NU 404 EXAM TWO QUESTIONS AND ANSWERS

NU 404 EXAM TWO QUESTIONS AND ANSWERS what are the risk factors for low back pain - Ans:-obesity, cigarette smoking, poor posture, stress, poor physical condition, poor sleep position, occupation that requires heavy lifting how does smoking influence low back pain - Ans:-nicotine in cigarettes is though to interfere with vital nutrient absorption by the intervertebral discs which leads to disc degeneration what are the signs and symptoms of low back pain - Ans:-muscle spasms in single muscle or group of muscles, dull/acute pain in the lumbar region that is exacerbated by movement, numbness /tingling/weakness in the leg or foot what causes numbness/tingling in the effected extremity with a person with low back pain - Ans:- nerve root compression (radiculopathy) What is radiculopathy? - Ans:-nerve root compression resulting in numbness in affected extremity as well as pain, weakness, inability to control motor movement in affected area What is spinal stenosis? - Ans:-constriction of the spinal foramina that results in pressure of the spinal cord ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/51 what can cause spinal stenosis - Ans:-spinal cord injury, herniated disc and spinal tumor what are the signs and symptoms of a herniated disc - Ans:-extreme constant back pain that shoots down an arm/leg. pain occurring on ones side of the body ( sharp, shooting feeling what are some complications of a herniated disc - Ans:-numbness(paresthia) weakness, loss of bowel/badder control, increase pain in the back, arm, leg and neck , saddle anesthesia which is loss of sensation of inner thigh, back of legs, rectum what are some nursing interventions for a patient who just had a spinal cord surgery /lamectomy - Ans:-passive/active ROM, senses of lower extremities (lumbar) and hands/arms(cervical), log roll, splint back when going to a seated position, fracture bed pan, observe for edema in the face, apply lumbar brace when the patient is supine in bed what meds are given in low back pain - Ans:-Nsaids, corticosteroids, opioids, muscle relaxants, tricyclic antidepressants, anticonvulsants, local anesthetics nursing interventions for a person that has low back pain - Ans:-admin a stool softener (straining to have a BM can exacerbate LBP), increase fluid intake, ROM< avoid bending at the waist, lifting with straight knees or push/pull objects that are greater than 5 pounds what is multiple sclerosis - Ans:-neurological disorder that results in impaired function of voluntary muscles - buildup of sclerosis or scar tissue during demyelination ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/51 what are the risk factors for multiple sclerosis - Ans:-living in cold climate, fatigue, overexertion, extreme temperatures, viral infections, immunological function What are the s/s of multiple sclerosis? - Ans:-muscle flaccidity, fatigue in Lower extremities, pain, paresthesia, impaired movement and thinking, numbness and weakness in limbs, diplopia, decreased visual acuity, electric shock sensation with head movement , dysphagia, nystagmus, muscle spaced what meds are given in multiple sclerosis - Ans:-beta interferon, immunosuppressant (glucocorticoid, cephalosporin/exythromycin), colic, anticholinergic, antispasmodic/convulsant, beta blocker for tremor patient teaching for a person w multiple sclerosis - Ans:-plan rest periods, encourage exercise and stretching, alternate eye patch between eyes every 3 hours for ur diplopia what is ALS - Ans:-progressive degeneration that leads to death of cells that results in the brain losing it's ability to initiate or control muscle movement which leads to all voluntary muscles being affected and pt will become paralyzed with ALS, what will remain intact - Ans:-sensation what will a patient with ALS first present with - Ans:-muscle cramps, stiffening, muscle weakness on one part of the body, slurred speech, dysphagia with ALS, you must have clinical manifestations of... - Ans:-BOTH UPPER AND LOWER MOTOR NEURON DAMAGE THAT CANNOT B ATTRIBUTED TO ANY OTHER CAUSE ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/51 Upper motor neuron in ALS refers to - Ans:-spascity upper motor neuron ALS s/s - Ans:-hyperreflex, positive babinski, spas city Lower motor neuron in ALS refers to - Ans:-flaccidity Lower motor neuron s/s ALS - Ans:-muscle cramps, asymmetric distal weakness, muscle fasciculation's and atrophy what are the complications of ALS - Ans:-aspiration, respiratory failure, pneumonia, pressure injury, DVT, PE, contractors, depression, weight loss, loss ability to care for self what are some nursing interventions for a patient w ALS - Ans:-elevate HOB when eat, drink, brush teeth, turn, cough and deep breathe, turn every 2 hours, discuss/informed decision for ventilator, enteral tube feed, intubation, report increased difficulty swallowing and breathing, muscle strength and endurance test, CT (brain), MRI(spine) what are medications for ALS - Ans:-tricyclic antidepressants, muscle relaxants and stool softener/laxative cervical spine precautions when back boarding - Ans:-- have the board in line with the patient and the blanket inline with the lower body area. - contact precautions / scene safety ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/51 - have xtra person maintain c-spine stabilization ( thumbs up. hands beneath keeping the patient with nose in line w navel. don't let go - have patient put hands up with spread fingers-- u are going to check pulses , spread fingers out and have patient squeeze/resisit against you , "can u feel this finger I am touching with out nodding - check lower posterior tibial pulse, can u pull feet up against my hands, can u push down against my hands , which toe am I touching, - measure from the trapezius to side of the chin to the neck for the cervical collar - confirm if the patient can still breathe and swallow , lift board at 45 degree angle and slide the board in until it is flushed with their back , 5 straps on both side - if stuck don't pull, palpate the pelvic bones , check the secureness of the straps, secure the head to the board - take chalk blocks and slide them down like sunglasses so that they are even with the eyebrows Cervical cord injuries - Ans:-Affects body BELOW the neck. Impaired breathing Affects ALL 4 limbs "Can't move anything" Injury at C1 to C4 level - Ans:-quadriplegia with loss of spontaneous respiratory fun ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 6/51 Injury to C4-C5 - Ans:-quadraplegia w possible phrenic nerve involvement Injury at C5, C6 - Ans:-quadriplegia with gross arm movements phrenic nerve intact injury C6,C7 - Ans:-quadriplegia with boceps intact, diaphragmatic breathing Injury at C7-C8 - Ans:-quadriplegia with triceps, biceps, and wrist extension intact and some fun of intrinsic hand movement thoracic spinal cord injuries - Ans:-located in the mid back T1-T5 injury - Ans:-paraplegia with trunk and leg involvement, normal arm and hand movement T6-T12 - Ans:-Paraplegia with fair ability to control balan