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NSG 210 Ch. 65

Mgmt of Pt w/ Oncologic or Degenerative Neurologic Disorders

rapid, jerky, involuntary, purposeless mvmts of extremities or facial muscles, including facial grimacing chorea
imparied ability to execute voluntary mvmts dyskinesia
small and often illegible handwriting micrographia
edema of optic nerve papilledema
Brain tumors originating within brain tissue are known as (primary, secondary) and the most common type is? primary, gliomas
The most common type of gliomas are astrocytomas graded from I to IV with this being I and II and glioblastoma being III and IV
Brain tumors arising from supporting structures like the meninges is called meningiomas....oma = tumor
Brain tumors that dev large mass of blood vessels and have high risk of bleeding are angiomas
seizure-like mvmts localized on one side of the body indicates brain tumor where? motor cortex
Visual loss in half of the visual field(contralateral homonymous hemianopsia), visual hallucinations indicates brain tumor where occipital lobe
dizziness, ataxia, staggering gait, muscle incoordination, nystagmus(involuntary rhythmic eye mvmts) indicate brain tumor where? cerebellam
Change in personality, emotional state/behavior, use obscene language, untidy, careless indicates brain tumor where? frontal lobe
In diagnostic testing for brain tumors, this test gives specific info of number, size, density of lesions CT scan
This test is helpful in detecting brain tumors, smaller lesions, in brain stem/pituitary and can often make biopsy unecessary MRI
This test shows shows metabolic activity of the tumor and helps w/ tx. PET scan
Cancer pt in chemotherapy often need this to replinish their bone marrow bone marrow transplant infused after chemo is over
Name two drugs for chemotherapy one that x BBB and one doesn't. nitrosoureas, not x BBB temozolomide, does x BBB
To reduce HA, edema, inflammation in brain tumors will be? To decrease fluid, ICP? Antiseizure med? corticosteroids: dexamethasone (Decadron), prednisone fluid: Mannitol seizure: phenytoin(Dilantin)
1.Intramedullary lesions? 2.extramedullary-intradural lesions? 3.extramedullary-extradural lesions? 1. w/in spinal cord 2.w/in or under spinal dura 3. outside dural membrane
what is primary tx for spinal cord tumors? What is hallmark of spinal metastasis? surgery Pain
A slowly progressing neurodegenerative disease with decreased levels of dopamine(inhibitory) are? Parkinson's Disease
Main s/s of Parkinson's Disease tremor, rigidity(cog wheeling), bradykinesia other s/s: pill rolling, shuffling gait
When do s/s appear for Parkinson's Disease 5th decade
How do antiparkinsonian drugs act? increase dopamine, reduce cholinergic(excitatory), giving balance bn dopamine/cholinergic
What is the most effect drug for Parkinson's Disease Levadopa where it's converted to dopamine in basal ganglia x BBB producing relief.
What anticholinergic drugs help control tremors Artane, Congentin
What antiviral drugs help with Parkinson's Amantadine(Symmetrel)
This inhibitor can have incr BP if tyramine foods are eaten. MAO inhibitors
Other drugs used in Parkinson's: Antidepressants: Tricyclic SRRIs Antihistimines tri: Elavil SRRI: Prozac, Wellbutrin anth: Benadryl, Neo-Synephrine
Which pt are candidates for stereotactic surgical procedure with Parkinson's? Pts with idiopathic disease, taking max dose of Levadopa, not with dementia.
What are nsg mgmt for Parkinson's in improving motility? Bowel elimination? Swallowing? Mot: teach to swing arms, walk erect, marching(lift feet) Bow: fluids, schedule, no lax, Metamucil Swall: eat upright, thick fluids
A progressive disease that leads to choreiform mvmts and dementia is known as? Chorea like mvmts are? Huntington's Disease abnormal involuntary mvmts
What medical mgmt control chorea in Huntington's Disease? Overmedication is seen as motor restlessness known as Navane, Haldol, which block dopamine receptors Nsg mgmt: alt comm. system akathisia, can be mistaken for disease s/s and be overlooked
Alzeheimer's Disease prgresses into 3 stages that present with what s/s? progressive loss of memory, loss of reason, loss of functional abilities
This is a progressive loss of motor neurons(atrophy of muscles in arms, legs, trunk), so still can feel and known also as Lou Gehrig's disease Amyotrophic Lateral Sclerosis (ALS), no cure
This progressive disease is characterized by wasting, weakening of muscle fibers thus skeletal/voluntary muscles Muscular Dystrophiesm, no cure
Degenerative Disk Disease results in what to the intervertebral disks in either cervical/thoracic/lumbar areas herniation
Surgical terms for herniations of cervical/lumbar disks: discectomy? laminectomy? hemilaminectomy? foraminotomy?
Elderly people developing weakness, fatigue, and musculoskeletal s/s with a hx of polio are suffering from? Postpolio Syndrome and tx is to control joint s/s(joint/muscle weakness)
this polyneuropathic disease is caused by food poisoning. s/s? tx? Botulism s/s: N/V, diarrhea in 12-36h, ptosis(eye drooping) tx: botulinum antitoxin IV and purge GI tract, gastric lavage
Stage 3 of syphilis presents how? tx? + RPR, dementia/psychosis tx: penicillin
This diseases causes an acute encephalitis from wild animals? s/s? tx? rabies s/s: hydrophobia(want, but can't drink), coma, death tx: vaccine(prevent), post vaccines: immune globulin(passive immunity), vaccine series(active immunity) day 1, 3, 5, 7, 14
Created by: palmerag