MDC4 exam 1 latest 2023 graded A

MDC4 exam 1 latest 2023 graded A Alzheimer's dx moderate Stage Wondering behavior, Agitation, Incontinence Migraine signs/symptoms Episodic, head pain lasting from 4 to 72 hours Steady ache to violent throbbing Unilateral, worse with activity Aura Photophobia, phonophobia, osmophobia Education about Propranolol take daily at the same time Multiple Sclerosis treatment immunomodulators and immosuppressants. commonly given as injections so rotate injection sites clinical manifestations of meningitis nuchal rigidity (stiff neck), positive kernigs, brudzinskis sign, treatment for severe migraines* ergotamine tartrate (taken at the start of the headache) can take up to 6 tablets in 24 hours How does ergotamine tartrate work? acts by constricting the cerebal blood vessels priorities for seizure precautions lay on left side, adequate airway, padded rails. how to manage a patient with active seizure suction and 02, bedrails up and padded, IV access, give ativan/lorazepam New onset of a migraine and the doctor wants a ct with contrast ask if allergic to shellfish, seafood, iodine dietary restrictions for people with migraines caffeine, alcohol, pickled foods What can we do if someone has increased ICP? How do you want the head of the bed 30-45 degrees How do Alzheimer's patients act with changes in their environment anxious/anxiety What is our priority with cervical spinal injuries ABC's and stabalize stroke nursing interventions small bites with food, diet - pureed, watch the affected side for food pocketing, dentures, sit up right 90 degrees, DO NOT use straws. CSF clear fluid, halo ring, DO NOT put things in their ears Stroke tuck chin to swallow to prevent aspiration Contraindication for increased ICP lumbar puncture Elevated ICP elevate bed Significant sign of ICP LOC Cervical injury: Above level of C4 keep body in alignment so that jugular does not occlude Proprioception perception/position to space - forget about body on the one side Monitor BP after giving meds to a stroke pt do neuro checks Treatment for a Hemorrhagic STROKE vit k, fresh frozen plasma and surgery EEG for organ donor checking brain death Broca's - receptive speech area If a person has damage to Broca's area, sounds can be made, but words cannot be formed. MS- what medication is used to help treat spasms? Baclofen Highest risk with myasthenia gravis with eating and drinking Respiratory Differences between Myasthenia Gravis and Guillain Barre progression, autoimmune vs viral Proximal to distal muscle weakness Myasthenia Gravis Ascending symmetrical muscle weakness ( from feet-up) Guillain Barre Health hx of pt with Gillian Barrie- exposure to virus Normal ICP? 10-15 Patient care of ICP of 22 Decrease ICP by: Decrease noise in pt room, Give stool softener What is the easiest lab to do before a stroke alert? blood sugar check Embolic stroke doing an ECHO- what are we looking for? see if pt has AFIB. Most of these types of clots come from the heart Caring for pt with stoke that has broca's aphasia- communication board TIA Indications you're going to have a stroke, a high risk of a stroke Family decides that they want the pt to be an organ donor- Ensure organs maintain perfusion Looking a CSF that has yellow ring tests positive for glucose Pt in ER that has stoke but CAT shows hemorrhagic stroke- prep patient for surgery Pt with Parkinson's and displaying slow movement (dyskinesia) pt states he know he needs extra time to complete activities- he understands his condition Pt with BLE loss of sensation- Gillian Barres Syndrome Improving breathing post surgery Encourage client to use Incentive spirometry, Deep breath, and Cough Priority assessment after spinal surgery- ABC Pt with seizure would be described as a loss of consciousness, incontinence, and breathing cessation followed by postictal state the last 10 minutes- Tonic Clonic Pt going to surgery labs came back-= HGB of 3 notify provider and no surgery Baclofen- muscle relaxant Levodopa use for Parkinsonia symptoms of shaking, stiffness and difficulty moving Which vital sign after TPA is most important to control 24 hr- BP Sudden chest pain, dyspnea, cyanosis, and tachycardia- PE Which phase do u count sponges intraoperative Preventing DVT post operatively Early ambulation, SCD, anticoagulation Evisceration care apply warm moist sterile saline dressing Mask like face muscle rigidity, hypokinesis Parkinsons PCA pump- Client controls it Pt with paraplegic T6-T7 priority automonimc dysreflexia Assess bowel and bladder Pt with major seizure and is now sleeping for long periods Postictal phase Three components of Glasgow coma scale eye opening, verbal, motor Scrubbing hands for surgery 3-5 mins Field and find pt with head injury, clear drainage from nose- DON"T blow nose Head injury in ED- DO not do lumbar puncture Components of cushing triage- Widen pressure, Bradycardia, Hypertension 18. Parkinson's screening- shuffling, proposal forward movement Agnosia- Cannot recognize or identify objects or people Myasthenia Gravis IGG used for- To decrease production of acetylcholine Delirium Acute Confusion Anomia Inability to find Words Pt unable to wrinkle forehead- bells palsy Gave pt Ativan 20 mins ago promote safety- raise HOB and put rails up Informed consent, pt doesn't understand- get provider SX- Tachy, diaphrosis, rising body temp, emergent situation in operating room Malignant hyperthermia- treatment for malignant hyperthermia Dantrolene Which nurse is responsible for verifying consent form is signed- circulating nurse Pt with general anesthetic- know what general anesthetic (Gas to breathe in and med in IV) Pt understand operative teaching- I will sign consent form, surgeon will want me to ambulate, nurse will want deep breaths following surgery, constipation with pain meds General anesthesia- Gas and IV medication Morning hygiene, ambulation, and routine vitals Can be delegated to a UAP Atonic Seizure Muscle tone loss, last for seconds, postictal confusion Seizure Interventions Teach patient to continue phenytoin or other antiepileptics even when seizures have stopped. Spinal Cord Injury interventions Risk for pressure ulcers, VTE, reposition client every 1-2 hours. Ensure client is wearing dentures during feedings, thicken all fluids atonic seizure sudden loss of muscle tone simple partial seizure Focal seizure in which consciousness is NOT impaired psuedo-seizures Clinical events that are not associated with abnormal cortical electrical discharges embolic stroke often result from Heart disease or heart surgery Apraxia Apraxia is an effect of neurological disease. It makes people unable to carry out everyday movements and gestures. For example, a person with apraxia may be unable to tie their shoelaces or button up a shirt. People with apraxia of speech find it challenging to talk and express themselves through speech. The patient with a ischemic stroke cannot receive thrombolytic until which vital sign is within normal limits? Early signs of increased ICP change in LOC speech is slow and slurred delayed verbal response increasing drowsiness restless for no reason confusion 2 MULTIPLE CHOICE OPTIONS Symptoms of Colinergic crisis Muscular weakness 3 MULTIPLE CHOICE OPTIONS Abnormal postoperative signs Emesis that is red Ptosis Myasthenia Gravis Ascending paralysis Gullian-Barre The nurse is administering Heparin 2500 units sq every 12 hours. The amount available is 5000 units/ml. How many ml should the nurse administer per dose? 0.5ml Dangerously high body temperatures Malignant Hyperthermia Potassium: 5.8 mEq/L Notify physician