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Med Surg ll > Quiz #1 Neurological Disorders > Flashcards

Quiz #1 Neurological Disorders Flashcards

1
Q

Multiple Sclerosis

A

Autoimmune disorder that affects nerve cells in the brain and spinal cord.

— destroys myelin sheath
— women at higher risk

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2
Q

Risk factors of MS

A
  • viruses and infectious agents such as respiratory infections
  • living in cold
  • Physical injury
  • emotional distress
  • pregnancy
  • Fatigue
  • overexertion
  • Hot/ cold bath
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3
Q

MS clinical manifestations

A

Motor: fatigue, spasticity and/ or weakness, dysarthria (slurred speech), tremors
Sensory: visual disturbances, decreased hearing, tinnitus, paresthesia
Cerebellar problem: dysphagia, ataxia, nystagmus

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4
Q

Drug therapy for MS exacerbation

A

Methylprednisolone

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5
Q

Methylprednisolone

A

Initial treatment response for MS
Decreases inflammatory by inhibiting immune function
— decreasing extravasating with immune cells into the central nervous system

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6
Q

Prednisone pt teaching

A

Used for MS
— hyperglycemia
— insomnia
— bone density
— risk for infection

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7
Q

Prednisone

A
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8
Q

Dantrolene

A

Preventing spasms
Used for an anesthesia reaction known as malignant hyperthermia

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9
Q

Dantrolene pt teaching

A

Report yellow of eyes to provider immediately (scleral jaundice)

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10
Q

A nurse is teaching a client who has multiple sclerosis about a new prescription for baclofen. Which of the following instructions should the nurse include in the teaching?

A. “Do not take antihistamines with this medication.”
B. “Take the medication on an empty stomach.”
C. “Stop taking the medication immediately for a headache.”
D. “Expect to develop diarrhea initially.”

A

A. “Do not take antihistamines with this medication.”

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11
Q

Laxatives

A

MS can cause
- constipation
- spastic or flaccid bladder

Psyllium
— can help with constipation
— make sure to teach patient to take with 8 ounces of water** (Increase volume intake)
— All mush no push

Docusate sodium
— stool softener
— draws water into the colon

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12
Q

MS PO meds

A

Make sure to teach pt to take with sip of water

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13
Q

Nystagmus

A

Condition where eyes make repetitive movements to rapidly move up and down and side to side.

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14
Q

Triad diagnosis for Parkinson’s

A

Tremor
Rigidity (stiffness)
Bradykinesia (slow moving)

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15
Q

Other symptoms of Parkinson’s

A

Pill rolling
Decreased swinging arm movements
Expressionless
Drooling, slurred speech
Depression (from low dopamine)

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16
Q

Ataxia

A

Impaired coordination, balance, and speech

17
Q

Testing for shuffling gait

A

Walk from one end of the exam room to the other (ataxia)

18
Q

Parkinson’s teaching & interventions

A

Monitor patient as much as possible
Stand up slowly
— Low dopamine - high risk for falls (orthostatic hypotension)
At high risk for dysphagia
— due to drooling
— monitor airway and have suction

19
Q

MAOIs

A

Phenelzine
Isocarboxazid
Tranylcypromine
Selegiline

20
Q

Selegiline

A

Increases availability of dopamine
Make sure to avoid charcuterie (fermented cheese, meat, and wine)

21
Q

First line of treatment for Parkinson’s

A

LevoDOPA/ CarviDOPA
— 5 year effectivity window
— watch for psychotic behavior can happen with too much dopamine

22
Q

Oxybutynin

A

An anticholinergic used for MS
Used for muscle tone drying for loose stool
Watch for dry mouth
— can be treated by giving patient hard candy

23
Q

Amitriptyline

A

For MS
Known as a antidepressant Tricyclic
- also used for peripheral neuropathy nerve pain and depression

24
Q

Benztropine use and adverse effect

A

Anticholinergic used for Parkinson’s
— since drooling can increase risk of aspiration
adverse effect includes urinary retention

25
Q

A nurse is teaching a client who is taking benztropine (Cogentin) to treat Parkinson’s disease. The nurse should instruct the client to report which of the following adverse effects? (Select all that apply)

A

difficulty voiding
constipation

26
Q

Sidenafil contraindication

A

Nitroglycerin Or isosorbide
Rationale: both dilate blood vessels which may lead to lethal drop in blood pressure and shock

Sidenafil is a phosphodiesterase inhibitor which is used for MS for remylenation

Med Surg ll (8 decks)

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