chapter 40

The nurse caring for a patient with bacterial meningitis is administering dexamethasone (Decadron) that has been ordered as an adjunct to antibiotic therapy. When does the nurse know is the appropriate time to administer this medication?

15 to 20 minutes before the first dose of antibiotic and every 6 hours for the next 4 days

The nurse is volunteering for a Red Cross blood drive and is taking the history of potential donors. Which volunteer would the nurse know will not be allowed to donate blood?

A donor who was in college in England for 1 year

The nurse is administering the IV antiviral medication ganciclovir (Cytovene) to the patient with HSV-1 encephalitis. What is the best way for the nurse to administer the medication to avoid crystallization of the medication in the urine?

Administer via slow IV over 1 hour.

A client with a brain tumor has begun to exhibit signs of cachexia. What subsequent assessment should the nurse prioritize?

Assessment of nutritional status

chronic phase

Characterized by emotional and physical disintegration. The person is usually intoxicated more often than sober.

recovery phase

Client regains physical and emotional control

A client with suspected Creutzfeldt-Jakob disease (CJD) is being admitted to the unit. The nurse would expect what diagnostic test to be ordered for this client?

EEG

A nurse is reviewing a client's medical record and finds that the client has a spinal cord tumor that involves the vertebral bodies. The nurse identifies this as which type of spinal tumor?

Extradural

A family member of a client diagnosed with Huntington disease calls you at the clinic. She is requesting help from the Huntington's Disease Society of America. What kind of help can this client and family receive from this organization? Select all that apply.

Information about this disease Referrals Public education

The nurse educator is facilitating a class on neurological function with a group of nursing students. When discussing problems that can result from growing brain tumors, the nurse educator should include that clients can experience which neurologic deficits even after surgical resection? Select all that apply.

Paralysis Incontinence Aphasia

A male client presents at the free clinic with reports of erectile dysfunction. Upon physical examination, the nurse practitioner notes the presence of hypogonadism. What diagnosis should the nurse suspect?

Prolactinoma

A client with diabetes presents to the clinic and is diagnosed with a mononeuropathy. This client's nursing care should involve which of the following?

Protection of the affected limb from injury

During the recovery phase of a neurologic deficit, assessment tools may be used to help identify a client's level of functioning. Which tool is used to measure performance in activities of daily living (ADL)?

The Barthel Index

A client with Huntington disease has just been admitted to a long-term care facility. The charge nurse is creating a care plan for this client. Nutritional management for a client with Huntington disease should be informed by what principle?

The client is likely to have an increased appetite.

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.

A client diagnosed with a pituitary adenoma has arrived on the neurologic unit. When planning the client's care, the nurse should be aware that the effects of the tumor will primarily depend on what variable?

The specific hormones secreted by the tumor

cachexia

a condition of physical wasting away due to the loss of weight and muscle mass that occurs in patients with diseases such as advanced cancer or AIDS

neurologic deficit

a nerve function that is diminished or absent - such as partial paralysis or weakness

A critically ill client is being treated for signs and symptoms of altered level of consciousness (LOC), hypertension, fever, and difficulty in breathing. Identify the phase of neurologic deficit that the client is experiencing.

acute

Acute Phase

acute phase follows a sudden neurologic event, such as a cerebrovascular accident (CVA) or a head or spinal cord injury.

A client with a neurologic deficit is feeling frustrated because it is very difficult to pronounce words since having a stroke. The client is struggling with:

dysarthria.

A client is brought into the ED after falling to the ground and reporting excruciating pain in the head before losing consciousness. Upon examination and after a quick CT scan, the ED physician calls a neurosurgeon and schedules the client for surgery. Based on this, it is clear that the client's condition is considered:

grave

receptive aphasia

inability to understand spoken or written words

dysarthria

slurred speech

expressive aphasia

trouble communicating thoughts through speech or writing

A client with a neurologic impairment reports having problems with constipation. Which foods might the nurse recommend?

vegetables

grave

very serious