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PN3 > Test 1 > Flashcards

Test 1 Flashcards

1
Q

What is myasthenia Gravis and what are medications to treat it?

A

An auto immune disease where body has inability to transmit nerve impulses to voluntary muscles.

Meds- mestinon (neotigmine bromide), prostigmin, and mytelase (ambenonium chloride) to increase acetylcholinesterase neuromuscular function

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2
Q

What is Glasgow’s coma scale?

Score of 15 indicates-

Score of 7 or less -

Score of 3 or less -

A

And objective tool used for assessing consciousness and clients

15- fully oriented person

7- consider state of coma

3- lowest possible score/deep coma (no response )

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3
Q

What to do for low Glasgow’s coma scale scores?

A

Physician must be notified immediately and measures taken to decrease intracranial pressure

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4
Q

Pulpillary reactions and how to get a response ?

A

Size (symmetry), equality, and rounded of pupils may change and are assessed

Measure in mm

React to light by shinning a penlight obliquely into clients eye from outer edge of eye toward the center of eye.

Reaction may be brisk, sluggish, consensual,or non reactive

PERRLA is used when reaction is normal

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5
Q

What is a TIA?

A

Mini strokes and frequently precede a stroke. Which is caused by temporary impairment of blood flow to the brain

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6
Q

Risk factors of TIAs?

A

HTN , diabetes, atherosclerosis, aneurysm, cardiac disease , high blood cholesterol, obesity, sedentary lifestyle, smoking, stress, drug abuse (cocaine) , use of oral contraceptives, ppl with more than one of these are at greater risk

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7
Q

Types of TIA strokes -

Occurs as a result of an obstruction with in a blood vessel supplying blood to the brain.

Occurs when weakened blood vessel ruptured and bleeds.

Caused by a temporary clot.

A

Ischemic (clots)

Hemorrhagic

Transient ischemic attack

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8
Q

What meal safety precautions one should take with Parkinson’s disease ? When taking levodopa

A

Avoid a high protein diet

Protein may interfere with the medication absorption of levodopa into the brain.

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9
Q

Diagnostic testing of meningitis and encephalitis (swelling of brain)

A

Lumbar puncture

CBC

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10
Q

Treatment of meningitis / encephalitis and nursing interventions

A

Give Fluids to rehydrate client

Place client in isolation to avoid spreading virus

Antibiotics or anti-infectives

Corticosteroids and diuretics given for cerebral edema

Anticonvulsants to prevent seizures

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11
Q

What to teach a pt about anticonvulsant medications ?

A

Used to control seizures

Start one at a time and gradually increase doses

When d/c gradually decrease

Abrupt withdrawal can cause status epilepticus which is a prolonged seizure lasting at least 30 min

Monitor blood level for therapeutic range

Monitor for side effects of drug toxicity

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12
Q

Head injuries include trauma to where ?

A

Scalp, skull, brain

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13
Q

Caused by injuries of accreditation such as Baseball bat, car fourth, rotational force or whiplash, bullet

A

Brain injuries

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14
Q

Type of injury ? Skull fractures and penetrating injuries : bleeding from nose, ears , mouth , eyes.

*fluid may leak from ears

A

Open head injury

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15
Q

These Injuries are caused by blunt force it to the head such as concussion and laceration

Hemorrhage in the brain, hematomas,Cerebral Adema

A

Closed head injury

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16
Q

Device used for draining and maintaining adequate O2 levels and perfusion in brain after head injury

A

ICP

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17
Q

Other treatment for head injury?

A

Surgical decompression - alllows excess drainage

Meds - corticosteroids, muscle relaxants, diuretics, antacids

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18
Q

Early warning signs of severe head injury?

A

Consciousness, abnormal eye movement , pupil changes, abnormal vital signs, abnormal pulse , muscle weakness, muscle twitching, nausea, vomiting, visual or hearing disturbances

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19
Q

Nursing interventions for head injury?

A

Monitor I &O

Elevate head 30-40 degrees

Maintain airway and O2

Fluid restrictions

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20
Q

What is the purpose of suctioning in severe head injury patients ? Risks?

A

To decrease pulmonary complications

Risks include possible sudden increase in intercranial pressure (icp) and may cause further cerebral damage

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21
Q

Repositioning after back surgery?

A

Reposition using log roll turning to prevent injury to vertebrae and spine

Avoid twisting and limit sitting and bending

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22
Q

Chronic progressive degenerative disease of central nervous system - loss of myelin

A

MS - multiple sclerosis

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23
Q

What causes MS ?

What can trigger it ?

A

Autoimmune disease -

inflammation in the CNS the inflammation damages myelin which decreases nerve impulses in the body.

Stress , infections , pregnancy , trauma , fatigue,hit bathes or strenuous activity

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24
Q

Goals of MS ?

A

Reduce flare ups by:

taking medications ,

eating healthy diet,

exercise and staying active and independence

reduce stress, infections, and fatigue

Proper fluid intake

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25
Q

What kind of paralysis can spinal cord injuries cause?

A

Spinal shock

Areflexia

Flaccid paralysis

Neurogenic shock

Quadriplegia

Autonomic dysreflexia

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26
Q

Cessation of motor , sensory, autonomic and reflex impulses

A

Spinal shock

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27
Q

Absence of reflexes

A

Areflexia

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28
Q

Hypotension situation resulting from loss of sympathetic control of vital functions from the brain such as loss of ability to sweat below injuried area - can occur after CNS damage

A

Neurogenic shock

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29
Q

Complete under motor neuron injury , paralysis of both arms , legs , bowel and bladder and all four limbs

A

Quadriplegia

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30
Q

Can cause hypertensive crisis , bradycardia , severe headache , stroke or seizures - spinal cord injury at or above the sixth thoracic vertebral level T6

A

Autonomic dysreflexia

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31
Q

What will help ADLs and assessment with spinal cord injuries

A

Immobilization of headband neck and vertebral column , spinal column

Surgery : realignment of vertebral column

Medications- nifedipine, nitroprusside sodium

ROM and slow movements to prevent hypotension

Turn client frequently

Give calll light in reach

Adequate nutrition and fluid intake

Monitor vitals

Implement bowel and bladder training regimen

Assessment - Client input on pain , sensation and hx of accident

Clients respiratory status, airway breathing, circulation, disability, exposure, bowel and bladder function , skin condition, neuro assesment

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32
Q

Nursing interventions for autonomic dysreflexia?

A

Client education on causes and symptoms

Prevent bladder distention and fecal
Impaction

Observe for bradycardia , vasodilation, flushing, diaphoresis above site of injury

Raise HOB and lower legs to reduce bp and remove constrictive clothing

Asses urine for infection

Monitor bp q few min

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33
Q

Chronic sensory deprivation can cause what?

A

Inability to concentrate

Poor memory

Impaired problem solving ability

Confusion

Irritability

Mood swings

Hallucinations

Depression

Boredom and apathy

Drowsiness

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34
Q

A disorder that causes lens or its capsule to lose transparency and or become opaque

Clouding develops in the eyes as well as visual impairmentsAnd is associated with aging and usually affects both eyes

A

Cataracts

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35
Q

What to avoid with cataracts

A

Avoid reaching for objects

to maintain stability since depth perception is altered

Heavy lifting , straining during defecation, vigorous coughing and sneezing

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36
Q

Drugs for glaucoma

A

Drugs that enhance pupillary constriction

Miotics and choleinesterase inhibitors (cholinergic agonists)

timolol maleate

Pilocarpine hydrochloride

Betagan, diamox, alphagan

37
Q

What does a hearing aide do?

A

It amplifies sounds to make them louder in order for one to hear better

Convert environmental sound and speech into electronic signals that are amplified and converted to acoustic signals

38
Q

Nursing diagnosis of hearing loss

A

Social isolation related to hearing impairment

39
Q

Nursing diagnosis of cataracts

A

Disturbed visual sensory perception

Risk for injury - due to processing visual images and depth perception

Home impaired maintenance- related to age limited vision or activity restrictions due to surgery

40
Q

Interventions for hearing loss:

A

Hearing aids , surgical cochlear implant, how to mange such as using interpreter , writing notes, texting, computer, inform people who

41
Q

Hearing loss caused by damage to the inner ear or the nerve from the ear to the brain.

A

Sensorineural hearing loss

42
Q

occurs when there is a problem conducting sound waves anywhere along the route through the outer ear, tympanic membrane (eardrum), or middle ear (ossicles).

A

Conductive hearing loss

43
Q

caused by a combination of conductive damage in the outer or middle ear and sensorineural damage in the inner ear (cochlea) or hearing/auditory nerve.

A

Mixed hearing loss

44
Q

Also know as endolymphatic hydrops

An inner ear disorder that causes episodes of vertigo (spinning, tinnitus , uninlateral fluctuating hearing loss)

A

Ménière’s disease

45
Q

Delivers radioactive isotopes directly within the body by sealed or unsealed sources. To kill cancer in the body.

A

Internal radiation

46
Q

Nursing interventions for internal radiation ?

A

Prepare pt outside of room

Several nurses for lessened time

Wear lead apron or shield device ??

47
Q

What labs to look for with chemotherapy

A

Look at platelet levels count <50,000 or less indicates bone marrow dysfunction , wbc of <500 indicates neutropenia

and RBC levels ?

48
Q

A general state of ill health involving marked weight loss and muscle loss.

A

Cachexia

49
Q

What foods to eat with cachexia ?

A

Small portions of complex carbohydrates

High calorie diet , no sugar

50
Q

How to treat pain with cancer ?

A

Non invasive techniques such as heat, cold pack, massage, relaxation techniques, imagery, and hypnosis.

Drugs- Skin patches , slow release tablets, client controlled pumps

Nonopiods are the first step in nonopiods for mild to moderate pain

Morphine

Neurosurgical procedures such as nerve blocks

51
Q

Telepathy Or High energy radiation delivered on outpatient basis

A

External radiation

52
Q

Side effects of external radiation

A

Skin reactions, G.I. discomfort abdominal cramping, diarrhea, loss of appetite, and fatigue

53
Q

What is used to protect skin and main gain position in external radiation

A

Customized shielding blocks and immobilization device ??

54
Q

Radioactive implants place under anesthesia using radiological guidance. Lower dose permanent implants typically used . For internal radiation

A

Brachytherapy

55
Q

Risks for cancer ?

A

Smoking or tobacco use

Family hx

Age

Hormones

Over exposure to the sun and indoor tanning

Unhealthy diet

Not exercising

Not getting tested /examinations

Not getting enough sleep

Unhealthy weight

Unprotected sex

Chronic inflammation

Immunosuppression

Alcohol

Fair complexion

56
Q

Foods that increase cancer risk?

A

High fat foods/ red meats and high fat meats

Processed meat

Salt, sugar , and oily foods

Alcoholic beverages

57
Q

How to decrease risk of cancer ?

A

Do not smoke , or use tobacco

Avoid tanning beds and sun
Healthy diet

Exercise

Physical examination

Sleep

Self exam

Healthy weight

Protected sex

Safety in work place client

58
Q

What to monitor with thrombocytopenia?

A

Signs of bleeding , labs (low platelet count, Hgb, Hct, prolonged bleeding time. Bowel movements/constipation, pain, vital signs, and mental status.

59
Q

Low level

Of platelets in the blood

A

Thrombocytopenia

60
Q

Abnormally low count of a type of white blood cells?

A

Neutropenia

61
Q

What kinda of food to eat with neutropenia?

A

Nothing that could be undercooked.

PasteriZed dairy

Cooked veggies and fruit

Starches

Protein

62
Q

Care for people who are terminally ill who are expected to die In 6 months or less woh dignity in the comfort of the persons choice surrounded by loved ones

A

Hospice

63
Q

seizure that involves loss of consciousness and violent muscle contractions

A

Tonic clonic seizure

64
Q

Nursing interventions for tonic clonic seizures?

A

Turn client to the side to allow secretions to drain from the airway.

Prepare to suction oropharynx if necessary

Asses skin color and respiratory rate and depth after seizure

Give O2 PRN

Do not insert anything into mouth

Loosen restrictive clothing

Observe for injuries

After seizure , asses airway and turn to side

Ease client to the floor when it begins in supine positions

If I’m bed, use blankets or protective pads to line side rails

Low stimulative environment

Wear medical id tag

Client teaching of safe environment

65
Q

Prepares the body for intense physical activity (fight or flight response)

A

SNS

66
Q

Relaxes the body and inhibits it slows high energy functions ? (Conserves and restores)

A

PNS

67
Q

Response to stress and prepares the body to react to danger part of the autonomic nervous system. Maintains homeostasis

A

Fight or flight response

68
Q

The loss of full control of bodily movements

A

Ataxia

69
Q

Posture of abnormal posturing in which a person is stiff with bent arms, clenched fists , and legs held out straight. Arms are bent in torwards body and the wrists and fingers are bent and held on the chest.

The posture is a sign of severe damage in the brain

A

Decorticate

70
Q

A sensation perceived by a patient that proceeds a condition affecting the brain. It often occurs before a migraine or seizure. It may consist of flashing lights, a gleam of light, blurred vision, and order, the feeling of a breeze, numbness, weakness, or difficulty in speaking.

A

Aura

71
Q

What may leak through ears in open head injury?

A

Cerebral fluid make leak through ears

72
Q

What to do when some one has IV site pain?

A

Inspect site and remove needle if swelling

73
Q

What causes diarrhea in ppl with cancer

And what to eat and drink?

A

Chemo, Radiation, surgery, bone marrow stem cell transplant, Infections, stress and anxiety, cancer it’s self

Drink clear liquids, eat low fiber foods, frequent small meals, foods that are high in potassium, probiotics, avoid foods that irritate your digestive tract

74
Q

Earliest indicator in neurological status? Exam

A

Level of consciousness

, motor function, eye movement, pupil size and reaction, protective reflexes and vital signs

75
Q

What is mental status and

What to look for in change of mental status?

A

Ones Orientation, Memory, calculation, and fund of knowledge

Level of consciousness

76
Q

What is an internally planted device falls out?

A

Do not touch , put into a radioactive container, inform radioactive officer

77
Q

Seizure med side effects?

A

Drowsiness , diZzy, gastric distress, rash , blood dyscarsias, ataxia

78
Q

Signs and symptoms of ICP?

A

Headache nausea vomiting confusion , increased bp, pupils don’t respond to light , coma, seizures,shallow breathing

79
Q

Signs and symptoms of ICP?

A

Headache nausea vomiting confusion , increased bp, pupils don’t respond to light , coma, seizures,shallow breathing

80
Q

Most important vital sign to take with stroke ?

A

Bp

81
Q

Goal of cataracts for pts ?

A

20/20 vision

Eyelashes, lids , conjunctiva and structures inside eye do not have defects

82
Q

Affects only one limb and is associated with cerebral palsy

A

Monoplegia

83
Q

Affects one arm and one leg on the same side of body

A

Hemiplagia

84
Q

Paraplegia affects what?

A

Affects both legs

85
Q

Affects both arms and legs

A

Quadriplegia

86
Q

Assessment of spinal cord injury?

A

Neuro evaluation of motor and sensory function of extremities below herniated area

Reflex testing
ROM of affected area
Clients knowledge about disease , treatment and pain management and surgery and post care
Bowel and bladder elimination
Note gait alterations and bending limits

Vitals 
Skin conditions 
O2 status 
B and B 
Immobility complications
87
Q

_____ is the pressure exerted by a source. When light is hitting a surface it is also pushing down on the surface

A

Radiation pressure

88
Q

is a mixture of electromagnetic waves ranging from infrared (IR) to ultraviolet rays (UV). It of course includes visible light, which is in between IR and UV in the electromagnetic spectrum

A

Radiation from the sun

PN3 (4 decks)

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