome: Where does the muscle weakness start?

A

Lower periphery and move up the body. As it subsides, it will move in reverse order

110
Q

Guillain-Barre Syndrome: What is not affected here?

A

Cognition and LOC

111
Q

Guillain-Barre Syndrome: This typically follows what

A

Viral Infection

112
Q

Guillain-Barre Syndrome: What is recovery like?

A

Patients will have no residual disabilities

113
Q

Guillain-Barre Syndrome: Symptoms include what?

A

Weakness to Paralysis

Vocal Paralysis

Paresthesia

Pain

Diminished to Absent Reflexes starting toes to head

Tachy/Bradycardia

Hyper/Hypotension

114
Q

Guillain-Barre Syndrome: Risk factors?

A

Viral Infection

115
Q

Guillain-Barre Syndrome: How to prevent?

A

CAn’t prevent

116
Q

Guillain-Barre Syndrome: Labs for this?

A

Lumbar puncture will show elevated proteins with normal WBC

117
Q

Guillain-Barre Syndrome: Most important thing to do when in paralyzed state is to

A

Don’t develop comps . Do ROM, no Pneumonia, turn frequently, kep feet in proper alignment to prevent footdrop. Won’t have reflexes at all.

Watch VS because hypo/hypertensive

118
Q

Guillain-Barre Syndrome: Potential Complications?

A 
Resp Failure
Autonomic Dysfunction (BP, HR)
DVT (Immobile)
Pulmonary Embolism (Bedrest)
Urinary Retention (Bladder paralyzed)

Pain, Contractures, Skin Breakdown, Paralytic Ileus, SIADH

119
Q

Guillain-Barre Syndrome: Goals for this?

A

No Comp

Improved Resp Function

Increased Mobility

Improved nutritional status

Ability to communicate

Decreased fear/anxiety

120
Q

Guillain-Barre Syndrome: Ongoing assessment consists of

A

emphasis on early detection of life-threatening comps of respiratory failure, cardiac dysrhythmias , and DVT

121
Q

Guillain-Barre Syndrome: Monitor for changes in

A

vital capacity and negative inspiratory force

122
Q

Guillain-Barre Syndrome: What will be continuously monitored?

A

VS, ECG

123
Q

Guillain-Barre Syndrome: Nursing Diagnosis for this?

A

Ineffective Breathing Pattern

Impaired Gas Exchange

Impaired Physical Mobility

Imbalance Nutrition

Impaired Verbal Commun

Fear

Anxiety

124
Q

Guillain-Barre Syndrome: Meds to treat this?

A

None

125
Q

Guillain-Barre Syndrome: Antibiotics used to ..

A

prevent/tx UTI or resp infection

126
Q

Guillain-Barre Syndrome: Whats given for pain?

A

Morphine

127
Q

Guillain-Barre Syndrome: Why are anticoagulants given?

A

Prevent DVT and PE

128
Q

Guillain-Barre Syndrome: What to give if hypotensive?

A

Vasopressors

129
Q

Guillain-Barre Syndrome: What does medical management require?

A

Intensive care management with continuous monitoring and respiraotry support

130
Q

Guillain-Barre Syndrome: What is used to reduce circulating antibodies?

A

Plasmapheresis and IVIG

131
Q

Guillain-Barre Syndrome: What will be performed if someone cannot breathe?

A

Tracheostomy

132
Q

Guillain-Barre Syndrome: Treatment for bradycardia?

A

Pacemaker

133
Q

Guillain-Barre Syndrome: What to do if someone is on a ventilator?

A

TPN IV Fluids

134
Q

Guillain-Barre Syndrome and Interventions: How do you enhance physical mobility and prevention of DVT?

A

Support limbsin functional position

ROM twice daily

Position changes every 2 hours

Elastic compression hose (SCDS or Ted Hose) or sequential compression boots

Adequate hydration

135
Q

Guillain-Barre Syndrome and Interventions: What to do with aspiration?

A

Aspiration Precautions by assessing swallowing and gag reflex

136
Q

Guillain-Barre Syndrome and Interventions: What labs will be monitored?

A

I/O and Urinary Retention

137
Q

Guillain-Barre Syndrome and Interventions: Develop a plan for what?

A

Communication individualized to patient needs

138
Q

Guillain-Barre Syndrome and Interventions: How to decrease fear and anxiety?

A

Provide information and support

Referral to support group

Relaxation measures

Maintain positive attitude and atmosphere to promote sense of well-being

Diversional activites

139
Q

Guillain-Barre Syndrome: Patients and LOC

A

They never lose it. They have complete mental capacity during whole thing

140
Q

Guillain-Barre Syndrome: Patient Education?

A

Change position slowly due to orthostatic hypotension

Explain syndrome will reverse over time

141
Q

What are the Cranial Nerve Disorders?

A

Trigeminal Neuralgia (Tic Douloureux)

Bells’ Palsy

142
Q

Trigeminal Neuralgia (Tic Douloureux): What is this?

A

Condition of the fifth cranial nerve characterized by paroxysms of pain

143
Q

Trigeminal Neuralgia (Tic Douloureux): Most commonly occur in what branches of the nerve?

A

2nd and 3rd.

144
Q

Trigeminal Neuralgia (Tic Douloureux): Most probable cause of this?

A

Vascular compression and pressure

145
Q

Trigeminal Neuralgia (Tic Douloureux): Occurs more often to who and when?

A

Women that are 50-60 and those with MS

146
Q

Trigeminal Neuralgia (Tic Douloureux): Pain can occur when?

A

With any stimulation such as washing face, brushing teeth, eating, or draft of air

147
Q

Trigeminal Neuralgia (Tic Douloureux): Patients may do what to avoid the pain?

A

Avoid eating, neglect hygiene, and even isolate themselves to prevent attacks

148
Q

Trigeminal Neuralgia (Tic Douloureux): Patho of this?

A

Vascular compression and demylination of 5th cranial nerve causing paroxysm of pain when trigger zones (cheek, lip, gum, forehead) are stimulated

149
Q

Trigeminal Neuralgia (Tic Douloureux): What can the lightest sitmulation cause? (draft in room)

A

Severe pain

150
Q

Trigeminal Neuralgia (Tic Douloureux): How often does this occur?

A

Has exacerbations and remission periods

151
Q

Trigeminal Neuralgia (Tic Douloureux): How to prevent this?

A

Can’t

152
Q

Trigeminal Neuralgia (Tic Douloureux): Labs for this?

A

Xray to rule out infection

153
Q

Trigeminal Neuralgia (Tic Douloureux): Complications that can result?

A

Social Isolation

Malnutrition

Insomnia

154
Q

Trigeminal Neuralgia (Tic Douloureux): Nursing Diagnosis of this?

A

Acute Pain

Impaired Nutiriton

Disturbed Sleep Pattern

155
Q

Trigeminal Neuralgia (Tic Douloureux): What do you assess in patient?

A

How often pt experiences episdoes

Assess hygiene and eating habits

Pain scale

156
Q

Trigeminal Neuralgia (Tic Douloureux): Medical Management fr this, what medications prescribed?

A

Antiseizure meds or Antispasmodic Meds

Analgesics

157
Q

Trigeminal Neuralgia (Tic Douloureux): Surgical tx for this?

A

Microvascular decompression of trigeminal nerve

Rhizotomy: Destroys root, results in loss of reflex, sensation, and some m ovement

Radiofrequency thermal coagulation: Uses heat to destroy ganglion but preserves corneal reflex and sense of touch destroy

Percutanous baloon microcompression

158
Q

Trigeminal Neuralgia (Tic Douloureux): Nursing Interventions?

A

Pt Education RT Pain Prevention and Treatment Regimen

Avoid Triggers

Care of Pt with Pain

Maintain Hygiene

Use Soft foods, chew on unaffected side , no spicy, avoid extreme temp . Tube feedings if cannot do it

Maintain room at moderate temp

Provide small frequent meals of lukewarm meals

Interventions for anxiety
depression, insomnia

159
Q

Trigeminal Neuralgia (Tic Douloureux): Education for pt?

A

Avoidance of triggers

Chew on unaffected side

Avoid extremes of temp

160
Q

Trigeminal Neuralgia (Tic Douloureux): Goals for this?

A

Maintain nutrition and hydration

Control pain

Maintain hygeien

Achieve complete sleep cycle

161
Q

Bell’s Palsy: What is this?

A

Facial paralysis caused by unilateral infalmmation of seventh cranial nerve

162
Q

Bell’s Palsy: Signs of this?

A

Unilateral facial muscle weakness or paralysis with facial disortion and painful sensations in the face. May have difficuclty with speech and eating

163
Q

Bell’s Palsy: Recovery time?

A

In 3-5 weeks and the disorder rarely reoccurs

164
Q

Bell’s Palsy: Patho?

A

Inflammation of 7th cranial nerve caused by herpes Type 1 and herpes zoster, but can be caused by other virsues too

165
Q

Bell’s Palsy: Risk factors?

A

Herpes Infection

Viral Infection

166
Q

Bell’s Palsy: Labs and Diagnostic?

A

None

167
Q

Bell’s Palsy: Prevention?

A

None

168
Q

Bell’s Palsy: Complications?

A

Corneal Damage

Permanent contractures of facial muscle

169
Q

Bell’s Palsy: Nursing Diagnosis for this?

A

Acute Pain

Disturbed Sensory Perception

Disturbed Body Image

170
Q

Bell’s Palsy: Assessment of this?

A

Unilateral Facial Paralysis with sudden onset

Increased tearing on affected side

Loss of blink reflex on affected side

Loss of corneal reflex on affected side

Pain Scale

171
Q

Bell’s Palsy: Medical Treatment for this?

A

Corticosteroid therapy to reduce inflammation and diminish severity of disorder

Artifical tears 4x / day

Pt: Stimulate facial nerve and maintain muscle tone

172
Q

Bell’s Palsy: Why would Acyclovir be prescribed?

A

Antiviral Medication

173
Q

Bell’s Palsy: Why would Prednisone be prescribed?

A

Anti-Inflammatory

174
Q

Bell’s Palsy: Patient Education?

A

Assure that patient did not have stroke.

Protect eye with shield and tape shut at night. Or have them close eye and use sunglasses. Can use eye ointment or drops

Be careful using eye patch.

Perform facial exercises and massages to maintain muscle tone

175
Q

Bell’s Palsy: What nursing interventions will you perform?

A

Moist heat

Soft Meals

Inspect mouth after eating for pocketed food

Practice wrinkling foreheading, closing eye, blowing air through puckered lips, and whistling for 5 minutes 3-5 times a day

NRSG 110: Med Surg 2 (29 decks)

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