Neuro Flashcards
Sz disorder- “It’s ok to take over-the-counter meds
should not take without consulting with dr
LPN role
administrate meds
observing/documenting
turning pt
Sumatriptan- contraindications
used to tx migraine HA
Contraindicated in pats with autal or suspected: ischemi heart dz, cerebrovascular ischemia, THn, and peripheral vascular dz, Prinzmetal angina
med administration- bacterial meningitis
Bacterial meningitis is a medical emergency, and antibiotics are administered even before the diagnosis is confirmed (after specimens have been collected for culture). The other interventions will also help to reduce central nervous system stimulation and irritation and should be implemented as soon as possible but are not as important as starting antibiotic therapy.
Serious adverse effect of phenytoin therapy
Leukopenia is a serious adverse effect of phenytoin therapy and would require discontinuation of the medication.
used to tx sz
Q’s about orientation
After determining alertness in a patient, the next step is to evaluate orientation. When the patient’s attention is engaged, ask him or her questions to determine orientation. Varying the sequence of questioning on repeated assessments prevents the patient from memorizing the answers. Responses that indicate orientation include the ability to answer questions about person, place, and time, so the nurse should ask for information relating to the onset of the patient’s symptoms, the name of his or her health care provider or nurse, the year and month, his or her ad-dress, and the name of the referring physician or health care agency. Asking about the mayor’s affiliation or for his or her parents’ address may be inappropriate to assess orientation.
reappyling compression boots- role
AP
Tongue blades
Should neverr be at the bedsider and should never be inserted into patient’s mouth after sz begins
first priorty for pt with spinal cord injury
The first priority for the patient with a spinal cord injury is assessing respiratory patterns and ensuring an adequate airway. A patient with a high cervical injury is at risk for respiratory compromise because spinal nerves C3 through C5 innervate the phrenic nerve, which controls the diaphragm. The other assessments are also necessary but are not as high a priority.
Best nursing action- change in LOC from alert to lethargic
A change in level of consciousness and orientation is the earliest and most reliable indication that central neurologic function has declined. If a decline occurs, the nurse should contact the rapid response team or health care provider immediately. The nurse should also perform a focused assessment to determine if there are any other changes.
Estrogen therapy and migraine HA
SHOULd be avoided
A patient with a spinal cord injury reports a sudden severe throbbing headache that started a short time ago. Assessment of the patient reveals increased blood pressure (168/94 mm Hg) and decreased heart rate (48 beats/min), diaphoresis, and flushing of the face and neck. What action should the nurse take first?
The patient’s signs and symptoms are characteristic of autonomic dysreflexia, a neurologic emergency that must be promptly treated to prevent a hypertensive stroke. The cause of this syndrome is noxious stimuli, most often a distended bladder or constipation, so checking for poor catheter drainage, bladder distention, and fecal impaction is the first action that should be taken. Adjusting the room temperature may be helpful because too cool a temperature in the room may contribute to the problem. Acetaminophen will not decrease the autonomic dysreflexia that is causing the patient’s headache. Notifying the HCP may be necessary if nursing actions do not resolve symptoms.
One of the 1st sx of AD
short-term memory impairment
LPN education and team leader responsibility
includes checking for therapeutic and adverse effects of meds
Death span - pts with ALS
occurs 2-5 years after diagnosis
What to do first if pt has generalize tonic-clonic sz?
turn patient to the side
he priority action during a generalized tonic-clonic seizure is to protect the airway by turning the patient to one side to prevent aspiration. Administering lorazepam should be the next action because it will act rapidly to control the seizure. Although oxygen may be useful during the postictal phase, the hypoxemia during tonic-clonic seizures is caused by apnea, which cannot be corrected by oxygen administration. Checking the level of consciousness is not appropriate during the seizure because generalized tonic-clonic seizures are associated with a loss of consciousness.
Goal ADLs- pt with Parkinson’s
maintaining independence
although all of these actions fall within the scope of practice for an AP, the AP should help the patient with morning care as needed, but the goal is to keep the patient as independent and mobile as possible. The patient should be encouraged to perform as much morning care as possible. Assisting the patient in ambulating, reminding the patient not to look at his feet (to prevent falls), and encouraging the patient to feed himself are all appropriate to the goal of maintaining independence.
alteplase
why contraindicated for hemorrhagic stroke
clot buster
can cause more bleeding in the brain
