Shared Flashcard Set

Details

Med Surg 3
MSIII
198
Nursing
Undergraduate 4
04/03/2011

Additional Nursing Flashcards

 


 

Cards

Term
Acute and Chronic Gastritis
Definition

Acute – inflammation of the stomach mucosa lasting several hours to a few days

Chronic – prolonged inflammation of the stomach that may be caused by benign or malignant gastric ulcers or bacterial infection, H. Pylori Confirming Diagnostic Procedure - Endoscopy

Term
Contributing factors
Definition

Acute: Diet, ETOH, Aspirin,

NSAIDS, Bile reflux, Radiation therapy, Strong acid/alkalie solutions

 

 

 

 

Chronic: Bacteria, Ulcers, Autoimmune disorders, GERD, Smoking/ETOH disuse, Drugs, Hot Drinks

Term
Clinical Manifestations
Definition

Acute:

Abdominal discomfort; headache; N/V; hiccuping

Ulceration can lead to hemorrhage

Colic and diarrhea

Recovery 1 – 2 days

 

Chronic:

Anorexia; belching; ‘sour’ taste in mouth; N/V

Heartburn after eating, Symptoms of Vitamin B12 deficiency

Term
Medical Management: Acute Gastritis
Definition
  • Refrain from ETOH and irritating foods until symptoms subside
  • IV fluids therapy if symptoms persist [minimum of 1.5
  • liters/day]
  • Bleeding/Hemorrhage; Emergency surgery and gastric resection
  • If mucosal corrosion is severe, avoid emetics and gastric lavage
  • Use of N/G intubation, analgesics and sedatives
  • For ingestion of strong acid/alkalie products
  • Neutralize acids with common antacids, e.g., aluminum hydroxide
  • Neuralize alkalies with lemon juice or diluted vinegar
Term
Medical Managment: Chronic Gastritis
Definition

  • Diet modification
  • Rest
  • Stress reduction therapies
  • Pharmacotherpy
  • H. pylori - Amoxicillin
  • Assess electrolyte values q24 for fluid imbalance
  • Use of Aloe vera

Term
Nursing Care Management
Definition

  • Physical and emotional support
  • Avoid po foods/fluids for hours or days until symptoms subside
  • IV therapy and monitoring daily lab data
  • Offer ice chips and clear fluids PRN
  • Encourage client to discuss illness meaning

Term
Nursing Care managment
Definition

Physical and emotional support

Avoid po foods/fluids for hours or days until symptoms subside

IV therapy and monitoring daily lab data

Offer ice chips and clear fluids PRN

Encourage client to discuss illness meaning

Term
Nursing Care Managment
Definition

  • Encourage reduction of caffeinated beverages [as caffeine increases pepsin secretion]
  • Encourage strategies to reduce smoking [as nicotine inhibits the ability of the duodenum to neutralize gastric acid]
  • ETOH counseling/smoking cessation classes as appropriate

Term
Nursing Care Managment
Definition

  • Observe for hemorrhagic gastritis, i.e., increase in hematemesis, tachycardia, hypotension, anxiety and feelings of ‘impending doom’
  • Address knowledge deficit regarding foods, patterns of eating, substances to avoid, educating about prescribed drugs, and the need for long-term vitamin B12 injections

Term
Peptic Ulcer Disease
Definition

  • Peptic Ulcer – a deep excavation or erosion formed in the mucosal wall of the stomach, pylorus, duodenum or esophagus
  • More common in the duodenum but do occur often in the lesser curvature of the stomach
  • Often associated with H. pylori infection [70% - 95% of clients with gastric and duodenal ulcers]
  • Age – 40 to 60
  • More common in men

Term
PUD-predisposing factors
Definition

  • Family history
  • Blood type – more common in folks with Type O
  • Chronic use of NSAIDS
  • ETOH abuse
  • Smoking
  • Stress

Term
PUD Types
Definition

  • Zollinger-Ellison Syndrome [gastrinoma]
  • Severe peptic ulcer disease often resistant to standard medical therapy
  • Extreme gastric hyperacidity [hyper-secretion of gastric juice]; duodenal ulcer, gastrinoma, islet-cell tumors and pancreatic cancer [which are gastrin-secreting organs]
  • 90% of tumors are located in the gastric triangle
  • Most tumors are classified as malignant
  • Diarrhea and Seatorrhea are often present
  • Most frequent complaint is epigastric pain

Term
PUD Types: Curling's Ulcer
Definition

  • Curling’s ulcer [Stress ulcer]
  • Acute mucosal lining ulceration in stomach or duodenum due to physiologic stressful events
  • Burn victims and shock can be predisposing factors
  • Often found in ventilator-dependent and posttraumatic or surgical clients

Term
PUD-Diagnosis
Definition

  • Confirmed subjectively by client symptoms:
  • dull, gnawing pain in the mid-epigastrum or radiating pain to the back
  • Pain is relieved by eating or consuming alkali substances
  • sharply localized tenderness elicited with gentle palpation of the epigastric area
  • Pyrosis [heartburn] and eructation
  • Bleeding described in 25% of all cases

Term
PUD-Diagnosis
Definition

Confirmed objectively by:

  • Endoscopy
  • Hemoccult or Guaiac
  • Biopsy and histology of culture taken during endoscopic procedure

Term

 

Biomedical managment-PUD

Definition

  • Biofeedback, hypnosis, and behavioral modification therapies
  • Small frequent meals with histamine-blocking agents
  • Reducing the intake of caffeine and ETOH
  • Reduce diets rich in milk and cream
  • Smoking cessation
  •   Nicotine increases acid production in the duodenum
  •   Smoking impairs ulcer repair

Term
PUD=Pharm Therapy
Definition
  • The use of antibiotics to suppress H. pylori [Amoxcillan]
  • The use of H2 – receptor antagonists and proton pump inhibitors [Pepcid, Nexium]
  • The use of antacids in combination with cimetidine [Tagamet] or ranitidine [Zantac]
  • The use of anticholinergic agents, i.e. Setrol [Daricon]

 

Term
PUD-Surgical Interventions for Gastric Ulcers
Definition

Vagotomy - was once popular as a way of treating and preventing PUD and subsequent ulcerative perforations

a way to reduce the acidity of the stomach by denervating peptic cells that produce acid

 

 

Billroth I - an operation in which the pylorus is removed involving anastomosis of the distal stomach directly to the duodenum

 

 

Billroth II - an operation in which the lower part of the stomach (antrum) is removed and a loop of small bowel (jejunum) is brought up and joined to it in for drainage (gastrojejunostomy)

Term
PUD Nursing Diagnosis
Definition

  • Pain related to the effect of gastric acid secretion on damaged tissue
  • Anxiety related to coping with acute illness
  • Knowledge deficit about prevention of symptoms and life changing events

Term
PUD-Nursing care managment
Definition

  • Assess family history
  • Assess for malnutrition and weight loss [includes evaluating lab data]
  • Bowel sounds q4 hours
  • NG tube placement [Levine or Salem-Sump] for gastric decompression
  • Assess for occult blood in stools
  • Assess psychosocial and nutritional concerns [Dumping Syndrome]

Term
PUD=Nursing Care management
Definition

  • Assess client for hemorrhage, perforation and obstruction
  • Pain medications as ordered
  • Assess for hypotension
  • Assess environment
  • Monitor I/O
  • IV therapy
  • Use of anti-emetics and H2 antagonists

Term
Gastric (stomach Cancer)
Definition

  • Develops in any part of the stomach and may spread throughout the stomach and to other organs; particularly the esophagus, lungs, lymph nodes, and the liver
  • Causes about 850,000 deaths worldwide per year
  • Occurs in most folks older than 40
  • Greater incidence in Japan [perhaps due to a larger dietary consumption of smoked meats, nitrates and a diet that may be lacking in vegetables and fruit]

Term
Gastric Cancer: s/sx and diagnosis
Definition

Early stages:

Symptoms may be absent or similar to those with benign ulcers that are relieved with antacids

Progressive stages:

Indigestion, anorexia, dyspepsia [lasting over 3-4 weeks], weight loss, abdominal pain [usually a late sign], constipation, anemia, N/V and ascites [indicating liver metastasis] – prognosis poor

Diagnosis:

Radiographic with UGI barium swallow

CT , liver and bone scan [may evidence metastatic disease]

Term
Medical Managment: Gastric Cancer
Definition

  • Surgical removal; prognosis good if the tumor is still localized
  • Billroth I or Billroth II with possible total gastrectomy and anastomosis of the esophagus and jejunum
  • Palliative chemotherapy, i.e., 5-FU, Adriamycin, Mitomycin C
  • Radiation therapy
  • Tumor marker injection to determine effectiveness of ChemTx

Term
Nursing Care Managment: Gastric Cancer
Definition

  • Dietary history
  • Identify weight loss; assess appetite, eating habits
  • Pain assessement
  • Smoking history; ETOH intake
  • Family history
  • Psychosocial support, e.g. marital status, coping skill, emotional and financial resources
  • Complete physical exam

Term
Gastric Cancer nursing diagnosis
Definition

  • Anxiety related to . . .
  • Altered nutrition: less than body requirements related to . . .
  • Pain related to . . .
  • Anticipatory grieving related to . . .
  • Knowledge deficit related to . . .

Term
Gastric Cancer: promoting optimal nutrition
Definition

  • Small frequent meals
  • Non-irritating foods
  • High calorie diet with Vitamin A, C, and iron
  • Parenteral Vitamin B12
  • IV therapy
  • I/O and daily weights
  • Assess for signs of dehydration, e.g., thirst, decrease in urine output, poor skin turgor, tachycardia, dry mucous membranes
  • Lab data review
  • Anti-emetics PRN

Term
Upper gastric disorders and diet
Definition

  • Diet changes generally consist of 4 stages
  • Takes about 8 weeks to go through all 4
  • A return to eating many of the foods eaten in the past, but portion sizes must remain under control for best results

Term
Dietary changes following gastric surgery
Definition

 

 

 

 

Stage 1

- consists mainly of gelatins and clear liquids. Usually lasts 24-48 hours

 

Stage 2

- begins 24-48 hours following surgery and can last from 2 to 8 weeks. Consists mainly of such foods as baby food, low-sugar protein shakes and strained pureed foods.

 

Stage 3

- begins at 2 weeks or can wait as long as 8 weeks to begin this phase. Begins by adding soft foods back into the diet. Cottage cheese and eggs are examples of foods started first as they are high in protein content.

 

Stage 4

- after surgical healing, the client can eat almost anything except in smaller portions. Meats should be cut up into small pieces and softened with liquid.

 

Proceed with caution in advancing diet. Limit sugar and fat intake as these foods and their products cause discomfort and contribute dumping syndrome.

 

Term
Constipation
Definition

a condition of the digestive system in which a person experiences hard feces that is difficult to expel, related to:

the colon absorbing too much water from food due to the lack of water holding capacity of the contents of the bowels

food moving too slowly through the gi tract, the colon may absorb too much water, resulting in feces that are dry and hard

The process of defecation may be extremely painful, and in severe cases (fecal impaction) leads to symptoms of bowel obstruction

 

 

 

 

Obstipation is used for severe constipation that prevents passage of both stools and gas

Term
Constipation: causes
Definition

  • Age
  • Body mass
  • Dietary
  • Heredity, e.g., Hirschsprung’s disease
  • Medications, i.e. opiates vs laxatives
  • Heavy metals
  • Illness or disorder
  • Exercise

Term
Constipation manifestations and diagnosis
Definition

Abdominal distention

Borborygmus

Pain and pressure

Diagnosis:

 

History

 

 

 

 

 

Physical assessment

 

 

 

Barium enema*

 

 

 

Sigmoidoscopy

 

 

 

Stool for occult blood

 

 

 

Ano-rectal manometry

Term
Medical and Nursing care managment (constipation)
Definition

  • Assess fluid intake
  • Exercise and activity routine
  • Dietary assessment
  • Use of abusive laxatives
  • Use of osmotic agents, i.e., Colace; stimulants, i.e. Biscodyl, lubricants, i.e., Glycerin suppositories; prokinetic agents, Cisapride
  • Disimpaction

Term
Diarrhea
Definition

F

 

rom the Greek word, "diarrhoia" meaning "a flowing through"),

A condition of having three or more loose or liquid bowel movements per day

A common cause of death in developing countries and the second most common cause of infant deaths worldwide

The loss of fluids through diarrhea can cause dehydration and electrolyte imbalances

In 2009, diarrhea was estimated to have caused 1.1 million deaths in people aged 5 and over and 1.5 million deaths in children under the age of 5 years

Term
Diarrhea Causes
Definition

  • Medications
  • Tube feedings
  • Metabolic and endocrine disorders
  • Viral and bacterial infections
  • Malabsorption disorders
  • AIDS, i.e., opportunistic infection
  • Intestinal obstruction

Term
Diarrhea s/sx
Definition

  • Increased frequency and fluid content in stool
  • Abdominal cramping and distention
  • Anorexia and thirst
  • Ineffective straining [tenesmus]
  • Fluid and electrolyte imbalances

Term
S/sx: Stool Type
Definition

 

 

 

 

 

 

1.

 

Watery stools – may indicate small bowel disease

 

 

 

2.Loose, semi-solid – disorders of the colon

 

 

 

3.Voluminous and greasy – intestinal malabsorption

 

 

 

4.Muco-purulent – inflammatory enteritis or colitis

 

 

 

5.Oil droplets – pancreatic insufficiency

 

 

 

6.Nocturnal diarrhea – diabetic neuropathy

 

 

 

Complications – cardiac dysrhythmias; dehydration; muscle weakness, paresthesias, hypotension, anorexia, fatigue, death

Term
Diarrhea: Diagnosis
Definition

  • Stool cultures
  • Ova & Parasite profile
  • CBC
  • Chemical profile
  • Endoscopy/colonoscopy
  • Barium enema

Term
Medical and Nursing care managment (diarrhea)
Definition

  • controlling symptoms and preventing complications
  • Health history
  • Physical assessment; i.e., abdominal and skin
  • I/O
  • Weight
  • Using antibiotics and anti-inflammatory agents
  • Increasing oral and IV solutions, i.e., glucose and electrolyte solutions
  • Using antidiarrheals, i.e., diphenoxylate [Lomotil]; loperamide [Imodium]
  • Using emollients and lotions, saline-based cleansing agents

Term
Medical and Nursing care managment
Definition

  • Encourage bed rest, liquids, foods low in bulk
  • Limit caffeine consumption, carbonated beverages and either hot or cold foods that may stimulate intestinal motility
  • Inspect skin and mucous membranes to determine hydration status and for peri-anal irritation
  • Restrict milk products, fat, whole grain products, and fresh fruit and vegetables until symptoms decrease or subside

Term
Nursing Diagnosis: Diarrhea
Definition

Fluid volume deficit related to . . .

Anxiety related to . . .

Risk for impaired skin integrity related to . . .

Risk for tissue perfusion related to . . .

Term
Appendicitis
Definition

  • A condition characterized by inflammation of the appendix
  • Pain generally experience in the RLQ of the abdomen
  • It is a medical emergency
  • All cases require removal of the inflamed appendix, either by laparotomy or laparoscopy
  • Untreated, mortality is high, mainly because of peritonitis and shock

Term
Appendicitis
Definition

Prevalence higher among males than females

Incidence highest between the ages of 10 and 30

Term
Clinical s/sx and diagnosis
Definition

  • LRQ abdominal pain [may be experienced as intermittent pain]
  • Low grade fever
  • Nausea and vomiting
  • McBurney’s point [rebound tenderness in RLQ]
  • Rovsing’s sign [pain experienced paradoxically in LLQ]
  • Leukocyte count greater than 10,000/mm3
  • Pelvic ultrasound reveals RLQ density

Term
Appendicitis and Nursing Care
Definition

  • Preoperative care
  • Surgery
  • Postoperative care
  • Incision care
  • Antibiotics
  • Analgesics

Term
Small bowel obstruction
Definition

    • Accumulation of intestinal contents, fluid and gas that develops above the intestinal obstruction
    • Most bowel obstructions [85%] originate in the small intestine
    • Surgical adhesions account for 60% of all SBO
    • Results in decreasing circulation to the bowel leading to edema, congestion, necrosis, and ultimate rupture of the intestinal wall leading to peritonitis

Term
Clinical manifestations SBO
Definition

    • Cramp-like pain experienced as ‘wave-like’ and colicky
    • Peristaltic waves become vigorous assuming a reverse direction and propelling intestinal contents toward the mouth
    • If the obstruction is in the ileum, fecal vomiting occurs
    • High risk for dehydration
  • Tongue and mucous membranes become parched
      • If uncorrected, shock occurs due to F/E imbalances

Term
Diagnosis SBO
Definition
  • Symptoms
  • Radiologic
  • lab studies
Term
Medical Managment SBO
Definition

  • Bowel decompression
  • Surgical treatment to prevent bowel strangulation
  • IV therapy to replace water, na, k, cl

Term
Nursing Care SBO
Definition

  • Maintain function of the NG tube
  • Assess and record NG outpit
  • Ongoing abdominal assessment
  • Assess for F/E imbalance
  • Monitor nutritional status
  • Assess abdominal pain
  • Report discrepancies in I/O
  • Postoperative care if necessary

Term
Large bowel obstruction
Definition

  • Originates in lower GI tract
  • Dehydration occurs more slowly than with SBO
  • Strangulation of the bowel can occur leading to necrotic bowel . . . This is an emergency . . .
  • Symptoms occur more slowly than SBO

Term
S/Sx LBO
Definition

    • Constipation may be the only symptom for days
  • Obstruction in sigmoid or rectum
    • Abdomen becomes markedly distended while loops of bowel can be visibly seen through the abdominal wall
    • Use of rectal tube
    • Surgical resection with temporary or permanent colostomy or ileo-conduit if entire colon is removed

Term
Diagnosis LBO
Definition

  • KUB
  • UGI/LGI studies
  • Radiographic and barium studies

Term
Medical and Nursing managment LBO
Definition

  • Colonoscopy to try and untwist and decompress the bowel
  • Cecostomy
  • Rectal tube placement
  • Surgical resection
  • Nursing Care

Term
Chron's Disease
Definition

  • A subacute and chronic inflammation that extends through the entire bowel wall – often in the distal ileum and colon
  • Occurs more frequently in adolescents and young adults
  • Seen frequently in older populations [50 – 80]

Term
Chron's Patho
Definition

Major concern with Crohn’s disease is the formation of fistulas, fissures and abscesses that can invade the peritoneal cavity . . . Leading to a thickened bowel wall, intestinal fibrosis and a narrowing of the intestinal lumen . . .

Term
Chron's S/sx
Definition

  • Onset of symptoms is insidious
  • Prominent abdominal pain and diarrhea unrelieved by the act of defecation
  • Diarrhea present in 90% of the cases and is usually chronic
  • Cramp-like pain after meals . . . leading to weight loss, malnutrition, and anemia
  • Inflammed intestine often perforates . . . leading to intra-abdominal and anal abscesses

Term
Chron's s/sx
Definition

F

 

 

ever and leukocytosis

Symptoms may extend beyond the site[s] of inflammation . . . Arthritis, skin lesions [erythema nodosum], ocular disorders, i.e., conjunctivitis, and oral ulcers

Term
Chron's Diagnostic Evaluation
Definition
  • Barium studies – ‘String Sign’
  • CT scan
  • Sigmoidoscopic evaluation
  • CBC, ESR, Albumin and Protein levels
  • Stool exam for occult bllod and steatorrhea

 

Term
Medical and Nursing care managment Chron's
Definition

    • Goals of treatment include:
    • Reducing inflammatory process
    • Suppressing inappropriate immune responses
    • Providing rest for a diseased bowel
    • Attainment of ‘normal’ bowel function
    • Reduction of abdominal pain and cramping
    • Maintenance of optimal nutrition and prevention of weight loss
    • Avoiding fatigue and reducing anxiety
    • Effective coping; prevention of skin breakdown; addressing knowledge deficits regarding disease process

Term
Chron's diet and food intake
Definition

Goals of treatment include:

  • Reducing inflammatory process
  • Suppressing inappropriate immune responses
  • Providing rest for a diseased bowel
  • Attainment of ‘normal’ bowel function
  • Reduction of abdominal pain and cramping
  • Maintenance of optimal nutrition and prevention of weight loss
  • Avoiding fatigue and reducing anxiety
  • Effective coping; prevention of skin breakdown; addressing knowledge deficits regarding disease process

Term
Chron's Pharm Therapy
Definition

Goals of treatment include:

  • Reducing inflammatory process
  • Suppressing inappropriate immune responses
  • Providing rest for a diseased bowel
  • Attainment of ‘normal’ bowel function
  • Reduction of abdominal pain and cramping
  • Maintenance of optimal nutrition and prevention of weight loss
  • Avoiding fatigue and reducing anxiety
  • Effective coping; prevention of skin breakdown; addressing knowledge deficits regarding disease process

Term
Nursing Care management Chron's
Definition

  • Health History and Assessment
  • Maintaining normal elimination patterns as much as possible
  • Relieving pain such as anti-cholinergic agents, e.g., dicyclomine, and analgesics
  • Maintaining fluid and electrolyte balance
  • Promoting nutritional therapies such as TPN and small frequent feedings
  • Reducing physical activities to conserve energy and reduce peristaltic activity

Term
Nursing Care managment Chron's
Definition

 

 

    • S
  • trategies to reduce anxiety
  • Promoting coping skills and psychotherapy
  • Preventing skin breakdown
  • Preventing potential complications
  • Dysrhythmias, changes on LOC, monitor for hemorrhage, perforation
  • [diaphoresis, acute increase in abdominal pain, anxiety, rigid abdomen, vomiting, hypotension]
    • Toxic megacolon: abdominal distention, decrease or absent BS, changes in LOC, feve, tachycardia, hypotention, dehydration, changes in F/E

Term
Ulcerative Colitis
Definition

 

 

  • A recurrent ulcerative and inflammatory disease of the mucosal lining of the colon and rectum
  • Severe complications
  • High mortality rate
  • 15 -20% incidence of colon cancer
  • More common in Caucasian populations and people with Jewish heritage, peaking in the 30 -50 age range

Term
UC s/sx
Definition
  • Diarrhea
  • Abdominal pain
  • Ineffective straining or tenesmus
  • Anorexia, weight loss, fever, vomiting, diarrhea,
  • Cramping, urgency
  • Hypocalcemia and anemia
  • Rebound tenderness in RLQ
  • Skin and eye lesions

 

Term
Nursing and medical therapy UC
Definition

Nursing and Medical treatment very similar to the management of Crohn’s Disease

Term
Monroe-Kellie Hypothesis
Definition

The pressure-volume relationship between ICP,

 

 

volume of CSF, blood, and brain tissue, and cerebral perfusion pressure (CPP) is known as the Monro-Kellie hypothesis.

Term
Monroe Kellie Hypothesis
Definition

The volume inside of the cranium is a fixed

 

 

volume. The cranium and its constituents (blood, CSF, and brain tissue) create a state of volume equilibrium, such that any increase in volume of one of the cranial constituents must be compensated by a decrease in volume of another

Term
Normal ICP and CCp
Definition

Normal CPP

 

70 – 90 mm Hg

Normal ICP

 

0 – 10 mm Hg

Term
Definition of ICP
Definition

Elevated pressure of cerebral fluid beyond the

 

normal pressure exerted by blood, brain and cerebral spinal fluid within the skull

 

 

Results in decreased cerebral circulation and anoxia

Term
Key Points
Definition

 

The ICP is a symptom of brain pressure

 

 

alterations rather than a disease in itself

 

It can lead rapidly to irreversible damage or

 

 

death

Term
Goals of collaborative managment
Definition

  • Maintain ABCs
  • Maintain cerebral perfusion
  • Reduce intracranial pressure
  • Maintain fluid and electrolyte status
  • Maintain cognitive functions
  • Prevent complications

Term
Nursing Diagnosis
Definition

  • Ineffective airway clearance
  • Risk for injury
  • Potential complications
  • Altered nutrition
  • Ineffective family coping
  • Impaired skin integrit

Term
Risk factors-high ICP
Definition
    • Head injury/trauma
    • Meningitis
    • Brain tumors
    • Brain abscesses
    • Hemorrhage
    • Stroke
    • Hydrocephalus
    • Space-occup
    • ying lesion

Term
S/sx high ICP
Definition

  • Progressive LOC decline
  • Drowiness
  • Increased BP and widening pulse pressure
  • Pupil changes
  • Confusion and disorientation
  • Bradycardia
  • Restlessness and irritability
  • Abnormal posturing
  • Altered respirations

Term
S/sx high ICP 2
Definition

 

    • Elevated temperature
    • Weakness progressing to hemiplegia
    • Blurred vision
    • Headache
    • Vomiting
    • Positive Babinski reflex (
    negative after 2)Seizures

Term
Diagnositc tests
Definition

  • ICP Measurement
  • via ventriculostomy, epidural sensor, and subarachnoid screw
  • *** LP contraindicated***
  • History and physical
  • MRI
  • CT and CAT scans
  • EEG

Term
Common medical steps in managment
Definition

 

  • Oxygen therapy
  • Intubation, mechanical ventilation
  • Semi-Fowler’s positioning
  • Aggressive monitoring
  • Labs: K+, Na+, Glu, osmololity, BUN, serum

  • osmolarity & creatinine
    • Diuretics
    • CFS drainage via ventriculostomy
    • Anticonvulsants
    • Glucocorticoids

Term
Nursing care-high ICP
Definition

    Assessment

  • Respiratory status
  • Neurological status
  • Posturing
  • Decerebrate posturing - an involuntary flexion or extension of the arms and legs, indicating severe brain injury [involves the brain stem]
  • Decorticate or mummy baby posturing- arms flexed, or
    • bent inward on the chest, hands are clenched into fists, and the legs extended and feet turned inward [severe brain anoxia

Term
Nursing Care-high ICP
Definition

To identify and treat underlying cause(s):

* Patent Airway

* Avoid Trendelenburg position

Preventing increasing ICP

* Neutral head positioning

* Seizure precautions

* Maintain fluid restrictions

* Prevent jugular vein constriction

Term
Nursing Care high ICP
Definition

*

 

Avoiding morphine analgesics

* Safety measures

* Preventing complications of immobility

* Prepare for possible mechanical ventilation

* Emotional support

* Prepare for surgery if indicated

Term
Pharm High ICP
Definition

 

 

 

 

 

 

    • Corticosteroids-
    Decadron, hydrocortisone
  • Osmotic diuretics-
  • Mannitol
  • Anti-convulsants-
  • Dilantin
  • Anti-hypertensive agents-
  • Procardia [nifedipine sl]
  • Antipyretics-
  • Tylenol
  • IV fluids (avoid hypotonic solutions)
  • Electrolytes-
  • K+ replacement
  • Stool softners-
  • Dulcolax suppositories

Term
Complicaitons high ICP
Definition

  • Brain herniation: Uncal
  • Seizures
  • Cognitive deficits
  • Motor deficits
  • Sensory deficits
  • Coma
  • Death

Term
3 Types head injury
Definition

-fracture

-hemorrhage

-trauma

Term
Patho-head injury
Definition

Brain injury or bleeding within

 

 

the brain results in edema or hypoxia

Term
Key Points-head injury
Definition

 

Hemorrhage is not always

 

 

 

associated with head injuries

 

Cervical spine injuries are

 

 

 

often present in conjunction with head injury

Term
Goals of collaborative managment-head injury
Definition

  • Maintain ABCs
  • Maintain cerebral perfusion
  • Maintain cognitive function
  • Maintain fluid and electrolytes
  • Prevention of complications

Term
Medical Interventions-head injury
Definition

 

Restricted fluids

IV therapy for electrolyte

 

 

 

replacement

Intubation, mechanical ventilation

Semi-Fowler’s position

Monitor hemodynamic variables

Lab studies

Cervical collar

Pharmacology

Term
Nursing Diagnosis
Definition

Ineffective airway clearance

Risk for injury

Potential complication

Ineffective family coping

Term
Risk factors-head injury
Definition

Motor vehicle accidents

Sports injuries

Assaults

Gunshot wounds

Falls

Term
Key s/sx head injury
Definition

 

Disorientation to time, place

 

 

 

 

and person

Decreased LOC

Unequal pupil size

Term
Specific s/sx-head injury
Definition

Skull fracture

 

 

 

Concussion

 

 

 

Contusion

 

 

 

: ICP
: ICP, amnesia, hypotension
: CSF leakage from ears or nose, subdural hematoma, ICP
Term
hematoma
Definition

Hematoma

 

 

 

ICP, nuchal rigidity, fixed

 

 

dilated pupil on affected side, hemiparesis, hemiplegia, papilledema, leakage of CSF from nose or ears

:
Term
S/sx high ICP
Definition

 

 

Decreased level of

 

 

 

consciousness

Restlessness

Headache

N & V

Bradycardia

Respiratory pattern

 

 

 

disturbance

Widening pulse pressure

Term
high ICP cont'd
Definition

 

Rapid rise in body temperature

Increased systolic blood

 

 

 

 

pressure

Auditory or visual disturbances

Seizures

Weakness

Paralysis

Term
diagnostic and lab tests-head injury
Definition

 

History and physical

Skull X-rays

CBC

ABGs

Serum electrolytes

Fasting blood glucose

MRI

EEG

CT

 

 

 

or CAT scans

Glascow Coma scale

Term
nursing care-head injury
Definition

Assessment

 

 

 

1.

 

 

Neurological status every 15 minutes until stable

*

 

 

Vital signs

*

 

 

PERLA * LOC (level of consciousness)

2. Increased

3.

 

 

Posturing (decorticate, decerebrate, flaccid)

:
Term
Nursing Care assessment 2=head injury
Definition

4.

 

 

For cerebral spinal fluid in nose and ears (otorrhea, rhinorrhea)

5. For complications of immobility

6. For pain and restlessness

7. Monitor for diabetes insipidus

8. Check for cough and gag

 

 

reflexes

Term
Nursing care-head injury
Definition

 

 

 

Maintain

patent airway, oxygen

Activities to

 

 

 

reduce ICP

(elevate HOB, no coughing, noise, O2-Co2)

Seizure precautions

Pain control, avoid opiods

Safety measures

Watch for diabetes insipidus

Term
more nursing care-head injury
Definition

 

Check cough and gag

 

 

 

reflexes

Emotional support

Prepare for surgery if indicated

Term
Pharm-head injury
Definition

Corticosteroids

Osmotic diuretics

Anti-hypertensives

Antipyretics

Anticonvulsants

Analgesics

Term
head injury-complications
Definition

Cerebral edema

Cerebral hypoxia

Infection

Shock

Motor/sensory deprivation

Coma

CSF flow obstruction

Death

Term
CVA definition
Definition

A disruption of cerebral circulation that results

 

 

in motor and sensory deficits

Term
CVA key points
Definition

 

Mortality from stroke can be greatly decreased

 

 

 

by rapid assessment and intervention

 

Older adults are at increased risk for CVA as

 

 

 

well as people with atrial dysrythmic activity, and those individuals with HTN and receiving unmonitored anti-coagulant medication

Term
CVA: Goals of collaborative management
Definition

Early recognition and treatment

Maintaining ABCs

Maintaining functional capabilities

Preventing complications

Effective communication

Term
Causes of CVA
Definition

 

 

 

 

 

 

 

 

 

Cerebral hemorrhage

 

 

 

: rupture of cerebral blood vessel with bleeding into surrounding tissues which can cause anoxia and brain tissue death

 

Embolism

 

 

 

: a blood clot carried from another part of the body

Term
Causes of CVA (2)
Definition

 

 

 

 

 

 

 

 

 

Ischemia

 

 

 

: impaired circulation resulting in inadequate oxygenation of cerebral tissues

 

Thrombus

 

 

 

: an immobile blood clot inside cerebral tissues or vessels that provide oxygen to these structures, causing hypoxia to the affect organ

Term
CVA Risk Factors
Definition

Arteriosclerosis

Hypertension

Smoking

Sedentary lifestyle

Oral contraceptive use

Coagulation disorders

Sickle cell disease

Obesity

Hypothyrodisim

Substance Abuse

Term
CVA: Key stroke findings
Definition

Changes in level of consciousness

Paresthesias

Aphasia

Paralysis, hemiplegia

Weakness

Term
CVA S/Sx
Definition

Hypertension

Headache

N&V

Weakness or paralysis of face, drooping mouth

Sensory-perceptual disorders

Hemi-anopia

Term
CVA: S/sx (2)
Definition

Drowsiness

Urinary incontinence

Dysarthia

Flaccidity. spasticity or rigidity

Behavioral changes, emotional instability

Agnosia

Apraxia

Term
Diagnostics CVA
Definition

History and physical

MRI

CT and CAT scans

Arteriography

Cerebral angiography

Ultrasound (2D, 3D, Doppler)

Term
Key Diagnostic Findings: CVA
Definition

 

 

 

 

 

 

 

 

 

CAT scan and MRI

 

 

 

: intracranial bleeding, infarct, or shift of midline structures

 

Digital subtraction angiography

 

 

 

: occlusion or narrowing of vessels

Term
Key Medical Managment: CVA
Definition

Semi-Fowler’s position

Low-sodium, increased K+ diet

Oxygen therapy

Assessment of neurological signs

Pharmacology

Term
Nursing Care: CVA
Definition

Assessment

 

 

 

* Neurological assessment q15 min. until stable

* For signs of ICP

* Swallowing abilities

* Bowel and bladder function

* Lab studies [PT/INR PTT HgB/HCT]

:
Term
CVA Care
Definition

Care

 

 

 

* Maintain

 

 

patent airway , pulse oximetry

*

 

 

Seizure precautions

* Minimize activities that increase ICP

* Assistance with ADLs

* Safe environment

* Emotional support

* Prevent complications of immobility

:
Term
CVA Pharm
Definition

 

 

 

Anticoagulants (

 

 

not for a cerebral hemorrhage!)

Anti-platelets (

 

 

not for a cerebral hemorrhage !)

Anti-thrombolytic agents (

 

 

not for a cerebral hemorrhage!)

Hyperosmolar solutions

Anticonvulsants

Anti-hypertensives

Term
CVA Complications
Definition

Sensory-perceptual deficits

Aspiration pneumonia, pulmonary embolism

Seizures

Impaired communication

Depression

Constipation/urinary incontinence or stasis

ARDS

Coma

Death

Term
Client Intracranial Hemorrhage
Definition
Key points: a significant cause of increased ICP
Term
Intracranial Hemorrhage: goals of collaboartive management
Definition

Maintain ABCs

Maintain cerebral perfusion

Maintain fluid and electrolyte status

Maintain cognitive function

Prevent complications

Term
Intracranial hemorrhage: nursing diagnosis
Definition

Ineffective airway clearance

Risk for injury

Potential complications

Altered nutrition

Ineffective family coping

Term
Intracranial Hemorrhage: Types of Intracranial Pressure
Definition

 

 

 

 

 

 

 

 

 

Epidural hematoma

 

 

 

: forms rapidly from arterial bleed between the dura and the skull from a tear in the meningeal artery

 

Intercerebral hematoma

 

 

 

: multiple hemorrhages from closed head trauma, often in the frontal or temporal lobes

Term
Intracranial Hemorrhage: Subdural
Definition

 

 

 

 

Subdural hematoma

 

 

 

: forms slowly from continous bleeding beneath the dura from tears in veins crossing the subdural space

Term
Intracranial Hemorrhage: Risk factors
Definition

Hypertension

Arteriosclerosis/atherosclerosis

Trauma

Obesity

Diabetes Mellitus

Anticoagulant therapy

Genetics

Term
Intracranial hemorrhage: s/sx
Definition

Increased ICP

Hypertension

Dilated pupils or unequal pupil size

Cheyne-Stokes respirations

Nuchal rigidity

Facial drooping

Dysarthia

Term
intracran hemorrhage: s/sx (2)
Definition

Ataxia

Paralysis

Dysphagia

Decreased sensation

Hemiplegia

Unequal extremity strength

Decreased urine specific gravity

Term
intraC hemorrhage: Diagnostics
Definition

History and physical

MRI

CT and CAT scans

Glascow Coma Scale

EEG

Cerebral arteriography

Term
Nursing Care: IntraC hemorrhage
Definition

Assessment

 

 

 

Respiratory status

Neurological status checks every 15 minutes until stable For indications of infection

Care:

Maintain patent airway

:
Term
IntraC hemorrhage: care (2)
Definition

Measures to prevent ICP

Seizure precautions

Safety measures

Prevent complications

Emotional support

Prepare for surgery if indicated

Term
Pharm: IntraC hemorrhage
Definition

Corticosteroids

Osmotic diuretics

Anti-hypertensives

Antipyretics

Anticonvulsants

Analgesics

Nimodipine (

 

 

for subarachnoid hemorrhage )

Term
IntraC hemorrhage: Complications
Definition

Hypoxia

Hemiplegia

Aphasia

Bowel/bladder incontinence

Coma

Death

Term
Guillian-Barre
Definition

 

 

Autoimmune attack of peripheral nerve

 

 

 

myelin

 

Often preceded by respiratory or GI

 

 

 

infection 2 weeks before

 

Usually have complete recovery within 2

 

 

 

years

Term
Guillan Barre s/sx
Definition

Ascending weakness

Dyskinesia

Hyporeflexia

Parathesis

Respiratory failure

Vagus nerve

 

 

 

demyelination---cardiac instability

Guillan-Barre DOES NOT

 

 

AFFECT COGNITIVE FUNCTION OR LOC

Term
Diagnosis Guillian Barre
Definition

Serum lab tests are not useful

Diagnosis is based on symptomology

Term
Guillian Barre treatment
Definition

Respiratory care

Ventilation

Prevention of immobility complications

Plasmapheresis or IV/IgM

Term
Guilian Barre Nursing care
Definition

 

Improve respiratory function [vital capacity

 

 

 

is measured frequently]

Increased mobility

Improved nutrition

Effective communication

Term
Spinal Cord Injury
Definition

Traumatic injury to the spinal cord often

 

results in sensory and motor deficits

Term
Spinal Cord Injury Patho
Definition

 

 

 

Functions of spinal cord relate to motor,

 

 

sensory, and reflex. Loss of function in areas of the body innervated by nerves that leave the spine below the level of the disorder usually occurs

Injury may result in completely transecting

 

the spinal cord

Edema and hemorrhage from the injury

 

often causes ischemia

Necrosis and scar tissue generally form in

 

he area of injury

Term
Spinal Cord Key Points
Definition

 

 

Vertebrae often injured: 5

 

 

th, 6th, 7th cervical, 12th thoracic, 1st Lumbar

Level of cord injury decides

 

 

symptoms

Degree of injury varies and decides

 

 

severity of loss

Term
2 types Spinal Cord Injuries
Definition

Paraplegia

 

 

Quadriplegia

 

- paralysis of all 4 extremities and trunk

- paralysis of legs

 

Term
Quadraplegia
Definition

Results with complete transaction of

 

spinal cord in area of cervical nerves.

C1 to C3 =

 

complete respiratory paralysis, flaccidity, reflex loss

C4 = l

 

imited ventilation [May loose ‘sigh’ reflex]

C5 to C6 =

 

retention of deltoids, biceps & shoulder girdle is possible with physical and occupational therapy; deep tendon reflexes are lost

Term
Paraplegia
Definition

Thoracic and lumbar spine injury

 

results in less acute neurological damage

T1 level or below

Lower abdomen may be affected if

 

injury is high

Lumbar injury usually results in

 

flaccid paralysis, deep tendon reflex loss, urine retention, fecal incontinence, low back pain, sensation loss in lumbar area

Term
Spinal Cord Goals of collaborative management
Definition

Maintain ABC

Prevent extension of injury

Maintain functional abilities

Prevent complications

Maintain bowel and bladder function

Term
Nursing Diagnosis
Definition

Ineffective airway clearance

Ineffective breathing pattern

Impaired physical mobility

Altered elimination patterns

Impaired skin integrity

Body image disturbance

Potential for injury R/T complications

Term
Spinal Cord Injury Risk Factors
Definition

High-risk lifestyle activities

Male

Sports activities, especially diving

Age, teen to early 20s

Alcohol or drug abuse

Tumors

Term
S/sx spinal cord injury
Definition

Motor and sensory loss below level

 

of injury

Respiratory instability

Loss of reflexes below injury

Orthostatic hypotension

Pain

Quadriplegia or paraplegia

Term
Spinal Cord Injury S/sx
Definition

Hypercalcemia

Decreased cough reflex

Loss of bowel and bladder function

Urinary retention

Impotence

Muscle spasms

Term
Diagnostics Spinal Cord Injury
Definition

History and physical

X-rays

MRI

CT and CAT scans

EMG

Term
Key Diagnostic Findings-Spinal Cord
Definition

CT scan and MRI: spinal cord edema,

 

 

vertebral fracture, cord compression

Term
Key Medical Management-Spinal Cord Injury
Definition

 

 

Positioning: flat & neck immobilized

Cervical collar

Vertebral alignment: Stryker frame,

 

 

Crutchfield tongs, Halo brace

Specialized Beds: rotation (Roto-rest,

 

 

Tilt and Turn)

Pharmacology

Term
Spinal Cord Injry-Nursing Care
Definition

Assessment

 

 

Oxygen saturation levels

Vital signs

Neurological status

Signs of thrombophlebitis

For

 

spinal shock

For

 

autonomic dysreflexia

For bladder distension

:
Term
Spinal Cord Injury=Care 2
Definition

Care

 

 

* Maintain patent airway

* Mechanical ventilation if indicated

* CPT or chest percussion therapy (to

 

avoid excess coughing and suctioning)

* Passive exercises

* Maintain skin integrity

* Maintain adequate fluid intake

:
Term
Nursing Care-3 Spinal Cord
Definition

 

 

Teach self-catheterization

Institute bowel and bladder training if

 

 

indicated

Education regarding sexual

 

 

dysfunction

Reinforce independence

Term
Spinal Cord Injury-Pharm
Definition

Adrenocortical steroids

Vasopressive

Muscle relaxants

Anti-spasmotics [B&O suppositories]

Analgesics

Anticoagulants

Vasodilators

Antidepressants

Histamine H

 

 

2 -receptor antagonists [What about Curling’s Ulcers]

Stool softeners

Term
Spinal Cord Complications
Definition

Respiratory distress

Paralysis

Autonomic dysreflexia

Neurogenic shock

Contractures

Muscle atrophy

Pressure ulcers

Stool impaction

Death

Term
Autonomic Dysreflexia Care
Definition

A hyper-reflexive state seen in cervical

 

and high thoracic injuries

Cause

 

 

Symptoms

 

 

:

elevated BP, headache, blurred vision, nausea, slow pulse, diaphoresis, flushing of skin above lesion level, absence of sweating below lesion

:

can be distended bladder or bowel or any noxious stimuli that triggers SNS and release of catacholamines

Term
Autonomic Dysreflexia Care-Interventions
Definition

Interventions:

 

 

 

Elevate HOB and determine cause

 

 

Notify MD

 

 

Apresoline

 

 

NTG or sublingual Nifedipine

Term
Spinal Shock
Definition

Can occur with complete or incomplete

 

cord transection, usually soon after injury

Symptoms

 

 

Interventions

 

 

:

Maintain ABCs, decompress GI tract, suction, insert indwelling [Foley] catheter

:

loss of sensory, motor, autonomic, reflex activity below level of injury

Term
Huntington's Disease
Definition

The disorder is named after George Huntington,

 

 

 

an American physician who published a remarkably accurate description of this disorder in1872

Term
Huntington's Etiology
Definition

 

A slow, chronic, progressive and

 

 

 

HEREDITARY disease that includes involuntary choreiform movement and dementia

Premature death of cells in striatum of

 

 

 

basal ganglia, cortex and cerebellum

Term
Huntington's S/sx
Definition

Chorea-abnormal, involuntary movements

Intellectual decline

Later writhing,

twisting, uncontrolled movementsand dementia Emotional disturbance

 

 

 

Slurred speech,

hesitant, explosive => unintelligible

 

Loss of bowel and bladder

chewing/swallowing difficulty

Disorganized gait

 

 

 

 

Loss of bowel and bladder

chewing/swallowing difficulty

Disorganized gait

 

 

 

 

Loss of bowel and bladder

chewing/swallowing difficulty

Disorganized gait

 

 

 

 

 

 

Term
Huntington's Diagnosis
Definition

Clinical presentation and family history

Term
Huntington's Treatment
Definition

 

 

Navane & Haldol --- block dopamine

 

 

receptors

Reserpine --- decreases chorea

Treat akathasia (motor restlessness) due

 

 

to overmedication---can be mistaken for restless fidgeting

Anti-psychotic meds

Psychotherapy

Levodopa—if muscle rigidity is present

Term
Huntington's Nursing Care
Definition

Teaching

Maintenance of function if possible

Home care assistance

Term
Multiple Sclerosis
Definition

Progressive demyelinating disease of

 

motor and sensory neurons hat has periods of remission and exacerbation

 

 

 

Primarily occurs in young adults

Term
MS Patho
Definition

 

Scattered demyelination occurs in brain

 

 

and spinal cord

Degeneration of myelin sheath results

 

 

in patches of sclerotic tissue and impaired conduction of motor nerve impulses

Term
MS Causes
Definition

Unknown

Autoimmune disease

Viral

Term
MS Risk Factors
Definition

Infection

Living in cold climate

Physical injury

Emotional stress

Pregnancy

Fatigue

Familial history

Term
MS Key S/sx
Definition

Weakness of both lower extremities

Nystagmus

Diplopia

Paresthesia of one or more extremities

Blurred vision

Impaired sensation

Paralysis

Optic neuritis

Term
MS more s/sx
Definition

Poor coordination

Bowel and bladder dysfunction

Depression

Sexual dysfunction

Seizures

Uhthoff’s sign:

 

 

temporary worsening of vision and other neurologic functions after exertion or when exposed to heat

Term
MS Diagnostics
Definition

History and physical

Neurological assessment

MRI of brain and spine

CSF analysis

Evoked potentials of optic and auditory

 

pathways

Term
MS KEY diagnostic findings
Definition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CT scan

 

 

: normal, except in chronic illness when atrophy is found

MRI

 

 

: normal except in chronic illness when atrophy is found

CSF

 

 

: increased immunoglobulin G (IgG), protein, WBCs

Evoked potentials

 

 

: slowing of nerve conduction

EMG

 

 

: abnormal

Term
MS Medical Management
Definition

Plasmaphoresis

Muscle relaxant

Glucocorticoids

Immunosuppressants

Skeletal muscle relaxants

Physical therapy

High-calorie, high-protein, high-vitamin,

 

 

gluten-free, low-fat diet

Term
(MS) Preventions for at risk clients
Definition

Wash hands thoroughly

Avoid people with infections

Live in warmer climates

Use stress reduction & relaxation techniques

Plan for pregnancies

Prevent UTI

Avoid extreme temperatures, i.e., heat

 

increases the risk of weakness

Term
MS Nursing Care
Definition

Assessment

 

 

Fluid intake and output

Ability to perform ADLs

Neurological status

Evaluate reactions to stress

Levels of fatigue

:
Term
MS Key nursing care
Definition

Care

 

 

Encourage expression of feelings

Maintain active and passive ROM

Establish bowel and bladder program

Maintain fluid intake at 2000 mL/ 24hrs

High-fiber diet

Adequate rest periods, most activity early in day

Avoid temperature extremes

:
Term
(MS) more nursing interventions
Definition

Assist in managing self-care deficits

Protect from falls

Maintain stress a free environment

Evaluate medication effectiveness

Term
MS Pharm
Definition

Corticosteroids

Antispasmotics

Interferon

 

- b1

Anticonvulsants

Stool softeners

Antineoplastic

Antacids

Term
MS Complications
Definition

 

Bacterial infection, especially bladder &

 

lungs

Contractures

Pressure ulcers

Seizures

Paraplegia or quadriplegia

Depression

Term
Parkinson's Disease
Definition

A degenerative disease involving a

 

dopamine deficiency and cell degeneration in the basal ganglia.

 

 

Usual onset is in the 60+ age group

Term
Parkinson's Causes
Definition

Unknown

Imbalance of dopamine and

 

acetylcholine in basal ganglia

Cerebrovascular disease

Drug-induced (Regitine,Serpasil,

 

Aldomet, Reserpine)

Dopamine deficiency

Genetic predisposition

Older age

Brain tumor

Term
Parkinson's Patho
Definition
Nerve cells in basal ganglia are destroyed, resulting in impaired muscular function
Dopamine degenerates
Lack of dopamine results in decreased inhibition of the synaptic transmitter
Term
Parkinson's Management
Definition

Controlling symptoms

Education & support:

 

Intellectual abilities not impaired

Walk with wide base, heel-toe method

If patient "freezes", have patient walk over something to start gait again

Maintaining functional ability

Preventing complications

Term
Parkinson's Nursing Diagnosis
Definition

Self-care deficit

Impaired physical mobility

Altered nutrition

Sleep pattern disturbance

Alteration in bowel function

Impaired verbal communication

Term
Parkinson's Key S/sx
Definition

"Pill-rolling tremors" (at rest)

Shuffling gait

Festination (propulsive gait)

Stiff joints

Mask-like facial expression

Dyskinesia

"Cogwheel" rigidity

Stooped posture

Term
Parkinson's more s/sx
Definition

Slow, monotone speech

Difficulty sleeping

Drooling

Excessive perspiration

Diminished memory

Oculogyric crises

eyes fixed upward and to one side or downward

Constipation, incontinence

Decreased sexual capability

Term
Parkinson's Diagnostic
Definition

History and physical

MRI

CT and CAT scans

EEG

Term
Possible test findings Parkinsons
Definition

EEG: minimal slowing

 

CT scan: normal

Term
Parkinson's Medical Management
Definition

High-residue, high-calorie, high-

 

protein, soft foods

Physical therapy

Pharmacology

Term
Nursing Care Parkinsons
Definition

Assessment

Neurovascular and respiratory status

Swallowing difficulties

Drug effectiveness

Safety

Nutrition and hydration status

Term
Parkinson's Nursing Interventions
Definition

Care:

Maintain patent airway

Safety measures to prevent falls

Reinforce gait training

Reinforce independence in care

Establish effective communication

 

strategies

Promote sleep and rest

Term
(Parkinsons) decrease choking hazards
Definition

Cut food into smaller pieces

Suction the mouth/oral care

 

frequently

Offer only soft foods

Term
Parkinsons Pharm
Definition

Eldepryl (Selegilene) –

 

MAO Inhibitor can be used as protective therapy for neurons, delays need for L-dopa

Dopamine replacement

Dopamine antagonists

Anticholinergic agents such as

 

Cogentin, Artane, Parsidol (for muscle rigidity & spasms)

Antiviral drugs

Term
Parkinsons's Complications
Definition

Injury due to falls

Malnutrition

Impaired communication

Social Isolation/Depression

Aspiration/airway obstruction

Constipation

Corneal ulceration

Psychosis

Term
Incidence of Trauma
Definition
•Third leading cause of death for all ages in U.S.
•First leading cause of death for persons between ages of one and 44.
–Motor vehicle crashes 28%
–Suicide 21%
–Homicide 17.5%
–Other 33.5%
Term
Tridomal pattern of fatalities
Definition
•First phase (50% of deaths)
–Occur immediately at the scene
•Second phase (30% of deaths)
–Early deaths within two hours of injury
–This is the golden hour
•Third phase (20% of deaths)
–Late deaths occur from days to weeks of injury
–Sepsis, ARDS, multiple organ failure
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