NURS 623 exam 4 questions and answers 2024

What are the typical demographics of a patient with MS (what type of person does this disease normally effect) Young, caucasion female of eastern European desent At the onset of alzheimers, what category of medications should be initiated Cholinesterase inhibitors Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:08 / 0:15 Full screen Brainpower Read More What factors contribute to a patient being high risk for falls History of falls, medications, vision impairment, heat rate/rhythm abnormalities, footwear issues, home environment, gait/mobility issues, poor reflexes. What classes of antibiotics would need to be renally dosed with a patient with impaired renal function Vanc, floroquinolones, and aminoglycosides What does FAST mean when assessing for s/s of stroke Face, Arms, Speech, Time How does an absence seizure present (symptoms) Sudden onset, blank stare (upward rotation of eye), activity stops and appears transfixed, few seconds to 1 min What is the difference between delirium and dementia First involves underlying acute cause, abrupt onset, hours to days, reversible, hallucination, incoherent speech, and confusion. The second can have various causes, gradual change with mental status, months to years, progressive to irreversible (speech, memory, mood, and judgment). What are the risk factors for development of a pressure ulcer? Elderly are most at risk population. Thin skin and less subcutaneous fat along with less movement create and environment for pressure ulcers. What are the red flag signs of a patient with low back pain. Hx trauma, fever, unexplained weight loss, hx cancer, incontinence, long term steroid use, parental drug abuse, intense localized pain, inability to find comfortable position, Cadua Equina Syndrome. Always assess radiation of pain, bowel, bladder. What are the common bacterial organisms associated with bacterial meningitis. Neisseria meningitides (high mortality), haemophilus influenza type B, streptococcus pneumoniae most common What are the s/s of alzheimers? Presence of dementia by clinical exam and MMSE (mini-mental state exam) deficit in 2 or more areas of cognition, progressive worsening of memory and cognitive function without disturbed consciousness and absence of systemic illness/other brain disease. Impaired ability to learn new info along with disturbance in language, function, or perception. What are the s/s of Parkinsons? Age >60, tremor at rest (pill rolling), rigidity, bradykinesia, masked face, stopped posture, shuffling gait, arching (limbs, neck, back), decrease facial dexterity, dysphagia, orthostatic hypotension, anosmia, depression, cognitive impairment, freezing phenomenon, cogwheeling, postural instability (advanced disease) What are the s/s of GB? Prickling, pins and needles sensations in your fingers, toes, ankles or wrists. Weakness in your legs that spreads to your upper body. Unsteady walking or inability to walk or climb stairs. Difficulty with eye or facial movements, including speaking, chewing or swallowing. Severe pain that may feel achy or cramplike and may be worse at night. Difficulty with bladder control or bowel function. Rapid heart rate. Low or high blood pressure. Difficulty breathing. What are s/s of temporal arteritis? Jaw claudication (pain with chewing that is relieved when stops chewing), unilateral pain, temporal area with scalp tenderness; skin over artery is indurated, tender, warm, and reddened. Amaurosis fugaz (temporary blindness), may occur. Low-grade fever and fatigue, occurs sometimes. ESR/sed rate (often reaches 100 mm/hr or more). CRP elevated >50. Medical Urgency: polymyalgia rheumatica common in these patients, older adults and elder are more common. What are articular bone structures? Includes structures like the synovium, synovial fluid, articular cartilage, joint capsules, and juxta-articular bone. Articular disorders may be characterized by deep or diffuse pain, pain or limited ROM on active and passive movement, swelling, crepitus. What are non-articular bone structures? Supportive structures such as tendons, bursae, muscles, fascia, bone, nerve, overlying skin. Tend to be painful on active but not passive (assisted) ROM. Seldom demonstrate swelling, crepitus, instability, or deformity by itself. What dx test is most useful in patient who presents with lumbar radiculopathy? The straight leg raise (assesses L5-S1). This is best initial diagnostic because the most common disc herniation is at L5-S1. Straight leg raise will cause sciatica and radicular pain. In older adults, how can you increase physical activity-things you can encourage or are there certain underlying factors that would enable a patient to be more successful? Ensure the patient is motivated