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NRSG 110: Med Surg 2 > [Exam 4] Chapter 70: Management of Patients with Oncologic or Degenerative Neurologic Disorders (Page 2101 - 2119) > Flashcards

[Exam 4] Chapter 70: Management of Patients with Oncologic or Degenerative Neurologic Disorders (Page 2101 - 2119) Flashcards

1
Q

Parkinson’s Disease: What is this associated with?

A

Decreased levels of dopamine caused by destruction of cells in the basal ganglia; this affects the neurotransmission of impulses

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2
Q

Parkinson’s Disease: Patho?

A

Basal ganglia destruction causes a decrease level of dopamine, lack of dopamine affects the neurotransmission of impulses

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3
Q

Parkinson’s Disease: What are some signs of this?

A

Tremor, Cogwheel Rigidity (Moves and then freeze, and then move), Bradykinesia (slowness of movement), Postural Instability (lean forward), Depression and other Psychiatric Changes, Dementia, Autonomic Symptoms (watch vitals), Sleep Disturbances

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4
Q

Parkinson’s Disease: When can tremors be seen?

A

Only when patient is awake and at rest

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5
Q

Parkinson’s Disease: Risk factors?

A

Family history

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6
Q

Parkinson’s Disease: Labs?

A

None

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7
Q

Parkinson’s Disease: Prevention?

A

None

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8
Q

Parkinson’s Disease: Complications from this?

A

Aspiration

Falls

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9
Q

Parkinson’s Disease: Longer patient has it, the more…

A

their health will degrade

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10
Q

Parkinson’s Disease: What was dopamine do?

A

SLows things down

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11
Q

Parkinson’s Disease: What does acetylcholine do?

A

Speeds things up

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12
Q

Parkinson’s Disease: Decreased dopamine means what?

A

They aren’t able to slow down, which is why their symptoms are the way that they are

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13
Q

Parkinson’s Disease: What are some signs of Bradykinesia?

A

Loss of normal arm swing

Decreased blinking

Loss of ability to swallow

Blank Expression

Difficulty initiating movement

Quiet Speech

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14
Q

Parkinson’s Disease: How fast is onset?

A

Gradual, usually after age 50

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15
Q

Parkinson’s Disease: Rarely occurs in what population?

A

Black`

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16
Q

Parkinson’s Disease: Assessment.. focus on what?

A

Degree of disability and function of the patient including ADLs and cognitive function

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17
Q

Parkinson’s Disease: Assessment of patient includes..

A

Meds and Response to Them

Emotional responses/family coping

Tremors assessed when at rest

Home care/education needs

Fall risk assesssment

Manifestations/potential complications RT specific disorder (aspiration, poor nutirion)

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18
Q

Parkinson’s Disease & Interventions: What clothing changes have ben made?

A

Shirts with no buttons, the use of velcro instead

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19
Q

Parkinson’s Disease & Interventions: What assistive device can be used?

A

Weighted spoons to help with tremors

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20
Q

Parkinson’s Disease & Interventions: Which other professionals will assist?

A

OT, PT, ST

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21
Q

Parkinson’s Disease & Interventions: How will diet/ eating look like?

A

Semi-solid foods with thickened liquids while chin tucked with swallowing

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22
Q

Parkinson’s Disease & Interventions: What should you encourage?

A

socialization and support groups

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23
Q

Parkinson’s Disease & Interventions: What should be performed daily?

A

Exercise with stretching and ROM

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24
Q

Parkinson’s Disease & Interventions: Patient needs to have frequent//

A

rest periods

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25
Q

Parkinson’s Disease: Nursing Diagnosis here? (11)

A

Impaired Physical Mobility

RF Activity Intolerance

Disturbed Thought Process

Self-Care Deficit

Imbalanced Nutrition

Constipation

Impaired Verbal Communication

Ineffective Coping

Deficient Knowledge

RF Injury

Risk for Aspiration

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26
Q

Parkinson’s Disease: What are the major goals for the patient?

A

Improved functional ability,

maintaining indepence in ADLs,

achieving adequate bowel elimination,

attaining nutrtion,

effective communication,

preventing aspiration

Developing positive individual and family coping skills

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27
Q

Parkinson’s Disease: How do you enhance self-care ability?

A

Encourage, educate, and support independence

Environmental modifications

Use of assistive and adaptive devices

Consult with OT

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28
Q

Parkinson’s Disease: How to help with support of coping?

A

Set achieveable, realistic goals

Encourage socialization, recreation and independence

Planning programs of activity

Supports groups and support services: Counselors, social workers, home care

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29
Q

Parkinson’s Disease: Patient Education?

A

No rugs, proper shoes, use of assistive devices

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30
Q

Parkinson’s Disease: Medicine for this?

A

Carbidopa - Levodopa - assess for Tardive Dyskinesia (Repeitive movements like lip smacking)

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31
Q

Parkinson’s Disease: How do you protect from injury and aspiration?

A

No rugs, semisolid food with thickened liquids

Use chin tuck to swallow

use assistive devices

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32
Q

Parkinson’s Disease: How do you help improve mobility?

A

Daily exercise with ROM/Postural Exercises

PT

Walking techniques for safety/balance with proper shoes

Frequent rest, because it exacerbates symptoms

Proper use of assistive devices

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33
Q

Huntington’s Disease: Patho of this disease?

A

Basal ganglia and cortex cell loss. Progressive with no cure

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34
Q

Huntington’s Disease: Risk factors for this?

A

Family history : Autosomal Dominant Trait

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35
Q

Huntington’s Disease: How to prevent this?

A

None

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36
Q

Huntington’s Disease: Labs and Diagnostic Testing?

A

Genetic Testing

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37
Q

Huntington’s Disease: Complications of this?

A

Aspiration, Malnutrition, Pneumonia, Death

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38
Q

Huntington’s Disease: Nursing Diagnosis of this?

A

RF Aspiration

Imbalanced Nutrition

Impaired Skin Integrity

Impaired Communication

RF Falls

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39
Q

Huntington’s Disease: Goals of this?

A

No Complication

Effective Communication

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40
Q

Huntington’s Disease: Nursing Interventions for this?

A

Soft Foods

High Calorie Foods

Safe Environment

Avoid Fatigue

Pressure Mattress

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41
Q

Huntington’s Disease: Patient Education for this?

A

Labile mood is part of the disease

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42
Q

Huntington’s Disease: What is Huntingtons Disease?

A

Chronic progressive hereditary disease that results in choreiform movement and dementia

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43
Q

Huntington’s Disease: How is this transmitted?

A

As an autosomal dominant trait

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44
Q

Huntington’s Disease: Patho involves what?

A

Loss of cells in the basal ganglia and the cortex

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45
Q

Huntington’s Disease: How does this progress?

A

Progressive and Degenerative

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46
Q

Huntington’s Disease: Cure for this?

A

None

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47
Q

Huntington’s Disease: What is Choreiform movement?

A

Repetitive and rapid, jerky, involuntary movement that appears to be well coordinated

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48
Q

Huntington’s Disease: Patients have what type of movements?

A

Choreiform movements

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49
Q

Huntington’s Disease: Signs of this disease?

A

Abnormal movement and progressive dementia

Psychologic manifestations

Severe depression/memory loss

Decreased ability to concentrate

Emotional liability

Impulsiveness

Increased appetite (bc of movement and can’t eat)

Emotional and personality changes (Depression)

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50
Q

Huntington’s Disease: Medical management for this?What meds and procedures?

A

Antipsychotics and Antidepressants

Antichorea Agents

Fetal Tissue Transplants

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51
Q

Alzheimer’s Disease: Also called what?

A

Senile Dementia

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52
Q

Alzheimer’s Disease: Most common cause of?

A

Dementia

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53
Q

Alzheimer’s Disease: How does this progress?

A

Chronic, Progressive, Degenerative

54
Q

Alzheimer’s Disease: Patho of this?

A

Loss of nerve cells and the presence of neuritic plaques, neurofibrillary tangles, and amyloid angiopathy. Leads to dementia

55
Q

Alzheimer’s Disease: Risk Factors for geting this?

A

Aging

Family Hx

Smoking/Alcohol

Atherosclerosis

High Cholesterol

Diabetes Melitus

Down Syndrome

56
Q

Alzheimer’s Disease: How to prevent this?

A

Stay mentally and physically active

57
Q

Alzheimer’s Disease: Dementia is a symptom of what?

A

Multiple diseases

58
Q

Alzheimer’s Disease: If you have Alzheimers, what else do you have?

59
Q

Alzheimer’s Disease: Labs for this?

60
Q

Alzheimer’s Disease: Complications of this?

A

Falls

Aspiration

Skin Breakdown

Death

61
Q

Alzheimer’s Disease: What are some of the signs of dementia?

A

Impairment of short and long-term memory

Decreased ability for abstract thinking

Impaired judgement and problem solving

Changes in personality -> Agitation

Delusions and Hallucinations

62
Q

Alzheimer’s Disease: Agitation increases when?

A

Afternoon to evening

63
Q

Alzheimer’s Disease: Die how long after diagnosis?

A

4-6 years after

64
Q

Alzheimer’s Disease: Nursing Diagnosis for this?

A

RF Injury

Imbalanced Nutrition

Disturbed Thought Process

Caregiver Role Strain (Roam a lot, so caregiver has to find them)

65
Q

Alzheimer’s Disease: What is a big issue with these patients?

A

Roam a lot. They don’t understand that walking into a street is bad

66
Q

Alzheimer’s Disease: Goals of this?

A

No Complications

67
Q

Alzheimer’s Disease: Patient education for this?

A

Provide calendars and pill boxes

68
Q

Alzheimer’s Disease: What interventions will the nurse do for the patient?

A

Avoid Fatigue/Overstimulation

Safe environment for roaming

Bed Alarm

Help with feeding, frequent high calorie meals

69
Q

Alzheimer’s Disease: When this first starts, they are having trouble with

A

short term memory

70
Q

Alzheimer’s Disease: What is Sundowners Syndrome?

A

When sun goes down or in a dimmly lit room, agitation increases

71
Q

Alzheimer’s Disease: What to do if agitation increases?

A

Determine baselines and find out what caused them to have an increase in agitation. (UTI, Dehydration?)

72
Q

Alzheimer’s Disease: Environment needs to match

A

their functional abilities

73
Q

Alzheimer’s Disease: Earlier stages they are

A

self-sufficient

74
Q

Alzheimer’s Disease: Later stages, they are in

A

total care

75
Q

Alzheimer’s Disease: What drugs can be given?

A

Acetylcholine levels low due to death of neurons.

Acetylcholinesterase Inhibitors (improve memory) by slowing down the destruction of acetylcholine

76
Q

Alzheimer’s Disease: What Acetylcholinesterase Inhibitors can be given?

A

Tacrine Hydrochloride (Cognex)

Donepezil Hydrochloride (Aricept)

Rivastigmine Tartate (Exelon)

77
Q

Alzheimer’s Disease: Do not take antihistamines because

A

manifestations can make symptoms worse

78
Q

Alzheimer’s Disease: Waht does NMDA and Namenda do?

A

Slow the neuron death

79
Q

Alzheimer’s Disease: Antidepressants and Transquilizers help with what?

A

The roaming

80
Q

Amyotrophic Lateral Sclerosis (ALS): Also known as

A

Lou Gehrig’s Disease

81
Q

Amyotrophic Lateral Sclerosis (ALS): What happens first in patho?

A

Loss of motor neurons in the anterior horn of the spinal cord and loss of motor nuclei in the brainstem

82
Q

Amyotrophic Lateral Sclerosis (ALS): What does the loss of motor neurons cause?

A

Progressive weakness and atrophy of the muscles of the extremities and trunk

83
Q

Amyotrophic Lateral Sclerosis (ALS): Weakness impairs what?

A

Swallowing an talking. A long with Respiratory Function

84
Q

Amyotrophic Lateral Sclerosis (ALS): Risk factors?

85
Q

Amyotrophic Lateral Sclerosis (ALS): Labs?

86
Q

Amyotrophic Lateral Sclerosis (ALS): Prevention?

87
Q

Amyotrophic Lateral Sclerosis (ALS): Complications sfrom this?

A

Death in 3-5 years

88
Q

Amyotrophic Lateral Sclerosis (ALS): What happens when muscles atrophy in trunk?

A

Diaphragm affected meaning they cannot breathe anymore

89
Q

Amyotrophic Lateral Sclerosis (ALS): What are the signs of this?

A

Progressive Muscle Weakness and Atrophy

Decreased Coordination

Muscle Spasm

difficulty chewing and swallowing

emotional liability

speech difficulty

pulmonary compromise

90
Q

Amyotrophic Lateral Sclerosis (ALS): Nursing Diagnosis of this?

A

RF Disuse Syndrome

Ineffective Breathing Problems

Impaired Verbal Communication

91
Q

Amyotrophic Lateral Sclerosis (ALS): Goals for this?

A

Effective Communication

ADLS Completed for PT

No Comp

92
Q

Amyotrophic Lateral Sclerosis (ALS): Advanced Directives include what?

A

Tube Feedings

Ventilator

How long do you want to be on life support

93
Q

Amyotrophic Lateral Sclerosis (ALS): Advanced Directives important because

A

they lose ability to speak later on

94
Q

Amyotrophic Lateral Sclerosis (ALS): What will patient need to learn as disease progresses?

A

Augmentative Alternative Communication, meaning they will need an alternative way to communicate, such as with eyes

95
Q

Amyotrophic Lateral Sclerosis (ALS): Medical Management includes what?

A

Muscle Relaxants

Riluzole - Protects the neurons from excitotoxicity.but is very toxic to liver and masks illness. Take temps daily and no alcohol.

96
Q

Amyotrophic Lateral Sclerosis (ALS): What therapy healthcare workers will be included?

A

PT, OT, ST

97
Q

Amyotrophic Lateral Sclerosis (ALS): Education for patient?

A

Develop way to communicate with eyes

Educate on living will

No cure for disease

98
Q

Amyotrophic Lateral Sclerosis (ALS): Intervntions for patient?

A

ROM, HIgh PRotein Nutrition, Turn every 2 hours and pain control.

Prevent infection and pneumonia, high risk for it.

99
Q

Amyotrophic Lateral Sclerosis (ALS): Where should head of bed be?

100
Q

Degenerative Disk Disease: Patho of this?

A

Degenerative changes occur due to aging or trauma. As structure changes, this causes pressure on the nerve of spinal cord

101
Q

Degenerative Disk Disease: Risk Factors for this?

A

Heavy Lifting

Older Age

102
Q

Degenerative Disk Disease: How to prevent this?

A

Proper body mechanics

Calcium intake

103
Q

Degenerative Disk Disease: Labs to test for this?

104
Q

Degenerative Disk Disease: Complications that can result from this?

A

Loss of movement

Loss of sensation

Chronic pain

105
Q

Degenerative Disk Disease: What is a significant public health disorder and has significant economic and social costs?

A

Low back pain

106
Q

Degenerative Disk Disease: Most back problems are related to

A

disk disease

107
Q

Degenerative Disk Disease: Degenerative changes occur with

A

aging, or are the result of previous trauma

108
Q

Degenerative Disk Disease: What produces pain?

A

Radiculopathy. This is where the nerve that is damaged radiates pain down that extremity

109
Q

Degenerative Disk Disease: Continued pressure may produce what?

A

Degenerative changes in the nerve with resultant changes in sensation and motor responses (Weakness, Paresthesia)

110
Q

Degenerative Disk Disease: Treatment usually consisits of what?

A

Rest and Therapy and Meds, very conservative

111
Q

Degenerative Disk Disease: What may be required to treat this?

112
Q

Degenerative Disk Disease: How can pain be caused?

A

Herniation onto nerve or degenerative disk where its compressed on it

113
Q

Degenerative Disk Disease: Assessment consists of what?

A

Determining onset, location, radiation

Determine whether symptoms bilateral

Range of motion in neck and shoulders

Patient Education

114
Q

Degenerative Disk Disease: What specific things will y ou assess for?

A

6 P’s. Assess for paresthesia, limited movement and diminished function of neck, shoulder, and upper extremities (ROM)

115
Q

Degenerative Disk Disease: Cervical spine palpated to assess

A

muscle tone and tenderness

116
Q

Degenerative Disk Disease: If someone has surgery, what on their body is assessed?

A

Dressing assessed for serosanguinous drainage (dural leak)

117
Q

Degenerative Disk Disease: What will we perform assessment while after surgery?

A

5 P’s. Pain, Pallor, Paresthesia, Pulse, Paralysis

Dressing check

Monitor for hematoma

118
Q

Degenerative Disk Disease: Changes in motor responses produces what?

A

Limited movement

119
Q

Degenerative Disk Disease: Changes in sensation produces what?

A

Paresthesia

120
Q

Degenerative Disk Disease: Pt reporting headache indicates what?

A

That there is a CSF leak

121
Q

Degenerative Disk Disease: What position do they lay in?

A

Proper anatomical position

122
Q

Degenerative Disk Disease: Nursing Diagnosis of this?

A

Acute pain RT surgical procedure

RF Chronic Pain

Impaired mobility RT postoperative surgical regimen

Deficient knowledge about postop course and home care management

123
Q

Degenerative Disk Disease: Goals for patient?

A

Pain relief

Improved mobiltiy

Increased knowledge of proper body mechanics

No complications

124
Q

Degenerative Disk Disease: Treatment is conservative with?

A

Rest, Meds, PT

125
Q

Degenerative Disk Disease: You should assist patient with

126
Q

Degenerative Disk Disease: How to relieve some pain?

A

Heat or Cold Packs

127
Q

Degenerative Disk Disease: Make sure to maintain what after surgery?

A

Proper alignment after surgery

128
Q

Degenerative Disk Disease: Potential complications after surgery?

A

Hematoma: At surgical site resulting in cord compression and neurologic deficit (bleeding or leaking CSF)

Recurrent or persistent pain after surgery

129
Q

Degenerative Disk Disease: Medical management for this?

A

Conservative tx or if unsuccessful surgery may be required

130
Q

Degenerative Disk Disease: Education to patient?

A

Proper body mechanics

131
Q

Degenerative Disk Disease: How should you roll the patient?

NRSG 110: Med Surg 2 (29 decks)

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