Neuro 3 Flashcards
Patient reports increased fatigue and stiffness of the extremities. These symptoms had occurred in the past, but resolved and no medical attention was sought. Which questions of the nurse asked to assess whether the symptoms may be associated with multiple sclerosis?
- Do you have a persistent sensitivity to cold
- Do you ever have slurred speech or trouble swallowing
- Has anyone in your family been diagnosed with multiple sclerosis
Patient with multiple sclerosis is prescribed oral prednisone 60 mg daily for seven days following a course of IV methylprednisone. Which laboratory abnormality is a side effect of the medication?
Decrease in serum potassium
The patient is a woman in her early 30s was recently been diagnosed with multiple sclerosis. The nurses has taught the patient’s husband about the course of the illness and what problems might occur in the future. Which statement by the husband indicates the need for additional teaching?
Later on she could have intermittent short-term memory loss
The patient and family are referred to the nurse for education about amyotrophic lateral sclerosis. What information does the nurse include an educational session?
- It is a progressive disease involving the motor system
- The cause of ALS is unknown
- There is no cure for ALS
What early symptoms does the nurse expect to observe in a 50-year-old patient recently diagnosed with ALS?
Tongue atrophy and dysphagia
The nurses assessing a patient with a diagnosis of Gillion bar syndrome. Which signs and symptoms are consistent with GPS?
- Sudden onset of weakness in the legs
- Decrease deep tendon reflexes
- Ataxia
During shift report, the nurse here’s the patient with GBS has a decrease in vital capacity that it’s less than two thirds of normal, and there’s a progressing inability to clear a cop up secretions. The physician been notified and is coming to evaluate the patient. What interventions the nurse prepared to implement for this patient?
Elective intubation
The patient with GBS is identified as having poor dietary intake secondary to dysphasia. A feeding tube is prescribed. How does the nurse monitor this patient’s nutritional status?
- Weighing the patient three times a week
2. Monitoring weekly sorry I’m pre-albumin level
The patient my GPS is in intubated for respiratory failure. The nurse must suction the patient. In assessing the risk for vagal nerve stimulation, what does the nurse closely monitor the patient for?
Bradycardia
The patient is admitted for a probable diagnosis of GPS, but needs additional diagnostic testing for confirmation. Which test does the nurse anticipate will be ordered for this patient?
- Electrophysiologic study
2. Electromyography
The nurses reviewing the cerebrospinal fluid results for patient with probable GBS. Which abnormal finding is common in GPS?
Increase in CSF protein level
An ambulatory patient has sought treatment for symptoms of GBS within two weeks of symptom onset. Which drug therapy is likely preferred for this patient?
Immunoglobulin
The patient is scheduled to receive immunoglobin therapy. Before administering the medication nurse ensures that which laboratory tests of been completed?
Serum IgA
Which interventions are appropriate for pain management and an older adult with GBS?
- IV opiates
- Neurontin
- Massage
- Music therapy
The patient with CVS is receiving IV immuno globulin. The nurse monitors for which major potential complication of this drug therapy?
Anaphylaxis
The nurse is monitoring a patient with GBS undergoing plasmapheresis. The patient reports dizziness and has a heart rate is dropped 48 bpm. The nurse notifies the primary care provider. Which ordered as the nurse anticipate?
Atropine IV push
The patient is the newly diagnosed with GBS the nurses teaching the patient and family about the condition. Which statement by the family indicates a need for additional teaching?
He’ll never be able to walk again
Which strategies should be incorporated in the plan of care to provide emotional support for patient with GBS who has the ascending Paralysis?
- Encouraged patient to verbalize feeling
- Teach the patient and family about the condition
- Explain all procedures and test
- Assess previous coping skills
What is the priority expected outcome in a patient with GBS?
Maintain airway patency and gas exchange
The nurses reviewing the admission and history notes for patient admitted for GPS. Which medical condition is most likely to be present for the onset of GBS?
Recent G.I. illness
The patient with GBS describes the chronological progression of motor weakness that started in the legs and spread to his arms and upper body. Which type of GPS to these symptoms indicate?
Ascending
The patient my GPS is in the plateau period. Which intervention is best for the nurse to delegate to the nursing assistant?
Performed passive range of motion every 2 to 4 hours
The nurses assessing patient with myasthenia gravis. Wish manifestations commoners expect to observe?
- Ptosis
- Diplopia
- InComplete Eye closure
Which statements about MG are accurate?
- It is an acquired autoimmune disease
- It occurs equally and men and women
- There is a small Familal incidence
- It is characterized by remissions and exacerbations
What is the most common electrodiagnostic test performed to detect MG?
Repetitive nerve stimulation
What is the cause of a cholinergic crisis?
Too many anticholinesterase drugs
What test is used to differentiate a cholinergic crisis from a myasthenia crisis?
Tensilon testing
What factors are associated with the development of GBS?
- Recent immunization
- Systemically lupus erythematosus
- Acute illness
- Trauma
The nurses receiving the biographic data and history for patient with MG. What does a nurse expect to see included in the patient’s residence?
Muscle weakness that increases with exertion or as the day wears on
Because the most common symptoms of MG are related to involvement of the levator palpebra it or extraocular muscles, which assessment technique does the nurse use?
Face the patient and direct him or her to open and close the eyelids
The patient with MG has bulbar involvement. What is the nurses priority assessment for this patient?
Ability to chew and swallow
The patient with MG the nurse are having a long discussion about plans for the future. After an extended conversation what does the nurse anticipate will occur in this patient?
Voice may become weaker or exhibit a nasal twang
Patient with MG reports having difficulty climbing stairs lifting heavy objects and raising arms overhead. What is the pathophysiology of this patient’s symptoms due to?
Limb weakness is more often proximal
