Neurological Disorders Flashcards
What is the primary drug treatment for Parkinson’s disease?
Carbidopa-Levodopa (Sinemet)
-Replenishes dopamine in the brain
What are common side effects of Carbidopa-Levodopa?
Nausea, orthostatic hypotension, dyskinesias, hallucinations
What is Benztropine (Cogentin) used for in Parkinson’s?
Reduces tremors and muscle rigidity (anticholinergic)
What class of drugs are used alongside Levodopa to prolong its effect?
COMT inhibitors (Entacapone)
What is the purpose of Baclofen (Lioresal) in multiple sclerosis (MS)?
Relieves muscle spasticity
Which drug class includes interferon beta and Fingolimod, used for MS?
Disease-modifying agents (immune modulators)
Which corticosteroid is commonly used to treat MS flare-ups?
Methylprednisolone or Prednisone-reduces inflammation, shortens relapse
What does Galtiramer acetate (Copaxone) do in MS?
Converts harmful T cells into protective T cells
What medication is used for urinary retention in MS?
Bethanechol
What medication helps with urinary incontinence in MS?
Oxybutynin or Botulinum toxin
What seizure medication is used for tonic-clonic seizures and status epilepticus?
Phenytoin (Dilantin), Diazepam, Fosphenytoin
What are key diagnostics for seizure disorders?
EEG, CT, MRI, Serum electrolytes
What medication is used for ALS to slow progression?
Riluzole (Rilutek)
Which med is used in myasthenia Travis to improve muscle strength?
Pyridostigmine (Mestinon)
What diagnostic test confirms myasthenia gravis?
Edrophonium (Tensilon) test- rapid improvement in muscle strength
What medications treat Guillain-Barre Syndrome (GBS)?
IV immune globulin (IVIG), plasmapheresis
What is Donepezil (Aricept) used for?
Treats memory loss in Alzheimer’s disease (cholinesterase inhibitor)
What does Memantine (Namenda) treat?
Moderate-to-severe Alzheimer’s (NMDA receptor antagonist)
What’s a key symptom of Huntington’s disease?
Choreiform (jerky) movements; treated with tranquilizers & antiparkinsonian drugs
What is the function of the myelin sheath?
Speeds up nerve impulse conduction along axons
What is a major cause of meningitis?
Bacteria like N. Meningitidis & S. Pneumoniae
What are signs of bacterial meningitis?
Fever, headache, unchallenging rigidity, photophobia, vomiting
What are CSF findings in bacterial meningitis?
cloudy CSF, elevated WBCs, positive culture
What medications are used for bacterial meningitis?
IV antibiotics (penicillin, vancomycin), anticonvulsants if seizures occur
What are symptoms of encephalitis?
Fever, headache, altered LOC, seizures, slow wave EEG
What are treatment strategies for encephalitis?
Antipyretics, anticonvulsants, anti-inflammatory drugs, analgesics
What is the hallmark finding in Guillain-Barre Syndrome?
Ascending muscle weakness, areflexia, elevated CSF protein
What are the nursing priorities for Guillain-Barre Syndrome?
Monitor respiratory function, support mobility, prevent complications
What medications are given in status epileptics?
Diazepam, Midazolam, Fosphenytoin
What is the difference between simple and complex partial seizures?
Simple: consciousness retained
Complex: consciousness impaired
What are the phases of a tonic-clonic seizure?
Preictal (aura), tonic, clonic, postictal
What does an EEG measure?
Electrical activity in the brain-used for diagnosing seizures
What nursing action is priority during a seizure?
Maintain airway, protect from injury, do not restrain
What are early signs of Alzheimer’s disease?
Memory loss, difficulty performing familiar tasks, personality change
What class of drugs is Donepezil (Aricept)?
Cholinesterase inhibitor—slows cognitive decline in Alzheimer’s
What is Memantine (Namenda) used for?
Moderate-to-severe Alzheimer’s—reduces overstimulation of NMDA receptors
What neurotransmitter is deficient in Parkinson’s disease?
Dopamine
What causes chorea in Huntington’s disease?
Genetic neurodegeneration of basal ganglia neurons
What is a key diagnostic for Multiple Sclerosis?
MRI showing demyelinated plaques, CSF with elevated IgG
What medication class is used for MS mood stabilization?
Tranquilizers
What is the gold standard for identifying brain lesions in MS?
MRI—reveals demyelinated plaques
What CSF finding supports a diagnosis of multiple sclerosis?
Elevated immunoglobulin G (IgG) and white blood cells
What confirms Guillain-Barre Syndrome via lumbar puncture?
Elevated CSF protein with normal WBC count
What tests confirms Myasthenia Gravis?
Edrophonium (Tensilon) test—shows temporary muscle strength improvement
What diagnostic test is used for seizure disorders?
Electroencephalogram (EEG)—identifies abnormal brain activity
What does a CT or MRI show in a traumatic brain injury like an epidural hematoma?
Blood accumulation between skull and dura mater
What diagnostic reveals slow brain waves in encephalitis?
EEG (electroencephalogram)
What position should a client with increased intracranial pressure be in?
Head of bed at 30 degrees, midline to promote venous drainage
What is the priority nursing action during a seizure?
Maintain airway, protect from injury, time the seizure
What should the nurse monitor when administering phenytoin (Dilantin)?
Gum health (gingival hyperplasia), therapeutic levels, and liver function
What is a key teaching point for clients on carbidopa-levodopa?
Take consistently, avoid high-protein means, report involuntary movements
What is important to teach clients taking corticosteroids for MS?
Take with food, monitor blood sugar, watch for signs of infections
What psychosocial support is important for clients with Parkinson’s or Alzheimer’s?
Support groups, structured routine, safety modifications, caregiver support
What is an appropriate interventions for a client with MS experiencing urinary incontinence?
Bladder training, anticholinergic medications (oxybutynin)
What diet-related advice should be given to a client on levodopa?
Avoid excessive protein—it can impair drug absorption
A client with a history of a fall presents with drowsiness, sluggish pupils, slurred speech, and left arm weakness. What diagnosis is likely?
Epidural hematoma—a medical emergency due to increased ICP
A client reports numbness in the legs, progressive weakness, and had a recent cold. What disorder is suspected?
Multiple sclerosis (MS)
A client with Parkinson’s says their “pill doesn’t work like it used to.” What is the likely cause?
Wearing-off phenomenon—may require medication adjustment or addition of COMT inhibitor
A client with diabetes & Parkinson’s has a glucose of 289 and an A1c of 8.2%. What nursing priority emerges?
blood sugar management to reduce neurovascular complications
A client with MS complains of blurry vision & unsteady walking. What safety intervention should the nurse prioritize?
Fall prevention—use assistive devices, remove trip hazards
A nurse is caring for a client newly diagnosed with Parkinson’s disease. Which of the following findings should the nurse expect?
A. Hyperactive reflexes
B. Intention tremors
C. Mask-like facial expression
D. Positive Babinski reflex
C. Mask-like facial expression
-A mask-like face is a classic sign of Parkinson’s. Intention tremors are more associated with MS; hyperreflexia & Babinski reflex suggest upper motor neuron disorders, not Parkinson’s.
A client with multiple sclerosis is prescribed baclofen. The nurse knows this medication is given to:
A. Improve cognitive function
B. Prevent seizures
C. Manage urinary retention
D. Reduce muscle spasticity
D. Reduce muscle spasticity
-Baclofen is a muscle relaxant used to treat muscle spasticity in MS. It does not affect cognition or seizures
A client with myasthenia gravis is experiencing a myasthenia crisis. The priority nursing action is to:
A. Provide a high-protein diet
B. Administer a laxative
C. Monitor respiratory status
D. Encourage ambulation
C. Monitor respiratory status
-Myasthenic crisis can lead to respiratory failure due to muscle weakness. Airway management is the priority
Which of the following lab findings is most concerning in a client taking phenytoin (Dilantin)?
A. AST 40
B. Sodium 139
C. Phenytoin level 25
D. Hemoglobin 14.1
C. Phenytoin level 25
-Normal phenytoin levels are 10-20. A level of 25 suggests toxicity & requires immediate intervention
A client with Guillain-Barré syndrome is admitted to the unit. Which intervention takes priority?
A. Administer IV steroids
B. Assess for recent travel history
C. Monitor vital capacity & respiratory effect
D. Start client on high-calorie diet
C. Monitor vital capacity & respiratory effect
-GBS can rapidly progress to respiratory paralysis, so monitoring breathing is crucial
A nurse is reinforcing teaching about levodopa/carbidopa (Sinemet). Which statement by the client indicates understanding?
A. “I’ll take it with high-protein meals to prevent nausea.”
B. “It might take a few weeks before I notice improvement.”
C. “I can stop the medication once I feel better.”
D. “I should take it only when symptoms are severe.”
B. “It might take a few weeks before I notice improvement.”
-Levodopa may take several weeks for full effect. It should not be stopped abruptly or used only as needed
A client with Alzheimer’s disease is prescribed donepezil. What is the expected outcome of this medication?
A. Permanent reversal of symptoms
B. Improvement in fine motor skills
C. Slowed progression of cognitive decline
D. Increase in dopamine levels
C. Slowed progression of cognitive decline
-Donepezil is a cholinesterase inhibitor that slows cognitive decline but does not cure the disease
Which of the following clinical signs would support a diagnosis of an epidural hematoma after a head injury?
A. Nystagmus & double vision
B. Sudden lucidity followed by unconsciousness
C. Hypotension & bradycardia
D. Gradual onset of fever & stiff neck
B. Sudden lucidity followed by unconsciousness
-Epidural hematomas are classically associated with a “lucid interval” before rapid deterioration
Which clinical finding is most characteristic of Parkinson’s disease?
A. Intention tremor
B. Bradykinesia
C. Hyperreflexia
D. Positive Kermit’s sign
B. Bradykinesia
-Slowness of movement is a cardinal symptom of Parkinson’s
The nurse should instruct a client taking carbidopa-levodopa to avoid which of the following?
A. Foods high in fiber
B. Green leafy vegetables
C. High-protein meals
D. Citrus juices
C. Citrus juices
-Protein can interfere with levodopa absorption
A client reports “pill-rolling” tremor & rigidity. Which medication should the nurse anticipate?
A. Donepezil
B. Pyridostigmine
C. Baclofen
D. Carbidopa-Levodopa
D. Carbidopa-Levodopa
-It’s the first-line treatment for Parkinson’s motor symptoms
Which symptom would indicated the “wearing-off” phenomenon in Parkinson’s disease?
A. Constipation
B. Sweating
C. Return of tremors before next dose
D. Headache
C. Return of tremors before next dose
-Wearing-off means symptoms return as the medication effect fades
A client with Parkinson’s disease is having difficulty swallowing. What is the priority action?
A. Encourage fluids
B. Provide large meals
C. Consult speech therapy
D. Offer carbonated beverages
C. Consult speech therapy
-Swallowing issues increase aspiration risk; speech therapy can evaluate and recommend safe swallowing strategies
Which symptom is commonly associated with multiple sclerosis (MS)?
A. Resting tremor
B. Nystagmus
C. Sudden loss of consciousness
D. Myoclonic jerks
B. Nystagmus
-Nystagmus is due to demyelination in the brain stem or cranial nerves
Which diagnostic finding supports a diagnosis of MS?
A. Cloudy CSF
B. Low serum glucose
C. Elevated CSF IgG
D. Decreased sodium
C. Elevated CSF IgG
-Increased IgG in CSF is a hallmark of MS
A client with MS is prescribed corticosteroids. what should the nurse monitor?
A. Blood glucose levels
B. Serum potassium
C. Pupillary response
D. Urine ketones
A. Blood glucose levels
-Corticosteroids can increase glucose levels
Which intervention helps prevent complications in a client with MS and limited mobility?
A. Apply compression stockings at bedtime
B. Encourage frequent rest periods
C. Restrict fluid intake
D. Avoid sunlight exposure
B. Encourage frequent rest periods
-Reduces fatigue & prevents complications from immobility
A client with MS reports bladder incontinence. What medication may be prescribed?
A. Pyridostigmine
B. Baclofen
C. Oxybutynin
D. Interferon beta
C. Oxybutynin
-Anticholinergic used to treat urinary incontinence
A client is experiencing a tonic-clonic seizure. What is the nurse’s priority action?
A. Insert a tongue blade
B. Restrain the client
C. Protect the client’s head
D. Administer oral phenytoin
C. Protect the client’s head
-Preventing injury is the immediate priority during a seizure
A client taking phenytoin reports sore gums. What should the nurse do?
A. Notify the provider immediately
B. Encourage regular oral hygiene
C. Discontinue the drug
D. Restrict citrus juices
B. Encourage regular oral hygiene
-Gingival hyperplasia is a common side effect; oral care helps manage it
Which finding requires immediate intervention in a client on valproic acid?
A. Hair loss
B. Tremors
C. Easy bruising
D. Weight gain
C. Easy bruising
-May indicate thrombocytopenia, a serious side effect of valproic acid
A client is having a seizure that lasts over 5 minutes. What condition is suspected?
A. Partial seizure
B. Absence seizure
C. Status epilepticus
D. Myoclonic episode
C. Status epilepticus
-A medical emergency; seizures >5 minutes require intervention
What medication is given IV to stop seizure in status epilepticus?
A. Lamotrigine
B. Gabapentin
C. Diazepam
D. Carbamazepine
C. Diazepam
-Benzodiazepines like diazepam are first-line for status epilepticus
A client with Guillain-Barré syndrome is at greatest risk for which complication?
A. Hypoglycemia
B. Respiratory
C. Stroke
D. Renal failure
B. Respiratory failure
-Ascending paralysis can impair diaphragm movement
What is a priority nursing intervention for Guillain-Barré syndrome?
A. Administer antihypertensives
B. Apply heat to limbs
C. Monitor vital capacity
D. Begin physical therapy
C. Monitor vital capacity
-Tracks respiratory muscle function
A client is diagnosed with myasthenia gravis. Which med should the nurse expect?
A. Edrophonium
B. Pyridostigmine
C. Baclofen
D. Atropine
B. Pyridostigmine
-Increases acetylcholine at neuromuscular junctions
Which assessment finding is most concerning in ALS?
A. Muscle twitching
B. Speech slurring
C. Trouble breathing
D. Drooling
C. Trouble breathing
-ALS can cause respiratory muscle weakness & failure
What is the expected outcome of riluzole therapy in ALS?
A. Reversal of disease
B. Muscle regeneration
C. Slower disease progression
D. Improved coordination
C. Slower disease progression
-Riluzole extends survival but does not cure ALS
A client with Alzheimer’s is prescribed donepezil. What should the nurse monitor?
A. Blood pressure
B. Skin integrity
C. Cognitive function
D. Blood glucose
C. Cognitive function
-Donepezil is a cholinesterase inhibitor used to improve cognitive
What is a safety concern for late-stage Alzheimer’s clients?
A. Overeating
B. Wandering
C. Verbal aggression
D. Sensory hallucinations
B. Wandering
-Memory loss & confusion often lead to wandering
A client suffered a head injury & now has a lucid interval followed by unconsciousness. What is suspected?
A. Subdural hematoma
B. Meningitis
C. Epidural hematoma
D. Stroke
C. Epidural hematoma
-A classic pattern of epidural hematoma post-trauma
What is the nurse’s priority in a client with increased intracranial pressure (ICP)?
A. Keep head flat
B. Encourage coughing
C. Keep head midline at 30 degrees
D. Administer opioid analgesics
C. Keep head midline at 30 degrees D
-Promotes venous drainage & reduces ICP
A client with MS has blurred vision, weakness, & a history of a recent virus. What diagnostic test is likely?
A. CT scan of the spine
B. Lumbar puncture
C. Serum electrolyte panel
D. Blood glucose test
B. Lumbar puncture
-Used to detect elevated IgG & confirm MS
