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Med Surg > Med Surg Final > Flashcards

Med Surg Final Flashcards

1
Q

What are the s/s of trigeminal neuralgia?

A

sudden, intense unilateral facial pain, tearing of the eye and freq blinking

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2
Q

Treatment of trigeminal neuralgia

A 
Anticonvulsants (tegretol and trileptal)
Sugery:
1. local nerve block
2. Glycerol Rhizotomy
3. Microvascular decompression
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3
Q

What do we need to know about anticonvulsants (especially tegretol)

A
  • must use tegretol cautiously because it can further damage the liver
  • must assess alcohol intake
  • assess liver enzymes
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4
Q

Diet for Trigeminal Neuralgia

A

high protein, high calorie diet that is warm and easy to chew

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5
Q

How can we tell if the meds for trigeminal neuralgia are effective?

A

if they are performing social activities

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6
Q

What are things that we need to assess for, for our patients with trigeminal neuralgia?

A
  • if they are eating (I&O)q

- if they are performing oral care

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7
Q

Pt teaching after glycerol rhizotomy?

A

pt may have to do facial exercises to improve their facial muscles

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8
Q

What CN has inflammation in Bell’s Palsy?

A

CN VII (facial)

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9
Q

What can be the first presentation of bell’s palsy?

A

herpes/pain around the ear

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10
Q

S/s of Bell’s Palsy

A
  • unilateral paralysis of facial muscles
  • unilateral loss of taste and hearing
  • possible tearing
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11
Q

What meds are used to MANAGE Bell’s Palsy?

A

corticosteriods (for 2 weeks) + acyclovir

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12
Q

Non-Medical interventions for ball’s palsy

A
  • moist heat and gentle massage
  • eye patch and artificial tears ( to avoid eye abrasions)
  • oral care
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13
Q

Guillian_Barre Syndrome

A

ascending, symmetric paralysis that usually affects cranial nerves and the PNS

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14
Q

What are the s/s of Guillian Barre Syndrome?

A

bilateral weakness, pain (worse at night), paresthesia, hypotonia, areflexia => paralysis

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15
Q

How do you “diagnose” GBS?

A

r/o MS

  • lumbar puncture
  • EMG- dec nerve conduction velocity
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16
Q

Treatment for GBS?

A
  • plasmapheresis

- IV sandoglobulin

17
Q

IV sandoglobulin

A

immunoglobulin

** must keep pt hydrated because it affects renal fucntion

18
Q

Complications of GBS?

A
  • respiratory depression!!!
  • orthostatic hypotension
  • HTN
  • bradycardia, dysrhythmias
  • DVT
  • Pressure shore
  • UTI
  • incontinence/retention
  • small bowel obstruction
19
Q

What might be an indicator that someone with GBS might require intubation?

A

continuous drooling of saliva

20
Q

Above what vertebrae will the pt lose their ability to breathe on their own?

A

C4 and above

21
Q

What 2 vertebrae might you be able to move your arms?

A

C7 and T1

22
Q

When are you concerned with autonomic dysreflexia?

A

above T6

23
Q

Spinal Shock

A 
happens immediately (complete loss of skeletal muscle function)
- dec reflexes, loss of sensation, flaccid paralysis below lvl of injury
24
Q

When is there a higher risk for GI prob (small bowel obstruction, paralytic ileum, bladder distention)

A

above T5

25
Q

Reglan

A

helps with the delayed gastric emptying

26
Q

poikilothermism (thermoregulation)

A

ability to shiver and ability to sweat

27
Q

Cervical injury below C4

A

diaphragmatic breathing if phrenic nerve is still functioning

28
Q

How do we know if spinal shock is resolving

A
  • return of reflexes
29
Q

What medications do you give someone with a spinal cord injury?

A
  • methylprednisolone (give early and in large doses) Must be within EIGHT hours of injury
  • must be diluted and given IV
30
Q

Non-operative care for a SCI

A
  • traction/realignment- halo vest
31
Q

Surgical Care for a SCI

A
  • decompression laminectomy
32
Q

What must you assess for after a decompression laminectomy?

A
  • dusky skin or trouble breathing

- hoarseness will indicate a knick on the pharynx

33
Q

What are the s/s of autonomic dysreflexia?

A
  • throbbing HA
  • bradycardia
  • HTN
  • blurred vision
  • diaphoresis and flushing of the skin above the lesion
  • piloerection
  • nausea
  • sudden nasal congestion
34
Q

Nursing intervention for autonomic dysreflexia?

A
  • sit them up (or elevate 45 degrees)
  • address cause
  • call doc

Med Surg (7 decks)

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