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Illness and Patho 1 > Neuro > Flashcards

Neuro Flashcards

1
Q

Disease of the basal ganglia

A

Parkinson’s Disease

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2
Q

What is Parkinson’s characterized by?

A

Slowing down in the initiation and execution of movement, increased muscle tone, tremors at rest, and impaired postural reflexes

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3
Q

Who is Parkinson’s more common in?

A

Men older than 50

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4
Q

What is the pathology of Parkinson’s Disease?

A

Degeneration of dopamine-producing neurons in substantia nigra of the midbrain, disrupting the dopamine-acetylcholine balance in basal ganglia

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5
Q

What is dopamine essential for the normal functioning of?

A

Posture, support, and voluntary motion

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6
Q

When do the symptoms of Parkinson’s begin?

A

After 80% of the neurons in the substantia nigra are gone

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7
Q

What is the hallmark of Parkinson’s?

A

Cogwheel rigidity

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8
Q

What is the rigidity in Parkinson’s caused by?

A

Sustained muscle contractions

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9
Q

What are the nursing interventions for patients with Parkinson’s?

A

Fall risk, aspiration risk, nutrition risk

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10
Q

How is Parkinson’s diagnosed?

A

Solely on history and clinical features

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11
Q

What confirms a Parkinson’s diagnosis?

A

A positive response to anti-parkinsonian medications

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12
Q

What is the goal of drug therapy for Parkinson’s?

A

Enhance or release the supply of Dopamine and block the effects of overactive cholinergic neurons

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13
Q

Dopamine receptor antagonist that promotes the release of dopamine

A

Parlodel

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14
Q

In which patients is Parlodel used?

A

Patients who experience dyskinesias or orthostatic hypotension while receiving Sinemet

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15
Q

Precursor of dopamine the can cross the blood brain barrier and convert to dopamine in the basal ganglia

A

Levodopa with carbidopa

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16
Q

What does long term use of levodopa with carbidopa lead to?

A

dyskinesia

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17
Q

How should levodopa with carbidopa be used?

A

Before meals to increase absorption and transport across the blood brain barrier

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18
Q

Drug used to block specific enzymes that inactivate dopamine

A

MAO Inhibitor

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19
Q

What teachings should accompany MAO Inhibitors?

A

There are many food interactions that continue for 14 days after discontinuation

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20
Q

Why are anticholinergic drugs used to manage Parkinson’s?

A

They decrease the activity of acetylcholine

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21
Q

What does surgery to to treat Parkinson’s?

A

Decrease the increased neuronal activity produced by dopamine depletion

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22
Q

Which surgeries are used in the treatment of Parkinson’s?

A

Ablation and Deep Brain Stimulation

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23
Q

What are the nutritional concerns in patients with Parkinson’s?

A

Malnutrition, constipation, and aspiration

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24
Q

How should the nutritional concerns of Parkinson’s patients be addressed?

A

Food easy to chew, thicken, small frequent meals, and adequate roughage

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25
Q

What is the cause of Parkinson’s?

A

Possible genetic component, stress

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26
Q

What do Parkinson’s patients look like?

A

Hunched over, shuffled gait and pill rolling fingers

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27
Q

What sensory impairment do patients with Parkinson’s have?

A

Dry eyes do to excessive blinking

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28
Q

What do Parkinson’s patients usually die of?

A

Pneumonia due to aspiration and immobility

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29
Q

What are the five Fs of Neurodegenerative diseases?

A

Fatigue and immobility, fluctuations in function, frequent medication changes, fecal, and flow

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30
Q

Chronic demyelinating disease of the entire central nervous system caused by plaque, inflammation, edema and recovery of the nerve cells

A

Multiple Sclerosis

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31
Q

Where are people more likely to develop MS?

A

Not near the equator

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32
Q

Who is more likely to develop MS?

A

Young caucasian women

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33
Q

What causes MS?

A

Possible post-viral stimuli, possible genetic component, autoimmune disease

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34
Q

What is the biggest impediment to adjusting to the diagnosis of MS?

A

The uncertain course of the disease and the inability to plan for the future

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35
Q

How is MS diagnosed?

A

Rule out everything else, then look at an MRI for two areas of demyelination or two or more exacerbations

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36
Q

What are the signs of MS?

A

Paresthesias, double vision, tremors, nystagmus, schitomas, Lhermitte’s sign

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37
Q

Seeing floaters in eyes

A

Schitomas

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38
Q

Flexing neck causes shooting, electric like pain in the lower extremities

A

Lhermitte’s sign

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39
Q

What brings a patient with MS in initially?

A

Vision changes

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40
Q

What is the goal for the drug therapy of patients with MS?

A

Keep the disease in remission

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41
Q

What medications are used to treat MS?

A

IV and PO corticosteroids, Copaxone, and Baclofen

42
Q

What is Baclofen used to treat in MS patients?

A

Spasticity

43
Q

How are corticosteroids used in MS patients?

A

As a rescue treatment

44
Q

How is Copaxone used for MS patients?

A

It is an immunomodulator used to reduce the frequency of relapses

45
Q

What risk accompanies Copaxone and corticosteroids?

A

Risk for infection

46
Q

What considerations need to be taken when using steroids?

A

Low K, bleeds, psuedodiabetes

47
Q

Why are MS patients on antibiotics?

A

Frequent UTIs

48
Q

What do MS patients have to be taught about urination habits?

A

Use the Crede method

49
Q

What are the nursing interventions for patients with MS?

A

Impaired mobility, altered urinary elimination, risk for falls

50
Q

What are the major problems for MS patients?

A

Motor balance and coordination

51
Q

What are the sensory dysfunctions for patients with MS?

A

Loss of sensitivity or tingling, pins and needles, numbness

52
Q

What is the worst kind of MS?

A

Primary Progressive

53
Q

What is the main dysfunction of MS?

A

Urinary interruptions and muscle spasticity and weakness

54
Q

When do tremors occur in patients with MS?

A

With activity

55
Q

What causes a relapse of MS?

A

Stress to the body or mind

56
Q

What are the side effects of Levidopa?

A

Makes the patient extremely sexual and tar dive dyskinesia

57
Q

What is Requip used for in patients with Parkinson’s?

A

It mimics dopamine

58
Q

What sensory dysfunction occurs with MS?

A

Loss of sensitivity, tingling, pins and needles and numbness in extremities

59
Q

What is TENS?

A

Low does electricity used to treat MS

60
Q

What is the nursing priority for patients with MS?

A

Prevent falls

61
Q

What part of the nervous system does MS attack?

A

CNS

62
Q

Destruction of the myelin sheath in peripheries caused by multiple immunizations or an autoimmune attack

A

Guillain Barre

63
Q

Who does Guillain Barre affect?

A

Men and women over 55

64
Q

What is the problem in Guillain Barre?

A

The lymphocytes are not making the distinction between self and non self cells

65
Q

What part of the nervous system does Guillain Barre affect?

A

PNS

66
Q

Where in the body does Guillain Barre start?

A

Starts at toes and works its way up

67
Q

What sensory dysfunctions does Guillain Barre cause?

A

Paresthesia, blindness, and a blank stare

68
Q

What is the major problem of Guillain Barre

A

Respiratory depression from paralysis of muscles

69
Q

How is Guillain Barre treated?

A

Plasmapheresis and IV-IG

70
Q

What are the side effects of IV-IG?

A

Chills, fever, myalgia, acute renal failure, and anaphylaxis

71
Q

What can patients with Guillain Barre never be given?

A

Corticosteroids

72
Q

What are the nursing interventions for patients with Guillain Barre?

A

Prepare to intubate, impaired mobility, ineffective airway clearance

73
Q

What is the prognosis for Guillain Barre?

A

The disease should remit and go away within 2 years

74
Q

Autoimmune disorder in which antibodies attack the acetylcholine receptors at neuromuscular junctions, impairing the transmission of impulses

A

Myasthenia Gravis

75
Q

Who does MG affect?

A

Women younger than 40 and men older than 60

76
Q

What can cause MG?

A

Thymus problems, stress

77
Q

What are the motor dysfunctions in patients with MG?

A

Muscle fatigue and aches

78
Q

What are the sensory dysfunctions for patients with MG?

A

Impaired facial expressions, paresthesia, impaired chewing and swallowing, decreased smell and tastes, dysphonia, and ptosis

79
Q

What is the major problem for patients with MG?

A

Respiratory Failure

80
Q

What is used to treat MG?

A

Immunosuppressants, thyroidectomy and anticholenergases

81
Q

Name an anticholenergase drug

A

Mestinon

82
Q

What teaching needs to accompany a MG diagnosis?

A

Teach family CPR and how to respond to respiratory distress

83
Q

What causes a myasthenic crisis?

A

Too little acetylcholine

84
Q

What happens to patients in a myasthenic crisis?

A

Increased heart rate, increased respirations, and elevation in blood pressure

85
Q

What causes a cholenergic crisis?

A

Too much acetylcholine

86
Q

What happens to patients in a cholenergic crisis?

A

Nausea, vomiting, diarrhea, pallor, twitching, and hypotension

87
Q

What are the nursing interventions for patients with MG?

A

Keep the airway patent and keep the patient away from extremes in temperature

88
Q

How is MG diagnosed?

A

Tensilon Test

89
Q

What is a Tensilon Test?

A

Give the patient an injection of acetylcholine and see if their symptoms resolve

90
Q

What are the four major symptoms of Parkinson’s?

A

Tremors, rigidity, bradykineisa, and postural imbalances

91
Q

Where does the demyelination of neurons take place in patients with Guillain Barre?

A

At the Nodes of Ranvier

92
Q

Which neuro patient is at risk for developing DVTs?

A

Guillain Barre

93
Q

Which neuro patients have hyporeflexia?

A

Guillain Barre

94
Q

What is the diagnostic tool for Guillain Barre?

A

Presence of protein in the CSF

95
Q

What are the complications associated with plasmapheresis?

A

Infection, hypovolemia, hypokalemia, hypocalcemia, temporary paresthesia

96
Q

How long can a patient be intubated before a trach is needed?

A

10-14 days

97
Q

Which gland is involved in MG?

A

Thymus

98
Q

What is the first symptom of MG?

A

Ptosis

99
Q

How should Mestinon be given?

A

Eat 45 minutes to an hour after administration

100
Q

Which MG crisis requires intubation?

A

Myasthenic

101
Q

What do patients with Parkinson’s have to be closely monitored for?

A

Drug toxicity

Illness and Patho 1 (12 decks)

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