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Nursing Praxis V > Scenario Test > Flashcards

Scenario Test Flashcards

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1
Q

What is M.S.?

A

Multiple Sclerosis: autoimmune disorder of the CNS. Demyelination of nerve fibres in the brain, spinal cord and optic nerves.

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2
Q

M.S. manifestations?

A

Symptoms manifest as motor, sensory, cerebellar, and emotional problems.

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3
Q

What are sensory abnormalities in M.S.?

A 
Tingling
Numbness
Parasthesias
Patchy blindness (scotomas)
Blurred vision 
Vertigo
Tinnitus
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4
Q

What is Lhermitte’s sign (M.S.)?

A

Sensory symptom described as an electric shock radiating down the spine and into the limbs with flexion of the neck.

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5
Q

Potential complications of M.S.

A

Convulsive seizures

Dementia

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6
Q

GI complications of M.S.

A 
Dysphagia
Trouble chewing
Decreased sphincter control
Incontinence
Constipation
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7
Q

Exacerbations in M.S. are triggered by?

A 
Infection
Trauma
Immunization
Childbirth
Stress
Climate change
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8
Q

Types of drug therapy for M.S.

A 
Corticosteroids
Immunosuppressants
Immunomodulators
Cholinergics
Anticholinergics 
Muscle relaxants
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9
Q

Nursing interventions for M.S. clients

A 
Help client to use assistive devices
Do active ROM
Perform stretching exercises
Change position of client if bedridden
Teach signs and symptoms of UTI
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10
Q

M.S. diagnostic testing

A 
Hx and physical examination
CSF analysis
Evoked response testing
CT scan
MRI
MRS
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11
Q

Normal blood pH range?

A

7.35 - 7.45

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12
Q

Normal PaCO2 range?

A

35 - 45 mm Hg

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13
Q

Normal bicarbonate (HCO3) range?

A

22 - 26 mEq/L

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14
Q

Normal sodium (Na) range?

A

135 - 145 mmol/L

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15
Q

Normal potassium (K) range?

A

3.5 - 5.0 mmol/L

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16
Q

Normal blood urea nitrogen (BUN) range?

A

3.6 - 7.1 mmol/L

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17
Q

Normal creatinine range?

A

44 - 133umol/L

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18
Q

Goals for M.S. clients

A 
Maximize neuromuscular functioning
Maintain independence for as long as possible
Manage fatigue
Optimize psychosocial well-being
Adjust to illness
Reduce triggers for exacerbations
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19
Q

What is Parkinson’s Disease (PD)?

A

Neurodegenerative disease of the basal ganglia in the CNS. PD is a movement disorder.

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20
Q

What are characteristics of Parkinson’s Disease?

A

Slow movement (bradykinesia)
Rigidity
Tremor at rest
Impaired postural reflexes

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21
Q

Types of drug therapy for PD?

A 
Antiparkinsonians
Dopaminergic
Anticholinergic
Antihistamine
Monoamine Oxidase Inhibitors
Catechol-O-Methyltransferase (COMT) Inhibitors
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22
Q

Parkinson’s medications?

A

Levodopa
Benadryl
Comtan
Mirapex

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23
Q

Goals for PD clients

A

Experience lower frequency of symptoms
Maximize neurological function
Maintain independence for as long as possible
Optimize psychosocial well being

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24
Q

Nursing interventions for PD clients

A 
Assist with ambulation
Teach mobility and stretching exercises
Massage patient's facial and neck muscles
Increase fibre in diet
Monitor swallowing ability
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25
Q

What is the role of dopamine in PD clients?

A

In PD, the dopaminergic neurons in the basal ganglia become damaged, resulting in a decrease of dopamine in relation to acetylcholine. This causes an imbalance of motor activity.

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26
Q

Clinical manifestations of PD?

A

Shuffling, propulsive gait
Changes in speech patterns
Flexed arms
Loss of postural reflexes

27
Q

Parkinson’s Triad?

A

Bradykinesia
Tremor at rest
Rigidity

28
Q

What is dementia?

A

It is a collection of symptoms. Progressive decline in cognitive functioning. Can be caused by various diseases that affect the brain.

29
Q

Normal magnesium (Mg) range?

A

0.65 - 1.05 mmol/L

30
Q

Normal calcium (Ca) range?

A

2.2 - 2.58 mmol/L

31
Q

Frontotemporal dementia (FTD)?

A

Formerly called Pick’s Disease
Onset between 50 - 60 years
Degeneration of frontal lobe, temporal lobe, or both.

32
Q

What is Creutzfeldt-Jakob Disease (CJD)?

A

Rare and fatal infectious brain disorder.
Abnormally folded prion protein
No treatment available

33
Q

Symptoms of Creutzfeldt-Jakob disease

A 
Memory lapses
Mood swings
Behaviour changes
Involuntary movements
Mental deterioration
Coma leading to death
34
Q

What is vascular dementia?

A

AKA: Multi-infarct dementia

Blood and oxygen supply to the brain is blocked, causing cell death.

35
Q

What causes vascular dementia?

A

Single stroke
Multiple strokes
Results from ischemic, ischemic-hypoxic, or hemorrhagic brain damage caused by cardiovascular disease.

36
Q

Types of drug therapy for dementia

A 
Cholinesterase inhibitors
Selective serotonin reuptake inhibitors (SSRIs)
Atypical antipsychotics
Benzodiazepines
Anticonvulsants
37
Q

Medications for dementia

A 
Aricept
Zoloft
Celexa
Ativan
Risperdal
Tegretol
38
Q

Mini-Mental Staus Exam (MMSE)

A

Orientation to time
Registration (3 word recall)
Naming objects
Reading

39
Q

Interventions for dementia

A 
Give one simple direction at a time
Identify usual patterns of behaviour
Assist/cue for ADLs
Maintain independence for as long as possible
Get into a routine of care
40
Q

What is Alzheimer’s Disease?

A

Chronic, degenerative, progressive disease of the brain.

41
Q

Dementia is categorized into 5 strains. What are they?

A 
Alzheimer's Disease
Vascular dementia
Dementia with Lewy bodies
Frontotemporal dementia
Creutzfeldt-Jakob disease
42
Q

What is delirium?

A

State of acute mental confusion.
Common in older adults.
Medical emergency

43
Q

3 subtypes of delirium

A 
Hyperactive delirium (restlessness)
Hypoactive delirium (lethargy)
Mixed delirium
44
Q

Drug therapy for delirium?

A

Antipsychotics (neuroleptic agents).
Haloperidol is the first-line of treatment
Benzodiazepines are contraindicated (unless delirium is caused by withdrawal)

45
Q

List the 6 influencing factors on intracranial pressure (ICP)

A 
Blood pressure
Cardiac function
intra-abdominal and intrathoracic pressure
Body position
Temperature
Blood gases (particularly CO2)
46
Q

What is increased ICP?

A

Life-threatening

Results from an increase in brain tissue, blood and/or CSF.

47
Q

Risks associated with increased ICP

A

Brain ischemia and infarction

48
Q

Nursing interventions for increased ICP

A

Head of the bed at 30 degrees or greater with head in a neutral position
Drug therapy (diuretics, anticonvulsants, antipyretics)
Decrease stimuli in room
Monitor vitals closely
Monitor intake and output
Passive/assistive ROM

49
Q

What are seizures?

A

Paroxysmal, uncontrolled electrical discharge of neutrons in the brain. This disrupts normal functioning.

50
Q

What is a tonic-clonic seizure?

A

Characterized by loss of consciousness and falling, to stiffening of the body (tonic phase) and subsequent jerking of limbs (clonic phase).

51
Q

What are the phases of a seizure?

A 
Prodromal phase (signs the precede a seizure)
Aural phase (sensory warning)
Ictal phase (full seizure)
Postictal phase (period of recovery)
52
Q

What is status epilepticus?

A

State of continuous seizure or recurring seizures without regaining consciousness. This is a neurological emergency.

53
Q

Drug therapy for seizure disorders?

A

Barbiturates (phenobarbital)
Benzodiazepines
Sodium channel blockers

54
Q

Nursing interventions for client with seizure disorders

A

Loosen constrictive clothing
Following seizure, assess for trauma, weakness or paralysis
Patient teaching regarding med action adherence

55
Q

Normal Hb levels

A

Males: 138 - 180 g/L
Females: 120 - 160 g/L

56
Q

Normal Hct levels

A

Males: 0.37-0.49
Females: 0.36-0.46

57
Q

Normal bilirubin level

A

5.1 - 17 mmol/L

58
Q

Normal albumin level

A

35 - 48 g/L

59
Q

Normal chloride level

A

95 - 105 mmol/L

60
Q

Normal phosphate level

A

0.97 - 1.45 mmol/L

61
Q

Normal glucose level

A

4 - 6 mmol/L

62
Q

INR

A

0.81 - 1.2

63
Q

PT (prothrombin time)

A

11 - 13 seconds

64
Q

PTT (partial thromboplastin time)

A

25 - 35 seconds

Nursing Praxis V (1 decks)

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