NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8, 9, 10, 11)
1. Delirium Definition: State of temporary acute mental confusion. Usually
develops over a 2-3 day person. It is life-threatening & possibly preventable
syndrome. Most frequent complication of hospitalization in older adults. Priority of
safety and treating underlying cause. Delirium, often called acute confusional
state, begins with disorientation and, if not recognized and treated, can progress
to changes in level of consciousness, irreversible brain damage, and sometimes
death
2. Dementia Definition: Initial symptoms are related to changes in cognitive
function. The cognitive, functional, and behavioral changes that characterize
dementia eventually destroy a person's ability to function. The symptoms are
usually subtle in onset and often progress slowly until they are obvious and
devastating. Family members often report to doctor: Memory loss, Mild
disorientation, Trouble with words and/or numbers Confusion:
3. Suspected Elderly Abuse: Neglect or abuse of the patient can occur, and
this has been documented in home situations as well as in institutions. If neglect
or abuse of any kind—including physical, emotional, sexual, neglect, or financial
abuse—is suspected, the local adult protective services agency must be notified.
The responsibility of the nurse is to report the suspected abuse, not to prove it.
4. What is the point of medications in Alzheimer's?: Slow the Progression 5.
What two categories of medications are used to treat Alzheimer's?:
Acetylcholinesterase inhibitor & N-methyl-D-aspartate receptor antagonist
6. N-methyl-D-aspartate receptor antagonist: Name? What Disease? What to
watch for? What does it do?: Alzheimer's
Memantine- Namenda
Decreases glutamate circulation in the brain
• Watch renal disease
7. Acetylcholinesterase Inhibitor: Name? What Disease? What to watch for?
What does it do?: Alzheimer's
, NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8, 9, 10, 11)
Increases uptake of acetylcholine (Donepezil- Aricept, Rivastigmine- Exelon)
• Watch liver disease
8. Cardinal Signs of Parkinson's: Symptoms: Tremor, Rigidity, Bradykinesoa
(overall slowing of active movement), Postural Instability (postural and gait
problems),
Gradual onset, symptoms progress slowly over a chronic, prolonged course
9. Diagnosis of Parkinsons:: Although laboratory tests and imaging studies are
not helpful to the clinician in diagnosing PD ongoing research with PET and
single-photon emission computed tomography scanning has been helpful in
understanding the disease and advancing treatment. Currently, the disease is
diagnosed clinically from the patient's history and the presence of two of the
four cardinal manifestations: tremor, rigidity, bradykinesia, and postural
changes. CT scan can show some chronic changes but will not change long
term outcomes. The medical history, presenting symptoms, neurologic
examination, and response to pharmacologic management are carefully
evaluated when making the diagnosis.
10. Confirmation Diagnosis of Parkinson's: Give patient Levodopa-Carbodopa
and see if they respond to it or not.
11. What does Levodopa do? & What disease is it used in?: Increases
dopamine available in the brain Parkinson's
12. What does adding Carbidopa to Levodopa do? What disease is it used
in?: Adding Carbidopa can slow how quickly Levodopa is absorbed
Parkinson's
13. What is the brand name of Carbidopa/Levodopa?: Simemet
14. Why would a provider add Entacapone (Comtan) to a Sinemet medication
regimen?: Works well in combo with Simemet
, NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8, 9, 10, 11)
15. What does Amatnadine (Symmetrel) do?: increases dopamine release in
the nigrostriatal pathway
16. 2 Things to Remember in Parkinson's:: Close monitoring of swallowing
safety and intake
Measure weights weekly
17. Best plan of care for Parkinson's?: Medication Management
18. What is the desired effect of medication in Parkinson's?: Decrease of
tremors, rigidity, and symptoms
19. Cranial Arteritis Definition: Cranial arteritis is a cause of headache in the
older population, reaching its greatest incidence in those older than 70 years
of age. Inflammation of the cranial arteries is characterized by a severe
headache localized in the reon of the temporal arteries. The inflammation may
be generalized (in which case cranial arteritis is part of a vascular disease) or
focal (in which case only the cranial arteries are involved).
20. Symptoms of Cranial Arteritis: Cranial arteritis often begins with general
manifestations, such as fatigue, malaise, weight loss, and fever. Clinical
manifestations associated with inflammation (heat, redness, swelling,
tenderness, or pain over the involved artery) usually are present. Sometimes a
tender, swollen, or nodular temporal artery is visible.
21. Treatmnet of Cranial Arteritis: The medical management of cranial arteritis
consists of early administration of a corticosteroid to prevent the possibility of
loss of vision due to vascular occlusion or rupture of the involved artery. The
patient is instructed not to stop the medication abruptly because this can lead
to relapse.
Analgesic agents are prescribed for comfort.
22. Premonitory Stage of Migraine: First Stage
1. Delirium Definition: State of temporary acute mental confusion. Usually
develops over a 2-3 day person. It is life-threatening & possibly preventable
syndrome. Most frequent complication of hospitalization in older adults. Priority of
safety and treating underlying cause. Delirium, often called acute confusional
state, begins with disorientation and, if not recognized and treated, can progress
to changes in level of consciousness, irreversible brain damage, and sometimes
death
2. Dementia Definition: Initial symptoms are related to changes in cognitive
function. The cognitive, functional, and behavioral changes that characterize
dementia eventually destroy a person's ability to function. The symptoms are
usually subtle in onset and often progress slowly until they are obvious and
devastating. Family members often report to doctor: Memory loss, Mild
disorientation, Trouble with words and/or numbers Confusion:
3. Suspected Elderly Abuse: Neglect or abuse of the patient can occur, and
this has been documented in home situations as well as in institutions. If neglect
or abuse of any kind—including physical, emotional, sexual, neglect, or financial
abuse—is suspected, the local adult protective services agency must be notified.
The responsibility of the nurse is to report the suspected abuse, not to prove it.
4. What is the point of medications in Alzheimer's?: Slow the Progression 5.
What two categories of medications are used to treat Alzheimer's?:
Acetylcholinesterase inhibitor & N-methyl-D-aspartate receptor antagonist
6. N-methyl-D-aspartate receptor antagonist: Name? What Disease? What to
watch for? What does it do?: Alzheimer's
Memantine- Namenda
Decreases glutamate circulation in the brain
• Watch renal disease
7. Acetylcholinesterase Inhibitor: Name? What Disease? What to watch for?
What does it do?: Alzheimer's
, NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8, 9, 10, 11)
Increases uptake of acetylcholine (Donepezil- Aricept, Rivastigmine- Exelon)
• Watch liver disease
8. Cardinal Signs of Parkinson's: Symptoms: Tremor, Rigidity, Bradykinesoa
(overall slowing of active movement), Postural Instability (postural and gait
problems),
Gradual onset, symptoms progress slowly over a chronic, prolonged course
9. Diagnosis of Parkinsons:: Although laboratory tests and imaging studies are
not helpful to the clinician in diagnosing PD ongoing research with PET and
single-photon emission computed tomography scanning has been helpful in
understanding the disease and advancing treatment. Currently, the disease is
diagnosed clinically from the patient's history and the presence of two of the
four cardinal manifestations: tremor, rigidity, bradykinesia, and postural
changes. CT scan can show some chronic changes but will not change long
term outcomes. The medical history, presenting symptoms, neurologic
examination, and response to pharmacologic management are carefully
evaluated when making the diagnosis.
10. Confirmation Diagnosis of Parkinson's: Give patient Levodopa-Carbodopa
and see if they respond to it or not.
11. What does Levodopa do? & What disease is it used in?: Increases
dopamine available in the brain Parkinson's
12. What does adding Carbidopa to Levodopa do? What disease is it used
in?: Adding Carbidopa can slow how quickly Levodopa is absorbed
Parkinson's
13. What is the brand name of Carbidopa/Levodopa?: Simemet
14. Why would a provider add Entacapone (Comtan) to a Sinemet medication
regimen?: Works well in combo with Simemet
, NSG 123 Medical Surgical Nursing: Exam 4 (Modules 8, 9, 10, 11)
15. What does Amatnadine (Symmetrel) do?: increases dopamine release in
the nigrostriatal pathway
16. 2 Things to Remember in Parkinson's:: Close monitoring of swallowing
safety and intake
Measure weights weekly
17. Best plan of care for Parkinson's?: Medication Management
18. What is the desired effect of medication in Parkinson's?: Decrease of
tremors, rigidity, and symptoms
19. Cranial Arteritis Definition: Cranial arteritis is a cause of headache in the
older population, reaching its greatest incidence in those older than 70 years
of age. Inflammation of the cranial arteries is characterized by a severe
headache localized in the reon of the temporal arteries. The inflammation may
be generalized (in which case cranial arteritis is part of a vascular disease) or
focal (in which case only the cranial arteries are involved).
20. Symptoms of Cranial Arteritis: Cranial arteritis often begins with general
manifestations, such as fatigue, malaise, weight loss, and fever. Clinical
manifestations associated with inflammation (heat, redness, swelling,
tenderness, or pain over the involved artery) usually are present. Sometimes a
tender, swollen, or nodular temporal artery is visible.
21. Treatmnet of Cranial Arteritis: The medical management of cranial arteritis
consists of early administration of a corticosteroid to prevent the possibility of
loss of vision due to vascular occlusion or rupture of the involved artery. The
patient is instructed not to stop the medication abruptly because this can lead
to relapse.
Analgesic agents are prescribed for comfort.
22. Premonitory Stage of Migraine: First Stage
