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Medical Surgical > Neuro, Sensory, Musculo Study Set > Flashcards

Neuro, Sensory, Musculo Study Set Flashcards

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USMLE® Step 1 flashcards
1
Q

Treatment for ischemic stroke

A

Alteplase tPA therapy

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2
Q

How do we treat a hemorrhagic stroke?

A

Surgical decompression

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3
Q

Risk factors of stroke?

A

Obesity, high cholesterol, hypertension, cocaine use, ATRIAL FIBRILATION

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4
Q

How do we diagnose stroke?

A

CT, MRI

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5
Q

F.A.S.T

A

Face droops, arm weakness, speech difficulty, time is critical

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6
Q

What do we do if the patient is having autonomic dysreflexia?

A

1) immediately raise the head of the bed
2)notify the HCP
3)check for noxious stimuli
4) administer antihypertensive

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7
Q

Signs and symptoms of stroke?

A

Facial drooping, slurred speech, arm weakness, visual changes, headache, paralysis

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8
Q

Right side of brain controls movement on?

A

Left side of body

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9
Q

Right side stroke patient will experience?

A

Behavioral changes (impulsive), memory deficits
(They always think they are right)

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10
Q

Left sided stroke pt will experience?

A

Language deficits, slow cautious behavior
(They think what is left for them)

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11
Q

What is the time frame for stroke?

A

3 hour window for treatment

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12
Q

Why are we worried about stroke?

A

Hemorrhage or clot can result in brain tissue ischemia and loss of function

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13
Q

What are signs and symptoms of retinal detachment?

A

Flashes of light, floating spots, loss of specific field of vision, curtain being drawn over eye

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14
Q

Treatment for retinal detachment

A

Laser photocoagulation, cryotherapy, pneumatic retinopathy

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15
Q

Nursing care for retinal detachment

A

Cycloplegic, mydriatic, and anti infective eyedrops. Eye patches on the operative eye or both.

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16
Q

Glaucoma causes?

A

Loss of peripheral vision

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17
Q

What is glaucoma?

A

Increased intra ocular pressure due to obstruction of the outflow of aqueous humor

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18
Q

S/S of glaucoma

A

Excruciating pain, colored halos around light, increase in IOP 50 or higher

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19
Q

What is a Normal IOP?

A

10-22

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20
Q

Medications for glaucoma?

A

Acetazolamide, mannitol, timolol maleate

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21
Q

What can happen if glaucoma isn’t treated?

A

Blindness may occur

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22
Q

What is cataracts?

A

Clouding of the lens

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23
Q

What can put you at risk for cataracts?

A

Old age, diabetes, HTN

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24
Q

S/S of cataracts?

A

Blurred vision, difficulty reading fine print, diplopia, photosensitivity, glare

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25
Q

How do we treat cataracts

A

Surgery

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26
Q

After cataract surgery what do can be given?

A

Corticosteroids and antibiotics

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27
Q

What puts you at risk for diabetic neuropathy?

A

Diabetes mellitus

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28
Q

Nursing care for diabetic neuropathy

A

Tight control of blood glucose levels

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29
Q

Can we suction for a patient with Increased ICP?

A

NOOOO

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30
Q

Signs of neurogenic shock

A

Bradycardia, hypotension, vasodilation

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31
Q

Signs of spinal shock

A

Loss of ability to move the body

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32
Q

What should we do for pt with spinal cord injury?

A

Stabilized the head and immobilize the spine

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33
Q

How do we diagnose spinal cord injury?

A

CT scan, MRI, X-ray to check spine

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34
Q

Signs and symptoms of spinal cord injury

A

Paralysis, loss of motor movement

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35
Q

Complications of spinal cord injury?

A

Autonomic dysreflexia

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36
Q

Signs of autonomic dysreflexia

A

Throbbing headache, hypertension, FLUSHING (upper body),

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37
Q

Autonomic dysreflexia lower part of body

A

Low BP, cool skin, pale extremities

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38
Q

Parkinson’s neurotransmitter

A

Low dopamine, increased acetylcholine levels

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39
Q

Parkinson’s S/S

A

Tremors, muscle rigidity, bradykinesia, shuffling gait, dysphagia, stooped posture

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40
Q

Parkinson’s treatment?

A

Carbidopa- levodopa, benzotropine, hydrochloride

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41
Q

What can we do for pt with Parkinson’s?

A

PT and OT, food that’s easy to chew and swallow, small frequent meals

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42
Q

What is RICE therapy?

A

Rest, ice, compression, elevate

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43
Q

What does phalen’s sign look like?

A

Reverse prayer hands

44
Q

When do we use phalen’s sign?

A

Carpal tunnel syndrome

45
Q

Tinsels sign is? What do we use it for?

A

Tapping of hand. Used for carpal tunnel.

46
Q

What is osteoporosis?

A

A decrease in bone density causes fragility to bones

47
Q

Does osteoporosis hurt?

A

No

48
Q

In what gender is osteoporosis most common in?

A

Women

49
Q

S/S of osteoporosis

A

Weak bones, decrease in height, low back pain, spontaneous fractures

50
Q

How Do we diagnose osteoporosis?

A

BMD measurement with DEXA low bone mass

51
Q

What is the main medication we give to pts with osteoporosis?

A

ALENDRONATE!!!!! and ibandronate
Both are bisphosphonates

52
Q

What is good for pts with osteoporosis?

A

WEIGHT BEARING EXERCISES (walking, hiking, weight training, stair climbing, tennis, dancing)

53
Q

What should we know about alendronate?

A

Taken on empty stomach, stay upright for 30 min after.

54
Q

Normal calcium levels for woman without estrogen therapy

A

1,500 and 1,000 with estrogen therapy

55
Q

What is rheumatoid arthritis?

A

Autoimmune disease, results in joint inflammation

56
Q

Risk factors for RA

A

Smoking and genetics

57
Q

RA S/S

A

Periods of remission and exacerbation, pain, swelling stiffness, fatigue anorexia, low grade fever

58
Q

How would we know someone has RA?

A

Morning stiffness that lasts longer than 30 min, joint pain, muscle weakness, fatigue

59
Q

Diagnostic test we can do for RA

A

ANA, RF, ESR, CRP
Synovial fluid cloudy and yellow

60
Q

RA medications

A

DMARDs: methotrexate, NSAIDs, corticosteroids

61
Q

Nursing care for pt with RA

A

Heat and COLD therapy application, avoid over exertion during flare ups

62
Q

What is osteoarthritis?

A

NON- INFLAMMATORY disease, loss of cartilage at joint margin

63
Q

What puts you at risk for osteoarthritis?

A

OBESITY, trauma

64
Q

S/S of osteoarthritis

A

Joint pain, morning stiffness lasting 30 min, crepitus affects one side, heberden’s and bouchard’s nodes

65
Q

diagnostic tests for Osteoarthritis

A

CT, MRI, ESR, synovial fluid CLEAR yellow

66
Q

Treatment for osteoarthritis

A

Heat application to relieve stiffness, heat used more often than cold!!!!, loosing weight

67
Q

Nursing care for osteoarthritis

A

Balance rest and activity, avoid immobilization for more than 1 hour, decrease stress on affected joint

68
Q

Trigeminal neuralgia affects which nerve

A

5th nerve

69
Q

Trigeminal neuralgia is?

A

Disorder that causes excruciating knife like pain in the lips, checks, side of the nose and forehead.

70
Q

Medication for Trigeminal neuralgia

A

Gabapentin

71
Q

What medications can be given for seizures

A

Phenytoin, gabapentin, carbamazepine, levetiracetam, diazepam

72
Q

Avoid what with increased ICP?

A

Straining, coughing, sneezing, suctioning

73
Q

Medications for myasthenia gravis

A

Neostigmine, pyridostigmine (mestinon), corticosteroids, cyclosporine

74
Q

Main concern with multiple sclerosis

A

Fatigue and weakness

75
Q

MS diagnostic test

A

No definitive test. MRI shows lesions at late stage

76
Q

MS medications

A

Adreno-corticotrophic hormones, corticosteroids, baclofen.

77
Q

What is MS?

A

Chronic progressive degenerative disease
Associated with destruction of myelin sheath.

78
Q

What is myasthenia gravis?

A

Autoimmune attack on acetylcholine resulting in muscle weakness

79
Q

S/S with myasthenia gravis

A

Respiratory muscle weakness (may require mechanical ventilation), dysphagia, diplopia

80
Q

What would we do for myasthenia gravis?

A

Neostigmine IV

81
Q

Diagnostic tests for myasthenia gravis

A

EMG, edrophonium: tensilon test.

82
Q

We avoid aspirin with what disease

A

Gouty arthritis

83
Q

What do we treat Alzheimer’s with?

A

Donepezil, mamantine, rivastigmine, lorazepam, haloperidol, fluoxetine

84
Q

Nursing care for pt with Alzheimer’s

A

Ensure safety, frequent high calorie meals, reorient often.

85
Q

Diagnostic test for seizures

A

CT, MRI, blood test, EEG

86
Q

What do we do if pt having seizure

A

Turn patient to side on floor, maintain patent airway, note time and duration of seizure, do not restrain pt, administer oxygen, suction secretions if needed

87
Q

What is our main concern with ALS?

A

Muscle weakness, breathing problems, aspiration (may require mechanical ventilation)

88
Q

ASL results in what?

A

Muscle wasting, weakness and some twitching

89
Q

Medications for ALS

A

Riluzole and edaravone

90
Q

Prognosis of ALS

A

Usually 3-5 years after diagnosis

91
Q

Nursing interventions with ALS

A

Physical therapy, speech and respiratory therapy, encourage exercise for trunk and limbs, watch for respiratory failure (most common cause of death)

92
Q

Meningitis signs

A

Brudinski’s and kernigs sign

93
Q

What is meningitis?

A

Acute infection of the meninges (bacteria or viral)

94
Q

Diagnostic tests for meningitis

A

CT scan and lumbar puncture

95
Q

When would we not do a lumbar puncture?

A

Increased ICP, may cause herniation

96
Q

If ICP is not increased in pt with meningitis can we do a lumbar puncture?

A

Yes

97
Q

Kernigs sign

A

Looks like kick while patient is laying down

98
Q

Brudzinskis sign

A

Flexion of knee and neck

99
Q

Treatment for meningitis

A

Multiple IV antibiotics, corticosteroids (decrease ICP), anticonvulsants to reduce risk of seizure, antipyretics, iv fluids to hydrate patient

100
Q

Patient with meningitis will be what precaution

A

Droplet precautions

101
Q

Nursing interventions for meningitis

A

Decrease bright lights (can cause seizure), may use cooling blanket, place patient on seizure precautions

102
Q

How can we prevent meningitis?

A

Getting the vaccine

103
Q

What is gouty arthritis?

A

Metabolic type of arthritis, results from buildup of uric acid in the body.

104
Q

What Do we avoid with gouty arthritis?

A

Organ meats, seafood, red meat, alcohol

105
Q

What are signs and symptoms of gouty arthritis?

A

Several pain and inflammation usually in a single joint. Big toe is usually affected but can happen in any joint

106
Q

What meds do we use to treat gouty arthritis?

A

Colchicine, allopurinol, NSAIDs, corticosteroids, probenecid
NO ASPIRIN

107
Q

Nursing interventions for gouty arthritis

A

Increase fluids to excrete uric acid, advise which foods to avoid, avoid putting pressure on affected joint, immobilize the joint

Medical Surgical (4 decks)

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