Exam 3 Study Tips for NSG 3250-3280:
Essential Preparatory Notes
Helpful Study Tips Worksheet 3250/3280
• For someone who is having an MRI, can they have people go into the
room with them?
NO
Why or why not?
Don’t know
Safety? Magnetic field? LOL
Neurological
• What is homonymous hemianopsia?
Visual field loss of the same side of the visual field in both eyes
How does this affect the patient?
Patients can’t see objects in the same field of both eyes.
o Ex. If the left visual field is affected, the patient won’t see anything to
the left of the midline in both eyes.
If they have homonymous hemianopsia on the left side of their visual
field, would you place a call bell on the patient's left side?
No
• What is the Glasgow Coma Scale?
Tool to assess LOC
Establishes baseline data
When would you use it?
After an acute head injury, Neuro assessment (stroke, tumors, infections
(meningitis, encephalitis), or post-surgical.
What is the best and worst score for the patient?
Best 15, Worst 3
What does a decrease of 2 points on the scale alert the nurse to?
Deterioration of neuro status
Critical Rescue
o Is clinically significant, and the MD must be notified!
What does the patient look like when they are at their worst scores?
o No eye-opening, even in response to pain
o No verbal response/sounds, even with stimuli
o No motor response to stimuli/pain
o Unresponsive/unconscious
o Lack of movement
o Fixed & dilated pupils
, o Abnormal posturing (decerebrate/decorticate) may be present
before reaching a score of 3
o Postures absent at 3
• The normal Phenytoin (Dilantin) level is 10-20 mcg/ml. What would
you do if someone is not in a therapeutic range for their seizure
control? (high or low)
o Notify the provider for a dosage adjustment.
o Monitor or recheck levels.
• What medication is used for migraine control?
Triptans -serotonin receptor agonists
o Vasoconstriction
o Reduce inflammation
o Reduce pain transmission
o First-line treatment
What are some side effects/contraindications of the drug?
Contraindicated in
o Patients w/ischemic heart disease
Side effects
o Increased Bp
o Drowsiness
o Muscle pain
o Sweating anxiety
• What is the basic patho of a seizure?
Abnormal episodes of motor, sensory, autonomic, or psychic activity (or a
combination of these) resulting from a sudden, abnormal, uncontrolled
electrical discharge from cerebral neurons.
What are seizure precautions? What would you do for the patient who
needs seizure precautions?
Oxygen & suction at bedside
Be sure the patient has a working IV
, • What yiis yian yiEEG?
A yidiagnostic yitest yithat yimeasures yielectrical yiactivity yiin yithe yibrain.
o Used yito yidetect yi& yievaluate yiabnormalities yiin yithe yibrain’s
yielectrical y i activity.
• What yiare yithe yidifferent yitypes yiof yiseizures, yiand yiwhat yiwould yiyou
yisee yiwith yieach?
Absent yiSeizures yi- yiAKA yipetit yimal
o Staring yior yisubtle yibody yimovement, yibrief yiloss yiof yiconsciousness
Myoclonic yiSeizures
o Sudden yijerks yior yitwitches yiof yiarms yiand yilegs
Atonic yiSeizures yi– yiAKA yiDrop yiattacks
o Loss yiof yinormal yimuscle yitone, yia yisudden yicollapse yior yifall
Tonic-Clonic yiSeizures yi- yiAKA yiGrand yimal
o Most yiintense yiof yiall yiseizures
o Loss yiof yiconsciousness, yiintermittent yistiffening yi& yishaking
o Dizziness
o Tongue yiis yichewed
o Cyanosis yiand yiincontinence yiare yiexpected.
o Postictal y i state
o Can yilast yifor yiminutes
• What yiare yithe yidifferent yiphases yiof yia yigrand-mal yiseizure?
What yiare yithe yinurse’s yiprimary yiresponsibilities yiin yieach yiphase?
Be y i prepared/plan y i ahead!
• Pre-ictal yiphase
• Circumstances
• Aura
• Triggers
• Ictal yiphase
• Safety
• Lower y i to y i floor
• Remove y i pillows y i / y i raise y i side y i rails
• Loosen y i clothing
• Move y i furniture
• DO yiNOT yiOPEN yiMOUTH
• DO yiNOT yiRESTRAIN
• Seizure yicharacteristics
• Length
• Type
• LOC/cognition
• Privacy
Essential Preparatory Notes
Helpful Study Tips Worksheet 3250/3280
• For someone who is having an MRI, can they have people go into the
room with them?
NO
Why or why not?
Don’t know
Safety? Magnetic field? LOL
Neurological
• What is homonymous hemianopsia?
Visual field loss of the same side of the visual field in both eyes
How does this affect the patient?
Patients can’t see objects in the same field of both eyes.
o Ex. If the left visual field is affected, the patient won’t see anything to
the left of the midline in both eyes.
If they have homonymous hemianopsia on the left side of their visual
field, would you place a call bell on the patient's left side?
No
• What is the Glasgow Coma Scale?
Tool to assess LOC
Establishes baseline data
When would you use it?
After an acute head injury, Neuro assessment (stroke, tumors, infections
(meningitis, encephalitis), or post-surgical.
What is the best and worst score for the patient?
Best 15, Worst 3
What does a decrease of 2 points on the scale alert the nurse to?
Deterioration of neuro status
Critical Rescue
o Is clinically significant, and the MD must be notified!
What does the patient look like when they are at their worst scores?
o No eye-opening, even in response to pain
o No verbal response/sounds, even with stimuli
o No motor response to stimuli/pain
o Unresponsive/unconscious
o Lack of movement
o Fixed & dilated pupils
, o Abnormal posturing (decerebrate/decorticate) may be present
before reaching a score of 3
o Postures absent at 3
• The normal Phenytoin (Dilantin) level is 10-20 mcg/ml. What would
you do if someone is not in a therapeutic range for their seizure
control? (high or low)
o Notify the provider for a dosage adjustment.
o Monitor or recheck levels.
• What medication is used for migraine control?
Triptans -serotonin receptor agonists
o Vasoconstriction
o Reduce inflammation
o Reduce pain transmission
o First-line treatment
What are some side effects/contraindications of the drug?
Contraindicated in
o Patients w/ischemic heart disease
Side effects
o Increased Bp
o Drowsiness
o Muscle pain
o Sweating anxiety
• What is the basic patho of a seizure?
Abnormal episodes of motor, sensory, autonomic, or psychic activity (or a
combination of these) resulting from a sudden, abnormal, uncontrolled
electrical discharge from cerebral neurons.
What are seizure precautions? What would you do for the patient who
needs seizure precautions?
Oxygen & suction at bedside
Be sure the patient has a working IV
, • What yiis yian yiEEG?
A yidiagnostic yitest yithat yimeasures yielectrical yiactivity yiin yithe yibrain.
o Used yito yidetect yi& yievaluate yiabnormalities yiin yithe yibrain’s
yielectrical y i activity.
• What yiare yithe yidifferent yitypes yiof yiseizures, yiand yiwhat yiwould yiyou
yisee yiwith yieach?
Absent yiSeizures yi- yiAKA yipetit yimal
o Staring yior yisubtle yibody yimovement, yibrief yiloss yiof yiconsciousness
Myoclonic yiSeizures
o Sudden yijerks yior yitwitches yiof yiarms yiand yilegs
Atonic yiSeizures yi– yiAKA yiDrop yiattacks
o Loss yiof yinormal yimuscle yitone, yia yisudden yicollapse yior yifall
Tonic-Clonic yiSeizures yi- yiAKA yiGrand yimal
o Most yiintense yiof yiall yiseizures
o Loss yiof yiconsciousness, yiintermittent yistiffening yi& yishaking
o Dizziness
o Tongue yiis yichewed
o Cyanosis yiand yiincontinence yiare yiexpected.
o Postictal y i state
o Can yilast yifor yiminutes
• What yiare yithe yidifferent yiphases yiof yia yigrand-mal yiseizure?
What yiare yithe yinurse’s yiprimary yiresponsibilities yiin yieach yiphase?
Be y i prepared/plan y i ahead!
• Pre-ictal yiphase
• Circumstances
• Aura
• Triggers
• Ictal yiphase
• Safety
• Lower y i to y i floor
• Remove y i pillows y i / y i raise y i side y i rails
• Loosen y i clothing
• Move y i furniture
• DO yiNOT yiOPEN yiMOUTH
• DO yiNOT yiRESTRAIN
• Seizure yicharacteristics
• Length
• Type
• LOC/cognition
• Privacy
