Meds/Neuro

acetazolamide

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baclofen (Lioresal)

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A client is arousing from a coma and keeps saying, "Just stop the pain." The nurse responds based on the knowledge that the client's first response to pain will be to:

Escape the source of pain. Explanation: The client's innate responses to pain are directed initially toward escaping from the source of pain. Variations in tolerance and perception of pain are apparent only in conscious clients, and only conscious clients can employ distraction to help relieve pain.

The physician prescribes diazepam (Valium), 10 mg I.V., for a client experiencing status epilepticus. Which statement about I.V. diazepam is true?

It should be administered no faster than 5 mg/minute in an adult. Rationale: To prevent adverse reactions, which are common, I.V. diazepam should be administered no faster than 5 mg/minute in an adult and should be given over at least 3 minutes in children. Diazepam shouldn't be mixed with other drugs in an infusion because of the high risk of incompatibility. To help prevent extravasation, the nurse should avoid administering diazepam in a small vein. I.V. diazepam may cause cardiorespiratory depression; to detect this adverse reaction, the nurse should monitor the client's vital signs carefully during administration

The client asks when to stop taking the eye medication for chronic open-angle glaucoma. The nurse should tell the client:

To use the eye medication for the rest of life. Explanation: To control increased intraocular pressure, the client will need to continue taking eye medications for the rest of life. Any loss of vision that the client has suffered will be permanent. Vision loss can occur gradually without any symptoms. Intraocular pressure will increase once medications are discontinued

A client experienced a stroke that damaged the hypothalamus. The nurse should anticipate that the client will have problems with:

body temperature control. Explanation: The body's thermostat is located in the hypothalamus; therefore, injury to that area can cause problems with body temperature control. Balance and equilibrium problems are related to cerebellar damage. Visual acuity problems would occur following occipital or optic nerve injury. Thinking and reasoning problems are the result of injury to the cerebrum

Diazapem

s

Hidralizine

s

To encourage adequate nutritional intake for a client with Alzheimer's disease, a nurse should:

stay with the client and encourage him to eat. Explanation: Staying with the client and encouraging him to feed himself will ensure adequate food intake. A client with Alzheimer's disease can forget how to eat. Allowing privacy during meals, filling out the menu, or helping the client to complete the menu doesn't ensure adequate nutritional intake

A client is having a cataract removed and will use eyeglasses after the surgery. The nurse should develop a teaching plan that includes which of the following? Select all that apply.

• Images will appear to be one-third larger. • Look through the center of the glasses. • Use handrails when climbing stairs. Explanation: The use of glasses following cataract surgery does not totally restore binocular vision. Glasses will cause images to appear larger and peripheral vision will be distorted; the client should look through the center of the glasses and turn his or her head to view objects in the periphery. The client should also use caution when walking or climbing stairs until he or she has adjusted to the change in vision. Changes in vision following cataract surgery are not immediate and the nurse can instruct the client to be patient while adjusting to the changes. The client does not need to stay out of the sun, but should wear dark glasses to prevent discomfort from photophobia

zolpidem tartrate (Ambien/Sublinox)

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The nurse is caring for a client with an injury to the thalamus. The nurse should plan to:

Monitor the temperature of the bathwater. Explanation: The spinal cord connects the brain to the periphery. The thalamus is located in the midbrain and integrates all sensory impulses except olfaction. The afferent impulses are received and then transmitted from the thalamus. Destruction or interruption of the neurosensory pathway results in loss of communication between the two systems. Monitoring the temperature of the bathwater is important because the client cannot feel whether the water is too hot or too cold. Damage to the thalamus does not result in loss of the corneal reflex. Loss of position and vibratory sense usually occurs with degeneration of the posterior column of the spinal cord; therefore, turning every 2 hours is critical to prevent skin breakdown related to increased capillary pressure. The nurse can give only the prescribed dosage of pain medication

A client with multiple sclerosis (MS) lives with her daughter and 3-year-old granddaughter. The daughter asks the nurse what she can do at home to help her mother. Which of the following measures would be most beneficial?

Regular exercise. Explanation: An individualized regular exercise program helps the client to relieve muscle spasms. The client can be trained to use unaffected muscles to promote coordination because MS is a progressive, debilitating condition. The data do not indicate that the client needs psychotherapy, day care for the granddaughter, or visits from other clients

The nurse is instructing the client about postoperative care following cataract removal. What position should the nurse teach the client to use?

Remain in a semi-Fowler's position. Explanation: The nurse should instruct the client to remain in a semi-Fowler's position or on the nonoperative side. Positioning the feet higher than the body does not affect the operative eye; placing the head in a dependent position could increase pressure within the eyes

When providing discharge teaching for a client with multiple sclerosis (MS), the nurse should include which instruction?

The nurse should instruct a client with MS to avoid hot baths and showers because they may exacerbate the disease. The nurse should encourage daytime naps because fatigue is a common symptom of MS. A client with MS doesn't require food or fluid restrictions

After 5 days of hospitalization, a client who is receiving morphine sulfate for pain control asks for pain medication with increasing frequency and exhibits increased anxiety and restlessness. The vital signs are within normal ranges. What is a possible cause of this behavior?

Tolerance to the dose of morphine. Correct Explanation: Tolerance to a regular opioid dose can develop with frequent use. The client experiences increased discomfort, asks for medication more frequently, and exhibits anxious and restless behavior, actions which are often misinterpreted as indicative of developing dependence or addiction. The client's symptoms do not suggest that the dosage is too high. Addiction is a psychological condition in which a client takes drugs for nontherapeutic reasons. This client is receiving morphine for pain control. There are no data given about the client's coping mechanism

A client with a head injury regains consciousness after several days. Which of the following nursing statements is most appropriate as the client awakens?

"You are in the hosipital. You were in an accident and unconscious." Explanation: It is important to first explain where a client is to orient to time, person, and place. Offering to get family and asking questions to determine whether the client is oriented are important, but the first comments should let the client know where he or she is and what happened. It is useful to be empathetic to the client, but making a comment such as "I'll bet you're a little confused" when the client first awakens is not helpful and may cause anxiety

A client is undergoing testing to confirm a diagnosis of myasthenia gravis. The nurse explains that a diagnosis is made if muscle function improves after the client receives an I.V. injection of a medication. What is the medication the nurse tells the client he'll receive during this test? a) Cyclosporine b) Edrophonium (Tensilon) c) Immunoglobulin G (Iveegam EN) d) Azathioprine (Imura

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What should a nurse do when administering pilocarpine (Pilocar)? a) Apply pressure on the outer canthus to prevent adverse reactions. b) Flush the client's eye with normal saline solution to prevent burning. c) Administer at bedtime to prevent night blindness. d) Apply pressure on the inner canthus to prevent systemic absorption

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A client undergoes cerebral angiography for evaluation after an intracranial computed tomography scan revealed a subarachnoid hemorrhage. Afterward, the nurse checks frequently for signs and symptoms of complications associated with this procedure. Which findings indicate spasm or occlusion of a cerebral vessel by a clot?

Hemiplegia, seizures, and decreased level of consciousness (LOC) Explanation: Spasm or occlusion of a cerebral vessel by a clot causes signs and symptoms similar to those of a stroke: hemiplegia, seizures, decreased LOC, aphasia, hemiparesis, and increased focal symptoms. Nausea, vomiting, and profuse sweating suggest a delayed reaction to the contrast medium used in cerebral angiography. Difficulty breathing or swallowing may signal a hematoma in the neck. Tachycardia, tachypnea, and hypotension suggest internal hemorrhage.

The nurse has administered mannitol I.V. Which of the following is a priority assessment for the nurse to make after administering this drug?

Monitor urine output. Explanation: Mannitol is an osmotic diuretic used in acute clinical situations. It increases osmotic pressure and draws fluid into the vascular space. Monitoring hourly urine output is a priority nursing assessment when administering mannitol. Electrolyte levels should also be monitored, most specifically sodium, chloride, and potassium. Calcium levels are not affected by mannitol. Bowel sounds and pupil reaction to light are not priority nursing assessments with mannitol.

A client with a head injury begins to have clear drainage from the nose. The nurse should:

Document the presence and amount of fluid. Explanation: The clear drainage (cerebrospinal rhiorrhea) may result from a basal skull fracture caused by leakage of cerebrospinal fluid. The nurse should document the finding. Most leaks will close spontaneously. Compressing the nares will obstruct the drainage flow. It is inappropriate to tilt the head back, which would allow the fluid to drain down the throat. It is not necessary to administer an antihistamine because the drainage may not be from postnasal dr

A client who had open heart surgery is being transported to the intensive care unit (ICU) for postoperative recovery from anesthesia. The nurse in the ICU is assessing the client's level of consciousness. When asked, the client can give his name but is not sure about where he is or the time of day. What should the nurse do?

Tell the client where he is and the time of day. Explanation: The first cognitive response that returns after anesthesia is orientation to person. The nurse assesses this by asking the client his name. Orientation to place and time usually occurs after orientation by the nurse because of confusion from anesthesia and waking in an unfamiliar place. The nurse can then continue to assess and document the client's cognitive ability to remember information. The nurse does not need to notify the surgeon. The client's cognitive response is normal. It is not necessary to ask the wife to reorient the client; however, she can continue to talk to him and help him regain consciousness

Which of the following statements would provide the best guide for activity during the rehabilitation period for a client who has been treated for retinal detachment?

The scarring of the retinal tear needs time to heal completely. Therefore, resumption of activity should be gradual; the client may resume her usual activities in 5 to 6 weeks. Successful healing should allow the client to return to her previous level of functioning