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NSG 210 Ch. 65
Mgmt of Pt w/ Oncologic or Degenerative Neurologic Disorders
| Question | Answer |
|---|---|
| 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
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