NUR 265 EXAM 3 LATEST UPDATE
What is encephalitis? - ANSWER: inflammation or infection of the brain
What causes encephalitis? - ANSWER: West Nile Virus
Herpes
What are the s/s of encephalitis? - ANSWER: High fever, N/V, stiff neck
Flu like symptoms
change in LOC
photophobia
pupil changes (dilate & less responsive to light)
What is used to dx encephalitis? - ANSWER: lumbar puncture
EEG
CT (looks for mass)
What are N/I for encephalitis? - ANSWER: Neuro checks
Monitor for s/s of ICP
Suction only resp compromised
HOB 30-45
Decrease stimuli
What is the tx for encephalitis? - ANSWER: acyclovir
What are complications from encephalitis? - ANSWER: ICP that leads to herniation of
brain tissue or death
What is myasthenia gravis? - ANSWER: Autoimmune disorder that is characterized by
weakness in the muscles
What causes myasthenia gravis? - ANSWER: lack of Ach receptor sites, leads to lack
of nerve impulses
What are s/s of myasthenia gravis? - ANSWER: difficulty holding up head or brushing
teeth
double vision
ptosis
dysphagia
loss of bowel & bladder control
decrease sense of smell & taste
How is myasthenia gravis diagnosed? - ANSWER: tensillon test.
s/s improve with Edrophonium .
,How does edrophonium work? - ANSWER: w/in 30-60sec of 1st dose, most show lots
of improvement, lasts 4-5mins
What are n/i for myasthenia gravis? - ANSWER: assess adls, speech & facial weakness
resp support
keep oxygen equipment & suction at bedside for r/f of resp distress
promote mobility
What is tx for myasthenia gravis? - ANSWER: plasmapherisis
anticholinesterases (pyridostigmine) immunosuppressants
What is cholinergic crisis? - ANSWER: too much cholinesterase inhibitor drug
What are s/s of cholinergic crisis? - ANSWER: fasciculations
hypersalivation
sweating
bronchospasms
increase bronchial secretions
bradycardia
What is tx for cholinergic crisis? - ANSWER: atropine
DO NOT GIVE ANTICHOLINESTERASE
What is myasthenic crisis? - ANSWER: too little cholinesterase inhibitor drug
What is the priority with myasthenic crisis? - ANSWER: resp function
What are s/s of myasthenic crisis? - ANSWER: increase HR, RR, BP
decrease u/o
no cough or swallow reflex
dry
What time should ChE inhibitor be given? - ANSWER: 45-1hr before meals to avoid
aspiration
What can tensilon test cause? - ANSWER: cardiac dysrhythmias, have atropine on
hand
What is nursing priority with myasthenic crisis? - ANSWER: maintain airway, may
require to intubate
What is Guillain-Barre? - ANSWER: an uncommon acute inflammatory disorder that
affects axons and/or myelin sheath (neurons can't impulse)
where does Guillain Barre Syndrome start - ANSWER: -Starts in feet and hands
(numbness, tingling)
, What are causes of Guillain Barre? - ANSWER: bacterial infection
influenza
epstein barr
zika
What are s/s of guillain barre? - ANSWER: loss of reflexes
hypotension
labile BP
muscle weakness or paralysis (decreased DTR)
numbness
ataxia
blurred or double vision
palpitations
pain
tachycarida
What are complications from guillain barre? - ANSWER: resp & cardiac problems
decreased mobility, DVTs
What is tx for guillain barre? - ANSWER: plasmapheresis asap
IV immunoglobulin if can't do plasma right away
What do you NOT want to give w/ guillain barre? - ANSWER: CORTICOSTERIODS
What are n/i with guillain barre? - ANSWER: priority is airway
monitor abgs
monitor cardiac
monitor for resp distress
pt/ot for immobility
mech vent if needed
interdisciplinary tx
What is SCI? - ANSWER: loss of motor function, sensory perception reflex activity,
and bowel and bladder control
What are causes of SCI? - ANSWER: vehicle crashes
falls
acts of violence
sport-related accidents
What are primary causes of SCI? - ANSWER: hyperflexion
hyperextension
axial loading or vertical compression
excessive rotation
penetrating trauma
What are s/s of SCI? - ANSWER: bradycardia
What is encephalitis? - ANSWER: inflammation or infection of the brain
What causes encephalitis? - ANSWER: West Nile Virus
Herpes
What are the s/s of encephalitis? - ANSWER: High fever, N/V, stiff neck
Flu like symptoms
change in LOC
photophobia
pupil changes (dilate & less responsive to light)
What is used to dx encephalitis? - ANSWER: lumbar puncture
EEG
CT (looks for mass)
What are N/I for encephalitis? - ANSWER: Neuro checks
Monitor for s/s of ICP
Suction only resp compromised
HOB 30-45
Decrease stimuli
What is the tx for encephalitis? - ANSWER: acyclovir
What are complications from encephalitis? - ANSWER: ICP that leads to herniation of
brain tissue or death
What is myasthenia gravis? - ANSWER: Autoimmune disorder that is characterized by
weakness in the muscles
What causes myasthenia gravis? - ANSWER: lack of Ach receptor sites, leads to lack
of nerve impulses
What are s/s of myasthenia gravis? - ANSWER: difficulty holding up head or brushing
teeth
double vision
ptosis
dysphagia
loss of bowel & bladder control
decrease sense of smell & taste
How is myasthenia gravis diagnosed? - ANSWER: tensillon test.
s/s improve with Edrophonium .
,How does edrophonium work? - ANSWER: w/in 30-60sec of 1st dose, most show lots
of improvement, lasts 4-5mins
What are n/i for myasthenia gravis? - ANSWER: assess adls, speech & facial weakness
resp support
keep oxygen equipment & suction at bedside for r/f of resp distress
promote mobility
What is tx for myasthenia gravis? - ANSWER: plasmapherisis
anticholinesterases (pyridostigmine) immunosuppressants
What is cholinergic crisis? - ANSWER: too much cholinesterase inhibitor drug
What are s/s of cholinergic crisis? - ANSWER: fasciculations
hypersalivation
sweating
bronchospasms
increase bronchial secretions
bradycardia
What is tx for cholinergic crisis? - ANSWER: atropine
DO NOT GIVE ANTICHOLINESTERASE
What is myasthenic crisis? - ANSWER: too little cholinesterase inhibitor drug
What is the priority with myasthenic crisis? - ANSWER: resp function
What are s/s of myasthenic crisis? - ANSWER: increase HR, RR, BP
decrease u/o
no cough or swallow reflex
dry
What time should ChE inhibitor be given? - ANSWER: 45-1hr before meals to avoid
aspiration
What can tensilon test cause? - ANSWER: cardiac dysrhythmias, have atropine on
hand
What is nursing priority with myasthenic crisis? - ANSWER: maintain airway, may
require to intubate
What is Guillain-Barre? - ANSWER: an uncommon acute inflammatory disorder that
affects axons and/or myelin sheath (neurons can't impulse)
where does Guillain Barre Syndrome start - ANSWER: -Starts in feet and hands
(numbness, tingling)
, What are causes of Guillain Barre? - ANSWER: bacterial infection
influenza
epstein barr
zika
What are s/s of guillain barre? - ANSWER: loss of reflexes
hypotension
labile BP
muscle weakness or paralysis (decreased DTR)
numbness
ataxia
blurred or double vision
palpitations
pain
tachycarida
What are complications from guillain barre? - ANSWER: resp & cardiac problems
decreased mobility, DVTs
What is tx for guillain barre? - ANSWER: plasmapheresis asap
IV immunoglobulin if can't do plasma right away
What do you NOT want to give w/ guillain barre? - ANSWER: CORTICOSTERIODS
What are n/i with guillain barre? - ANSWER: priority is airway
monitor abgs
monitor cardiac
monitor for resp distress
pt/ot for immobility
mech vent if needed
interdisciplinary tx
What is SCI? - ANSWER: loss of motor function, sensory perception reflex activity,
and bowel and bladder control
What are causes of SCI? - ANSWER: vehicle crashes
falls
acts of violence
sport-related accidents
What are primary causes of SCI? - ANSWER: hyperflexion
hyperextension
axial loading or vertical compression
excessive rotation
penetrating trauma
What are s/s of SCI? - ANSWER: bradycardia
