Neuro 3

Question 1

describe Myastheria crisis

Answer 1

acute exacerbation of MG
breathing and throat muscle weakness
d/t little to no stimulus at junction (no Ach)

Question 2

describe a Cholinergic crisis

Answer 2

presents similar to Myastheria crisis
severe weakness and resp failure
excessive stimulation at junction(too much Ach d/t high dosage of MG med)

Question 3

how to differentiate Myastheria and Cholinergic crises

Answer 3

• perform Tensilon test with Edrophorium drug
• Myastheria: brief instant improvement of symptoms (muscle strength improved d/t extension of muscle stimulation)
• Cholinergic: symptoms do not improve with drug, will become worse

Question 4

antidote of cholinergic crisis

Answer 4

atropine

Question 5

meds of MG

Answer 5

anticholinesterase (Neostigmine and Pyridostigmine)
corticosteroids
plasmapharesis
thymectomy

Question 6

nursing care of MG

Answer 6

assess resp function
eat 1 hr after ChE inhibitors to avoid aspiration
eye protection, nutritional support

Question 7

describe trigeminal neuralgia

Answer 7

• 5th cranial nerve affected (above ear)
• unilateral facial pain (intense spasms)
• provoked by minimal stimulation of trigger zone
• extremely hyper sensitive

Question 8

type of pain experienced by trigeminal neuralgia

Answer 8

sharp, shooting, burning, jabbing, piercing

Question 9

management of trigeminal neuralgia

Answer 9

control pain
Dilantin or Tegretol
local anesthesia
*NSAIDS will not work on nerve pain

Question 10

abnormal, sudden uncontrolled discharge of neurons

Answer 10

seizure

Question 11

• chronic condition, recurrent seizures, may cause imbalance of neurotransmitters (GABA), and or electrical activity
• neural excitation, not orderly

Answer 11

epilepsy

Question 12

which type of seizure happens to both hemispheres of the brain

Answer 12

generalized

Question 13

describe tonic/clonic seizure

Answer 13

lasts 2-5 min, typical seizure

tonic: stiffen, rigid muscles
clonic: jerking of extremities

Question 14

describe absence seizure

Answer 14

often in children
brief stares
loss of consciousness

Question 15

describe myoclonic seizure

Answer 15

brief jerking, lasts few sec

Question 16

describe atonic seizure

Answer 16

sudden loss of muscle tone, fall and confused

Question 17

which type of seizure happens to just one hemisphere (local)

Answer 17

partial

Question 18

what is a common part of partial seizures

Answer 18

aura: impending doom of seizure is felt

Question 19

what are the types of partial seizure

Answer 19

simple: lose consciousness (1-3 min)
complex: remain conscious (unusual sensation)

Question 20

early warning sign of impending attack/seizure

Answer 20

prodromal

Question 21

visual disturbance, buzzing sounds before seizure

Answer 21

aura

Question 22

the event (seizure)

Answer 22

ictus

Question 23

maintained contractions r/t bombardment of motor impulses

Answer 23

tonus

Question 24

contraction/relaxation of muscle

Answer 24

clonus

Question 25

exhaustion (final stage of seizure)

Answer 25

postical

Question 26

should you put something in someone's mouth during seizure

Answer 26

NO

Question 27

describe status eptilepticus

Answer 27

* life threatening - brain in state of persistant seizure - prolonged seizure > 5 min or repeated episodes >30 min

Question 28

intervention for status eptilepticus

Answer 28

call 911 if lasts longer than 5 min give O2- ensure patent airway *ATIVAN-rescue drug OR Dilantin these are sedative and hypnotic drugs to shut off brain activity

Question 29

what to do during seizure

Answer 29

privacy, protect, pad side rails | ease to floor, protect from injury, loosen clothes

Question 30

what to do after seizure

Answer 30

``` position on side check VS allow time to sleep re orient pt document and time seizure ```

Question 31

what is another word for brain attack

Answer 31

stroke

Question 32

describe what a cerebrovascular accident is (CVA)

Answer 32

- interruption in cerebral blood flow - can be ischemia, hemorrhage, embolism - syndrome of rapid onset characterized by neruologic defect lasting >24 hrs - results in impaired brain circulation

Question 33

what are stroke risk factors

Answer 33

HTN, DM, obesity, smoking, oral contraceptive, A fib, sickle cell, hyperlipidemia

Question 34

describe an ischemic stroke

Answer 34

blood CLOT in artery of brain | 80% of strokes

Question 35

describe what TIA is

Answer 35

``` transient ischemic attack warning sign (first stroke) for MAJOR oncoming stroke ```

Question 36

describe a hemorrhagic stroke

Answer 36

- rupture of vessel in brain with subsequent bleeding in the brain - 20% of strokes - proceeded by "worst headache of life" - often die instantly d/t excessive cerebral bleeding

Question 37

what is the biggest risk of hemorrhagic stroke

Answer 37

HTN-high pressure can lead to rupture of vessel in brain

Question 38

what are the warning signs of stroke

Answer 38

- sudden weakness/numbness of face, arm, leg (esp one side) - sudden confusion, trouble speaking/understanding speech - sudden trouble seeing in 1 or 2 eyes - sudden severe headache

Question 39

recognition of stroke

Answer 39

FAST (face, arms, speech, time) | smile, make complete sentence, raise both arms