NU 404 EXAM TWO GUIDE WITH
COMPLETE SOLUTION
What are the risk factors for low back pain - ANSWER obesity, cigarette
smoking, poor posture, stress, poor physical condition, poor sleep position,
occupation that requires heavy lifting
how does smoking influence low back pain - ANSWER 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 - ANSWER 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 - ANSWER nerve root compression (radiculopathy)
What is radiculopathy? - ANSWER 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? - ANSWER constriction of the spinal foramina that
results in pressure of the spinal cord
what can cause spinal stenosis - ANSWER spinal cord injury, herniated disc
and spinal tumor
what are the signs and symptoms of a herniated disc - ANSWER 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 - ANSWER
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 - ANSWER 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 - ANSWER Nsaids, corticosteroids,
opioids, muscle relaxants, tricyclic antidepressants, anticonvulsants, local
anesthetics
nursing interventions for a person that has low back pain - ANSWER 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 - ANSWER neurological disorder that results in
impaired function of voluntary muscles - buildup of sclerosis or scar tissue
during demyelination
what are the risk factors for multiple sclerosis - ANSWER living in cold
climate, fatigue, overexertion, extreme temperatures, viral infections,
immunological function
What are the s/s of multiple sclerosis? - ANSWER 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 - ANSWER beta interferon,
immunosuppressant (glucocorticoid, cephalosporin/exythromycin), colic,
anticholinergic, antispasmodic/convulsant, beta blocker for tremor
patient teaching for a person w multiple sclerosis - ANSWER plan rest
periods, encourage exercise and stretching, alternate eye patch between eyes
every 3 hours for ur diplopia
what is ALS - ANSWER 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 - ANSWER sensation
what will a patient with ALS first present with - ANSWER muscle cramps,
stiffening, muscle weakness on one part of the body, slurred speech,
dysphagia
with ALS, you must have clinical manifestations of... - ANSWER BOTH UPPER
AND LOWER MOTOR NEURON DAMAGE THAT CANNOT B ATTRIBUTED TO
ANY OTHER CAUSE
Upper motor neuron in ALS refers to - ANSWER spascity
upper motor neuron ALS s/s - ANSWER hyperreflex, positive babinski, spas
city
Lower motor neuron in ALS refers to - ANSWER flaccidity
, Lower motor neuron s/s ALS - ANSWER muscle cramps, asymmetric distal
weakness, muscle fasciculation's and atrophy
what are the complications of ALS - ANSWER 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 - ANSWER 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 - ANSWER tricyclic antidepressants, muscle
relaxants and stool softener/laxative
cervical spine precautions when back boarding - ANSWER - have the board in
line with the patient and the blanket inline with the lower body area.
- contact precautions / scene safety
- 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
COMPLETE SOLUTION
What are the risk factors for low back pain - ANSWER obesity, cigarette
smoking, poor posture, stress, poor physical condition, poor sleep position,
occupation that requires heavy lifting
how does smoking influence low back pain - ANSWER 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 - ANSWER 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 - ANSWER nerve root compression (radiculopathy)
What is radiculopathy? - ANSWER 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? - ANSWER constriction of the spinal foramina that
results in pressure of the spinal cord
what can cause spinal stenosis - ANSWER spinal cord injury, herniated disc
and spinal tumor
what are the signs and symptoms of a herniated disc - ANSWER 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 - ANSWER
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 - ANSWER 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 - ANSWER Nsaids, corticosteroids,
opioids, muscle relaxants, tricyclic antidepressants, anticonvulsants, local
anesthetics
nursing interventions for a person that has low back pain - ANSWER 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 - ANSWER neurological disorder that results in
impaired function of voluntary muscles - buildup of sclerosis or scar tissue
during demyelination
what are the risk factors for multiple sclerosis - ANSWER living in cold
climate, fatigue, overexertion, extreme temperatures, viral infections,
immunological function
What are the s/s of multiple sclerosis? - ANSWER 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 - ANSWER beta interferon,
immunosuppressant (glucocorticoid, cephalosporin/exythromycin), colic,
anticholinergic, antispasmodic/convulsant, beta blocker for tremor
patient teaching for a person w multiple sclerosis - ANSWER plan rest
periods, encourage exercise and stretching, alternate eye patch between eyes
every 3 hours for ur diplopia
what is ALS - ANSWER 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 - ANSWER sensation
what will a patient with ALS first present with - ANSWER muscle cramps,
stiffening, muscle weakness on one part of the body, slurred speech,
dysphagia
with ALS, you must have clinical manifestations of... - ANSWER BOTH UPPER
AND LOWER MOTOR NEURON DAMAGE THAT CANNOT B ATTRIBUTED TO
ANY OTHER CAUSE
Upper motor neuron in ALS refers to - ANSWER spascity
upper motor neuron ALS s/s - ANSWER hyperreflex, positive babinski, spas
city
Lower motor neuron in ALS refers to - ANSWER flaccidity
, Lower motor neuron s/s ALS - ANSWER muscle cramps, asymmetric distal
weakness, muscle fasciculation's and atrophy
what are the complications of ALS - ANSWER 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 - ANSWER 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 - ANSWER tricyclic antidepressants, muscle
relaxants and stool softener/laxative
cervical spine precautions when back boarding - ANSWER - have the board in
line with the patient and the blanket inline with the lower body area.
- contact precautions / scene safety
- 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
