NUR 372 FINAL EXAM
NEURO/HEMATOLOGY/IMMUNITY, QUESTIONS AND
CORRECT ANSWERS, COMPLETE SOLUTION.
leukemia
bone marrow forms immature WBC production (leukemia/blast cells)
leukemia: manifestations
swollen, painful lymph glands
leukemia: complications
risk for infection
leukemia: neutropenia
if absolute neutrophil count (ANC) is less than 1000, initiate neutropenic precautions
neutropenic precautions
-wash hands and produce
-isolate patient/ private room
-avoid taking rectal temp/enema
-no live plants or cut flowers
DIC
abnormal blood clotting disorder
-stage 1: overactive clotting (treatment: anticoags)
-stage 2: spontaneous bleeding (treatment: fibrinogen)
thrombocytopenia
platelets below normal range (<150,000)
-potential cause: heparin induced thrombocytopenia antibodies
hemophilia
inadequate clotting factors
-type A: clotting factor VIII
-type B: clotting factor IX
-clinical manifestations only in males
-treatment: recombinant clotting factors
myasthenia gravis
progressive paresis of affected muscle groups that is partially resolved by rest
myasthenia gravis: manifestations
ocular: diplopia and ptosis
myasthenia gravis: diagnosis
tensilon testing (tensilon injected and improvement in muscle tone within 30-60 minutes
is noted)
-have atropine available
myasthenia gravis: treatment
-first line: anticholinesterase (CI: magnesium)
-drug of choice: pyradostigmine
myasthenia gravis: complications
myasthenic crisis (exacerbation of respiratory weakness, intubate, chest physiotherapy,
hold cholinesterase inhibitor)
, ischemic stroke
disruption of blood supply to brain
ischemic stroke: manifestations
abrupt onset
ischemic stroke: diagnosis
immediate CT
ischemic stroke: treatment
T-PA: busts clot and restores blood flow
ischemic stroke: complications
hemorrhagic transformation (bc of increased bleeding from T-PA)
left-hemispheric stroke: manifestation
aphasia
right-hemispheric stroke: manifestation
impulse behavior and poor judgement (risk for injury)
transient ischemic attack
neuro deficits that will resolve within 24 hours
-indicator that a stroke is impending
tool for recognizing stroke
Balance, Eyes, Face, Arm, Speech, Time
actions to take once stroke patient has been admitted:
1) initiate stroke protocol
2) assessment and CT SCAN
3) neuro specific assessment
4) initiate treatment once CT results are in
lymphoma
cancer that starts in the lymph system
lymphoma: manifestations
painless swelling of lymph nodes
Hodgkins lymphoma
presence of Reed Sternberg cells
-less common than NHL, but better survival
-s/s: alcohol induced pain
Non-Hodgkins lymphoma
no RS-H cells
-more common type, but lower survival
-s/s: auto-immune disorders
contusion
loss of consciousness, stupor
concussion
temporary loss of neurologic function
-repeated incidents can lead to chronic traumatic encephalopathy
epidural hematoma
rapidly expanding arterial bleed
-EMERGENCY
subdural hematoma
slowly expanding venous blood
NEURO/HEMATOLOGY/IMMUNITY, QUESTIONS AND
CORRECT ANSWERS, COMPLETE SOLUTION.
leukemia
bone marrow forms immature WBC production (leukemia/blast cells)
leukemia: manifestations
swollen, painful lymph glands
leukemia: complications
risk for infection
leukemia: neutropenia
if absolute neutrophil count (ANC) is less than 1000, initiate neutropenic precautions
neutropenic precautions
-wash hands and produce
-isolate patient/ private room
-avoid taking rectal temp/enema
-no live plants or cut flowers
DIC
abnormal blood clotting disorder
-stage 1: overactive clotting (treatment: anticoags)
-stage 2: spontaneous bleeding (treatment: fibrinogen)
thrombocytopenia
platelets below normal range (<150,000)
-potential cause: heparin induced thrombocytopenia antibodies
hemophilia
inadequate clotting factors
-type A: clotting factor VIII
-type B: clotting factor IX
-clinical manifestations only in males
-treatment: recombinant clotting factors
myasthenia gravis
progressive paresis of affected muscle groups that is partially resolved by rest
myasthenia gravis: manifestations
ocular: diplopia and ptosis
myasthenia gravis: diagnosis
tensilon testing (tensilon injected and improvement in muscle tone within 30-60 minutes
is noted)
-have atropine available
myasthenia gravis: treatment
-first line: anticholinesterase (CI: magnesium)
-drug of choice: pyradostigmine
myasthenia gravis: complications
myasthenic crisis (exacerbation of respiratory weakness, intubate, chest physiotherapy,
hold cholinesterase inhibitor)
, ischemic stroke
disruption of blood supply to brain
ischemic stroke: manifestations
abrupt onset
ischemic stroke: diagnosis
immediate CT
ischemic stroke: treatment
T-PA: busts clot and restores blood flow
ischemic stroke: complications
hemorrhagic transformation (bc of increased bleeding from T-PA)
left-hemispheric stroke: manifestation
aphasia
right-hemispheric stroke: manifestation
impulse behavior and poor judgement (risk for injury)
transient ischemic attack
neuro deficits that will resolve within 24 hours
-indicator that a stroke is impending
tool for recognizing stroke
Balance, Eyes, Face, Arm, Speech, Time
actions to take once stroke patient has been admitted:
1) initiate stroke protocol
2) assessment and CT SCAN
3) neuro specific assessment
4) initiate treatment once CT results are in
lymphoma
cancer that starts in the lymph system
lymphoma: manifestations
painless swelling of lymph nodes
Hodgkins lymphoma
presence of Reed Sternberg cells
-less common than NHL, but better survival
-s/s: alcohol induced pain
Non-Hodgkins lymphoma
no RS-H cells
-more common type, but lower survival
-s/s: auto-immune disorders
contusion
loss of consciousness, stupor
concussion
temporary loss of neurologic function
-repeated incidents can lead to chronic traumatic encephalopathy
epidural hematoma
rapidly expanding arterial bleed
-EMERGENCY
subdural hematoma
slowly expanding venous blood
