NU144- Chapter 70: Management of Patients With Oncologic or Degenerative Neurologic Disorders

neurodegenerative

a disease, process, or condition leading to deterioration of cells or function of the nervous system

bradykinesia

abnormally slow voluntary movements and speech

spondylosis

degenerative changes occurring in a disc and adjacent vertebral bodies; can occur in the cervical or lumbar vertebrae

dyskinesia

impaired ability to execute voluntary movements

sciatica

pain and tenderness that radiates along the sciatic nerve that runs through the thigh and leg

chorea

rapid, jerky, involuntary, purposeless movements of the extremities or facial muscles, including facial grimacing

The nurse is providing discharge teaching for a client who was admitted to hospital after having complex partial seizures secondary to a glioma. The client has been prescribed levetiracetam to manage the seizures. What should the nurse include in the discharge teaching for this medication?

"Driving a car should be avoided until the you know how this medication effects you."

The nurse is providing end-of-life care to a client who was diagnosed with glioblastoma multiforme (GBM) 8 months ago. Despite a calm interaction with the client 1 hour ago, the client is now angry and yells, "Get out of my room and don't touch me anymore. I don't need your help!" How should the nurse respond?

"I can tell now is not the right time for me to come in and check on you. Please let me know when it is a better time for me to come back."

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 nurse teaches the client diagnosed with Huntington disease that it is transmitted as which type of genetic disorder?

Autosomal dominant

Excessive levels of which neurotransmitter has been implicated in amyotrophic lateral sclerosis (ALS)?

Glutamate

A client has undergone surgery for a spinal cord tumor that was located in the cervical area. The nurse would be especially alert for which of the following?

Respiratory dysfunction

paresthesia

numbness, tingling, or a "pins and needles" sensation

The nurse identifies a nursing diagnosis of self-care deficit, bathing related to motor impairment and decreased cognitive function for a client with cerebral metastasis. Which outcome would the nurse most likely identify on this client's plan of care?

Client participates in daily hygiene activities with assistive devices.

The nurse is caring for a client hospitalized after a motor vehicle accident. The client has a comorbidity of Parkinson's disease. Why should the nurse closely monitor the condition and the drug regimen of a client with Parkinson's disease?

Drugs administered may cause a wide variety of adverse effects.

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 this finding?

Dysphonia

An acoustic neuroma is a benign tumor of which cranial nerve?

Eighth

The nurse is caring for a client with mid-to-late stage of an inoperable brain tumor. What teaching is important for the nurse to do with this client?

Explaining hospice care and services

A client is diagnosed with a brain angioma. When teaching the client about the risks associated with this type of brain tumor, the nurse would educate about signs and symptoms associated with which condition?

Hemorrhagic stroke

A client was undergoing conservative treatment for a herniated nucleus pulposus, at L5 - S1, which was diagnosed by magnetic resonance imaging. Because of increasing neurologic symptoms, the client undergoes lumbar laminectomy. The nurse should take which step during the immediate postoperative period?

Logroll the client from side to side.

A client with spinal cord compression from a tumor must undergo diagnostic testing. Which of the following is the most likely procedure for this client?

Magnetic resonance imaging

A client who has a pituitary adenoma would report which symptoms related to the presence of this type of tumor? Select all that apply.

Morning headaches Chiasmal syndrome Polydipsia Anorexia

Which of the following is a late symptom of spinal cord compression?

Paralysis

Which disease is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells?

Parkinson disease

A 55-year-old female client presents at the walk-in clinic complaining of feeling like a mask is on her face. While doing the initial assessment, the nurse notes the demonstration of a pill-rolling movement in the right hand and a stooped posture. Physical examination shows bradykinesia and a shuffling gait. What would the nurse suspect is the causative factor for these symptoms?

Parkinson's disease

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

Nursing students are reviewing the various types of brain tumors. The students demonstrate understanding of the material when they identify which of the following as the most common type?

Gliomas

A 37-year-old mother of three has just been diagnosed with a grade I meningioma. As part of patient education, the nurse tells the patient that:

Growth is slow and symptoms are caused by compression rather than tissue invasion.

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

Which nursing diagnosis takes the highest priority for a client with parkinsonian crisis?

Ineffective airway clearance

Bone density testing will be completed for the client with post-polio syndrome. The nurse teaches the client bone density testing is used to identify what potential complication?

Low bone mass and osteoporosis

The nurse explains to the client with projectile vomiting and severe headache that a medication is being prescribed to reduced edema surrounding the brain and lessen these symptoms. What medication is the nurse preparing to administer?

Mannitol

The nurse is conducting a preoperative assessment of a client who is scheduled for surgical removal of a primary spinal tumor. What should the nurse include in the preoperative session? Select all that apply.

Methods of pain control after surgery Adjusting to changes in daily activities Question about current bowel and bladder control

Which statement indicates appropriate nursing intervention for a client with post-polio syndrome?

Provide care aimed at slowing the loss of strength and maintaining overall well-being.

A client diagnosed with a malignant brain tumor is scheduled to receive chemotherapy intrathecally. When explaining this technique to the client, the nurse would describe the medication as being injected into which area?

Subarachnoid space

What interventions will best help the client with Huntington disease relieve anxiety and increase communication? Select all that apply.

Use biofeedback. Consult with a speech therapist.

dementia

broad term for a syndrome characterized by a general decline in higher brain functioning, such as reasoning, with a pattern of eventual decline in ability to perform even basic activities of daily living, such as toileting and eating

papilledema

edema of the optic nerve usually due to increased intracranial pressure (ICP)

A nurse is working on a surgical floor. The nurse must logroll a client following a:

laminectomy.

dysphonia

voice impairment or altered voice production

The nursing instructor gives their students an assignment of making a plan of care for a client with Huntington's disease. What would be important for the students to include in the teaching portion of the care plan?

How to facilitate tasks such as using both hands to hold a drinking glass

A client is admitted reporting low back pain. How will the nurse best determine if the pain is related to a herniated lumbar disc?

Have the client lie on the back and lift the leg, keeping it straight.

The nurse is providing health education to a client recently diagnosed with a brain tumor. During the appointment, the client states, "I'm really worried that I will have a seizure while I am at work or with my kids. Should I be concerned about this?" How should the nurse respond?

"There is a risk for seizures in people who have this diagnosis. What have you already discussed with your primary health care provider regarding management of seizures?"

The nurse is caring for a client who has been hospitalized for investigation of a sudden change in gait due to loss of balance and coordination. A magnetic resonance imaging scan reveals the client has a brain tumor. On or close to which brain structure is the tumor most likely situated?

Cerebellum

The nursing is assessing a client who has been diagnosed with a pituitary adenoma, but has not yet started treatment. The client reports having increased heart rate, hand tremors, difficulty sleeping, weight loss and hyperthermia. The nurse anticipates the client will require blood work to assess for overproduction of which hormone?

Thyroid-stimulating hormone

The nurse identifies a nursing diagnosis of imbalanced nutrition, less than body requirements related to difficulty in chewing and swallowing for a client with Parkinson's disease. Which of the following would be most appropriate for the nurse to integrate into the client's plan of care?

Encourage the client to massage the facial and neck muscles before eating.