Neurological Test 2 Flashcards
Discuss Parkinson’s disease and its possible complications. Please include the cause and expected findings.
Progressively debilitating disease affecting motor function.
List five expected findings in the client with Parkinson’s disease.
tremor
muscle rigidity
bradykinesia
postural instability
List a priority diagnosis for the client with advanced Parkinson’s disease.
Top priority is safety and aspiration, swallowing.
List two early symptoms of amyotrophic lateral sclerosis (ALS).
twitching and fatigue
Discuss amyotrophic lateral sclerosis (ALS) and nursing interventions related to this disorder.
What are the characteristics of the disease?
degenerative lateral sclerosis is a degenerative neurological disorder of the upper and lower motor neurons the result in deterioration and death of the motor neurons
results in progressive paralysis and muscle wasting that eventually causes respiratory paralysis and death.
How is amyotrophic lateral sclerosis (ALS) diagnosed?
diagnosed by Electromyogram, and muscle biopsy.
List a priority intervention for the client who has amyotrophic lateral sclerosis (ALS).
Airway and suction as needed.
What are the possible complications following a craniotomy? What might be expected findings?
SIADH
DI
Discuss meningitis including the definition, cause, signs, and at least 5 symptoms
Inflammation of the meninges, which are membranes that protect the brain and the spinal cord.
caused by: viral illness, fungal infections, bacterial infections, immunosuppression.
findings: constant excruciating headache nuchal rigidity (stiff neck) photophobia fever and chills altered LOC positive kernigs tachycardia seizures restless
Discuss Guillain-Barre syndrome. What are the possible signs and symptoms and complications of this disorder?
Develops in relation to acute destruction of the myelin sheath of peripheral nerves due to autoimmune disorder that results in varying degree of muscle weakness and paralysis.
weakness report of a virus previously 1-3 weeks acute progressive muscle weakness and paralysis muscle faccidity parasthesias diplopia facial weakness dysarthria dysphagia decreased
What causes Guillain-Barre syndrome? What are the priorities of care?
recent history of: acute illness viruses vaccination surgery
priorities of care: monitor respirations HOB elevated at 45 Monitor heart and BP assess gag reflex prevent skin breakdown
What are the expected findings in a client with a C4 spinal cord injury?
injuries are related to the diaphragm. client may or may not need intubation
loss of diaphragm function potential requirement of a ventilator for breathing limited ROM paralysis in arms, hands, torso and legs trouble controlling bladder/bowel
Define neurogenic shock and paralytic ileus.
common response of the spinal cord following an injury. symptoms include bradycardia, hypotension, faccid paralysis,, loss of reflex activity below of injury and paralytic ileum accompany spinal shock due to the loss of automatic function.
List five nursing interventions for the client who has meningitis. List the assessment that would be priority. List an intervention that would be priority.
isolate client as soon as meningitis is supsected maintain isolation precautions (droplet) neuro checks and VS q2-4 hours implement fever reduction decrease environmental stimuli maintain bed rest with HOB elevated to 3-0 monitor client fro increased ICP maintain client safety seizure precautions monitor IV fluids and electrolytes
Discuss myasthenia gravis. What are the expected findings? How treated?
A progressive autoimmune disease that produces severe muscle weakness. Characterized by periods of exacerbation and remission. Muscle weakness improves with rest.
findings: impaired respiratory status decreased swallowing ability poor muscle strength incontinence drooping eyelids poor posture
Which medications are used to treat myasthenia gravis?
cholinesterase inhibitor meds are first line
pyridostigmine (Mestinon) neostigmine (Prostigmin) Imurane Deltasone Prednisone
Compare and contrast cholinergic crisis and myasthenic crisis.
Myasthenic crisis: occurs when clients are experiencing a stressor that causes an exacerbation of MG, such as infection
Cholinergic crisis: is when clients have taken too much cholinesterase inhibitor.
What do clients with myasthenia gravis, Guillain-Barre syndrome, and amyotrophic lateral sclerosis have in common?
muscle weakness
dysarthria
dysphagia
all 3 do not have a cure
Discuss multiple sclerosis (MS). Include the cause and expected findings. What are possible exacerbation triggers?
Neurologic disease that affects the spinal cord, typically resulting in difficulties with gait, strength, and motor function
triggers: viruses and infectious agents living in a cold climate physical injury emotional stress pregnancy fatigue temperature extremes how shower/bath
Discuss Alzheimer’s disease including the cause and expected findings
nonreversible type of dementia that progressively develops over many years. subtype of neurcognitive disorder that is neurodegenerative, resulting in the gradual impairment of cognitive function.
advanced age genetics environmental agents (herpes, metal/toxic) previous head injury family history of alzheimers or downs
What signs and symptoms would the nurse expect in the client with stage 6 Alzheimer’s disease? (according to lecture material)
memory difficulties continue to worsen, loss of awareness of recent events and surroundings, may recall own name but not personal astray, delusions, hallucinations, compulsive h=behavior, wandering behavior, requires assistance in ADLs, normal sleep cycle disturbed, increased episodes or urinary/fecal incontinence