Nursing of Adults: Neurological Disorders part I

A medication for migraine headaches is (1)_______. This medication does what (2)?

1. ergotamine tartrate 2. constricts vessels

Which Glasgow Coma Scale rating would a patient receive who opens the eyes spontaneously, but has incomprehensible speech and obeys commands for movement?

12

Exacerbation of multiple sclerosis are precipitated by what?

fatigue chilling emotional disturbances

Which concern is a priority in a patient with an open head injury?

infection

The nurse is aware that the characteristic gait of the person with Parkinson disease is a propulsive gait, which causes the patient to walk in which manner?

shuffle with arms flexed.

A pt is experiencing an Absence (Petit Mal) seizure. The nurse knows this type of seizure causes

sudden vacant facial expression with eyes focused straight ahead

*DOSAGE CALCULATIONS*

D ( Desired Dose) HINT: What the doctors orders H (Dose on Hand) HINT: What is avaiable or you are given V (Volume) HINT: Always in mL D / H : V= Amount to Give (answer in mL) HINT: If the amount on had is PER ML.... multiply by that number. HINT: D/H x ML

In a pt with myasthenia graves, which drug would the use question if it was ordered?

Neomycin (mycifradin)

_________________ is/are responsible for the transmission of impulses between synapses.

Neurotransmitters

A patientis to have a myelogram to confirm the presence of a herniated intervertebral disk. Which nursing action will be planned with respect to this diagnostic test?

Obtain an allergy history before the test.

A pt is having seizures 3 times a week. The nurse knows the primary method of controlling seizures is what?

Pharmacological therapy

A family member of a patient who has just experienced a tonic-clonic seizure is concerned about the patient's deep sleep. What is this behavior called?

Postictal period

Which benefit do the drugs neostigmine and pyridostigmine have for the person with myasthenia gravis?

Promotes nerve impulse transmission.

When planning care for a pt with ALS, a priority nursing intervention would include:

clear airway maintenance

Apraxia is seen in the third stage of alzheimer's disease, this is know as what?

impaired ability to perform purposeful acts or use objects (cannot button buttons, hold a spoon, comb hair, etc..)

A pt is admitted to the ER with severe vomiting. The nurse knows vomiting causes _______ and MUST be controlled.

increased intracranial pressure

The nurse is aware that when assessing a patient by the FOUR score coma scale, the patient is assessed in four categories: eye response, brainstem reflexes, motor response, and respiration. In which manner are these results reported?

As individual scores in each category

The nurse is aware that the drug t-PA a tissue plasminogen activator, must be given within how many hours of the onset of symptoms to have maximum benefit?

3 hrs

Aura

A sensation that may precede a seizure (flashing lights, smells, numbness, tingling, hallucinations)

In which way will a nurse record the behavior when a patient with Alzheimer's disease attempts to eat using a napkin rather than a fork?

Agnosia

A nurse is observing a new grad as she evaluates a pt with the Glasgow coma scale. What indicates that the new grad understands the assessment criteria?

Eye opening, verbal response, motor response

Which sign is the cardinal sign of increased intracranial pressure in a patient who has sustained a brain injury?

Decrease in the level of consciousness

Multiple sclerosis is a result of what?

Demyelination of the nerve sheath

Amyotrophic Lateral Sclerosis (ALS) (Lou Gehrig's Disease)

Electrical and chemical messages originating in the brain do not reach the muscles to activate them

A mt with a head injury has been ordered mannitol IV. The pt is most likely receiving the mannitol because:

He has increased ICP

The nurse assures an anxious family member of a 92-year-old patient who is demonstrating signs of dementia that many causes of dementia are reversible and preventable. Which disorder is one example?

Hypotension

When would a lumbar puncture be contraindicated?

If client is showing s/s of increased ICP

Which aspect is the nurse assessing when asking the patient, "Who is the president of the United States?" during a level of consciousness data collection?

Knowledge

A patient is in which stage of Alzheimer's disease when demonstrating difficulty swallowing?

Late

Following a myelogram the nurse will include in the postprocedure care observing for which possible complication?

Loss of sensation in lower extremities.

For which reason is a "drug holiday" used in the treatment of Parkinson disease?

Restart drugs at a lower dosage with favorable results.

Postictal Period

Resting period of variable length (it is common to sleep for a long period of time after a seizure)

The nurse is caring for a patient with a new diagnosis of Parkinson disease. Which assessment data would best describe the symptoms of an individual with Parkinson disease?

Shuffling gait Dysphagia

In teaching a pt who is experiencing migraine head aches which of these behaviors indicates that patient teaching has been successful?

The to identifies the factors that trigger her headaches.

Which symptom is specific to migraine headaches?

They are preceded by an aura

In which way will the nurse instruct a patient with Parkinson disease to improve activity level?

To walk with hands folded behind back to help balance.

A pt has a seizure that is accompanied by incontinence. The to sleeps for several hours afterward. What kind of seizure did the patient most likely have?

Tonic-clonic

What is the MOST SIGNIFICANT symptom of increased intracranial pressure?

decrease in level of consciousness

The waxy substance that covers the neuron fibers and increases the rate of transmission of impulses is the ________.

myelin

A ___________ is a diagnostic procedure used to identify lesions by observing the flow of radiopaque dye through the subarachnoid space.

myelogram

Migraine headaches Prodromal (early s/s)

visual field defects, experiencing unusual smells or sounds, disorientation, paresthesias, and rarely paralysis of a part of the body

A pt has fallen from a horse and is brought to the ER for evaluation for a closed head injury. Which assessment finding should the nurse report immediately to the physician

vomiting

Multiple sclerosis is MOST common in what type of climates?

wet, cold climates

Which issue is the basic problem that prompts most of the early signs of Alzheimer's disease (AD)?

Memory loss that disrupts daily life

A pt admitted to the ER is experiencing ptosis and diplopia. These are common signs of what?

Myasthenia Gravis (The MOST COMMON s/s is Ptosis (eyelid drooping))

Involuntary rhythmic movement of the eyes, with oscillations that may be horizontal, vertical, or mixed movements, is called ___________________.

Nystagmus

A pt is being observed for for increased ICP. Which classification of drugs, besides anticonvulsants and corticosteroids , would the nurse expect the physician to order?

Osmotic diuretics

A pt admitted to the ER is experiencing "Pill-rolling" motions of his fingers. The nurse knows this is a sign of what?

Parkinson's Disease

A to asks the nurse why she must lie flat after her lumbar puncture. The nurse correctly answers the pt by saying:

"You may get a bad head ache if you sit up now"

What should be included in the plan of care for a patient undergoing a computed tomography scan with contrast?

-Placing the pt on NPO status for at least 4 hrs before the test - ascertaining allergies to seafood or iodine before the test

Which food should the person who experiences migraine headaches avoid?

-Yogurt -Caffeine -Marinated foods

Which factor is the nurse aware of when assessing a person with a craniocerebral injury?

Signs and symptoms may not occur until several days after the trauma.

A pt is experiencing a Tonic Clonic (Grand Mal) seizure. The nurse knows this type of seizure

involves the WHOLE body

The nurse explains to a patient and family that the triad of signs of Parkinson disease is: _______, rigidity, and bradykinesia.

Tremor

The nurse assesses a patient taking phenytoin (Dilantin) and finds gingival hyperplasia. What is the nurse's priority action?

Instruct the patient on oral hygiene (A side effect of phenytoin (Dilantin) is overgrowth of gum tissue. This can be minimized by frequent oral hygiene. If oral hygiene efforts do not improve gum condition, a consult with a dentist is recommended. Since this is an expected side effect, there is no indication to notify the health care provider or to hold the next dose.)