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48 Cards in this Set

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Chronic, progressive, degenerative disorder of the CNS characterized by dissemenated demyelination of nerve fibers of the brain and spinal cord.
Multiple Sclerosis
Lhermitte's sign
Transient sensory symptom described as an electrical shock radiating down the spine or into the limbs with flexion of the neck.
Diagnosis of MS?
History, clinical manifestations, and presents of multiple lesions over time (MRI)
What types of drugs are used to treat MS?
Prednisone

Immunosupressive drugs
Disease characterized by slowness of movement (bradykinesia), rigidity, tremor at rest, and impaired postural reflexes
Parkinson's disease
Triad of Parkinsons?
Tremor
Rigidity
Bradykinesia
Diagnosis of Parkinsons
Triad plus positive response to parkinsonian drugs
Most common medications used to treat Parkinsons?
Levodopa

(also levodopa with carbidopa: Sinemet)
Surgery for Parkisons?
Ablation
Deep brain stimulation
Transplantation (fetal tissue to produce dopamine producing cells)
An imbalance of dopamine and Ach is associated with?
Parkinsons
Autoimmune disease of the neuromuscular junction characterized by the fluctuating weakness of certain skeletal muscle groups?
Myasthenia Gravis
MG most often involves which muscles?
Ocular
chewing
Swallowing
Speaking
Breathing
Acute exacerbatinon of muscle weakness triggered by infection, surgery, emotional distress, drug overdose?
Myasthenic crisis

(concern is swallowing and breathing)
Tensilon test?
Patient shows improved muscle contractiltiy after injection of tensilon (anticholinesterase) if the patient has MG
Anticholinesterase drugs used to treat MG?
Prostigmin
Mestinon
Which classes of drugs are used to treat MG?
Anticholinesterase
Alternate-day corticosteroids
Immunosuppresants
ADL's in patients with MG
Plan to avoid fatigue

More energy in morning and after rest periods
Rare progressive neurologic disorder characterized by loss of motor neurons that results in death in 2-6 years
ALS

Lou Gherig's disease
Key distinction between delirium and dementia?
Perosn who exhibits sudden cognitive impairment, disorientation, or clouded sensorium is more likely to have delirium
What is Memantine used for?
To treat middle to late stages of Alzheimers

Protects against excessive glutamate, which is released by cells damaged by AD
Which drugs are used to treat dementia in AD patients?
Cholinesterase inhibitors

Aricept
Exelon
Razadyne
Disorder characterized by a disruption of the motor branches of the facial nerve CN VII
Bells Palsy
Treatment of Bells Palsy?
Moist heat
Gental massage
Electrical stimulation
Exercises
What virus is associated with Bells Palsy?
Herpes

(acyclovir treats)
Medication for Bells Palsy
Predisone
Disease that affects the peripheral nerevous system and results in loss of myelin and edema and inflammation fo the affected nerves, causing a loss of neurotransmission to the periphery?
Guillain-Barre syndrome
Guillian Barre is often preceded by?
Immune system stimulation from a viral infection, trauma, surgery, immunizations, or HIV
Most serious complication of Guillian Barre?
Respiratory failure
Diagnosis of Guillian Barre?
CSF is normal or low protein content initially and elevates after 7-10 days
Medication of Guillian Barre?
IV administration of high-dose immunoglobulin
Nursing assesment of Guillian Barre?
Monitor the ascending paralysis: respiratory function, ABG's, gag, corneal, and swallowing reflexes
Blood flow required for optimum brain functioning?
750-1000 ml
Penecambria?
Around the core area of ischemia is a border zone of reduced blood flow, where ischemia is potentially reversible
Symptoms of a transient ischemic attack?
Blurred vision
Ringing in the ears
HA
Tingling

(these subside with no long-term effects)
Most frequently used medication to prevent platelet aggregation
Aspirin
Other medications beside aspirin that prevent platelet aggregation?
Ticlid
Plavix
Persantine
Person is describing the "worst headache of their life," as the nurse you suspect?
Subarachnoid hemorrhage
What is Retivase?
Eats clot
What should you know prior to administering Retivase?
Must be given within 3 hours
Must do CT scan to rule out hemorrhage
Cannot do surgery or start IV for 48hrs
Symptoms of right brain stroke?
Paralyzed left side
Spatial-perceptual
Denial
Impulsive
Decrease attention span
Time
Symptoms of left brain stroke?
Paralyzed right side
Impaired speech
Slow movements
Aware of defecits, depression and anxiety
What medication do you give for low ANC
Aranesp- growth colony stimulating hormone
Nursing management Wilm's tumor?
Don't palpate abdomen
Strict I & O
NG tube
Dressing Post-op
How do you calculate ANC?
(Neutrophils + Bands) X WBC X 10
How do you calculate BSA?
CM X KG / 3600, then take square root
Nuraing management for Parkinson?
Promote independence
Rock to unfreeze, imagine stepping over line
Concerns for ALS?
Aspiration pneumonia
Fear going to whither away
TNM?
T umor size
N odes (spread to lymph)
M etastisis