Scc Basic-Med Surg Exam 4

Front 1

def. of seizures

Back 1

an abnormal, sudden, excessive, uncontrolled electrical discharge of neurons w/n the brain that may result in alteration in consciousness, motor, or sensory ability & or behavior

Front 2

def. epilepsy

Back 2

chronic disorder of recurrent, unprovoked seizure activity

Front 3

def. status epilepticus

Back 3

prolonged seizure, lasting more than 5 min or repeated seizures lasting over 30 min

Front 4

medication for status epilepticus

Back 4

valium (preferred)
or
Ativan

Front 5

pt care during status epilepticus

Back 5

*airway management (most important)
-establish an iv access
-protect from injury (guide pt's movements if necessary)
-admin meds (IV)-ativan or valium

Front 6

meds for tonic-clonic seizures

Back 6

Depakene, Tegretol, Dilantin

Front 7

meds for absence seizures

Back 7

Depakene

Front 8

meds for myoclonic seizures

Back 8

Depakene

Front 9

meds for complex partial seizures

Back 9

Dilantin

Front 10

meds for partial seizures

Back 10

tegretol

Front 11

how long does a tonic-clonic seizure last

Back 11

2-5 min

Front 12

tonic-clonic seizures starts with ____ reflexes, then loss of consciousness, then ____ follows with jerking of extremities

Back 12

tonic
clonic

Front 13

after a tonic seizure the pt will seem...

Back 13

fatigued, confused, lethargic

Front 14

Absence seizures are more common in children or adults?

Back 14

children

Front 15

What is the best way to get a child experiencing an absence seizure back on track?

Back 15

best to talk to them

Front 16

describe myoclonic seizures

Back 16

-stiffening of extremities that lasts for a very brief time (seconds)

Front 17

describe a atonic seizure

Back 17

sudden loss of muscle tone (seconds, followed by after seizure confusion)

Front 18

it is important to have pts that experience atonic seizures on ____ prevention.

Back 18

Fall Prevention due to the sudden loss of muscle tone that occurs with these seizures

Front 19

Partial seizures and evolve into what other types of seizuures?

Back 19

Generalized tonic-clonic, tonic or clonic seizures

Front 20

Partial seizures are most often seen in children or adults?

Back 20

Adults
-and generally less responsive to medical treatment

Front 21

describe Complex Seizures

Back 21

-loss of consciousness for a few minutes "black out"
-automatisms develop- picking at clothes, lip smacking
-amnesia postictal

Front 22

most seizures are which type of seizures?

Back 22

unclassified (50%)

Front 23

Diagnostic test for seizures

Back 23

EEG, CT, MRI, PET, and blood work (to determine if the seizure is due to an electrolyte imbalance or metabolic in nature)

Front 24

describe simple partial seizures

Back 24

-no loss of consciousness, pts also often report an aura
-may have unilateral movement
-may have psychic or autonomic symptoms (increased HR, RR, BP and flushed face)

Front 25

Some Seizure Causes

Back 25

-unknown 50%
-brain lesions/trauma
-alcohol w/drawal
-electrolyte imbalances
-heart disease
-genes - w/ Absence seizures

Front 26

decsribe the Nursing assessment during a seizure

Back 26

*key is to observe
-date/time/duration
-description of seizure
-where did it begin/how long did it progress
-description during seizure
-was there and aura?
-how was pt post seizure?
-how long b4 pt returned to normal

Front 27

what are seizure precautions during a seizure

Back 27

-"protect client", but don't restrain, guide movements if necessary
-turn pt to side if possible to avoid aspiration
-do not force anything into their mouth once seizure has started
-have airway equipment/ suctioning ready
-insert IV saline lock to pt susceptible to seizures if IV med must be given to stop the seizure
-keep bed in lowest position
-@ completion:
take VS, preform neuro check, keep pt on his/her side, allow pt to rest, document

Front 28

A pt taking tegretol should not drink ____?

Back 28

grapefruit juice

Front 29

a pt on valium or ativan should be monitored for what?

Back 29

respiratory
depression/hypotension

Front 30

Ativan should not be taken while ___?

Back 30

pregnant

Front 31

What should you do when admining Dilantin via IV?

Back 31

Should flush IV line w/ NS b4 and after admin, b/c it percipitates out

Front 32

What does Dilantin cause in pts

Back 32

causes gingival hyperplasia- encourage good dental visits, and daily oral hygiene

Front 33

information related to Depakene

Back 33

-can't be given w/ any other meds
-monitor for bruising related to liver toxicity

Front 34

Med things in common for seizure drugs

Back 34

-pt should wear a medication alert bracelet
-must continue taking med even if seizures have stopped
-when given IV all have a rate not to exceed
-may interact with other meds, including OTC
-all have therapeutic blood levels which should be monitored
-failure to take meds properly may be a reason for breakthrough seizures

Front 35

MS
the highest rate of incidence occurs between what age groups?

Back 35

20-40 yrs old

Front 36

describe MS

Back 36

MS in an inflammatory disorder of the NS causing scattered, patchy demyelinization of the CNS, nerve impulses being either blocked or slowed

Front 37

MS is characterized by periods of ________ and _______?

Back 37

remission and exacerbations

Front 38

etiology of MS

Back 38

unknown cause, although viruses have been suggested

Front 39

Assessment data of :
early S/S
late S/S
even later S/S

Back 39

Early:
*visual disturbances (usually an early diagnostic tool)
-weakness/numbness

Later:
-nystagmus
-disorders of speech
-urinary frequency/urgency
-change in muscle coordination and gait

Even later:
-urinary incontinence
-difficulty swallowing
-cognitive changes
-severe muscle spasms and contractures

Front 40

which type of meds are used for treating acute MS exascrbatios

Back 40

steroids

Front 41

known causes of exacerbations

Back 41

-fatigue
-excessive exertion
-stress
-infections
-pregnancy
-overheating
-excessive chilling

Front 42

Which type of drugs are used to stop the progression of MS

Back 42

immunosuppressive drugs

Front 43

what are the Diagnostic test for MS?

Back 43

MRI (definitive) -demonstrated the presence of plaques
CT- too

Front 44

etiology of Parkinson's disease

Back 44

unkown

Front 45

Classic symptoms of Parkinson's

Back 45

T.R.A.P.

-tremors, rigidity, akinesis, postural instability

Front 46

Pathophysiology of Parkinson's

Back 46

there is a depletion of dopamine, which causes pts not to have control of voluntary movement and posture

Front 47

Diagnostic test for Parkinson's

Back 47

none specific
-diagnosis is based on pts symptoms and history

Front 48

what are the drugs used for the drug therapy of Parkinson's

Back 48

Levodopa
-used later when ADL's are impaired

Dopamine Agonists-Parlodel
-most effective during the 1st 3-5 yrs
-associated w/ less problems w/ dyskinesias and "wearing off phenomenon"
- side effects- N, postural hypotension, hallucinations,
and drowsiness

Front 49

etiology of Myastenia Graves

Back 49

unknown

Front 50

describe Myastenia Graves

Back 50

-an autoimmune disorder where the nerve impluses fail to pass to the muscle @ the myoneural junction. This is manifested by weakness in the skeletal muscles. The weakness in the muscles increases as they are used and recover fairly rapily with rest.

Front 51

Myastenia Graves is characterized by ________ and _______, _____ and ______?

Back 51

remissions and flare ups, fatigue and weakness

Front 52

describe myastheia crisis

Back 52

acute excerbation of disease (Myastenia Graves) where breathing/ swallowing become life threatening

Front 53

describe chliergic crisis

Back 53

a toxic response to med (Tensilon) where respiratory failure may develop

Front 54

if pt gets worst during tensilon testing they are having a cholinergic reaction which may require ___ as an antidote

Back 54

atropine sulfate

Front 55

decribe the tensilon test

Back 55

md estimates strength of muscle, then the placebe challenege is done first to determine if pt's symptoms may be psychological /emotionaly related. then the tensilon is admined,if the pt has increased muscle tone its considered a positive result

Front 56

are Guillian-Barre cases typical?

Back 56

yes. the syndrome is characterized by a rapidly progessing symmetrical ascending flaccid paralysis usually following a viral illness. Recovery is usually complete; however, it can take months to years if there is extensive involvment

Front 57

with guillian-barre what is a potentially fatal respiratory dysfuntion?

Back 57

when the diaphragm becomes paralyzed

Front 58

what are the nutritional needs of a pt with guillian-barre?

Back 58

strict NPO when paralyzation effects the ability to swallow. pt will then have a feeding tube in palce.

Front 59

what are four complications of guillian-barre ?

Back 59

-thrombophlebitis
-muscle atrophy
-contractue
-GI hemorrhage

Front 60

describe amenorrhea

Back 60

absence of menstration

Front 61

describe primary amenorrhea

Back 61

-no period by age 16
-associated w/ problems of the reproductive tract/fertility

Front 62

describe secondary amenorrhea

Back 62

absence of menses for more than 3 months in a woman who has had normal menstruation

Front 63

what may secondary amenorrhea be due to

Back 63

stress, excessive exercise, anorexia

Front 64

postmenopausal bleeding could be caused by a _____ fo medical evaluation is important.

Back 64

malignancy

Front 65

describe endometriosis

Back 65

condiditon in which endometrial cells that normally line the uterus are seeded throughout the pelvis

Front 66

cause of endometriosis

Back 66

unknown

Front 67

what are the menopause S/S

Back 67

-*hot flashes
-*mood swings
-vaginal dryness
-decreased libido

Front 68

TSS classic S/S

Back 68

-palmar or diffuse erythrodermal
-sunburn-like rash on face

Front 69

diagnosis of TSS

Back 69

throguh cultures of staph aureus

Front 70

interventions for TSS

Back 70

-antibiotic therapy
-removal/discontinuation of tampon use
-seek immediate treatment

Front 71

pt education of TSS

Back 71

-wash hands b4 admin of tampon
-do not use tampon if dirty
-be careful when inserting the tampon
-change tampons every 3-6 hours
-do not use super absorbent tampons
-use a sanitary pad @ night

Front 72

describe a hydrocele

Back 72

-a fluid filled cysts that forms around the tresties usually due to a lymphatic drainage problem

Front 73

describe a Varicocele

Back 73

dilated veins above and behind the testies

Front 74

describe scrotal torsion

Back 74

twisting of the spermatic cord occuring most often during puberty

Front 75

S/S of scrotal torsion

Back 75

*pain* unrelieved by scrotal elevation
-blood in the semen
-lower abdominal pain
-red swollen testicle(s)

Front 76

what is used to dx
scrotal torsion

Back 76

a doppler ultrasound which shows decreased blood flow to the testicle

Front 77

decribe priapism

Back 77

an uncontrolled, long maintained erection w/o sexual desire
- this is a urologic emergencydue to in ability to void and decreased blood flow to penis

Front 78

decribe urethritis

Back 78

-often caused by chlamydia, candida and /or herpes
-man c/o urgency, frequency, and buring on urination
-also may have purulent urethral discharge

Front 79

decribe prostatitis

Back 79

inflammation of the prostate gland usually due to an infection of the lower urinary tract

Front 80

treatment of prostatitis

Back 80

-antibiotics for 30 days
-forcing fluids
-rest
-stool softeners
-application of sitz bath

Front 81

decribe epididymitis

Back 81

-frequent complication of gonorrhea
-may follow prostatectomy or prolonged catheterization
-untreated can lead to septocemia

Front 82

s/s of epididymitis

Back 82

-severe tenderness and pain
-sewlling of the scrotum
-hot to the touch

Front 83

what is used to maintain immobilization of a fracture?

Back 83

casts and traction

Front 84

what are 2 types of traction

Back 84

skin traction- adhesive directly on skin and attached to weights
skeletal traction- traction applied by placing a wire in the bone

Front 85

describe Buck's extension (boot)

Back 85

Simplest form of skin traction. Usually used to relieve muscle spasms and to immobilize a limb temporarily (usually after a hip fracture)

Front 86

Things to asses for while pts is in traction

Back 86

-pressure arease
-knots on the pulley
-sliding up and slidind down
-pin care-perform daily, small amount of clear fluid drainage "weeping" is expected

Front 87

what is a common site of ligament injuries____,
and what is a common site of tendon junjuries____?

Back 87

knee and achilles tendon

Front 88

amputations:
an open amputation is used if the pt is likely to have a ___?

Back 88

infection

Front 89

IV calcitonin is shown to ___ the pain associated w/ phantom limb pain.

Back 89

reduce pain

Front 90

which 2 groups of pts are at risk for amputations?

Back 90

-diabetics, especially those who smoke
-young men involved in motorcycle, MVA, industrial accidents

Front 91

for a pt undergoing an electromyography it is important to tell the pt they will experience____?

Back 91

mild to moderate discomfort

Front 92

acute stage of osteomyelitis s/s

Back 92

*bone pain common
-fever
-swelling/tenderness @ site
-erythema/warmth

Front 93

chronic stage of osteomyelitis s/s

Back 93

-poor circulation
-draining ulcers

Front 94

for osteomyelitis which diagnostic test is definitive?

Back 94

A bone biopsy

Front 95

a pt with osteomyelitis is on what type of precautions?

Back 95

contact precautions

Front 96

define pelvic inflammatory disease

Back 96

an infectious process involving the fallopian tubes and ovaries, pelvic peritoneum, pelvic veins, or pelvic connective tissue

Front 97

what does PID do in the body if untreated

Back 97

-purulent material collects inm the tubes
-adhesions form
-strictures may occur
-obstruction of the fallopian tubes
-sterility is a frequent result
-women at risk for ectopic pregnancy

Front 98

S/S of acute PID

Back 98

-*severe abdominal pain (usually what brings person in), pressure, and fullness
-lower abdominal cramps
-Intermenstrural spotting
-Fever, chills
-Malaise
-N/V

Front 99

S/S of chronic PID

Back 99

-chronic dull. aching pain in lower abdomen
-constipation
-low grade fever
-disturbances of menstration
-may have periods of exacerbation

Front 100

interventions for PID

Back 100

antibiotics, bed rest, heat, salpingectomy in advances disease

Front 101

define conductive hearing loss

Back 101

occurs due something physically blocking the sound wave transmission

Front 102

define sensorineural

Back 102

occurs due to a defect in the cochlea, the 8th cranial nerve or the brain (hearing loss from loud noises)

Front 103

define mixed conductive hearing loss

Back 103

sensorineural hearing loss-profound hearing loss

Front 104

define a voice test

Back 104

stand approximately 1 to 2 feet away and whisper a sentence. Have the person repeat it back to you. test 1 ear @ a time

Front 105

define external otitis

Back 105

"swimmer's ear"
-a painful sondition caused by irritating or infective agents coming in contact with the external ear

Front 106

treatment of external otitis (swimmer's ear)

Back 106

-topical antibiotics
-heat
-steroids
-analgesics

Front 107

describe acute otitis media

Back 107

ear infection that happens suddenly and is of short duration

Front 108

describe chronic otitis media

Back 108

ear infection that ossurs as a result of acute otitis media and leasts longer
-causes more hearing loss/pt @ greater risk

Front 109

treatment of otitis media (ear infections)

Back 109

medical-antibiotics, analgesics, antihistamines, decongestants

surgery- myringotomy-opening created in the eardrum which relieves the pressure. May have a tube put in place to allow drainage

Front 110

describe Mastoditis and what is used to treat it?

Back 110

- an infection of the mastoid air cells due to otitis media

-treated with antibiotics

Front 111

describe Meniere's disease, and what are it's 3 classic signs?

Back 111

-a chronic disorder of the inner ear that is characterized by tinnitus, on sided sensorineural hearing loss, and vertigo

Front 112

surgery for Meniere's disease

Back 112

labyrinthestomy-removal of the labyrinth- a last resort

Front 113

medical treatment of Meniere's disease

Back 113

-restriction if salt and fluids
-diuretic therapy