ATI-MedSurge-NEUROMUSCULAR
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| phenytoin (Dilantin), should be administered? | should be taken at the same time everday to maintain therapeutic levels
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| If a rash develops while taking phenytoin (Dilantin), pt. should? | report to HCP
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| Phantom limb pain should be treated as ________ | real pain
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| Neurontin (Gabapentin) is used for? | Tx of neuropathic pain
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| Post-OP amputation, pt. reports pain in residual limp, nursing priority? | treat the pain
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| Labyrinthitis and Ménière’s disease are... | inner ear problems
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| Labyrinthitis is? | an infection of the labyrinth, secondary to otitis media
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| Ménière’s disease is? | is a vestibular disease with a triad of symptoms – tinnitus, unilateral sensorineural hearing loss, and vertigo
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| Ménière’s disease, pt. teaching? | - move head slowly to decrease vertigo
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| Intracranial pressure S/S? | - restlessness
- the Cushing Reflex (HTN/ widened pulse)
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| Positive Romberg sign | It indicates that the patient is excessively reliant on his vision to maintain balance. The problem may lie in the vestibular or proprioceptive systems
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| Positive Babinski’s sign | No Response: Indicates damage to the peripheral nervous system, muscles, or tendons within the region.
Flexion: the toes all curve inwards. This is the normal response with functional CNS
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| To determine pt. pain severity, nurse should use? | Pt. report of pain on a standardized pain scale
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| Rheumatoid arthritis usually occurs? (bilaterally / unilaterally) | bilaterally & symmetrically
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| Osteoarthritis usually occurs? (bilaterally / unilaterally) | unilaterally
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| Deviation of Rheumatoid arthritis is usually seen in? | small joints
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| alendronate (Fosamax) is prescribed for? | osterporosis
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| When should alendronate (Fosamax) be administered? | before breakfast, pt. should sit upright for 30 min. after administration
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| If pt. in is in a balances suspension skeletal traction experiences muscle contractions, what is a nursing priority? | check position and weight of ropes
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| Osteoarthritis, S/S? | crepitus, decreased ROM, involvement of larger joints, joint pain that resolves w/rest
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| Knee and hip arthroplasty is used to treat? | osteoarthritis, rheumatoid arthritis
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| Total hip arthroplasty, dislocation precautions? | use: elevated toilet set, straight chairs w/arms, abduction pillow bet. pt.legs while in bed
-externally rotate the client’s toes
-don't cross less
-don't flex hips >90 deg.
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| Casts can be slit on one side (____) or both Sides (____) | univalved / bivalved
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| If compartment syndrome is suspected, priority nursing action? | Report finding to HCP
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| Open-angle glaucoma, is? | the aqueous humor outflow is decreased due to blockages in the eye’s drainage system (most common type)
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| Angle-closure glaucoma, is? | the angle between the iris and the sclera suddenly closes causing a increase in IOP
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| In emergency care of angle-closure glaucoma, nurse should anticipate to administer? | IV osmotic diuretics (rapidly reduce IOP)
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| Pupillary (constriction / dilation) is the effect to facilitate the flow of aqueous humor | constriction
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| Mydriatic ophthalmic drops cause pupillary(constriction / dilation)? | dilation
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| IV Epinephrine cause pupillary (constriction / dilation)? | dilation
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| Micturition reflex is the? | relaxation of the urethral sphincter in response to increased pressure in the bladder
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| Micturition reflex, can be stimulated by | pulling on pubic hair, stroking the inner thigh
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| Credé’s maneuver is done to? | downward pressure on the bladder to manually express the urine
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| Valsalva maneuver is performed by? | attempting to forcibly exhale while keeping the mouth and nose closed
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| Valsalva maneuver is done to? | evaluate the condition of the heart
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| Post-OP craniotomy nursing action? | elevate head of bed 30 deg, to reduce risk of intracranial pressure
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| Pts. with retinal detachment, usually report? | flashes of bright light or dark floating spots
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| The onset of retinal detachment is? | abrupt, vision loss without pain
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| A Basilar skull fracture involves? | a portion of the skull extending into the brain cavity
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| A Basilar skull fracture, can result in? | cerebrospinal fluid leakage, report to HCP
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| Glasgow Coma Scale, <8 | associated with severe head injury and coma
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| Glasgow Coma Scale, 9 - 12 | indicates a moderate head injury
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| Glasgow Coma Scale, >13 | reflects minor head trauma
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| Cheyne-Stokes respirations | breathing hyperventilation followed by apnea
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| CPAP | Continuous positive airway pressure
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| BiPAP | Bilevel positive airway pressure
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| PaCO2 of pt. on mechanical ventilator should be maintained at? | @ 35mm Hg
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| Respiration of pt. on mechanical ventilator should be checked every? | 1 to 2 hrs.
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| 3 types of ventilator alarms are ____, ____, and ____. | volume, pressure, apnea
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| Amyotrophic lateral sclerosis, is also know as ____ ____ ____. | Lou Gehrig's disease
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| Amyotrophic lateral sclerosis (ALS) is? | a disease of the nerve cells in the brain and spinal cord that control voluntary muscle movement
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| The greatest risk to ALS pt. is? | respiratory compromise due to paralysis of respiratory muscles
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| Death due to ALS usually occurs within? | 3 to 5 years of diagnosis
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| Hemianopsia is? | a condition in which a person can see only to one side, the left or right
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| When feeding pt. w/hemianopsia, nurse should encourage pt. to? | move visual field (head) to see full plate
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| Prior to feeding pt. w/CVA, nurse should assess? | swallowing and gag reflexes
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| Food should be placed where in mouth of pt. w/CVA | in the back of the mouth on the unaffected side.
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| Pt. w/CVA should be positioned how when eating? | upright position and swallow with the head and neck flexed slightly forward
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| Tensilon (Edrophonium chloride) test is? | an injection of edrophonium chloride used to diagnosis Myasthenia Gravis
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| Plasmapheresis is? | a blood purification procedure used to treat several autoimmune diseases
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| Myasthenic Crisis, S/S | respiratory muscle weakness, Myasthenic symptoms, hypertension, temporary relief w/Tensilon
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| Myasthenic symptoms include? | weakness, incontinence, fatigue
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| Cholingeric Crisis, S/S | muscle twitching, Cholinergic symptoms, hypotension, no relief w/Tensilon, relief w/Atropine
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| Cholinergic symptoms include? | Hypersecretions (nausea, diarrhea, respiratory secretions) and hypermotility (abdominal cramps)
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| A lumbar puncture is also known as a ____ ____. | spinal tap
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| Post-OP lumbar puncture pt. should | lie flat for 4 to 8 hrs.
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| An Embolic CVA is an? | ischemic types of stokes are caused by a thrombus or embolus
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| For an emergency Embolic CVA, nurse should anticipate administering? | Tissue plasminogen activator (Alteplase)
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| Recombinant Factor VIII, is administered in pt. with? | hemophilia
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| Nitro-Bid-IV (Nitroglycerin), is administered in pt. with? | angina
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| Lidocaine is administered in pt. with? | ventricular dysrhythmias
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| Sinemet should be administered with (high / low) protein foods? | Low, high-protein foods reduce absorption
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| Sinemet S/E | orthostatic HTN, dark urine, takes weeks for Therapeutic Effects
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| Guillain-Barre syndrome, greatest risk is? | Respiratory failure
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