Neuro, Sensory, Musculo Study Set Flashcards by Diana Portillo

Treatment for ischemic stroke

Alteplase tPA therapy

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How do we treat a hemorrhagic stroke?

Surgical decompression

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Risk factors of stroke?

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

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How do we diagnose stroke?

CT, MRI

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F.A.S.T

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

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

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

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Signs and symptoms of stroke?

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

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Right side of brain controls movement on?

Left side of body

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Right side stroke patient will experience?

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

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Left sided stroke pt will experience?

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

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What is the time frame for stroke?

3 hour window for treatment

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Why are we worried about stroke?

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

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What are signs and symptoms of retinal detachment?

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

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Treatment for retinal detachment

Laser photocoagulation, cryotherapy, pneumatic retinopathy

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Nursing care for retinal detachment

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

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Glaucoma causes?

Loss of peripheral vision

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What is glaucoma?

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

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S/S of glaucoma

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

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What is a Normal IOP?

10-22

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Medications for glaucoma?

Acetazolamide, mannitol, timolol maleate

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What can happen if glaucoma isn’t treated?

Blindness may occur

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What is cataracts?

Clouding of the lens

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What can put you at risk for cataracts?

Old age, diabetes, HTN

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S/S of cataracts?

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

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How do we treat cataracts

Surgery

After cataract surgery what do can be given?

Corticosteroids and antibiotics

What puts you at risk for diabetic neuropathy?

Diabetes mellitus

Nursing care for diabetic neuropathy

Tight control of blood glucose levels

Can we suction for a patient with Increased ICP?

NOOOO

Signs of neurogenic shock

Bradycardia, hypotension, vasodilation

Signs of spinal shock

Loss of ability to move the body

What should we do for pt with spinal cord injury?

Stabilized the head and immobilize the spine

How do we diagnose spinal cord injury?

CT scan, MRI, X-ray to check spine

Signs and symptoms of spinal cord injury

Paralysis, loss of motor movement

Complications of spinal cord injury?

Autonomic dysreflexia

Signs of autonomic dysreflexia

Throbbing headache, hypertension, FLUSHING (upper body),

Autonomic dysreflexia lower part of body

Low BP, cool skin, pale extremities

Parkinson’s neurotransmitter

Low dopamine, increased acetylcholine levels

Parkinson’s S/S

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

Parkinson’s treatment?

Carbidopa- levodopa, benzotropine, hydrochloride

What can we do for pt with Parkinson’s?

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

What is RICE therapy?

Rest, ice, compression, elevate

What does phalen’s sign look like?

Reverse prayer hands

When do we use phalen’s sign?

Carpal tunnel syndrome

Tinsels sign is? What do we use it for?

Tapping of hand. Used for carpal tunnel.

What is osteoporosis?

A decrease in bone density causes fragility to bones

Does osteoporosis hurt?

In what gender is osteoporosis most common in?

Women

S/S of osteoporosis

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

How Do we diagnose osteoporosis?

BMD measurement with DEXA low bone mass

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

ALENDRONATE!!!!! and ibandronate Both are bisphosphonates

What is good for pts with osteoporosis?

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

What should we know about alendronate?

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

Normal calcium levels for woman without estrogen therapy

1,500 and 1,000 with estrogen therapy

What is rheumatoid arthritis?

Autoimmune disease, results in joint inflammation

Risk factors for RA

Smoking and genetics

RA S/S

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

How would we know someone has RA?

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

Diagnostic test we can do for RA

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

RA medications

DMARDs: methotrexate, NSAIDs, corticosteroids

Nursing care for pt with RA

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

What is osteoarthritis?

NON- INFLAMMATORY disease, loss of cartilage at joint margin

What puts you at risk for osteoarthritis?

OBESITY, trauma

S/S of osteoarthritis

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

diagnostic tests for Osteoarthritis

CT, MRI, ESR, synovial fluid CLEAR yellow

Treatment for osteoarthritis

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

Nursing care for osteoarthritis

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

Trigeminal neuralgia affects which nerve

5th nerve

Trigeminal neuralgia is?

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

Medication for Trigeminal neuralgia

Gabapentin

What medications can be given for seizures

Phenytoin, gabapentin, carbamazepine, levetiracetam, diazepam

Avoid what with increased ICP?

Straining, coughing, sneezing, suctioning

Medications for myasthenia gravis

Neostigmine, pyridostigmine (mestinon), corticosteroids, cyclosporine

Main concern with multiple sclerosis

Fatigue and weakness

MS diagnostic test

No definitive test. MRI shows lesions at late stage

MS medications

Adreno-corticotrophic hormones, corticosteroids, baclofen.

What is MS?

Chronic progressive degenerative disease Associated with destruction of myelin sheath.

What is myasthenia gravis?

Autoimmune attack on acetylcholine resulting in muscle weakness

S/S with myasthenia gravis

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

What would we do for myasthenia gravis?

Neostigmine IV

Diagnostic tests for myasthenia gravis

EMG, edrophonium: tensilon test.

We avoid aspirin with what disease

Gouty arthritis

What do we treat Alzheimer’s with?

Donepezil, mamantine, rivastigmine, lorazepam, haloperidol, fluoxetine

Nursing care for pt with Alzheimer’s

Ensure safety, frequent high calorie meals, reorient often.

Diagnostic test for seizures

CT, MRI, blood test, EEG

What do we do if pt having seizure

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

What is our main concern with ALS?

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

ASL results in what?

Muscle wasting, weakness and some twitching

Medications for ALS

Riluzole and edaravone

Prognosis of ALS

Usually 3-5 years after diagnosis

Nursing interventions with ALS

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

Meningitis signs

Brudinski’s and kernigs sign

What is meningitis?

Acute infection of the meninges (bacteria or viral)

Diagnostic tests for meningitis

CT scan and lumbar puncture

When would we not do a lumbar puncture?

Increased ICP, may cause herniation

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

Yes

Kernigs sign

Looks like kick while patient is laying down

Brudzinskis sign

Flexion of knee and neck

Treatment for meningitis

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

Patient with meningitis will be what precaution

Droplet precautions

Nursing interventions for meningitis

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

How can we prevent meningitis?

Getting the vaccine

What is gouty arthritis?

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

What Do we avoid with gouty arthritis?

Organ meats, seafood, red meat, alcohol

What are signs and symptoms of gouty arthritis?

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

What meds do we use to treat gouty arthritis?

Colchicine, allopurinol, NSAIDs, corticosteroids, probenecid NO ASPIRIN

Nursing interventions for gouty arthritis

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