Download Galen NUR 242 Exam – Neuro 100% Correct Answers 2025 and more Exams Nursing in PDF only on Docsity!
Galen NUR 242 Exam – Neuro 100%
Correct Answers 2025
What is included in the central nervous system? - Correct Answer>>brain and spinal cord What is included in the peripheral nervous system? - Correct Answer>>cranial nerves, spinal nerves, ganglia What does the peripheral nervouse system act as? - Correct Answer>>relay station What three types of headaches impact quality of life? - Correct Answer>>migraine, tension, cluster What is the pain assessment guideline for migraine headaches? - Correct Answer>>P - provoking (what triggers) Q - quality (is it pulsating or throbbing) R - radiation (is it unilateral and supra retro orbital) S - severity (where is it on pain scale) T - time (typically 4-72 hours) What factors make migraines worse? - Correct Answer>>light, sound, movement Pathophysiology of migraine - Correct Answer>>most popular theory is that extracranial arteries expand and irritate nerves due to vasodilation Why are migraines a problem? - Correct Answer>>productivity, sick days, quality of life Migraine triggers - Correct Answer>>chocolate, red wine, hard cheeses, monosodium glutamate, hormonal changes, exertion, fatigue, and stress manifestation of migraine - Correct Answer>>Aura (20% of cases), steady throbbing pain, unilateral, sensitive to light, sound, odors
What does POUND stand for as it relates to migraines - Correct Answer>>Pulsatile One day Unilateral Nausea/vomitting Disabiling What are the abortive therapies for migraines? - Correct Answer>>Fioricet, NSAIDS, Triptans and ergotamines When is abortive therapy contraindicated for migraine treatment? - Correct Answer>>heart disease What is the best initial treatment for migraine - Correct Answer>>triptan derivative (ex: Imitrex) What is epilepsy? - Correct Answer>>recurrent, unprovoked seizures (at least 2, with no immediately identifiable cause) What is a seizure? - Correct Answer>>Uncontrolled electrical activity in the brain that causes disruption in brain activity Assesssment of epilepsy - Correct Answer>>details about the seizure activity, family history, collateral medical conditions (stroke, HTN, TBI) Seizure risk factors - Correct Answer>>Vascular Infection or Inherited condition Trauma Alzheimers or Autoimmune Metabolic derangements Idiopathic Neoplasm S - pSychiatric/pSeudoseizure What can trigger a seizure? - Correct Answer>>sleep deprivation, stress, alcohol withdrawl, food
Acute seizure treatment - Correct Answer>>patent IV, suction, oxygen, padded side rails, pillow, privacy, benzodiazapines(ativan, valium), antiepileptics (phenytoin,phosphenytoin) status epilepticus - Correct Answer>>A condition in which seizures recur every few minutes or last more than 30 minutes Priorities for status epilepticus - Correct Answer>>establish airway, ABGs, IV push lorazepam/diazepam, rectal diazepam (if not IV), loading dose of IV phenytoin Dilantin is caustic to the veins and should not be pushed any faster than - Correct Answer>>50mg per min Diagnostic workup for epilepsy - Correct Answer>>EEG, CT/MRI, excluse other causes, labs What labs are needed epilepsy? - Correct Answer>>electrolytes, drug levels What is the normal level for phenytoin - Correct Answer>> 10 - 20 What is the normal level for cabamazepine - Correct Answer>> 8 - 12 What is the normal level for valproic acid - Correct Answer>> 50 - 125 AED - Correct Answer>>Antiepileptic drug treatment of epilepsy - Correct Answer>>Medication Therapy:
- Antiepileptic drugs (AED's) Other Therapies:
- Ketogenic diet
- Rest
- Stress reduction patient education points for epilepsy - Correct Answer>>medication compliance, follow up drug levels, neurologist, medic alert bracelet, evaluation of employment safety, vocational rehab, social service resources for medications, driving restrictions based on state laws
Parkinson disease - Correct Answer>>A disorder of the central nervous system that affects movement, often including tremors. Pathophysiology of Parkinson Disease - Correct Answer>>familial, progressive and chronic, degradation of dopamine Onset of Parkinson Disease - Correct Answer>>asymmetric, resting tremor in upper extremity, restlessness during sleep, gradual decreased sense of smell Cardinal signs of Parkinson Disease - Correct Answer>>bradykinesia (slow movement, shuffling gait, drag feet), resting tremor, rigidity, postural instability Additional signs of Parkinson Disease - Correct Answer>>pill rolling, reduction in dexterity, masked facial expression, sleep distrurbances, autonomic dysfunction, bradyphrenia, dementia, night time drooling Physical exam findings in Parkinson disease - Correct Answer>>resting tremor, cogwheel rigidity, decreased speed of movement, micrographia, small & quiet voice with proper articulation, festinating gait Nursing Care for Parkinson Disease - Correct Answer>>fall precautions, aspiration precautions, nutritional assessment, I&O, high calorie high protein high fiber meanls, meds on time EVERY time, screen for depression/psychosis Drug therapy for Parkinson disease - Correct Answer>>dopaminergic, dopamine agonists, COMTs, anticholinergic, MAOI-B What is the gold standard treatment for Parkinson disease - Correct Answer>>carbidopa-levodopa mutiple sclerosis - Correct Answer>>progressive autoimmune disorder characterized by inflammation demyelination of the myelin sheath Types of Multiple Sclerosis - Correct Answer>>relapsing remitting primary progressive secondary progressive
Nursing considerations for Multiple Sclerosis - Correct Answer>>risk for infection, dysphagia, fatigue, urinary and bowel incontinence, pain, medications, vision changes Treatment of Multiple Sclerosis - Correct Answer>>Acute: Glucocorticoids (methylprednisolone) IV for 2-3 days Long-term: Interferon Beta, oral drugs are second line but do have less side effects (natalizumab, fingolimod) Symptom: Baclofen, Valium, Amantadine, Modafinil, phenytoin, pregabalin,carbamazepine,oxybutynin TIA - Correct Answer>>transient ischemic attack transient ischemic attack - Correct Answer>>brief interruption in cerebral blood flow; lasts 30-60 minutes Symptoms of TIA - Correct Answer>>blurred vision, diplopia, ataxia, extremity weakness, numbess, vertigo, aphasia, dysarthria Care consideration for TIA - Correct Answer>>reduce hypertension, control diabetes, heart healthy diet, stop smoking Medication management for TIA - Correct Answer>>statins, anti-hypertensives, and anti-platelets What is a stroke? - Correct Answer>>brain attack where the perfusion to the brain suddenly becomes interrupted Classifications of stroke - Correct Answer>>ischemic, hemorrhagic Ischemic stroke categories - Correct Answer>>thrombotic - atherosclerotic plaque embolic - dislodged clot Pathophysiology of stroke - Correct Answer>>Thrombotic - HTN, vascular disease, prodromal TIA Embolic - Afib, endocarditis Hemorrhagic - HTN, vessel disorders
Symptoms of stroke - Correct Answer>>altered level of consciousness, face, arm, speech alerations, gait distrubances Risk factors of stroke - Correct Answer>>smoking, AFIB, age, illicit drug use, alcoholism, uncontrolled hypertension, sedentary livestyle, obesity, hypercoagulability, hyperlipidemia, oral contraceptives, sickle cell disease, diabetes mellitus Assessment of stroke - Correct Answer>>Facial drooping Arm drift Speech articulation Time Diagnostic exams for stroke - Correct Answer>>CT scan at stroke center, MRI, carotid ultrasound Immediate interventions for stroke patient - Correct Answer>>ABC, GCS, routine labs, EKG, assess for hypoglycemia, or hypoxia, INR, NIH stoke scale, NPO What does the NIH Stroke Scale assess? - Correct Answer>>neurologic deficit Nursing care for ischemic stroke - Correct Answer>>TPA therapy (4 hr window), permissive HTN, head midline, low fowlers TPA Therapy - Correct Answer>>IV alteplase, continuous VS and LOC assessment, two large bore IVs, NO DEXTROSE, bleeding precautions for 24 hours (no sticks, no foley, no ng tube) signs of increased intracranial pressure - Correct Answer>>headache, nausea, vomitting, change in LOC, decreased pupil response, seizures, abnormal posturing, Cushing's triad Cushing's triad - Correct Answer>>Irregular respireations, bradycardia, wide pulse pressure tPA exclusion criteria - Correct Answer>>give within 4 hrs
