MDC 4 Exam 1 Rasmussen University 75 questions- Neuro and Perioperative

Which Migraine medications cannot be used in a patient with cardiac diseases and why? - Triptans and Ergotamine preparations- they will cause additional vasoconstriction of the head blood vessels What does abortive therapy do for migraines? - alleviate pain after the headache starts What does preventative therapy do for migraines? - prevent a headache is it occurs more than twice a week or is severe. A patient is taking beta blocker and calcium channel blockers to prevent a migraine. What education should the nurse give to the patient regarding these medications? - Do not stop the medications What are some trigger foods for migraines? - aged cheeses, smoked meats, fermented deli meats, pickles, beer, wine, nuts (think tyramine) A patient is trying to see what things trigger their migraines. What education can the nurse provide? - Keep a food diary and determine what foods may make the migraine occur. A patient tells the nurse that they see flashing lights before their headache starts. What is this called? - Aura A aura may happen with _______ and ________. - Migraines, Seizures S/S of Migraines - Photophobia, N,V,head pain, phonophobia A patient tells their spouse who is a nurse they are having a migraine. What would the nurse tell them to do? - Go into a cool dark room and rest while sitting up. A nurse is setting up a room for a patient coming in for a seizure. What things should be included in the room? - Working suction and o2, padded bed side rails, placement of an IV when patient arrives. What should you never place in a patients mouth when they are having a seizure? - Tongue blade What is the term for a seizure lasting more than 5 minutes or having multiples in a 30 min period? - Status Epilepticus What can you give to stop a seizure? - IV benzo A patient states to the nurse before leaving the doctors office his provider will place him on phenytoin. What education should the nurse give? - Do not stop the medication- if so a seizure may occur. A patient with a seizure disorder suddenly freezes up and drops without twitching. What type of seizure is this called? - Tonic A patient with a seizure disorder suddenly freezes up for a few seconds and starts to vigorously twitch. What type of seizure is the patient having? - Tonic Clonic A person starts to have brief twitches of their left arm while in line to check out at the store. What type of seizure is this? - Myoclonic A patient suddenly looses muscle tone and drops to the floor. What type of seizure is this? - Atonic A nurse starts to see the patient in a room starting to have a seizure. What is her next move? - Place patient on left side, lower bed, support head, no restraining them, timing the episode and calling for help. After a seizure is done, what actions should the nurse take? - Assess vitals, reorient patient, clean them up if they peed or pooped, call provider. A teen with a seizure disorder is cleared by the provider to take his drivers license test. What must her report to the DMV? - That he has a seizure disorder A female patient was recently diagnosed with a seizure disorder and is taking a oral contraceptive. What education must the nurse give? - She should switch off the pill as seizure prevention medications can cause the pill to not work. S/S of Parkinsons include: - bradykinesia, muscle rigidity, mask like face, postal instability, resting tremors, cogwheel rigidity, lead pipe rigidity, shuffling gait What are some concerns regarding Parkinsons disease? - Safety- fall precautions needed Aspiration- may need assistance or observation while eating Who is at risk for developing MS? - Females ages 20-40 S/S of MS: - based on area affected, fatigue, double vision, HA, trigeminal neuralgia, dysarthria, ataxia, incontinence, nystagmus. MS treatment - steroids and the S/S What is a hallmark manifestation of guillan barre? - Ascending paralysis What is a concern we can have with guillan barre? - Will eventually reach its way to diaphragm and cause respiratory compromise and need for mechanical ventilation When can one get Gillian barre? - After a virus or vaccine What is trigeminal neuralgia? - Pain of the CN 5, causes pain in the face. What is one medication we can give to a patient experiencing spasms of the face from trigeminal neuralgia? - Baclofen What are the highest priorities during the post-op period? - Patent airway and oxygen saturation At what level of the body will a patient have autonomic dysreflexia? - Above a T6 fracture A patient with a T1 fracture starts to have a headache and flushing of the skin. his most recent vitals are BP 170/90, HR is 50. What are interventions to assist with these manifestations? - Sit them up and look for a cause such as a full bladder and solve it What are some preoperative priorities? - Confirm consent is signed, verify any allergies, educate patient on what to expect during and after the procedure, ensure patient has been NPO for 6-8 hrs, baseline vitals, confirm the most recent labs, medications, pregnancy test. What can UAPs not do? - Assess, evaluate, or teach. No unstable patients, no meds, no invasive procedures. A patient who had a stroke has his meal on the floor. No modified barium swallow has been done yet. The UAP asks to go feed the patient. Should the nurse intervene? - Yes- the patient could aspiration without having the proper diet and feeding precautions established Parts of the Glasgow Coma Scale are: - Eye opening response, motor response, verbal response. If a patient has a GCS score of 8, what are they most likely in? - Coma If a patient has a GCS score of 3, what is happening? - They dead Decorticate posturing - characterized by upper extremities flexed at the elbows and held closely to the body and lower extremities that are externally rotated and extended. occurs when the brainstem is not inhibited by the motor function of the cerebral cortex. Decerebrate posturing - posturing in which the neck is extended with jaw clenched; arms are pronated, extended, and close to the sides; legs are extended straight out; more ominous sign of brain stem damage. Most Severe. What are priorities when patient is in the OR? - Safety and Infection Control What is evisceration? - protrusion of visceral organs through a wound opening What is dehiscence? - A separation of the wound incision A patient tells the nurse that when he went to cough her felt a popping sensation. Part of his intestines is out. What does the nurse do next? - Call for help, place a sterile moistened gauze over the area, patient will go to OR. How do we know a JP drain is working? - The bulb is squeezed and collapsed for suction Who should the nurse place a consult in for a patient who had a stroke and needs a swallow eval? - Speech Therapist