lOMoAR cPSD| 67756003
Med-Surg NUR 242 Exam 4 Study Guide
NEUROLOGICAL SYSTEM
Lumbar Puncture
• Positioning: Fetal position or leaning forward to widen intervertebral spaces.
• Purpose: Collect CSF for infection, bleeding, or multiple sclerosis diagnosis.
• Post-procedure care:
o Lay flat for 4–8 hours to prevent spinal headache. o Encourage
fluids to replace CSF volume. o Monitor puncture site for clear
fluid leakage.
o Assess for headache, back pain, or signs of infection (fever,
nuchal rigidity).
Migraines
• Types: With aura (classic), without aura (common).
• Meds: o Abortive: Triptans (sumatriptan), NSAIDs,
ergotamines.
o Preventive: Beta-blockers (propranolol), anticonvulsants (topiramate),
antidepressants (amitriptyline).
• Patient Teaching: o Identify and avoid triggers (e.g., stress,
chocolate, wine). o Use medication at onset of symptoms.
o Keep a headache diary.
Seizures
• Types: Generalized (tonic-clonic), partial (focal), absence.
• Seizure precautions:
o Padded side rails, oxygen/suction at bedside.
, lOMoAR cPSD| 67756003
o Turn patient to side, loosen clothing, protect head. o Do not restrain or insert
anything into mouth.
AEDs (Antiepileptic drugs):
o Common AEDs: Phenytoin, valproic acid, carbamazepine.
o Risks: Liver toxicity, sedation, gingival hyperplasia (phenytoin).
• Teaching: o Take meds consistently. o Regular blood tests for levels.
o Avoid alcohol, driving restrictions until seizure-free.
Decorticate vs. Decerebrate Posturing
• Decorticate: Arms flexed toward chest, legs extended; damage to cerebral hemispheres.
• Decerebrate: Arms and legs extended, wrists rotated; indicates brainstem damage (worse
prognosis).
Parkinson’s Disease
• Symptoms: Tremors, bradykinesia, rigidity, postural instability.
• Meds: o Levodopa-carbidopa (Sinemet): Avoid high-protein
meals.
o MAO-B inhibitors (selegiline), dopamine agonists (ropinirole).
• Teaching: o Fall prevention. o Encourage PT/OT. o Timing of
meds is critical to avoid "off" periods.
Multiple Sclerosis
• Types: o Relapsing-remitting (most common), progressive.
• Symptoms: Visual disturbances, fatigue, muscle weakness, numbness, bladder/bowel
dysfunction.
• Meds: o Interferon beta, corticosteroids, muscle relaxants.
• Nursing Care:
o Prevent fatigue (cool environment).
o Promote mobility, manage bowel/bladder.
Med-Surg NUR 242 Exam 4 Study Guide
NEUROLOGICAL SYSTEM
Lumbar Puncture
• Positioning: Fetal position or leaning forward to widen intervertebral spaces.
• Purpose: Collect CSF for infection, bleeding, or multiple sclerosis diagnosis.
• Post-procedure care:
o Lay flat for 4–8 hours to prevent spinal headache. o Encourage
fluids to replace CSF volume. o Monitor puncture site for clear
fluid leakage.
o Assess for headache, back pain, or signs of infection (fever,
nuchal rigidity).
Migraines
• Types: With aura (classic), without aura (common).
• Meds: o Abortive: Triptans (sumatriptan), NSAIDs,
ergotamines.
o Preventive: Beta-blockers (propranolol), anticonvulsants (topiramate),
antidepressants (amitriptyline).
• Patient Teaching: o Identify and avoid triggers (e.g., stress,
chocolate, wine). o Use medication at onset of symptoms.
o Keep a headache diary.
Seizures
• Types: Generalized (tonic-clonic), partial (focal), absence.
• Seizure precautions:
o Padded side rails, oxygen/suction at bedside.
, lOMoAR cPSD| 67756003
o Turn patient to side, loosen clothing, protect head. o Do not restrain or insert
anything into mouth.
AEDs (Antiepileptic drugs):
o Common AEDs: Phenytoin, valproic acid, carbamazepine.
o Risks: Liver toxicity, sedation, gingival hyperplasia (phenytoin).
• Teaching: o Take meds consistently. o Regular blood tests for levels.
o Avoid alcohol, driving restrictions until seizure-free.
Decorticate vs. Decerebrate Posturing
• Decorticate: Arms flexed toward chest, legs extended; damage to cerebral hemispheres.
• Decerebrate: Arms and legs extended, wrists rotated; indicates brainstem damage (worse
prognosis).
Parkinson’s Disease
• Symptoms: Tremors, bradykinesia, rigidity, postural instability.
• Meds: o Levodopa-carbidopa (Sinemet): Avoid high-protein
meals.
o MAO-B inhibitors (selegiline), dopamine agonists (ropinirole).
• Teaching: o Fall prevention. o Encourage PT/OT. o Timing of
meds is critical to avoid "off" periods.
Multiple Sclerosis
• Types: o Relapsing-remitting (most common), progressive.
• Symptoms: Visual disturbances, fatigue, muscle weakness, numbness, bladder/bowel
dysfunction.
• Meds: o Interferon beta, corticosteroids, muscle relaxants.
• Nursing Care:
o Prevent fatigue (cool environment).
o Promote mobility, manage bowel/bladder.
