Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med Surg 2 > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

What is multiple sclerosis (MS)?

A

autoimmune disorder that affects nerve cells in the brain and the spinal cord

MS= myelin sheath destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Who is most likely to get multiple sclerosis?

A

young adults (20-50 years)
women
those w/ genetic disposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Are there definitive diagnostic studies for MS? What can be done to see if it is MS?

A

no

MRI of brain can show sclerotic plaques in CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the criteria for an MS diagnosis?

A
  • at least 2 inflammatory demyelinating lesions in at least 2 different CNS locations
  • damage or an attack occurring at different times
  • all other possible diagnoses ruled out
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the clinical manifestations of multiple sclerosis?

A

weakness
diplopia (double vision)
tinnitus
paresthesia
chronic neuropathic pain
nystagmus (shaking of eyes)
dysphagia (difficulty swallowing)
ataxia (poor muscle control)
cognitive difficulties (word finding)
bowel/bladder problems
sexual dysfunction
depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What immunosuppressants are given for MS? When is it given?

A

corticosteroids (prednisone, methylprednisolone, dexamethasone)

methylprednisolone: treats MS exacerbations

give in AM w/ food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What immunomodulators are used for MS? WHich one will treat/prevent relapses?

A
  • interferon beta-1a and 1b: used to treat or prevent relapses
  • glatiramer acetate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What antispasmodics are used for MS? Why?

Which one is given for severe symptoms and why?

A
  • baclofen
  • dantrolene
    helps with spasms

dantrolene is used for severe symptoms bc it is fast acting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is important to monitor with dantrolene with MS? What should be reported?

A

monitor liver damage

report jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What antiseizures are used for MS? Why?

A
  • carbamazepine
  • gabapentin

used for paresthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What anticholinergics used for MS? Why?

A
  • oxybutynin
  • tolterodine
  • propantheline

used for bladder dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What laxatives are used for MS? Why?

A
  • stool softener (docusate sodium)
  • bulk forming (psyllium)

used for constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What antidepressants are used for MS?

A
  • amitriptyline (TCA helps w/ nerve pain)
  • sertraline
  • fluoxetine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What phosphodiesterase inhibitor is used for MS? What should not be given with this medication? Why?

A

Sildenafil
Do not give with nitroglycerin because it will decrease BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What CNS stimulants are given for MS? What do they do?

A
  • Methylphenidate (focus)
  • Modafinil (alertness)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What K+ channel blocker is given for MS? Why is it not used as often?

A

Dalfampridine

Not used often due to risk of cardiac dysrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why would a thalamotomy be used for MS?

A

It is deep brain stimulation for tremors unmanageable with drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What nursing interventions can be done with MS?

A
  • promote exercise with rest/diet (fiber)
  • encourage independence
  • prevent injury, and avoid stressors
  • teach self injection and self catheterization 
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe Parkinson’s disease

A

Chronic neurological disorder that affects motor function and destroys neurons which results in low dopamine and high acetylcholine

No DOPE in the PARK = low dopamine in Parkinson’s

High acetylcholine = high secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Who is more likely to get Parkinson’s disease?

A

Men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the clinical manifestations of Parkinson’s disease?

A

Triad:
- Tremors at rest
- Rigidity
- Brady kinesia

Shuffling gait
Expressionless
Drooling/slurred speech (dysarthria)
Pill rolling twitch
Depression
Constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are complications of Parkinson’s disease?

A

Dysphasia
Orthostatic hypotension (dopamine regulates BP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Are there any specific tests for Parkinson’s Disease?

A

No

but MRI will show substantia nigra breakdown

24
Q

What is the criteria for a Parkinson’s Disease diagnosis?

A

at least two of three characteristics of the classic triad (tremor, rigidity, bradykinesia)

25
Q

What dopaminergic agent is used for Parkinson’s Disease? Why? What should be avoided when taking this medication?

A

levodopa: leaves more dopamine
carbidopa: conserves more dopamine

Caution: psychosis can occur

avoid protein

26
Q

What dopamine agonist is used for Parkinson’s Disease? Why? What should be monitored while taking this medication?

A

bromocriptine (more commonly used)
apomorphine

stimulates dopamine response

monitor psychosis

27
Q

What MAO-B inhibitors are used for Parkinson’s Disease? Why? What should be avoided while taking this medication?

A

rasagiline
selegiline

prevents the breakdown of dopamine

avoid tyramine bc hypertensive crisis

28
Q

What COMT inhibitors are used for Parkinson’s Disease? Why? WHat is a normal finding?

A

entacapone
tolcapone

prevents the breakdown of dopamine

dark urine is normal

29
Q

What anticholinergic is used for Parkinson’s Disease? Why?

A

benztropine

less secretions
treats resting tremors

30
Q

What antihistamine is used for Parkinson’s Disease?

A

diphenhydramine

31
Q

What antiviral is used for Parkinson’s Disease? Why?

A

amantadine

increase dopamine levels

32
Q

What antidepressant is used for Parkinson’s Disease?

A

amitriptyline

33
Q

What anticholinesterase inhibitor is used for Parkinson’s Disease? Why?

A

donepezil

used when pt starts having bowel/bladder problems to reestablish secretions

34
Q

What nursing interventions can be done for Parkinson’s Disease?

A
  • promote exercise/diet
  • encourage independence
  • deep brain stimulation (fast access increase dopamine for severe PD)
35
Q

What is amyotrophic lateral sclerosis (ALS)?

A

aka Lou Gehrig’s disease

  • destroys motor neurons in the brain & spinal cord
  • results in total body paralysis
36
Q

Who is most likely to get amyotrophic lateral sclerosis (ALS)?

A

more common in men than women

37
Q

What are the clinical manifestations of ALS?

A

typical symptoms:
- dysarthria (difficulty w/ speech)
- dysphagia (difficulty swallowing)
- muscle weakness

dyspnea (difficulty breathing) — respiratory failure
fasciculations (twitching)
fatigue
drooling — aspiration pneumonia

38
Q

Are there definitive diagnostic studies for ALS? What can be done to see if it is ALS?

A

no

Electromyography (view muscle response)
Muscle biopsy
Pulmonary function test- PFT (to see how much air can be pushed out)

39
Q

What is the drug therapy for ALS? Why? What should be monitored while taking this medication? How should it be taken?

A

rilutek

to slow disease progression

monitor liver enzymes and take on empty stomach

40
Q

What nursing interventions can be done for ALS?

A

ALS = advanced life support

Monitor for pneumonia
Monitor fever over 100F
Monitor lung sounds - rhonchi

41
Q

What is Myasthenia Gravis (MG)?

A

autoimmune disease that destroys acetylcholine receptors which leads to low acetylcholine levels

42
Q

What can be seen in patients who have myasthenia gravis?

A

thymic tumor in 15% of patients

seen by MRI

43
Q

What are the clinical manifestations of myasthenia gravis?

A

ptosis (droopy eyes)
diplopia
dysphagia (difficulty swallowing)
dyspnea (difficulty breathing)
muscle weakness (hard time picking things up)

44
Q

What is myasthenic crisis?

A

DRY
undermedicated
respiratory distress

MG symptoms but worse

45
Q

What test can be done to determine if MG diagnosis is correct? What is the antidote?

A

edrophonium chloride (tensilon)
antidote: atropine

46
Q

What other diagnostic studies can be done for MG?

A
  • serum Ach receptor antibodies
  • electromyography
  • MRI of the thymus gland
47
Q

What anticholinesterase drugs are used for MG? Why?

A
  • pyridostigmine (best for long term treatment bc long acting, they cause secretions, give before meals)
  • atropine
48
Q

What immunosuppressants are used for MG?

A

corticosteroid
azathioprine

49
Q

What other therapy is used for MG? Why?

A

thymectomy
intravenous immunoglobulin (IVIG)
plasmapheresis (filters blood products to remove antibodies to decrease symptoms)

50
Q

What nursing interventions are done for MG?

A

maintain airway
small, frequent, high calorie meals
provide eye care
exercise/rest

51
Q

What is Guillain-Barre Syndrome?

A

acute rapidly progressing form of polyneuritis, caused by infection starting from the legs up

52
Q

What are the clinical manifestations of Guillain-Barre Syndrome?

A

muscle weakness
hyporeflexia
paresthesia and pain

respiratory failure
- inability to cough
- shallow respirations
- dyspnea/hypoxia

53
Q

What diagnostic studies are done for Guillain Barre Syndrome?

A

cerebrospinal fluid study
EMG
MRI brain to rule out MS

54
Q

Does the flu cause GBS?

A

no it will reactivate it

55
Q

What nursing interventions are done for GBS?

A

intravenous immunoglobulin (IVIG)
plasmapheresis
pain management
ventilatory support

56
Q

What are the clinical manifestations of multiple sclerosis?

A

weakness
diplopia (double vision)
tinnitus
paresthesia
chronic neuropathic pain
nystagmus (shaking of eyes)
dysphagia (difficulty swallowing)
ataxia (poor muscle control)
cognitive difficulties (word finding)
bowel/bladder problems
sexual dysfunction
depression

Med Surg 2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions