NUR 265 Exam 3

What is encephalitis? - inflammation or infection of the brain What causes encephalitis? - West Nile Virus Herpes What are the s/s of encephalitis? - High fever, N/V, stiff neck Flu like symptoms change in LOC photophobia pupil changes (dilate & less responsive to light) What is used to dx encephalitis? - lumbar puncture EEG CT (looks for mass) What are N/I for encephalitis? - Neuro checks Monitor for s/s of ICP Suction only resp compromised HOB 30-45 Decrease stimuli What is the tx for encephalitis? - acyclovir What are complications from encephalitis? - ICP that leads to herniation of brain tissue or death What is myasthenia gravis? - Autoimmune disorder that is characterized by weakness in the muscles What causes myasthenia gravis? - lack of Ach receptor sites, leads to lack of nerve impulses What are s/s of myasthenia gravis? - difficulty holding up head or brushing teeth double vision ptosis dysphagia loss of bowel & bladder control decrease sense of smell & tasteHow is myasthenia gravis diagnosed? - tensillon test. s/s improve with Edrophonium . How does edrophonium work? - w/in 30-60sec of 1st dose, most show lots of improvement, lasts 4-5mins What are n/i for myasthenia gravis? - assess adls, speech & facial weakness resp support keep oxygen equipment & suction at bedside for r/f of resp distress promote mobility What is tx for myasthenia gravis? - plasmapherisis anticholinesterases (pyridostigmine) immunosuppressants What is cholinergic crisis? - too much cholinesterase inhibitor drug What are s/s of cholinergic crisis? - fasciculations hypersalivation sweating bronchospasms increase bronchial secretions bradycardia What is tx for cholinergic crisis? - atropine DO NOT GIVE ANTICHOLINESTERASE What is myasthenic crisis? - too little cholinesterase inhibitor drug What is the priority with myasthenic crisis? - resp function What are s/s of myasthenic crisis? - increase HR, RR, BP decrease u/o no cough or swallow reflex dry What time should ChE inhibitor be given? - 45-1hr before meals to avoid aspiration What can tensilon test cause? - cardiac dysrhythmias, have atropine on handWhat is nursing priority with myasthenic crisis? - maintain airway, may require to intubate What is Guillain-Barre? - an uncommon acute inflammatory disorder that affects axons and/or myelin sheath (neurons can't impulse) where does Guillain Barre Syndrome start - -Starts in feet and hands (numbness, tingling) What are causes of Guillain Barre? - bacterial infection influenza epstein barr zika What are s/s of guillain barre? - loss of reflexes hypotension labile BP muscle weakness or paralysis (decreased DTR) numbness ataxia blurred or double vision palpitations pain tachycarida What are complications from guillain barre? - resp & cardiac problems decreased mobility, DVTs What is tx for guillain barre? - plasmapheresis asap IV immunoglobulin if can't do plasma right away What do you NOT want to give w/ guillain barre? - CORTICOSTERIODS