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NUR 137 unit 2
| Question | Answer |
|---|---|
| Absence seuizre | person loses consciousness looks like they're day dreaming |
| What is epilepsy? | A chronic disturbance of the nervous system characterized by recurrent seizures due to abnormal electrical activity in the brain. |
| Focal seizures | Begin in one area of the brain. |
| Generalized seizures | Affect both hemispheres of the brain. |
| Simple focal seizures | Consciousness remains intact; limited motor or sensory symptoms. |
| Complex partial seizures | Impaired consciousness; may include automatisms like lip smacking or chewing. |
| Partial seizures that become generalized | Start in one area and spread throughout the brain. |
| What is an absence seizure? | Also called petit mal seizures. Characterized by brief episodes of staring, unresponsiveness, and eye fluttering. Lasts only a few seconds. No postictal confusion. Common in children. |
| What is a myoclonic seizure? | Sudden, brief, shock-like muscle jerks that may affect one or multiple muscle groups. Patient remains conscious. Often occurs in clusters, especially when falling asleep or waking. |
| What is a clonic seizure? | Repetitive rhythmic jerking movements of muscles on both sides of the body. Loss of consciousness may occur. May last several minutes. |
| What is a tonic seizure? | Characterized by sudden stiffening (increased muscle tone) of the body, arms, or legs. Loss of consciousness is common. Often brief but can cause falls. |
| What is a tonic-clonic seizure? | Formerly called grand mal seizure. Has two phases:Tonic phase and Clonic phase Often followed by a postictal phase with confusion, fatigue, and muscle soreness. |
| Tonic phase | Muscles stiffen, loss of consciousness, cry or groan possible. |
| Clonic phase | Rhythmic jerking and convulsions. |
| What is an atonic seizure? | Also known as a drop attack. Sudden loss of muscle tone causing the person to collapse or fall. Brief loss of consciousness. High risk of head injury. |
| What are infantile spasms? | Seizures occurring in infants, often associated with high fever or neurological conditions. Characterized by sudden flexing or extending of the arms, legs, or head. May occur in clusters. |
| What are common nursing priorities during generalized seizures? | Maintain airway and breathing. Protect from injury (padded side rails, loosen clothing). Do not restrain or place anything in the mouth. Observe and document seizure duration, type, and postictal behavior. |
| What is status epilepticus? | A prolonged or repeated seizure without recovery between episodes. It is a medical emergency that can cause irreversible brain damage if not controlled. |
| How is status epilepticus treated? | Focus on maintaining airway and vital signs, providing respiratory support, and administering anticonvulsant medications. |
| What diagnostic tests are used for epilepsy? | History and physical exam, EEG, MRI, and laboratory tests for electrolyte imbalances. |
| What are common treatments for epilepsy? | Control or eliminate cause. Use of antiepileptic drugs. Ketogenic diet. Biofeedback therapy. Surgery if medications are ineffective. |
| What should a nurse observe during a seizure? | Start and end time. What the patient was doing before the seizure. Body parts involved, eye movements, head position, and repetitive movements. Changes in color, respiration, incontinence, and whether movements are symmetrical. |
| What are key points of a postictal assessment? | Ensure airway patency. Note time to regain awareness. Assess for confusion, headache, muscle soreness, speech changes, aura presence, and changes in vital signs. |
| What is a transient ischemic attack (TIA)? | A brief interruption in cerebral blood flow, causing temporary neurological symptoms that resolve within one hour without permanent damage. |
| How is a TIA diagnosed? | Carotid duplex ultrasound, MRI, EEG, and angiography. |
| How is a TIA treated? | Carotid endarterectomy or stent, antiplatelet therapy, and lifestyle modifications. |
| Define cerebrovascular accident (CVA or stroke). | A sudden loss of brain function resulting from disrupted blood flow to part of the brain, leading to tissue damage and neurological deficits. |
| What are modifiable and nonmodifiable risk factors for stroke? | Modifiable: Hypertension, diabetes, smoking, obesity, inactivity. Nonmodifiable: Age, gender, family history, race. |
| What are the types of strokes? | Ischemic (thrombotic or embolic). Hemorrhagic (intracerebral or subarachnoid). |
| What are warning signs of a stroke? | Sudden weakness or numbness, confusion, trouble speaking, vision changes, dizziness, severe headache, loss of coordination, or blackouts. |
| How is a stroke diagnosed? | MRI, cerebral angiogram, EEG, brain scans, Doppler flow studies, and lumbar puncture. |
| Phase I phase of stroke care | (Initial care): Maintain airway, baseline vitals, prevent complications. |
| Phase II phase of stroke care | (Rehabilitation): Start early rehab, collaborate with interdisciplinary team, support psychosocial needs. |
| Phase III phase of stroke care | (Continuity): Discharge planning, home care, ongoing rehab. |
| Aneurysm | Abnormal ballooning of an artery wall. |
| Arteriovenous malformation (AVM) | Congenital tangle of abnormal vessels between arteries and veins. arteries and veins twisted |
| What are common complications of stroke and brain disorders? | Rebleeding, seizures, hydrocephalus, and cognitive or mobility impairments. |
| What are signs and symptoms of a brain tumor? | Depend on location but may include headache, visual changes, balance issues, weakness, confusion, and seizures. |
| How are brain tumors treated? | Surgery, radiation therapy, chemotherapy, and supportive care. |
| What are key nursing management steps for a patient with a brain tumor? | Perform regular neurological assessments, monitor ADLs, manage pain, and watch for complications like hydrocephalus or hemorrhage. |
| What is bacterial meningitis? | Inflammation of the meninges caused by bacterial infection; presents with fever, severe headache, nuchal rigidity, and positive Brudzinski and Kernig signs. |
| How is bacterial meningitis treated? | Immediate antibiotics, dexamethasone, anticonvulsants, analgesics, and isolation precautions. |
| What is viral meningitis and how is it different? | Caused by viruses such as enteroviruses or herpes simplex; milder, self-limiting, and managed symptomatically. |
| What is encephalitis? | Acute inflammation of the brain, often due to viral infection or mosquito/tick-borne transmission. Symptoms include stiff neck, lethargy, seizures, and confusion. |
| What are the main types of headaches discussed? | Migraine, cluster, and tension headaches. |
| What is trigeminal neuralgia (Tic Douloureux)? | A rare disorder causing severe facial pain due to pressure on the trigeminal nerve. Treated with anticonvulsants like carbamazepine, baclofen, or gabapentin. |
| What is Bell’s palsy? | Temporary facial paralysis due to facial nerve inflammation, often linked to HSV infection or stress. Treated with corticosteroids, antivirals, and eye protection. |
| You determine that the appropriate problem statement for a patient with status epilepticus is Potential for injury due to seizure activity. An appropriate expected outcome would be: | The patient will be free from any injuries associated with the seizures. |
| Nursing care of a patient who just had a seizure includes which nursing intervention(s)? | Assess for injuries. Check glucose level, reassure and reoirtent Check the glucose level. Reassure and reorient the patient. |
| Which patient statement indicates a need for further teaching on the prevention of seizures? | “I am less likely to have seizures during menstruation.” |
| A patient is being evaluated in the emergency department with short-term memory loss, and alteration in hearing and smell abilities. A stroke or TIA is suspected. What area of the brain is being affected? | Temporal lobe |
| Which are true regarding a stroke? | Timing of treatment is important. A fibrinolytic drug will be given. A CT scan should be done within 20 minutes of arrival at the hospital. It may occur as a complication of atrial fibrillation. |
| A patient has had a cerebrovascular accident. You assess readiness for transfer to another level of care. The patient continues to have agnosia and apraxia. These findings indicate that the patient would: | Require assistance with undertaking activities of daily living. |
| Intracranial tumors may be treated by several modes of therapy. What types of therapy are you likely to see? | Insertion of tiny radioactive particles into the tumor Brain surgery where most or all of the tumor is removed Chemotherapy through a reservoir placed between scalp and skull |
| A 21-year-old male complains of sudden fever, severe headache, and stiff neck. You note a petechial rash on the chest and extremities. Which nursing action(s) are appropriate? | Institute Standard Precautions and droplet precautions. Administer antibiotics as prescribed. Maintain a quiet and dimly lit patient room. |
| A patient presents with abrupt, severe headaches that start during sleep and recur several times during the day. These symptoms suggest: | Cluster headaches |
| You are providing care to a 60-year-old patient with trigeminal neuralgia. Pain is the priority problem | Administering an anticonvulsant class of medication. |
| What causes Parkinson disease? | Not enough dopamine (depletion) |
| What are the cardinal signs and symptoms of Parkinson disease? | Tremor (often “pill-rolling”), bradykinesia (slowness of movement), muscular rigidity, and postural instability. Drooling and trouble swallowing as condition progessive |
| How is Parkinson disease treated? | Drug therapy: Levodopa/carbidopa, anticholinergics, dopamine agonists, MAO-B inhibitors, COMT inhibitors. Physical therapy: Maintain mobility and balance. Surgical options: Deep-brain stimulation. Support: Emotional and nutritional support. |
| What important dietary cautions exist for Parkinson patients taking MAOIs? | Avoid foods high in tyramine (aged cheese, fermented/smoked meats, yeast extract, Chianti wine, soy sauce, some beers) because they may cause hypertensive crisis. Avoid combining meperidine with MAOIs—can cause hyperpyrexia and death. |
| What patient-teaching points are important for Parkinson disease? | Take meds at the same time daily; avoid sudden movements to prevent falls; eat small, frequent, high-fiber meals; perform regular exercise; manage drooling with posture and swallowing strategies; and allow ample time for tasks. |
| What is Multiple Sclerosis (MS)? | A chronic, inflammatory, demyelinating disease of the central nervous system causing motor, sensory, and coordination problems. It’s autoimmune and progresses in episodes. |
| What are the major signs and symptoms of MS? | Motor: Weakness, spasticity, paralysis. Sensory: Numbness, vision changes, tingling. Coordination: Ataxia, tremor. Mental: Depression, cognitive changes. Other: Fatigue, bladder/bowel dysfunction. |
| Describe the types (progressions) of Multiple Sclerosis. | Relapsing-remitting: Most common; recovery between attacks. Primary progressive: Steady decline, no remission. Secondary progressive: Starts as relapsing-remitting, then steadily worsens. Relapsing-progressive: Relapses with continual decline. |
| What are treatments for Multiple Sclerosis? | Biologic response modifiers (interferon beta, glatiramer). IV methylprednisolone for acute exacerbations. Plasmapheresis or ACTH. Stem-cell therapy (experimental). |
| Nursing encouragement for multiple sclerosis | Encourage proper nutrition, fluids, fiber, and rest to prevent constipation and UTIs. |
| Describe Alzheimer disease and its key features. | A chronic, progressive, irreversible degeneration of brain tissue marked by loss of memory, judgment, and ability to function. Cause unknown; gradual onset; eventually fatal. Occurs in middle to later life. |
| What is Amyotrophic Lateral Sclerosis (ALS)? | Also called Lou Gehrig disease, it is a progressive neuromuscular disorder involving degeneration of motor neurons in the spinal cord and lower cranial nerves, leading to loss of voluntary muscle control while cognition remains intact. |
| What are the signs and symptoms of ALS? | Muscle weakness, atrophy, fasciculations, dysphagia, dysarthria, and respiratory failure as disease advances. |
| How is ALS managed? | No cure. Riluzole (Rilutek)—a glutamate antagonist—can slow progression. Noninvasive ventilation prolongs life. Nursing care focuses on airway management, nutrition, communication, and psychosocial support. |
| What is Guillain-Barré Syndrome (GBS), and what causes it? | An acute, immune-mediated polyneuropathy of the peripheral nervous system, often following viral infections such as cytomegalovirus or Epstein-Barr virus. The body attacks the myelin sheath of peripheral nerves. |
| What are the signs and symptoms of GBS? | Numbness and tingling in hands and feet. Ascending muscle weakness (legs → arms → respiratory muscles). Pain, tenderness, areflexia. May progress to paralysis within hours or days. |
| What are the three phases of Guillain-Barré Syndrome? | Acute phase: Onset to peak weakness. Static phase: Condition stabilizes (no progression). (no better or worse) Rehabilitation phase: Recovery of strength and function. |
| What is the treatment and nursing care for GBS? | Supportive maintain ventilation, manage pain, prevent aspiration, ensure nutrition, and support communication. Monitor for autonomic dysfunction and provide rehabilitation to regain strength. |
| Describe Huntington disease. | Abnormal movements with decline in intellectual capacity and emotional disturbances chromosome 4 No cure; treatment is supportive. Usually at 40 or 50 yrs old women and men |
| What is Myasthenia Gravis (MG) and its pathophysiology? | An autoimmune disease where antibodies destroy acetylcholine (ACh) receptors at the neuromuscular junction, leading to impaired nerve impulse transmission and skeletal muscle weakness (“grave muscle weakness”). |
| What are the signs and symptoms of Myasthenia Gravis? | Fluctuating muscle weakness, especially with activity; ptosis, diplopia, difficulty swallowing, speaking, and breathing. Symptoms improve with rest or after anticholinesterase medications. |
| How is Myasthenia Gravis diagnosed? | Tensilon (edrophonium) test—temporary improvement confirms MG. Antibody blood test for ACh receptor antibodies. Electrodiagnostic testing, chest X-ray or CT for thymus abnormalities. |
| What are the treatments for Myasthenia Gravis? | Anticholinesterase therapy (e.g., pyridostigmine) increases ACh at the junction. Thymectomy if thymus abnormality. Corticosteroids or immunosuppressants for severe cases. Plasmapheresis or IVIG during crises. |
| What are the nursing priorities for Myasthenia Gravis? | Prevent respiratory compromise and aspiration. Schedule medications before meals and activities. Avoid fatigue, infection, and stress (can cause myasthenic crisis). Encourage independence and family education for home care. |
| Differentiate between Myasthenic Crisis and Cholinergic Crisis. | Myasthenic Crisis: Undermedication or stress → severe muscle weakness, respiratory failure → give anticholinesterase. Cholinergic Crisis: Overmedication → muscle cramps, weakness, bradycardia, bronchospasm → withhold drugs, give atropine. |
| The health care provider discusses treatment options with a patient newly diagnosed with Parkinson’s disease. The patient asks, “What will happen to me?” Which response is most appropriate? | “You seem worried. Let’s talk about your concerns.” |
| A patient with PD has been taking carbidopa-levodopa (Sinemet) for 3 months. What findings are expected? (Select all that apply.) | Dark urine Walking without assistance |
| Which action by a nursing assistant feeding a dysphagic patient indicates a need for further teaching? | The patient is propped up with one pillow. |
| A 45-year-old patient newly diagnosed with MS asks about their future prognosis. What teaching is appropriate? | “The condition has remissions and exacerbations, but it’s manageable, and many live active lives. New immune-modifying drugs reduce flare-ups.” |
| A patient presents with progressive leg weakness and tingling after the flu a week ago. What interventions should you anticipate? (Select all that apply.) | Medication for pain and discomfort Possible need for ventilatory assistance Need for airway suctioning |
| A female patient with myasthenia gravis (MG) may need additional teaching when she states: | “Pregnancy hormones will control my symptoms.” |
| Which patient statement indicates a need for further teaching about pyridostigmine (Mestinon)? | “I can adjust the drug dosage depending on my daily activities.” |
| The priority nursing assessment for a patient with MG is: | Monitor the adequacy of respiratory function. |
| A patient presents with numbness and tingling in hands and feet, muscle pain, and weakness in the legs. The nurse suspects: | Guillain-Barré syndrome |
| Injury is a possible problem statement for patients with Restless Legs Syndrome (RLS). Which interventions help prevent injury? (Select all that apply.) | Educate the patient about possible daytime drowsiness—avoid driving or operating machinery. Advise the patient to rise slowly to a standing position. Install grab bars in the shower and tub. Remove throw rugs from the environment. |
| What does a keto diet consist of | High fat high protein |
| What does TIA stand for | Transient Ischemic Attack |
| Homonymous Hemianopsia | person loses vision in their eyes |
| Biofeedback | person able to control BP and pulse though meditation |
| Epilepsy pts cannot drive for at least | 6 months until cleared by doctor, shouldn’t bathe or cook alone, wear a bracelet |
| Pt only ate half of there food with homomyous | Spin their plate around so they can see |
| TSA | Anticoagulator Medication to stop platelet aggregation – TPA – drug that can prevent a stoke Tissue, Plasminogram, Activator (EXPENSIVE) Time frame - 3.5-6 hours |
| Two ways a stroke can happen | hemorrhagic or ischemic |
| left side brain damage | makes person slow |
| right side brain damage | makes them quick short attention span |
| Brain aneurysm TX | Clipping, coiling, flow diverter |
| AAA - aortic abdominal aneurysm | windowmaker, a weakened and bulging bulge in the wall of the aorta. It's also called a "silent killer" because it often has no symptoms until it ruptures |
| If person has warning signs of stroke ask them to | Smile Shrug the shoulders Repeat a sentence or saying what you say first Tell you who and where he or she is. |
| What does FAST stand for | Face Arm Speech Time |
| If previous had or family history of TIA more than likely to have a | CVA in future |
| Brain absesss | Prurrent fluid build up in the brain (pocket of puss) |
| Two types of ways a stroke can happen | hemorrhagic or ischemic |
| Before meningitis you have | meningeal irritation treat same as meningitis |
| Stiff neck is a cardial sign of | Nuchal rigidity - sign of meningitis |
| How is meningitis diagnosed | lumbar punchar spinal tap |
| Disruption of cranial nerve number 5 | Trigeminal Neuralgia(Tic Douloureux) |
| Also a disruption of cranial nerve number 5 | Bell's Palsy |
| repetitive, involuntary movements that can occur during seizures, such as lip smacking, chewing, blinking, picking at clothes, tapping, or swallowing movements. They are most commonly seen in complex focal (partial) seizures. | Automatisms |
| My son had a grand mal at 10am in the morning its now 10pm why does he not seem better? | Mrs. jones its normal for someone to take a hours to days to recover from a seizure |
| What is a Ketogenic diet | high fat and high protein diet that neurologist helps adolescents and teenagers from having seizures |
| TPA (tissue plasminogen activator) | prevents a stroke - platelet aggregation- 3.5 hours – 6 hours to give this drug (ethical call if to give it after this time frame) |
| Grandpa, who was in the war, had a right-sided stroke and now is aggressive and crying in the corner. What is he displaying due to his right-sided stroke? | Mood swings |
| This person has a stroke they have Homonymous Hemianopsia, and you are going to take them back to the room and you noticed they only ate ½ their plate, what do you do? | Turn the plate around so they can see the plate to finish eating |
| What is the early sign of brain abscess? | Persistent dull headache |
| A person was recently admitted with a TIA, and the symptoms resolved within an hour. What does the patient need to monitor and watch out for? | Modifiable risk factors ( eating high sodium, don't drink,) MONITOR BP |
| Patient is rude to staff due to not getting call light answered fast enough what do you say to the patient | Apologize and ask what you can do to help |
| What is a tension headache? | Tight felling in the head |
| Side effects of long term use steroids? | Increased blood glucose, decrease wound healing, weight gain, increased appetite |
| What is the period after a seizure called? | Postictal Assessment |
| Patient comes in with a headache with nausea and diarrhea what could they have? | Bacterial meningitis |
| What can a cluster headache feel like? | Pain in eyebrows, eyes watering and toothache |
| What is a definite sign of bacterial meningitis? | Puss in cerebral spinal fluid (lumbar puncture) |
| Classic sign of meningitis | Nuchal rigidity (stiff neck) |
| DBS | Deep brain stimulation surgical implants device used to help the symptoms of Parkinson's disease |
| A pacemaker-like device is surgically implanted to send electrical impulses to the brain, which helps control motor symptoms like tremors and stiffness. | Deep Brain Stimulation (DBS) |
| Prescription dopamine | Sinemet (carbidopa/Levodopa |
| Medication that "dry up" the salvia and drooling caused by Parkinson's disease | Anticholinergics |
| PT with Parkinson disease diet | Foods easy to chew and easy to swallow, no tyramines |
| Demyelination | No more myelin sheath that covers the axon |
| Device given for ALS pt to maintain lung strength | incentive spirometer |
| Starts in feet then works it way up the body | Guillain-Barre Syndrome over 24 to 72 h |
| Responsible for Guillain-Barré Syndrome | Epstein-Barr virus |
| Brain loses its ability to function completely | Huntington Disease |
| How is tensilon test given | First dose - muscle gets stronger then give Second dose - if muscles gets stronger after 2 doses pt has MS |
| Droopy eye, postive tensilon | Myasthenia gravis |
| Why do parkinsons pt need to wear protective clothing | Due to drooling |
| Ataxia | lack of voluntary muscle control and coordination, affecting movements, balance, and speech |
| Agnosia | cannot recognize familar objects |
| Apraxia | cannot comprehend verbal comands |
| Aphasia | difficulty speaking and comprehending |
| Aphagia | difficulty swallowing |
| Disease that gets better | Guillian-barre syndrome |
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