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Nur 114 Test 2 flash cards
n/a
105
Nursing
Undergraduate 2
02/26/2012

Additional Nursing Flashcards

 


 

Cards

Term

 

 

 

 

Oxcarbazepine

Definition

 

 

 

iminostilbene - antiepileptic

partial and secondary generalized seizures

most common adverse effects = headache, dizziness and nausea

Term

 

 

 

phenobarbital

Definition

bartbiturate - antiepileptic

schedule IV controlled substance

widely used for status epilepticus

control of febrile seizures

less commonly used for prevention 

most common adverse effect = sedation

once-a-day dosing

Term

 

 

phenytoin (Dilantin)

Definition

Hydantoin

used as 1st line antiepileptic drug for many years

tonic-clonic and partial seizures

most common adverse effects = lethargy, abnormal movements, mental confusion and cognitive changes

Term

 

 

valproic acid

Definition

unspecified antiepileptic

generalized seizures (absence, myoclonic and tonic-clonic)

most common adverse effects - drowsiness, nauses, vomiting, tremor, weight gain and transient hair loss

Term

 

 

Carbamazepine

Definition

iminostilbene - antiepileptic

2nd most prescribed

1st line treatment for partial and generalized tonic-clonic seizures

may worse myoclonic or absense seizures

Term

 

 

ethosuximide

Definition

succinimide - antiepileptic

uncomplicated absense seizures

Most common adverse effects = GI and CNS effects

Term

 

 

gabapentin (Neurontin)

Definition

Miscellaneous antiepileptic

adjunct treatment of partial seizures and prophylaxis of partial seizures

CNS and GI symptoms

most commonly used for neuropathic pain

Term

 

 

pregabalin

Definition

micellaneous antiepileptic

adjunct thearpy for partial seizures

most commonly used for neuropathic pain

CNS effects

Term

 

 

lamotrigine

Definition

micellaneous antiepileptic

adjunct therapy for partial seizures with or w/o secondary generalization

CNS effects

Term

 

 

tiagabine

Definition

 

micellaneous antiepileptic

adjunct therapy for partial seizures

CNS and GI symptoms

Term

 

 

warm phase of peripheral nerve trauma

Definition

 

 

extremity is warm and skin appears flushed or rosy

Term

 

 

cold phase of peripheral nerve trauma

Definition

 

 

after 2-3 weeks the skin appears cyanotic, mottled, or reddish-blue, feels cool compared to unaffected extremity 

Term

 

 

2 classifications of drugs that tend to dry the eye and increase IOP

Definition

 

 

Antihistimines and decongestants

Term

 

 

exophthalmos

Definition

 

 

protrusion of the eye

Term

 

 

enophthalmos

Definition

 

 

sunken appearance of the eye

Term

 

 

consensual response

Definition

 

 

constriction of both pupils when light is shown into just one eye

Term

 

 

hyperopia

Definition

 

 

farsightedness

refractive error

light focues behiind the retina

Term

 

 

myopia

Definition

 

 

nearsightedness

refractive error

light focuses in front of the retina

Term

 

 

presbyopia

Definition

 

 

impaired near vision in middle aged and older adults

loss of elasticity of the lens

Term

 

 

retinopathy

Definition

 

 

non-inflammatory eye disorder

leading cause of blindness

Term

 

 

strabismus

Definition

 

 

both eyes do not focus simultaneously

eyes appear crossed

Term

 

 

Cataract

Definition

 

 

increased opacity of the lens

most common eye disorder

Term

 

 

glaucoma

Definition

 

 

intraocular structural damage resulting from increased IOP

Term

 

 

Macular Degeneration

Definition

 

 

blurred central vision 

progressive degeneration of the center of the retina

Term

 

 

PERRLA

Definition

 

 

Pupils equal, round, reactive to light and accomodation 

Term

 

 

Epilepsy

Definition

 

 

2 or more unprovoked seizures 

Term

 

 

acute symptomatic seizures

Definition

 

 

acute injury

i.e., head trauma or menigitis 

Term

 

 

remote symptomatic seizures

Definition

 

 

without an immediate cause, but with an identifiable prior brain injury

i.e., hypoxia, stroke etc.

Term

 

 

cryptogenic seizures

Definition

 

 

no clear cause

Term

 

 

idiopathic seizures

Definition

 

 

genetic in origin

Term

 

 

partial seizures

Definition

 

 

simple or complex

Term

 

 

simple partial seizures

Definition

 

 

remain conscious 

Aura

can involve just one extremity 

Term

 

 

complex partial seizure

Definition

 

 

loss of consciouness 1-3 min

will not remember the seizure

may begin with an Aura

may have automatisms 

Term

 

 

Primary seizure

Definition

 

 

no underlying cause

Term

 

 

secondary seizure

Definition

 

 

has underlying cause and you should treat the underlying cause

Term

 

 

febrile seizure

Definition

typically occurs in infants and small children

lasts seconds to minutes

temp usually greater than 102 

usually occurs on 1st day of fever

Term

 

 

pseudo seizure

Definition

 

 

always takes place in public 

acting out related to stress/anxiety

attention seeking behavior

Term

 

 

status epilepticus 

Definition

medical emergency

 

longer than 5 min. or repeated seizures over a course of 30 minutes

Term

 

 

types of genrealized seizures

Definition

 

tonic-clonic

tonic

clonic

absense

atonic

myoclonic

Term

 

 

characteristics of generalized seizures

Definition

 

Loss of consciousness

impairment of motor funciton

no Aura

occur at anytime

interval between them = min, hours, weeks or even years

Term

 

 

Tonic - clonic seizure

Definition

 

most dramatic

tonic phase - eyes roll up, loss of consciouness, fall if standing, 10-30 seconds, stiffness 

clonic phase - intense jerking, 30-50 seconds

no recollection of the event

Term

 

 

absence seizures

Definition

 

 

sudden onset

brief loss of consciousness

blank stare

automatisms

usually 20+ events daily

last 5-10 seconds

will not remember event

Term

 

 

atonic seizures

Definition

 

sudden, momentary loss of muscle tone

severe episodes = falls to ground face first

Term

 

 

myoclonic seizures

 

Definition

 

sudden, brief contractions of a muscle or group of muscles

may occur singly or repeatively 

Term

 

 

tonic seizures

Definition

 

sudden onset of increased tone

falls if standing

average duration = 10 seconds

Term

 

 

clonic seizures

Definition

 

loss of consciouness 

decreased tone followed by jerking movements

1-several minutes

Term

 

 

most useful tool for evaluating a seizure disorder

Definition

 

 

EEG

Term

 

 

refractory seizures

Definition

 

the persistence of seizures despite adquate trials of 3 antiepileptic meds alone or in combination 

Term

 

 

1st line drug of choice for in-hospital management of status epilepticus

Definition

 

 

IV diazepam or larazepam (Ativan)

Term

 

 

2 vitamins that need to be taken with pehnobartbial or pheytoin 

Definition

 

Vitamin D and Folic acid

Term

 

 

seizure precautions

Definition

 

safety first

airway

suction equipment

oxygen

IV access

siderails up

Term

 

 

# 1 nursing diagnosis for seizures

Definition

 

 

risk for injury

Term

 

 

treatment of peripheral neuropathy

Definition

 

 

treat the underlying cause

Term

 

 

clinical manifestations of peripheral neuropathy

Definition

Motor = muscle weakness

Sensory = loss of sense of touch

"stocking glove effect"

paresthesias, aching, burning, shooting pain, "cold feet"

Term

 

 

Nursing interventions are focused on ____(3)_____ for cognitive disorders

Definition

protecting pt. dignity 

preserving functional status

promoting well being

Term

 

 

3 main cognitive disorders

Definition

 

 

delirium

dementia

amnestic disorder (don't learn about yet)

Term

 

 

delirium 

Definition

 

 

distrubance of consciousness and a change in cognition that develop over a short period of time

Term

 

4 cardinal features of delirium

Definition

 

 

acute onset and fluctuating course

inattention

disorganized thinking

distrubance of consciousness

Term

 

 

Order of loss of orientation in delirium

Definition

 

 

time --> place --> person

Term

 

 

illusions

Definition

 

 

errors in perception of sensory stimuli

 

can be explained to pt. 

Term

 

 

hallucinations

Definition

 

 

false sensory stimuli

 

cannot be explained to pt.

Term

 

 

autonomic signs seen in delirium

Definition

 

 

tachycardia, sweating, flushed face, dilated pupils and elevated blood pressure

Term

 

 

# 1 nursing diagnosis for delirium 

Definition

 

Risk for Injury

 

SAFETY!!!

 

(fear is another common one)

Term

 

 

overall outcome for pt. with delirium 

Definition

 

 

that pt. will return to the premorbid level of functioning 

Term

 

 

dementia 

Definition

 

 

progressive deterioration of cognitive functioning and global impairment of intellect w/ no change in consciousness

 

AD = #1 dementia 

Term

 

 

primary dementia 

Definition

 

 

irreverisble 

progressive

not secondary to any other disorder

Term

 

 

secondary dementia

Definition

 

 

occurs as a result of some other pathological process

Term

 

 

ocular dexter

Definition

 

 

right eye

Term

 

 

Ocular sinister

Definition

 

 

Left eye

Term

 

 

ocular uterque

Definition

 

 

both eyes

Term

 

 

 

emmetropia 

Definition

 

 

 

perfect retraction of the eye

Term

 

 

miosis 

Definition

 

 

papillary constriction

Term

 

 

Mydraisis

 

Definition

 

 

papillary dilation 

Term

 

 

age related functional changes of the eye

Definition

 

lens yellows

accomodation gradually lost

near point increases

far point decreases

color perception decreases

IOP increases <-- hint hint

Term

 

 

Dry macular degeneration 

Definition

 

ischemic/blocked retinal capillaries

most common

diabetics 

Term

 

 

wet macular degeneration 

Definition

 

 

increased growth of capillaries that leak

Term

 

 

nursing concerns for pt's with visual impairments 

Definition

 

# 1 = safety

 

How well are they functioning?

 

Change in ADLs?

Term

 

 

Most common type of hallucinations

Definition

 

 

auditory 

Term

 

 

The four A's of schizophrenia

Definition

 

 

affect - expressions

associative looseness

autism - has a world that is the pt's (it is real to them)

ambivalence - cannot decide one way or the other

Term

 

 

positive symptoms of schizophrenia

Definition

 

 

hallucinations

delusions

neologism - made up words

associative looseness

Term

 

 

Negative symptoms of schizophrenia

Definition

 

 

apathy

lack of motivation

anhedonia - no pleasure

poor though processes

Term

 

 

3 phases of schizophrenia

Definition

 

 

1. Acute - hospital setting

2. stabilization - group home, half-way house or nursing home

3. maintenance - prevents relapse

Term

 

 

types of delusions

Definition

control

ideas of reference

persecution

grandeur

somatic

erotomatic

jealousy

Term

 

 

anticonvulsants

Definition

 

 

prevent or reduce the severity of epileptic or other convulsive seizures

Term

 

 

antiepileptic drugs

Definition

 

 

prevent or reduce the severity of epilepsy and different types of epileptic seizures, not just convulsive seizures

Term

 

 

3 classes of antiepileptic drugs

Definition

 

barbiturates

hydantoins

iminostibenes

 

( and valproic acid )

Term

 

 

3 major pharmacologic effects of antiepileptics 

Definition

 

increase threshold of activity in the motor cortex

 

acts to limit spread of a seizure discharge from its origin

 

decrease the speed of a nerve impulse within a given neuron 

Term

 

 

commmon causes of status epilepticus 

Definition

 

sudden withdrawal from antiepileptic drugs

infections

acute alcohol or drug withdrawal

head trauma

cerebral edema

metabolic disturbances

 

Term

 

 

apraxia 

Definition

 

 

 

inability to use objects correctly

Term

 

 

aphasia 

Definition

 

 

inability to speak or understand language

Term

 

 

anomia 

Definition

 

 

 

inability to find words

Term

 

 

agnosia 

Definition

 

 

loss of sensory comprehension 

Term

 

 

traumatic relocation syndrome 

Definition

 

 

over-reaction to any change by becomign excessively aggressive or abusive 

Term

 

 

reality orientation 

Definition

 

 

appropriate for early AD or dementia 

Term

 

 

validation therapy 

Definition

 

 

appropriate for moderate to severe AD or dementia

 

-staff member recognizes and acknowledges the pt's feelings and concerns

Term

 

 

Raise the Siderails???

 

yes/no for Dementia ???

 

yes/no for seizures???

Definition

 

AD or dementia = no

 

Seizures = yes

Term

 

 

Pharmacodynamics 

Definition

 

 

Biochemical and physiological effects of drugs on the body, which include the mechanisms of drug action and it's effect

Term

 

 

Pharmacokinetics

Definition

 

 

the actions of the body on the drug

Term

 

 

communication 

Definition

 

 

an interactive process between 2 or more people who send and recieve messages to one another

Term

 

 

2 main principles that can guid the communication process during nurse-patient interview

Definition

 

 

clarity and continuity 

Term

 

 

Therapeutic communication techniques

 

Definition

 

Using silence

active listening

listening with empathy

clarifying techniques

asking open and closed ended questions that elicit a patient response

Term

 

 

clarifying techniques 

Definition

 

 

paraphrasing

re-stating

reflecting

exploring

Term

 

 

non-therapeutic communication techniques

 

Definition

 

 

giving pre-mature advice

minimizing feelings

falsely reassuring

making value judgments

asking excessive questions

giving approval, agreeing

disapproving, disagreeing

changing the subject

Term

 

 

attending behaviors

Definition

 

eye contact - culturally influenced

body language

intimate - 0-18 in.

personal - 18-40 in.

social - 4-12 ft.

public - 12 ft. or more

vocal quality

verbal tracking

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