Module 10 Test Specfic Hints (Lopez)

Question 1

Pt presents with white milk curd looking substances in the mouth. What would you ask the Pt?

Answer 1

Are you currently on any medications? Immunosuppressants?

Question 2

When a Pt has an unidentified skin condition what steps do we take first?

Answer 2

1. Assess the area
2. Test it to get diagnosis
3. Treat accordingly

Question 3

What is the most important thing we can do for psoriasis patients?

Answer 3

Provide emotional support

Question 4

For patients that complain of constant headaches what is the most important things to do?

Answer 4

Ask them to journal their symptoms and how often they have the headache and where.

Meds: start with least intense (Tylenol) to most intense

Question 5

What is the highest priority in Parkinson’s patients?

Answer 5

Nutrition! Patients are often malnourished. They need 6 small meals a day, cut up their food, provide plenty of time for them to eat. Watch for dysphasia, bradykinesia and aspiration precautions.
if on Levadopa make sure to not give protein until evening

Question 6

What is the best tx for Gullian Barre?

Answer 6

IV Immunoglobulin G

Question 7

Which diseases KEEP cognitive control?

Answer 7

ALS
Guillain Barre
MG

Question 8

Older patient skin care

Answer 8

Hydration!! And protection of skin
(Oral fluids, nutrition, lotion, turn Q2h)

Question 9

Gerontological skin changes

Answer 9

Skin:Decreased subcutaneous fat, degeneration of elastic folds, collagen stiffener, decreased sebaceous glands, increased capillary fragility and permeability

•Hair: Decreased melanin, decreased oil and density, decreased estrogen levels

•Nails: Decreased peripheral blood supply, increased keratin, decreased circulation

See table 22.1: ”Gerontological Assessment Differences”, page 398

Question 10

Light-dark skin assessments

Answer 10

Dark: palms, soles, lips, sclera, oral mucosa, fingernails
Erythema: deep blue-purple increased skin temp
Jaundice: yellow/green color often seen in sclera
Pallor: skin tone lighter than normal
Petechiae: oral mucosa or sclera
Scar: keloid development is common

Question 11

S/S of musculoskeletal disorders

Answer 11

MS =
•vision(blurry/double, red/green distortion, possible blinds in 1 eye)
•Lhermitte’s sign (shock pain down extremities)
•tremors, speech problems

Parkinson’s =
•Bradykinesia, rigidity, tremor, gait changes
•TRAP (tremors, rigidity, akinesia, postural Instability)

Myasthenia Gravis =
Fluctuating weakness in skeletal muscles. 1st involved usually ocular
•others: chewing, swallowing, speaking, breathing

ALS =
•*progressive muscle weakness & atrophy
•limb onset tripping/stumbling
•speech/swallowing problems (bulbar)
•drooling, spasticity, hyperreflexia

Huntington’s =
•involuntary movement disorder (chorea)
•writhing, twisting, aspiration risks
•speech, swallowing, chewing problems
•gait deterioration-walking becomes impossible
•psychiatric symptoms present early
•COD: PNA & suicide

Guillain Barre =
•**Ascending symmetrical weakness. 1st sign- weakness, paralysis, hypotonia of lower limbs
•reflexes weak/absent
•watch as symptoms change starting from lower body and climbs (respiratory/intubation problems!!!)

Question 12

Which disorders LOSE cognitive function

Answer 12

Huntington’s
Multiple sclerosis

Question 13

Levadopa

Answer 13

-Monitor for signs of dyskinesia
-Monitor for short-term adverse side effects of nausea, vomiting, lightheadedness
-stress to pt’s that effects may be delayed for several weeks to months
-teach patient or caregiver to report any uncontrolled movement of face eyelids, mouth, tongue, arms, hands, or legs, mental changes, palpitations, and difficulty urinating
-do not give with food because protein reduces absorption