🔥NEUROLOGIC DISORDERS🔥 Meds:

✔️ANTICHOLINESTERASE = backbone of treatment

1. 🔥PARKINSON'S DISEASE -take meds before meals
✔lack of Dopamine receptors. Where: BASAL GANGLIA
Dopamine: for smoothness of muscular movement Nursing Intervention:
🌻What should always be at the bedside: SUCTION
Earliest sign: 🌻Change in penmanship MACHINE
Hallmark signs: 🌻 (bradykinesia, tremors, muscular Monitor for possible Crisis:
rigidity, pillrolling) -due to: LACK OF DOPAMINE ✓MYSTHENIC CRISIS: due to underdosage of meds

Meds: ✓CHOLINERGIC CRISIS: due to over dosage of drug

- DOC: LEVODOPA (for life) Antidote: Anticholinergic drug(ATROPHINE SULFATE)
✓Avoid vit B6
✓Don't give patient with GLAUCOMA since it can ⬆️IOP ✓BRITTLE CRISIS: pt. develop TOLERANCE to drug
✓Causes POSTURAL HYPOTENSION mgt: Plasmapheresis
✓BROMOCRIPTINE(parlodel)- for levodopa tolerance
-DOPAMINE 4. 🔥GUILLAIN BARRE SYNDROME
-ARTANE (anticholinergic drug)- to reduce rigidity (Fun fact: [G.B. = (Guillain Barre) • G.B.= (Ground to Brain
meaning manifestations will show from down(ground) to
Nursing Intervention: up(brain)) =ASCENDING PARALYSIS
✔SAFETY
•No fork and knife Cause: ACUTE INFECTION of CRANIAL AND SPINAL NERVES
•use of assistive devices (cane, walker)
Earliest sign: Clumsiness
2. 🔥MULTIPLE SCLEROSIS
(Fun fact: [M.S.= (Multiple Sclerosis) • M.S.= (Mind to Nursing Int.
Sole, meaning manifestations will show from Up(mind) to ✔Prep for ventilatory devices (PRIORITY: Respi Status)
Down(sole)) =DESCENDING ✔W.O.F. Pneumonia
✔Assess DVT, risk of Pulmonary Embolism
Most common: young women! 🌻What should always be at the bedside: TAPEMEASURE
✔characterized by Remission and exacrbation =To check for leg circumference to assess DVT.
✔Demyelination of neurons=brain & spinal cord ✔Wasting Syndrome- muscular atrophy as a result of
immobility
Etiology: UNKNOWN
Earliest sign: VISUAL DISTURBANCES 🔥AMYOTROPHIC LATERAL SCLEROSIS/ LOU GEHRIG'S
🌻CHARCOATS TRIAD DISEASE
✓Nystagmus=abno lateral mov't of eyes -Combi of upper & lower motor neurons
✓Intentional tremmors -FATAL MOTOR NEURON DISEASE
✓Scanning speech
Hallmark sign: DIPLOPIA Manifestation:
✔Progresive weakness of upper extremities
Nursing intervention: Poor prognosis: WILL DIE WITHIN 6 MONTHS
✔Safety
✔Avoid: stress, going to warm/tropical areas 5. 🔥HUNTINGTON'S CHOLERA
✔Encourage eye patch -Autosomal Dominant Disorder with multiple triple CAG
Meds: on chromosome 4 which is responsible for the
-Steroids, Anti convulsant, Beta blockers, Anti histamine, development of basal ganglia
Interferon -Genetically transmitted
🌻Most common cause of death: U.T.I. (so give cranberry -Defect in GABA
juice)
Manifestation:
3. 🔥MYASTHENIA GRAVIS ✔Dementia
(Fun fact: [M.G.= (Myasthenia Gravis) • M.G.= (Mind to ✔CHOREA: irregular jerking movement/ choreiform
Ground, meaning manifestations will show from Up(mind) movement/ dancelike movement
to Down(ground)) = DESCENDING
Hallmark sign:
✔Lack: ACETYLCHOLINE RECEPTORS ✓chorea
✔Weakness of voluntary muscles ✓dementia
✓altered behavior
Hallmark sign: PTOSIS
Dx test: TENSILON TEST- injection of EDOPHONIUM Cause of death: severe dementia/respiratory failure
HYDROCHLORIDE (I.V) will result to sudden disappearance
of symptoms Mgt:
(+) Tensilon = (+) M.G. Antipsychotic Meds- to control violent behavior
Affixing titles after names like R.N, MAN etc. -- liable for
misdeamenor case or false representation or
misrepresentation
Written defamatory act is
libel
Orally Spoken defamatory act is
Slander
Process standards include care plans, nursing procedure
to be done to address the needs of the patients.
The following are basic steps in the controlling process of
the department. Which of the following is NOT included?
D. Identify possible courses of action
Which of the following statements refers to criteria?
B. Characteristics used to measure the level of nursing
care
Which of the following tasks is NOT included in th
controlling proces
A. Instructing the members of the standards committee to
prepare policies
Ms. Valencia prepares the process standards. Which of
the following is NOT a process standard?
C. Patients’ reports 95% satisfaction rate prior to
discharge from the hospital.
Which of the following is evidence that the controlling
process is effective?
A. The things that were planned are done
Ms. Valencia is responsible to the number of personnel
reporting to her. This principle refers to:
A. Span of control
She notes that there is an increasing unrest of the staff
due to fatigue brought about by shortage of staff. Which
action is a priority?
B. Initiate a group interaction
is a member of the Nursing Research Council of the
hospital. His first assignment is to determine the level of
patient satisfaction on the care they received from the
hospital. He plans to include all adult patients admitted
from April to May, with average length of stay of 3-4 days,
first admission, and with no complications. Which of the
following is an extraneous variable of the study?
C. Age of patients
He thinks of an appropriate theoretical framework.
Whose theory addresses the four modes of adaptation?
b. Sr. Callista Roy
He opts to use a self-report method. Which of the
following is NOT TRUE about this method?
C. Most accurate and valid method of data gathering
Which of the following articles would Kevin least consider
for his review of literature?
B. “Turnaround Time in Emergency Rooms”
Which of the following variables will he likely EXCLUDE in
his study?
C. Salary of nurses
He plans to use a Likert Scale to determine
A. degree of agreement and disagreement
He checks if his instruments meet the criteria for
evaluation. Which of the following criteria refers to the
consistency or the ability to yield the same response upon
its repeated administration?
B. Reliability
Which criteria refer to the ability of the instrument to
detect fine differences among the subjects being studied?
A. Sensitivity
Which of the following terms refer to the degree to which
an instrument measures what it is supposed to be
measure?
A. Validity
He plans for his sampling method. Which sampling
method gives equal chance to all units in the population
to get picked?
A. Random
Raphael is interested to learn more about transcultural
nursing because he is assigned at the family suites where
most patients come from different cultures and countries.
Which of the following designs is appropriate for this
study
B. Ethnography
The nursing theorist who developed transcultural nursing
theory is
B. Madeleine Leininger
Activated charcoal action -- stops toxins from being
absorbed in the stomach by binding to them. The body is
unable to absorb charcoal, and so the toxins that bind to
the charcoal leave the body in the feces.
Cognitive behavioral therapy is a treatment that takes a
hands-on approach to problem-solving and attempts to
assist the patient to change their thought processes that
lead to behaviors that create psychological or
physiological problems.
Peer support therapy is a therapy approach that has
clients meet in group therapy sessions with others that
have similar life-altering difficulties, i.e. Alcoholics
Anonymous.
risperidone for schizophrenia-related delusions.
Turners sydrome s/sx
Amenorrhea, web neck, low hair line, short stature is a
symptom of Turner’s syndrome, which appears at
puberty.
Myths sorrounding rape
(ACDFG)
a. women are usually raped by a stranger. correct
c. most rapes occur away from home areas such as alleys
and behind buildings.
d. documented rape cases include women from 8 to 70
years old.
f. rape is usually an impulsive, spur-of-the-moment
decision by the rapist.
g. unless the assailant is armed, most women should be
able to get away and avoid the rape
Breath Alcohol content ==== 0.05%--0.08% legal limit
Early signs and symptoms of alcohol withdrawal include
TACHYCARDIA ,anxiety, anorexia, tremors, and insomnia.
They may begin up to 8 hours after the last alcohol intake.
Al-Anon is a support group for families of alcoholics.

Clients higher risk for suicide -----the best action for the A patient who is taking disulfiram (Antabuse) -----avoid
nurse is to ask the client directly about whether a specific ingesting products that contain alcohol, such as cough
plan for suicide has been formed. syrup, fruitcake, and sauces and soups made with cooking
wine.
surgical treatment for retinal detachment
- Scleral buckling Disulfiram (Antabuse) avoid metronidazole (Flagyl) ---
interact and cause a psychotic reaction.
Accoustic neuroma
- inner ear every 4 hours ----standard VS monitoring
- COCHLEA
Carotid is VS below the JAW
Retained peripheral vision
- macular degeneration The nurse should follow these guidelines when caring for
a patient who is experiencing alcohol withdrawal:
Central vision 1. Maintain a calm environment, keep intrusions to a
- glaucoma minimum, speak slowly and calmly,
2. adjust lighting to prevent shadows and glare
Retinal hemorrhage 3. call the patient by name,
- shaken baby syndrome 4. have a friend or family member stay with the patient, if
possible.
acute narrow-angle glaucoma, a nurse expects to give
which of the following medications? The therapeutic regimen for an alcoholic patient includes
a. Acetazolamide (Diamox) folic acid, thiamine, and multivitamin supplements as well
as adequate food and fluids.
cataract surgery, the nurse is to administer prescribed eye
drops. The nurse reviews the physician’s orders, expecting alcohol withdrawal delirium most commonly occurs 3 to 4
which type of eye drops to be instilled? days after admission.
c. A mydriatic medication
Confrontation is a communication technique ------ nurse
right cataract removal surgery. In which position should points out discrepancies between the patient’s words and
the nurse place the client? his nonverbal behaviors.
c. Left side or supine.
Treatment for alcohol withdrawal ---- administration of
surgical approaches for removing an acoustic neuroma; I.V. glucose forhypoglycemia, I.V. fluid containing
select all that apply thiamine and other B vitamins, and antianxiety,
retrosigmoid antidiarrheal, anticonvulsant, and antiemetic drugs.
translabyrinthine approach
middle cranial fossa approach (Facial nerve repair) thiamine in alcoholics -----help prevent peripheral
neuropathy and Korsakoff’s syndrome.
Otoscope examination in a client with mastoiditis reveals
a red, dull, thick and immobile tympanic membrane, with Alcohol withdrawal may precipitate seizure activity
or without perforation
IN SEIZURE PRIORITY IS SAFETY (protect head)
alcohol withdrawal?
Diazepam. SUICIDE
When caring for a depressed patient, the nurse’s first
PAG WALA Diazepam (Valium) PWEDENG ISAGOT priority is safety because of the increased risk of suicide.
orazepam (Ativan), and chlordiazepoxide (Librium)
Basta benzodiazepine A patient who has a chosen method and a plan to commit
suicide in the next 48 to 72 hours is at high risk for
lorazepam (Ativan) or oxazepam (Serax) for the treatment suicide.
of patients with advanced cirrhosis or acute alcoholic
hepatitis. REMOVE BOTTLES OF ORANGE JUICE INSIDE WARD

Naltrexone does not treat withdrawal symptoms; , it will LITHIUM

only suppress cravings for alcohol or opiate drugs.
The therapeutic serum level for lithium is 0.5 to 1.5 -Vertigo
mEq/L.
A serum lithium level that exceeds 2.0 mEq/L is DiagnosiS
considered toxic. -Tympanometer (doctor looks inside the ear to see if the
bones move)
Signs of lithium toxicity include diarrhea, tremors, nausea,
muscle weakness, ataxia, andconfusion. Treatment
Only "cure" is surgical procedure
If a patient has symptoms of lithium toxicity, the nurse
should withhold one dose and call the physician. -Cochlear implants
-Stapedectomy (removal of stapes and insertion of micro
A patient who is taking lithium (Eskalith) for bipolar prosthesis)
affective disorder must maintain a balanced diet with -Stapedotomy (Small hole/opening in the stapes footplate
adequate salt intake. and insertion of micro prosthesis)

In a patient who is stabilized on lithium (Eskalith) therapy,

blood lithium levels should be checked 8 to 12 hours after
the first dose, then two or three times weekly during the
first month.

Levels should be checked weekly to monthly during

maintenance therapy.

Phobic disorders are treated with desensitization therapy,

which gradually exposes a patient to an anxiety-producing
stimulus.

Dysfunctional grieving is absent or prolonged grief.

Diphenhydramine (Benadryl) relieves the extrapyramidal

adverse effects of psychotropic drugs.

During phase I of the nurse-patient relationship

(beginning, or orientation, phase), the nurse obtains an
initial history and the nurse and the patient agree to a
contract.

During phase II of the nurse-patient relationship (middle,

or working, phase), the patient discusses his problems,
behavioral changes occur, and self-defeating behavior is
resolved or reduced.

During phase III of the nurse-patient relationship

(termination, or resolution, phase), the nurse terminates
the therapeutic relationship and gives the patient positive
feedback on his accomplishments.

Otosclerosis
- Abnormal bone growth around the footplate of the
stapes, resulting in the stapes becoming fixed, limiting its
movement and reducing the sound that is transferred to
the cochlea

Main types of Otosclerosis

Conductive hearing loss
-Affects the middle ear

Symptoms
Generally affects 1 ear at a time (over time, it can begin to
affect the other ear)

-Hearing loss
-Paracusis (someone who can hear better with
background noise)
-Tinnitus