Notes; Syllabus change 1st day notes;
- Remediation on the 3 lowest score; and quizzing and the focused
review.
- 50 ATI MEDSURGE Question weekly
- 1/13/2025 – ATI A 48 hours.
- Mass casualties; for exam 3
- Exam 3 will be on the 2/10/2025 change in schedule.
- Final exam will mostly be renal- approx about 50%
- Math exams and Pharm(related to the disease), Fundies, Next Gen
NCLEX,
- Every exam has 85 questions, Final exam 125 questions
- 20% between pharm and math;
- Prep Us for all Chapters
- Case studies; 2 attempts
- No remediation for ATI proctored – technically no credit for it.
Chapter 64; Autoimmune disorders; BIG ON SAFETY
- Health assessment test;
- Focus on what makes the disorders different they will cause falling
and paresthesia ( not being able to feel things)
- DO NOT MEMORIZE S/S – FOCUS ON SPECIFIC CHARACTERISTICS
OF THE DISEASE
Multiple Sclerosis:
- What occurs here?
- Patho: myelin sheet is damaged; demyelination of the nerves
o We are not getting signal transmission
o Cause is unknown
Maybe temperature variations, family HX, and
environment factors
It happens in the northern latitudes.
- S/s
o s/s fatigue, vague symptoms, Chronic fatigue ( this makes it
different)
- DX;
o MRI: sclerosis lesions of the brain; patches, the patient will have
2 sclerotic patches at different locations on the MRI. – IMPPPP
, - When they come in and complain about fatigue, it is because they are
unable to perform their ADLSs
o So, some Education for fatigue will be;
Take breaks
Avoid cold temperatures- they can cause them to have a
flare
Other things to have in mind is;
o Bladder dysfunction causing retention; bladder scan and if it +
(straight Cath)
o No indwelling catheter because there is an increased risk for
infection.
Intervention for spasticity; pt is in constant movement;
- Baclofen – for spasticity; - MED IMP
o Dizziness and drowsiness are a huge one
o Do not make important decisions
o Do not drink alcohol
Because they can develop blurred vision and Diplopia and They can go
blind; what to do we worry about?
- Fall precautions (fundies) due to the fatigue and also the vision
damage
MS may go away; however, exacerbations occur because of an infection,
stress this is one of the main reasons they are admitted in the hospital, but
is mainly managed at home. THERE IS NO CURE.
DO NOT LOOK AT ALL 4 TYPES; DO NOT KNOW DIFF
Review of MS:
MS; what is the first sign you will see?
- Fatigue; first signs
Other signs? Spasticity, bladder dysfunction,
Interventions:
, - Fall precautions, prevent fatigue, may need straight catheter, muscle
relaxants ( Baclofen)
o s/e of baclofen, drowsiness
o know baclofen education
Other medicine.
- Beta-blockers and gabapentin, and benzos
o Beta blockers; assess for HX of asthma and HR ( make sure is
above 60)
Main medicine to control flares and reduce progression
- Interferon beta – MAIN MEDICATION
o Look at the liver function, LFTS before and during
o Hepatotoxic
Treat methyl prednisone; ONLY ON EXACERBATIONS:
- 3 TO 5 days IV 1 gram
- Cushions like syndrome
- Hyperglycemia
- Weight gain
- Electrolyte imbalances;
- Osteoporosis – diet in C and D vitamin
- Immunosuppressed; not sick people and no large clouds
Exercises. IMP
- resistive exercises, to prevent contractures
o always remember to provide appropriate rest
- Avoid extreme HOT and COLD
- Stretching
- Activity with REST
Myasthenia Gravis: this is purely a motor disorder; no sensation or
coordination disorder;
- What makes MG different?
- Nerves get weak over time, during the day, the more muscle they use
the weaker they get.
o PROGRESSIVE MUSCLE WEAKNESS THROUGHOUT THE DAY;
, Education:
- MG patients, they need to take a break since the continuous muscle
use will cause them to get progressively weaker.
Patho:
- The Acetylcholine receptors are blocked, causing the muscle
weakness
Medications:
- The medications that they are going to take are extended release and
maintenance (immediate release).
Treatments;
- Medication: KNOW is (the same pyridostigmine) – they need the
medicine on THEM, NEVER LEAVE HOME without it.
- Pyridostigmine.
o Extended-release 2 times a day
o Maintenance(immediate) day 4 times a day
Give maintenance on schedule, and consistently. 30 to 60
min before meals
If the miss a dose; if too close to the next dose do NOT
take it, 1 hour, take it.
- IVIGs – 5 day treatment
- Cytotoxic meds ( to decrease immune activity)
- Thymus removal tumor
o Improvement is seen in 7 months
- Apheresis; plasma exchange – separation of antibodies (kind of like
dialysis)
o monitor their BP.
Dx:
- Acetylcholinesterase inhibitor test; we give the medicine
(edrophonium), and it improves is MG
o When we do this test, we have atropine available, because it can
cause severe bradycardia and ATROPINE reverses it.
- Ice test
o This is placed over the patient’s eyes, and if it resolves
temporarily is MG
- Remediation on the 3 lowest score; and quizzing and the focused
review.
- 50 ATI MEDSURGE Question weekly
- 1/13/2025 – ATI A 48 hours.
- Mass casualties; for exam 3
- Exam 3 will be on the 2/10/2025 change in schedule.
- Final exam will mostly be renal- approx about 50%
- Math exams and Pharm(related to the disease), Fundies, Next Gen
NCLEX,
- Every exam has 85 questions, Final exam 125 questions
- 20% between pharm and math;
- Prep Us for all Chapters
- Case studies; 2 attempts
- No remediation for ATI proctored – technically no credit for it.
Chapter 64; Autoimmune disorders; BIG ON SAFETY
- Health assessment test;
- Focus on what makes the disorders different they will cause falling
and paresthesia ( not being able to feel things)
- DO NOT MEMORIZE S/S – FOCUS ON SPECIFIC CHARACTERISTICS
OF THE DISEASE
Multiple Sclerosis:
- What occurs here?
- Patho: myelin sheet is damaged; demyelination of the nerves
o We are not getting signal transmission
o Cause is unknown
Maybe temperature variations, family HX, and
environment factors
It happens in the northern latitudes.
- S/s
o s/s fatigue, vague symptoms, Chronic fatigue ( this makes it
different)
- DX;
o MRI: sclerosis lesions of the brain; patches, the patient will have
2 sclerotic patches at different locations on the MRI. – IMPPPP
, - When they come in and complain about fatigue, it is because they are
unable to perform their ADLSs
o So, some Education for fatigue will be;
Take breaks
Avoid cold temperatures- they can cause them to have a
flare
Other things to have in mind is;
o Bladder dysfunction causing retention; bladder scan and if it +
(straight Cath)
o No indwelling catheter because there is an increased risk for
infection.
Intervention for spasticity; pt is in constant movement;
- Baclofen – for spasticity; - MED IMP
o Dizziness and drowsiness are a huge one
o Do not make important decisions
o Do not drink alcohol
Because they can develop blurred vision and Diplopia and They can go
blind; what to do we worry about?
- Fall precautions (fundies) due to the fatigue and also the vision
damage
MS may go away; however, exacerbations occur because of an infection,
stress this is one of the main reasons they are admitted in the hospital, but
is mainly managed at home. THERE IS NO CURE.
DO NOT LOOK AT ALL 4 TYPES; DO NOT KNOW DIFF
Review of MS:
MS; what is the first sign you will see?
- Fatigue; first signs
Other signs? Spasticity, bladder dysfunction,
Interventions:
, - Fall precautions, prevent fatigue, may need straight catheter, muscle
relaxants ( Baclofen)
o s/e of baclofen, drowsiness
o know baclofen education
Other medicine.
- Beta-blockers and gabapentin, and benzos
o Beta blockers; assess for HX of asthma and HR ( make sure is
above 60)
Main medicine to control flares and reduce progression
- Interferon beta – MAIN MEDICATION
o Look at the liver function, LFTS before and during
o Hepatotoxic
Treat methyl prednisone; ONLY ON EXACERBATIONS:
- 3 TO 5 days IV 1 gram
- Cushions like syndrome
- Hyperglycemia
- Weight gain
- Electrolyte imbalances;
- Osteoporosis – diet in C and D vitamin
- Immunosuppressed; not sick people and no large clouds
Exercises. IMP
- resistive exercises, to prevent contractures
o always remember to provide appropriate rest
- Avoid extreme HOT and COLD
- Stretching
- Activity with REST
Myasthenia Gravis: this is purely a motor disorder; no sensation or
coordination disorder;
- What makes MG different?
- Nerves get weak over time, during the day, the more muscle they use
the weaker they get.
o PROGRESSIVE MUSCLE WEAKNESS THROUGHOUT THE DAY;
, Education:
- MG patients, they need to take a break since the continuous muscle
use will cause them to get progressively weaker.
Patho:
- The Acetylcholine receptors are blocked, causing the muscle
weakness
Medications:
- The medications that they are going to take are extended release and
maintenance (immediate release).
Treatments;
- Medication: KNOW is (the same pyridostigmine) – they need the
medicine on THEM, NEVER LEAVE HOME without it.
- Pyridostigmine.
o Extended-release 2 times a day
o Maintenance(immediate) day 4 times a day
Give maintenance on schedule, and consistently. 30 to 60
min before meals
If the miss a dose; if too close to the next dose do NOT
take it, 1 hour, take it.
- IVIGs – 5 day treatment
- Cytotoxic meds ( to decrease immune activity)
- Thymus removal tumor
o Improvement is seen in 7 months
- Apheresis; plasma exchange – separation of antibodies (kind of like
dialysis)
o monitor their BP.
Dx:
- Acetylcholinesterase inhibitor test; we give the medicine
(edrophonium), and it improves is MG
o When we do this test, we have atropine available, because it can
cause severe bradycardia and ATROPINE reverses it.
- Ice test
o This is placed over the patient’s eyes, and if it resolves
temporarily is MG
