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Nursing 221-222 > Test 3. - 222 > Flashcards

Test 3. - 222 Flashcards

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1
Q

Pt has difficulty hearing, what is the nurse most concerned with?

A

-History of Gentamyin (or Vancomycin, Lasix)

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2
Q

Symptoms of Parkinsons

A
  1. Tremor (worse at rest) pill rolling
  2. Ridigity (no smooth movements)

Cogs-wheel/jerking

3.Bradykinesia- shuffled gait/difficult movements

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3
Q

Nursing DX for Bells Palsy?

A

Disturbed Body Image

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4
Q

Meds for Bells Palsy?

A

Antivirals! Zovirax, Valtrex

(Prognosis is very good, usually goes away within 6 months)

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5
Q

Tensilon Test

A
  • If muscle function improves, the test is positive and pt is in a MYATHENIC STATE.
  • if it gets worse, the pt is in a CHOLINERGIC STATE.

(Prepare to administer Atropine for Bradycardia)

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6
Q

Post Op Discharge for ear problems

A

Nurse will teach proper way to administer ear drops.

Tilt head to unaffected side

Adul pull ear up and out

Child pull ear down and back

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7
Q

What part of the brain controls gait, balance, and posture?

A

-Cerebellum

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8
Q

What part of the brain controls the vital signs?

A

The Brainstem- (medulla, pons)

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9
Q

What does the frontal lobe control?

A

impulses, personality, sexual desires

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10
Q

Temporal part controls

A

hearing

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11
Q

MRI is contraindicated with?

A

-Any metal in the body (pacemaker, hip or knee replacements, lumbar fixation)

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12
Q

Three components of neuro assessment

A
  1. LOC
  2. Pupils
  3. Motor Ability
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13
Q

Glasgow Coma Scale?

A

Measures eye opening, verbal, and motor response.

7- Pt is in a coma state

15- is normal

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14
Q

What should you teach pt to avoid with hearing problems?

A

-Avoid LOUD music

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15
Q

Snellen Chart

A

If pt wears glasses, tell patient to leave them on during test.

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16
Q

Spinal Shock (cord damage) what may occur?

A
  • lose motor, sensory and autonomic activity below the level of injury may result in decrease in BP.
  • Parts of body below level of cord lesion are paralyzed/
  • Condition persist for several days to months after injury.

FLACCID PARALYSIS BELOW LEVEL OF INJURY.

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17
Q

-DECORTICATE (flexor posturing)

A

-flexed in toward the cord.

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18
Q

-Drug for maintainence of Meniere’s

A

-Antivert (antivertigo)

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19
Q

Maintainence drug for Meniere’s Disease

A

-Antivert (Antivertigo)

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20
Q

Nsg Dx for Meniere’s Disease

A

Fluid Volume Depletion r/t vomiting

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21
Q

What drug do give for ischemic stroke?

A

-tPa within 3 hours

(Ischemic stroke is decreased blood flow to brain secondary to occlusions… two types: thrombotic and embolic)

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22
Q

Grand Mal Seizure

A
  • Most common. Person loses conciousness.
  • jerking/ cyanosis/ excessive salivation/ incontinence
  • usually last 1-5 min
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23
Q

Grand Mal Post Ictal

A

-Maintain airway and check for injury

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24
Q

Lumbar Puncture

A
  • Dx for CNS infection, intracranial bleed
  • Lay client in FETAL position, local anesthetic, consent

(Fetal position opens up spinal vertebrae for tap;; stay still to avoid injury.)

Post test: lay flat for 2 hrs, encourage fluids

IF YOU SUSPECT BRIAN BLEED, THIS TEST IS CONTRAINDICATED B/C HEMORRHAGE CAN MOVE DOWN, MRI FIRST.

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25
Q

Should you give narcotics to neuro patients?

A

-No,

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26
Q

Multiple Sclerosis med tx

A
  • ABC therapy (Avenox, Betaserone, Copaxane)
  • Interferon B
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27
Q

What is scleral buckling?

A
  • Reattaches sclera to retina
  • Post op: BED REST/ LIMITED HEAD MOVEMENT, check with dr about activity
28
Q

s/s of retinal detachment

A

visual field loss and the appearence of flashing lights

29
Q

Manitol (for ICP)

A

Osmotic Diuretic, pulls fluid from the third space into vascular space then diuresis the pt, fliters through kidneys.

CHECK RENAL FUNCTION AND ELETROLYTES

30
Q

Decadron (FOR icp)

A

-corticosteroid- stabilizes capillary membrane permiability (leaky) doesnt leak to 3rd space in brain

31
Q

-Ear drops

A

-WARM them before administration

32
Q

Cushings Triad

A

-Widening Pulse Pressure, respirations, bradycardia

33
Q

s/s Menieres

A
  • vertigo, sensorineural loss, tinnitus
  • avoid getting up suddenly
34
Q

Injury above C6, assess what?

A

-Respirations and need for ventilator because of weakness in intercostal muscles

35
Q

Autonomic Dyspreflexia

A
  • caused by visceral stimulations (visceral organs include bowel, bladder, and skin)
  • urinary retention= straight cath
  • skin= remove clothes

Pt develops increases HTN, LOC changes, pounding headache, goosebumps, stroke if left untx

36
Q

Normal IntraOcular Pressure

A

10-21 mm

37
Q

Pt has functional blindness, how should nurse plan the care?

A

functional blindness 20/200

  • check visual acquity
  • orient to environment
  • Promote safety
38
Q

Pt has pain in eye after post op cataract surgery

A

-REPORT to dr. Could be infection, hemorrhage, or increase IOP.

39
Q

Photopsia, Floaters, and loss of peripheral vision are clinical manifestations of

A

-retinal detachment

40
Q

Increased IOP and peripheral vision loss indicate

A

Glaucoma

41
Q

Betoptic, Timoptic, Diamox (beta blockers)

A

Decreases aqueous humor production which then decreases IOP.

42
Q

Pilocarpine

A
  • Constricts pupil
  • increases outflow of aqueous humor
43
Q

When patient has clear discharge from the nose or ear….

A

do glucose test to detect CSF leakage.

44
Q

bells palsy

A

Cranial 7.

  • Antivirals.
  • Gentle upward massage of face, use heat, avoid cold.
45
Q

ALS (Lou Gherigs)

A
  • 2-5 YRS after prognosis, terrible prognosis.
  • check gag reflex
  • end stage- pt on vent or hospice because respiratory system affected.
  • Rilutek- drug slows progression.
46
Q

How do you know that Sinemet (Levadopa/Carpadopa) is no more effective?

A

-bradykinesia, tremors, and shuffling gait return

47
Q

What to teach pt taking Dilantin? (Anti-seizure)

Maintainence drug for seizures normal level 10-20

A

-do oral care, and have regular visits with dentist to check for gingival hyperplasia.

48
Q

During seizure what do you document?

A

-What pt was doing before seizure, what part of body was affected, and where twitching started first.

49
Q

As patient is having seizure..

A
  • turn them on their sside to prevent aspiration, and do not put anything in their mouth.
  • loosen any restrictive clothing.
  • do not restrain
50
Q

Pt has brain tumor what symptom will they most likely experience?

A

-Early morning headache.

51
Q

ICP- prevent increase

A
  • treat cause
  • elevate HOB30 degress!
  • fluid restrictions
  • Manitol, Decadron, Diuretics
  • Seizure precautions ( padded bed rails, dim lights, decrease stimuli, let them rest. )
52
Q

Open Angle Glaucoma

A

>50

53
Q

Labs for pt on decadron

A

hyperglycemia, hyponatremia, hypokalemia

Pt with Na of 129 would be most concern to RN

54
Q

Pt presents with eye injury

A

-do head to toe assessment

55
Q

Pt with dysplasia, what do you check before they eat?

A

-gag reflex

56
Q

First symptom of cataracts

A

-nighttime glare (probs driving at night)

57
Q

First thing people complain of with Multiple Sclerosis?

A
  • optic neuritis (blurred vision)
  • falls
58
Q

Epidural Hemorrhage

A
  • EMERGENCY SITUATION:collection of blood btwn skull and dura
  • Always go to surgery
  • Epidural bleed is arterial bleed
59
Q

Subdural Hemorrhage

A
  • Venous bleed
  • depends how quickly the bleed is. if slow, or stopping, the neurosurgeon will let it absorb itself…
  • family can sometimes miss the symptoms
60
Q

Mestinon

A
  • Treatment for Myasthenia Gravis
  • take p.o on schedule with meals
61
Q

Neurontin

A
  • given for seizures, safer for elderly
  • come back to check serum levels
62
Q

Petit mal seizure

A
  • children
  • blinking, brief staring spell, rolling of eyes
  • 5-10 seconds
  • no post ictal symptoms
  • do not lose conciousness
  • often misdiagnosed.
63
Q

Midriatics

A

-Dilate the pupil

64
Q

Post op eye surgery are patients encouraged to cough and deep breath?

A
  • NO!
  • avoid coughing, sneezing, cant drive 4-6 weeks, avoid anything that increases IOP. sex, bending, lifting
65
Q

Bilateral eye patching should be done in tauma or in possible retinal detachment because

A

-eyes are consensual, they move together

goal is to prevent further ischemia to retina

66
Q

Humonymous Hermianopsia

A

-blindness on same side in both eyes , put everything in their line of vision!!!!

approach from unaffected side and manually scan environment!

67
Q
A

Nursing 221-222 (9 decks)

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