Med Surg Chapter 70

A nurse knows that a patient exhibiting seizurelike movements localized to one side of the body most likely has what type of tumor?

A motor cortex tumor

When a patient is diagnosed with Parkinson's disease, what clinical manifestation is present at diagnosis?

A slow unilateral resting tremor

Describe the physiologic changes that result from the infiltration of tissues subsequent to the growth of a brain tumor

A variety of physiologic changes can occur, such as increased ICP and cerebral edema, seizure activity and focal neurologic signs, hydrocephalus, altered pituitary function

Very slow voluntary movements and speech

Bradykinesia

Rapid, jerky, purposeless movements of extremities or facial muscles

Chorea

Impaired ability to execute voluntary movements

Dyskinesia

The 5 chief symptoms of amyotrophic lateral sclerosis are

Fatigue, progressive muscle weakness, cramps, fasciculations (twitching), incoordination

The 3 most common systemic signs of increase intracranial pressure (ICP) are

Headache, nausea and vomiting, papilledema

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

A patient with a brain tumor is complaining of headaches that are worse in the morning. What does the nurse know could be the reason for the morning headaches?

Increased intracranial pressure

The nurse is caring for patients with Parkinson's disease and is preparing to administer medication. What does the nurse administered to the patient that is considered the most effective drug currently given for the tremor of Parkinson's?

Levodopa

The majority of metastatic lesions to the brain occur from six ares:

Long, breast, lower gastrointestinal tract, Pancreas, kidney, skin

Minute and illegible handwriting

Micrographia

Sensation of "pins and needles"

Paresthesia

5 degenerative disorders of the central and peripheral nervous system are

Parkinson's disease, Huntington's disease, Alzheimer's disease, Amyotrophic lateral sclerosis, muscular dystrophies, degenerative disk disease, post polio syndrome

What is the difference between primary and secondary brain tumors

Primary brain tumors originated from cells within the brain. Secondary or metastatic rain tumors developed from structures outside the green and are twice as common as primary brain tumors

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

A patient with Huntington's disease is prescribed medication to reduce the chorea. What medication will the nurse administer that is the only drug approved for the treatment of this symptom?

Tetrabenazine (Xenazine)

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 near immobility, followed by a sudden return of effectiveness of the medication

The 4 cardinal signs of Parkinson's disease are

Tremor, rigidity, bradykinesia, postural instability

A patient is diagnosed with and amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig's disease. The nurse understands that the symptoms of the disease will begin in what way?

Weakness starting in the muscles supplied by the cranial nerves

A spinal cord tumor located within the spinal cord is classified as

intramedullary

A patient with Parkinson's disease asks the nurse what can be done to prevent problems with bowel illumination. What would be an intervention that would assist this patient with a regular stool pattern?

Adopt a diet with moderate fiber intake

Restlessness and agitation

Akathisia

A patient is diagnosed with an intracerebral tumor. The nurse knows that the diagnosis may include which of the following? (select all that apply)

Astrocytoma, Ependymoma, medulloblastoma

Describe the various classifications 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 brain tissue and metastatic lesions originating elsewhere in the body

Cervical disk herniation usually occurs are the _______ interspaces

C5 to C6 or C6 to C7

Describe the process of stereotactic biopsy and its benefits in the diagnosis of brain tumors

Computer assisted stereotactic biopsy is used to diagnose deep-seated brain tumors and to provide a basis for treatment and prognosis. Stereotactic approaches involve the use of three-dimensional frame that allows very precise localization of the tumor; A stereotactic frame and multiple imaging studies are used to localize the tumor and verify its position. Brain mapping technology helps determine how close disease areas of the brain are to structures essential for normal brain function

The nurse is performing an assessment for patient in the clinic with Parkinson's disease. The nurse determines that the patients voice has changed since last visit and is now more difficult to understand. How should the nurse document this finding?

Dysphonia

The 3 common focal or localized symptoms of increased ICP are

Hemaparesis, seizures, mental status change

Two major collaborative problems for patient with a cervical diskectomy would be

Hematoma at the surgical site, causing cord compression; And neurologic deficit and recurrent or persistent pain after surgery

2 common characteristics of muscular dystrophies are

Progressive muscle wasting and weakness, abnormal elevation in blood muscle enzymes

An older adult patient exhibiting clinical manifestations of a brain tumor is admitted to the hospital for testing. What tumor types does the nurse know are commonly seen in an older adult?

medulloblastoma

A patient is exhibiting bradykinesia, rigidity, and tremors related to Parkinson's disease. The nurse understands that the symptoms are directly related to what decreased neurotransmitter level?

Dopamine

Abnormal voice quality caused by incoordination of speech muscles

Dysphonia

Disease of the spinal nerve root

Radiculopathy

A patient with myotrophic lateral sclerosis asks if the nurse has heard of a drug that will prolong 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)

A patient is diagnosed with a spinal cord tumor and has a course of radiation and chemotherapy. Two months after the completion of radiation, the patient complains of severe pain in the back. What is pain and indicator of in a patient with a spinal cord tumor?

Spinal metastasis