Med Surg II - Test 3

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TMill
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149689
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Med Surg II - Test 3
Updated:
2012-04-23 22:19:19
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Neurological
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4-24-2012
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  1. What is Parkinson's Disease caused by?
    Deficiency of Dopamine
  2. 4 Cardinal symptoms of Parkinson's?
    • Tremor (pill rolling)
    • Rigidity (cogwheel)
    • Bradykinesia
    • Postural Instability
  3. What should you be aware of about Dopamine Agonist drugs such as Levodapa & Sinement used for Parkinson's?
    Cause Orthostatic Hypotension, drowsiness, hullicanations, etc.
  4. Which Stage of Parkinson's?

    Unilateral
    Minimal weakness
    Trembling
    Stage 1
  5. Which Stage of Parkinson's?

    Bilateral
    Masklike facies
    Shuffling gait
    Stage 2
  6. Which Stage of Parkinson's?

    Postural Instability
    Gait Disturbance
    Stage 3
  7. Which Stage of Parkinson's?

    Akinesia
    Rigidity
    Stage 4
  8. Which Stage of Parkinson's?

    Complete Dependence
    Stage 5
  9. Patient teaching for Eldepryl for Parkinson's?
    Avoid TYRAMINE (cheese, wine, beer)
  10. What are the Side Effects of Cogentin used for Parkinson's?
    Dry Secretion... cant pee, cant see, cant spit, cant shit etc.
  11. Nursing Diagnosis for Parkinson's?
    Risk for Falls, Aspiration, & Risk for poor Nutrition
  12. Which types of therapy should you do for Stage 1 Alzheimer's Disease?
    Reality Orientation & Reminiscence Therapy
  13. Which types of therapy should you do for Stage 2 Alzheimer's Disease?
    Validation & Redirection
  14. Intervention for alzheimer's pt?
    • Establish daily routine
    • Do not overstimulate
    • Place armband on them
  15. Nursing Diagnosis for Alzheimers?
    • Chronic Confusion
    • Risk for Injury
  16. What is Huntington's Disease due to?
    Decrease in GABA & Ach

    EXCESS DOPAMINE
  17. S/S of Huntington's?
    Choreiform Movements (rapid, jerk movements) & Mental status change r/t dementia
  18. Nursing Diagnosis for Huntington's?
    • **Risk for aspiration r/t impaired swallowing
    • Imblanaced nutrition
    • Impaired skin integrity
    • Impaired verbal communication
  19. What disorder is characterized by many exacerbations and remissions that progesses to an increasing loss of function?
    Multiple Sclerosis
  20. What is affected in Multiple Sclerosis that causes the problems?
    Myelin Sheath
  21. What are some thing people with MS should avoid?
    • Alcohol
    • Laxatives
    • Stress
    • Fatigue
    • Overexertion
    • Extreme temps
  22. What are the 2 main early manifestations you will notice with MS?
    Vision changes (double/blurred) & FATIGUE
  23. What is Myasthenic crisis due to?
    UNDERMEDICATION
  24. what is Cholinergic Crisis due to?
    OVERMEDICATION
  25. If someone has a Myasthenic Crisis, how would we treat this?
    Watch for sudden respiratory distress BUT drugs would be held for 2 days then resumed slowly
  26. Myasthenic or Cholinergic Crisis?


    S/S: Tachycardia, tachypnea, hypertension, dysphagia
    Myasthenic
  27. Myasthenic or Cholinergic Crisis?

    S/S: N/V, diarrhea, blurred vision, pallor, hypotension, facial muscle twitching
    Cholinergic Crisis
  28. How would you treat Cholinergic Crisis?
    Hold drugs and give ATROPINE 1 mg
  29. What is the antidote for Tensilon?
    Atropine
  30. Tensilon Test:

    Improvement in muscle strength within 30-60 seconds for 5 min
    Myasthenia Gravis
  31. Tensilon Test:

    Improvement
    Myasthenic Crisis
  32. Tensilon Test:

    No improvement
    Cholingergic Crisis
  33. What are you at risk for when doing a Tensilon test?
    VFib & Cardiac Arrest
  34. Pt. teaching about meds for Myasthenia Gravis?
    Take on time & take before activities
  35. What should family members know for Myasthenia Gravis?
    CPR


    O2 and intubation tray at bedside & airway resuscitation supplies at bedside
  36. What disease is where the muscles cannot contract?
    Myasthenia Gravis
  37. Which syndrome causes ascending paralysis?
    guillian barre
  38. What is the biggest concern for gullain barre?
    Respiratory Statues - elevate HOB, suction, humidified O2, etc.
  39. What causes excruciating facial pain? (cranial nerve 5)
    Trigeminal Neuralgia
  40. What are triggers for Trigeminal Neuralgia?
    Light touch, wind, talking, chewing, brushing, sneezing, shaving, washing, etc.

    Fear of Attack
  41. Nursing Diagnosis for Trigeminal Neuralgia?
    Acute PAIN
  42. Post op care for Rhizotomy?
    Assess corneal reflex, facial nerve, clench teeth

    Ice pack to effected side

    Avoid chewing/rubbing effected side
  43. Bell's palsy occurs on which cranial nerve?
    7
  44. Treatment for Bell's Palsy?
    Corticosteroids, Analgesics, Acyclovir

    Heat & gentle massage
  45. What is Bell's Palsy sometimes related to?
    Herpes simplex virus
  46. Kernig's Sign?
    Pain upon trying to extend lower leg after hip and knee is flexed 90 degrees - positive sign suggests meningitis
  47. Brudzinski's Sign?
    place hands behind neck and gently elevate head toward chest & hips and knees will rise as well - suggests meningitis
  48. CSF analysis of Bacterial Meningitis?
    • Cloudy
    • Decreased Glucose
    • Increased pressure
  49. What are the 3 S/S of Cushing's Triad?
    • Widened pulse pressure
    • Bradycardia
    • Hypertension

    NOTIFY PHYSICIAN!!!

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