1
NUR2571 Exam 3 Study Guide : Professional Nursing II / PN 2
PN2 Exam 3
Neuro
- S/s, causes of autonomic dysreflexia
o s/s: hypertensive crisis, bradycardia, severe headache,
stroke or seizure activity
o Cause: noxious stimuli such as a full bladder, fecal
impaction, wrinkle in clothing, menstrual cramps,
erection, ingrown toenail, bladder infection, sitting on
catheter tubing
o High blood pressure and spinal cord injury- check
their bladder
o Hypertensive crisis (elevated systolic pressures of 260
to 300)
- Gillian Barre, s/s, complications
o s/s: starts in the legs and works its way up, motor
weakness, areflexia (absence of reflexes), respiratory
failure, face muscle deficit
▪ causes paresthesia and pain in hands and feet –
this is reversible
o Complications: respiratory distress
- Multiple Sclerosis – s/s, what to avoid
o s/s: NYSTAGMUS fatigue in lower extremities, pain
or paresthesia, diplopia (changes in peripheral vision),
tinnitus, vertigo, dysphagia,
o avoid: avoid extreme temperatures, stress, smoking
- Parkinson’s – What tx and meds are supposed to help
o Levodopa/Carbidopa (Sinemet)- provides dopamine
replacement to treat motor symptoms
o Watch their swallowing- speech therapist
o Provide finger foods
o Encourage activity
- Myasthenia Gravis – Testing for
o Tensilon Test: baseline measurement of the cranial
muscle strength
▪ Have atropine available (antidote)
- ALS – patient and family teaching (SATA), late s/s
o Teaching: emotional support, teaching about
signs/prevent respiratory distress, speech therapy (how
, 2
to communicate), physical therapy, talk about choices
for end of life care
o Late s/s: respiratory distress
- Alzheimer’s – pt. and family teaching, what meds are used
for, safety measures
o Safety measures: remove scatter rugs, lock
doors/alarms, good lighting, install handrails, place
mattress on the floor, remove clutter, secure electrical
cords to baseboards, keep cleaning supplies locked,
wear identification bracelet
o Meds: doesn’t cure but helps with behavior/emotional
problems
o Teaching: encourage AD support groups, safe
environment, keep on a sleeping schedule, provide
verbal and nonverbal communication, offer snacks and
finger food, be consistent and repetitive, give memory
training
o promote self-care for as long as possible
- Migraines – what helps, patient teaching, s/s of common
migraine (SATA)
o s/s: photophobia, pulsating sensation (throb), pain that
gets worse with activities
o patient teaching/what helps: dark environment
- SCI (Spinal Cord Injury) – what to assess first, pt. teaching
for respiratory
o If blood pressure is high assess bladder first
o Use of incentive spirometer to prevent pneumonia or
ARDS
Eyes
- What is Strabismus
o Commonly known as cross eyed; a vision condition in
which a person cant align both eyes simultaneously
under normal conditions. One or both of the eyes may
turn in, out, up, or down
- S/s, tx of cataracts
o s/s: decreased visual acuity (reduced night vision)
blurred vision, diplopia (double vision), glare and light
sensitivity, halo around lights, absent red reflex,
visible opacity, progressive and painless loss of vision
o Treatment: surgical removal of the lens
, 3
- What is macular degeneration
o The gradual central loss of vision that affects the
macula of the eye
o Often called age-related macular degeneration
- Glaucoma, cause and tx
o Leading cause of blindness
o Cause: decreased fluid drainage or increased fluid
secretion increases intraocular pressure and causes
atrophic changes of the optic nerve and visual defects.
o Treatment:
▪ prescribed eye medication (Pilocarpine, timolol,
beta blockers
▪ check pulse and blood pressure before taking
timolol
Ears
- What ototoxicity causes
o Sensorineural hearing loss
- Causes of sensorineural and conductive hearing loss
o Conductive (something is physically stopping the
sound): otosclerosis, ear wax, infection
o Sensorineural: ototoxicity (mycin, flagel, NSAIDS,
aspirin overdose)
- Treatment and patient teaching for acute otitis media
o At risk for loss of balance
o Bacterial: treated with antibiotics
o (SATA) Teaching: finish all antibiotics, take
analgesics, apply a warm cloth, if pain gets
uncontrollable then seek help
Diabetes/Thyroid
- Graves – pt. teaching, diet
o Patient must discontinue any iodine containing
medication 1 week prior to a thyroid scan
o Radioactive Iodine teaching: not if pregnant, don’t
kiss anyone or have sex for 5 days, don’t sit next to
someone in a car for more than an hour, stay away
from babies for 24 hours
o Teaching: Monitor pulse, eat meals frequently
o Diet: higher calories
- Type 1 – Cause
o Auto-immune response or idiopathic
o Diagnosed in childhood, little or no insulin, first sign
is DKA
, 4
o Metabolic acidosis (Kussmauls respirations)
- Type 2 – Pt. teaching (SATA), testing for
o Testing for metabolic syndrome (Syndrome X)
o Teaching:
▪ High fiber diet
▪ Exercise
- Insulin – Pt. teaching about overall administration, which
one goes IV
o IV: regular (Humalin R)
o Teaching: always clear before cloudy, monitor for
hypoglycemia
▪ Rotate sites (wait 3-6 weeks to use that site again)
▪ Check sugar before giving insulin
- Lispro and NPH – onset, peak times
o Lispro: onset 2-4 hours; no peak
o NPH: onset 1.5 hours; peak 4-12 hours
- How to prevent lipodystrophy
o insulin
- Foot care teaching
o Don’t clip toe nails
o Don’t wear open toed shoes
- Thyroid post-op complications and what to assess
o Assess for signs of hypocalcemia: positive Chvostek’s
and trousseaus
o Assess for bleeding behind the neck
o Vocal cord paralysis or damage: sounding hoarse
- Hypothyroid – s/s, meds for, will take meds forever
o s/s: no energy, GI slows, weight gain, cold, no
circulation, slurred speech
▪ tend to have cardiac disease
o Meds: Levothyroxine (Synthroid)
o Yes, they take them forever
o Patient can become depressed because they are very
tired
- How often to get eyes checked
o Annual – due to retinopathy
- Pts. At greatest risk for Diabetes
o Obese, family history, 45 and older, hypertension,
American Indians
- Good exercises for diabetics
- DKA s/s
NUR2571 Exam 3 Study Guide : Professional Nursing II / PN 2
PN2 Exam 3
Neuro
- S/s, causes of autonomic dysreflexia
o s/s: hypertensive crisis, bradycardia, severe headache,
stroke or seizure activity
o Cause: noxious stimuli such as a full bladder, fecal
impaction, wrinkle in clothing, menstrual cramps,
erection, ingrown toenail, bladder infection, sitting on
catheter tubing
o High blood pressure and spinal cord injury- check
their bladder
o Hypertensive crisis (elevated systolic pressures of 260
to 300)
- Gillian Barre, s/s, complications
o s/s: starts in the legs and works its way up, motor
weakness, areflexia (absence of reflexes), respiratory
failure, face muscle deficit
▪ causes paresthesia and pain in hands and feet –
this is reversible
o Complications: respiratory distress
- Multiple Sclerosis – s/s, what to avoid
o s/s: NYSTAGMUS fatigue in lower extremities, pain
or paresthesia, diplopia (changes in peripheral vision),
tinnitus, vertigo, dysphagia,
o avoid: avoid extreme temperatures, stress, smoking
- Parkinson’s – What tx and meds are supposed to help
o Levodopa/Carbidopa (Sinemet)- provides dopamine
replacement to treat motor symptoms
o Watch their swallowing- speech therapist
o Provide finger foods
o Encourage activity
- Myasthenia Gravis – Testing for
o Tensilon Test: baseline measurement of the cranial
muscle strength
▪ Have atropine available (antidote)
- ALS – patient and family teaching (SATA), late s/s
o Teaching: emotional support, teaching about
signs/prevent respiratory distress, speech therapy (how
, 2
to communicate), physical therapy, talk about choices
for end of life care
o Late s/s: respiratory distress
- Alzheimer’s – pt. and family teaching, what meds are used
for, safety measures
o Safety measures: remove scatter rugs, lock
doors/alarms, good lighting, install handrails, place
mattress on the floor, remove clutter, secure electrical
cords to baseboards, keep cleaning supplies locked,
wear identification bracelet
o Meds: doesn’t cure but helps with behavior/emotional
problems
o Teaching: encourage AD support groups, safe
environment, keep on a sleeping schedule, provide
verbal and nonverbal communication, offer snacks and
finger food, be consistent and repetitive, give memory
training
o promote self-care for as long as possible
- Migraines – what helps, patient teaching, s/s of common
migraine (SATA)
o s/s: photophobia, pulsating sensation (throb), pain that
gets worse with activities
o patient teaching/what helps: dark environment
- SCI (Spinal Cord Injury) – what to assess first, pt. teaching
for respiratory
o If blood pressure is high assess bladder first
o Use of incentive spirometer to prevent pneumonia or
ARDS
Eyes
- What is Strabismus
o Commonly known as cross eyed; a vision condition in
which a person cant align both eyes simultaneously
under normal conditions. One or both of the eyes may
turn in, out, up, or down
- S/s, tx of cataracts
o s/s: decreased visual acuity (reduced night vision)
blurred vision, diplopia (double vision), glare and light
sensitivity, halo around lights, absent red reflex,
visible opacity, progressive and painless loss of vision
o Treatment: surgical removal of the lens
, 3
- What is macular degeneration
o The gradual central loss of vision that affects the
macula of the eye
o Often called age-related macular degeneration
- Glaucoma, cause and tx
o Leading cause of blindness
o Cause: decreased fluid drainage or increased fluid
secretion increases intraocular pressure and causes
atrophic changes of the optic nerve and visual defects.
o Treatment:
▪ prescribed eye medication (Pilocarpine, timolol,
beta blockers
▪ check pulse and blood pressure before taking
timolol
Ears
- What ototoxicity causes
o Sensorineural hearing loss
- Causes of sensorineural and conductive hearing loss
o Conductive (something is physically stopping the
sound): otosclerosis, ear wax, infection
o Sensorineural: ototoxicity (mycin, flagel, NSAIDS,
aspirin overdose)
- Treatment and patient teaching for acute otitis media
o At risk for loss of balance
o Bacterial: treated with antibiotics
o (SATA) Teaching: finish all antibiotics, take
analgesics, apply a warm cloth, if pain gets
uncontrollable then seek help
Diabetes/Thyroid
- Graves – pt. teaching, diet
o Patient must discontinue any iodine containing
medication 1 week prior to a thyroid scan
o Radioactive Iodine teaching: not if pregnant, don’t
kiss anyone or have sex for 5 days, don’t sit next to
someone in a car for more than an hour, stay away
from babies for 24 hours
o Teaching: Monitor pulse, eat meals frequently
o Diet: higher calories
- Type 1 – Cause
o Auto-immune response or idiopathic
o Diagnosed in childhood, little or no insulin, first sign
is DKA
, 4
o Metabolic acidosis (Kussmauls respirations)
- Type 2 – Pt. teaching (SATA), testing for
o Testing for metabolic syndrome (Syndrome X)
o Teaching:
▪ High fiber diet
▪ Exercise
- Insulin – Pt. teaching about overall administration, which
one goes IV
o IV: regular (Humalin R)
o Teaching: always clear before cloudy, monitor for
hypoglycemia
▪ Rotate sites (wait 3-6 weeks to use that site again)
▪ Check sugar before giving insulin
- Lispro and NPH – onset, peak times
o Lispro: onset 2-4 hours; no peak
o NPH: onset 1.5 hours; peak 4-12 hours
- How to prevent lipodystrophy
o insulin
- Foot care teaching
o Don’t clip toe nails
o Don’t wear open toed shoes
- Thyroid post-op complications and what to assess
o Assess for signs of hypocalcemia: positive Chvostek’s
and trousseaus
o Assess for bleeding behind the neck
o Vocal cord paralysis or damage: sounding hoarse
- Hypothyroid – s/s, meds for, will take meds forever
o s/s: no energy, GI slows, weight gain, cold, no
circulation, slurred speech
▪ tend to have cardiac disease
o Meds: Levothyroxine (Synthroid)
o Yes, they take them forever
o Patient can become depressed because they are very
tired
- How often to get eyes checked
o Annual – due to retinopathy
- Pts. At greatest risk for Diabetes
o Obese, family history, 45 and older, hypertension,
American Indians
- Good exercises for diabetics
- DKA s/s
