Neurosensory ATI EXAM(Answered;graded A+)
caring for client with Parkinsons disease. Prescribed 25 mg diphenhydramine (Benadryl) PO 3 times daily. Based on med regimen, whats expected therapeutic outcomes ?decreased tremors (antihistamines have mild central anticholinergic & sedative effects that may help reduce tremors & muscle stiffness) reinforcing teaching for client/family receiving tx for a spinal cord injury w/ a halo fixation device. Whats an appropriate statement ?"The purpose of this device is to immobilize the cervical spine." planning care for client postop who is having headaches due to receiving spinal anesthetic. Whats suggested for inclusion in plan of care ?encourage increased intake of fluids (increased oral fluid intake promotes increases intracranial pressure which may relieve spinal headaches) implementing precautions for client who has a cerebral aneurysm. Whats actions should nurse take ?elevate the head of bed 30° (should elevate hob 30° to support venous return & lower ICP) caring for hospitalized older adult F who has hemiplegia from a cerebrovascular accident. Clients adult son is distressed over mothers crying & deteriorating condition. Appropriate response ?"It must be hard to see your mother so ill & upset" (demonstrates empathy & acknowledges sons feelings of helplessness & powerlessness) collecting data on client who has meningitis & notes when passively flexing clients neck there is an involuntary flexion of both legs. What condition is client displaying ?Brudzinski sign (manifesting Brudzinski sign, flexes hips & knees when neck is flexed, common sign of meningitis) assisting care of a client w/ increased ICP & is told by charge that client demonstrates decorticate posturing. Whats expected to observe ?plantar flexion of the legs (decorticate posturing is a result of lesions of the corticospinal tracts) diagnosed with myasthenia gravis (MG). Whats a complication of MG nurse should observe for ?respiratory difficulty (progressive weakness of the diaphragmatic & intercostal muscles may cause resp distress)nurse is shopping & finds a woman who has collapsed w/ right sided weakness & slurred speech. Appropriate action ?call emergency management services (client displays symptom of a stoke & is a medical emergency)
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