Neuro Chapter 70
What does the nurse recognize as the most prominent features related to the diagnosis of huntington's disease
the most prominent clinical featured of the disease that this patient is experiencing are chorea (rapid jerky involuntary movements) and impaired voluntary movement. Other prominent features include intellectual declines, and often personality changes.
A nurse knows that a patient exhibiting seizure-like movements localized to one side of the body most likely has what type of tumor?
A motor cortex tumor
the three most common systemic signs of ICP are
Headache N/V papilledema
An older adult patient exhibiting clinical manifestations of a brain tumors is admitted to the hospital for testing. What tumor types does the nurse know are commonly seen in the older adult?
Medulloblastoma
Micrographia
Minute and illegible handwritting
The four cardinal signs of Parkison's disease are
Tremors Rigidity Bradykinesia (abnormal slow mov) Postural instability
The five degenerative disorders of the central and peripheral nervous systems are
Parkinson's disease Huntington's disease Alheimer disease Amyotrophic lateral sclerosis Muscular dystrophies Degenrative diskd Postpolio Syndrome
What is the different between primary and secondary brain tumors
Primary tumors originate from cells within the brain Secondary, or metastatic, brain tumors develop from structures outside the brain and are twice as common as primary brain tumors.
Akathisia
Restlessness and agitation
A patient with Parkinson's Disease is experiencing an on-off syndrome. What does the nurse recognize that the patient's clinical symptoms will be?
The patient will have periods of immobility, followed by a sudden return of effectiveness of the medications.
Bradykenesia
Very slow voluntary movement and speech
Describe the process of stereotactic biopsy and its benefits in the diognosis of the brain tumors
Computer assisted stereostatic (30) biopsy is used to diagnose deep-seated brain tumors and provide a basis fro treatment and prognosis. Stereostatic aproaches involves the use of a 3D frame that allows very precise Localization of the tumor; a stereotactic frame and multiple imagin studies ( x-ray, CT scan, and MRI) are used to localized the tumor and verify its position. Brain mapping technology helps determine how close diseased areas of the brain are to structures essential for normal brain funtion
Radiculopathy
Disease of the spinal nerve root
The five chief symptoms of amyotrophic lateral sclerosis are
Fatigue Progressive muscle Cramps Fasciculation (twitching) Incoordination
Dyskinesia
Impaired ability to execute voluntary movement
A patient with a brain tumor is complaining of headaches the are worse in the morning. What does the nurse know could be the reason for the morning headaches?
Increase Intracranial pressure
The nurse is developing a plan of care for Charles.What goals does the nurse set for him?
The goals for the patient may include impoving functional mobility, maintaining independence in activities of daily living, achieving adequate bowel elimination, attaining and maintaining acceptable nutrition status, achieving effective communication, and developing positive coping mechanisms
When a pt is diagnosed with parkinson's disease, what clinical manifestation is present at diagnosis
A slow, unilateral resting tremors is present in the majority of pt at the time of the diagnosis
Mike has informed the nurse that he has no relatives or close friends who would be able to assist with his care. What information should Mike receive about resources to help with his options
The huntington's Disease Society of America helps patients and families by providing information, referrals, family, and public education, and support for research.
The three most common focal or localized symptoms of increased (ICP) are
Hemiparesis Seizures Mental Status change
The nurse is caring for a patient with Huntington's disease in the long-term care facility. what does the nurse recognize as the most prominent symptom of the disease that the patient exhibits?
Rapid, jerky, involuntary movements
Chorea
Rapid, jerky, purposeless movement of extremities or facial mucles
A patient with amyotrophic Lateral sclerosis asks if the nurse has heard of a drug that will prolonged the patient's life. The nurse knows that there is a medication that may prolong the life by 3 to 6 months. What medication is the patient referring to?
Riluzole (Rilutek)
Two major collaborative problems for pt with a cervical discectomy would be
Hematoma at the surgical site, causing cord compression ; and neurologic deficit and recurrent or persistent pain after surgery
Paresthia
A sensation of " pins and needles"
A Spinal cord tumor located within the spinal cord is classified as
Intramedullary
Dysphonia
Abnormal voice quality caused by incoordination of speech muscles
Cervical disk hernation usually occurs at the (blank or (blank) interspace
C5-C6 C6-C7
Charles will be started an chemotherapy program using carbidopa/levodopa. Why will cabidopa be added to the levodopa?
Carbidopa is often added to levodopa to ovoid metabolism of levodope before it can reach the brain
The majority of metastatic lession to the brain occurs from six areas
Lungs Breast Lower Intestinal Tract Pancreas Kidneys Skin
Two major characteristics of muscular dystrophies are
Progressive muscle weakness Abnormal elevation in blood muscle Enzymes
Mike has been prescribed a selective serotonin re-uptake inhibitor (SSRI) included with other medication. What benefit will the SSRI have for him during his disease?
SSRI and Tricyclics have been recommended for control of psychiatric symptoms. The treat of suicide is present particularly early in the course of the disease. Psycothic symptoms usually respond to anti-psychotic medications. Psychotherapy aimed at allaying anxiety and reducing stress may be beneficial.
Describe the physiological changes that results from the infiltration of tissue subsequent to the growth of a brain tumor
A variety of physiologic changes can occur, such as increase ICP and cerebral edema, seizure activity and focal neurologic signs, hydrocephalus, and altered pituitary function
Why is it important for the nurse to ensure that Charles be started on an exercise regimen as part of his treatment plan? what type of exercise might the nurse recommend and why?
A progressive program of daily exercise will increase muscle strength, improve coordination and dexterity, reduce muscular rigidity, and prevent contractures that occur when are not used. Walking, riding a stationary bicycle, swimming,and gardening are all exercises that help maintain joint mobility. Stretching ( stretch-hold-relax) and range-of- motion exercises promote joint flexibility. Postural exercises are important to counter the tendency of the head and neck to be drawn forward and down. A physical therapist may be helpful in developing an individualized exercise program and can provide instruction to the patient and caregiver on exercising safely. Faithful adherence to an exercise and walking program helps delay the progress of the disease. Warm baths and massage, in addition to passive and active exercise, help relax muscles and relieve painful muscle spasms that accompany rigidity
A patient is exhibiting bradykenesia, rigidity, and tremors related to parkinson's disease. The nurse understands that these symptoms are directly related to what decreased neurotransmitter level?
Dopamine
The nurse is performing an assessment for a patient in the clinic with Parkinson's disease. The nurse determines that the patient's voice has changed since the last visit and is now more difficult to understand. How should the nurse document the finding?
Dysphonia
The daughter of a patient with Huntington's Disease asks the nurse what the risk is of her inheriting the disease. What is the best response by the nurse?
If one parent has the disorder, there is a 50% chance that you will inherit the disease.
Describe the various classification of brain tumors based on their pathophysiology
Brain tumors are classified according to origin: those arising from the covering of the brain, those developing in or on the cranial nerves, those originating within the brain tissue, and metastatic lesions orginating elsewhere in the body
A patient with Parkinson's Disease ask the nurse what can be done to prevent problems with bowel elimination. What would be an intervention that would assist this patient with a regular stool pattern?
Adopt a diet with moderate fiber intake.
A patient is diagnosed with intracranial tumor. The nurse knows that the diagnosis may include which of the following? SATA
Astrocytoma Ependymona Medulloblastoma
The nurse is caring for patient with parkinson's disease and is preparing to administer medication. What does the nurse administer to the patient that is consider the most effective drug currently given for the tremor of parkinson's?
Levodopa
A patient is diagnosed with a spinal cord tumor and has dad course of radiation and chemotherapy. Two months after the completion of the radiation, the patient complains of severe pain in the back. what is pain an indicator of in patient with a spinal cord tumor?
Spinal metastasis
A patient with Huntington's disease is prescribed medication to reduce Chorea. What is the only drug approved for the treatment of this symptom?
Tetrabenazine (Xenazine)
A patient is diagnosed with amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig's disease. The nurse understand that the symptoms of the disease will begin in what way?
Weakness starting in the muscle supplied by the cranial nerves
