HESI Study Guide - Misc.

First line drug to treat Parkinson's Disease

Levodopa/carbidopa (don't take with meals)

Teaching for Parkinson's Disease

Promote physical exercise enhances patient's functional ability, but does not stop disease progression

Work with caregivers to promote independence and self-care

Well-balanced diet

Eat 6 small meals per day (provide ample meal time)

Effective management of sleep problems, good sleep hygiene

In early stages, patients can develop depression and anxiety, therefore provide psychological therapy and counseling

Help caregiver find resources to help them with their caregiver stress and burden

Delirium

Abrupt onset that can fluctuate day to day

Lasts hours to days, but can be prolonged

Patient's thoughts are disorganized, distorted, delusional, hallucinations, incoherent speech

Behavior can be hyperactive or hypoactive

Disturbed sleep, patient's have reversed sleep-wake cycle

Caused by underlying disease that must be treated

Delirium can be reversible

Alzheimer's Management

• Drug therapy for cognitive problems

• Behavior modification

• Moderate exercise

• Assistance with functional independence

• Assistance and support for caregivers

Drugs for Alzheimer's Patients

Benzos

SSRIs

Antipsychotics

Ambien (Zolpidem)

Donepenzil (Aricept)

Galantamine (razadyne)

Rivastigmine (exelon)

Raynaud's Phenomenon s/s

Decreased perfusion to fingers that turn white, then turn blue when cyanotic, then red when blood flow is restored.

Coldness and numbness during the vasoconstrictive phase

Throbbing, aching pain, tingling, and swelling when blood flow is restored

brittle nails, thickened skin

Can last minutes to hours

Raynaud's triggers

Cold exposure

emotional stressors

tobacco use

caffeine

Exposure to heavy metals

high homocysteine levels

use of vibrating machinery

Raynaud's Drugs

Calcium channel blockers (first line treatment)

Smooth muscle relaxers

Vasodilators

Topical nitroglycerin

Systemic Lupus Erythematosus

multisystem inflammatory autoimmune disease

Systemic Lupus Erythematosus Diagnostic Assessments

• History and physical assessment

• Antibodies (ANA, anti-DNA, anti-Sm, antiphospholipid)

• CBC

• Serum complement

• Urinalysis

• X-ray of affected joints

• Chest x-ray

• ECG to assess cardiac involvement

Systemic Lupus Erythematosus Assessments

Fever pattern

Joint inflammation

Limitation of movement/motion

location and degree of discomfort

fatigue

Weight

fluid intake

output

Monitor for any neurological problems

Lupus Drug Therapy

• NSAIDs or acetaminophen for mild disease

• Steroid-sparing drugs (e.g., methotrexate)

• Antimalarials (e.g., hydroxychloroquine)

• Corticosteroids for flares and severe disease

• Immunosuppressive drugs (e.g., cyclophosphamide, azathioprine)

Lupus Patient Teaching

Tell patient Lupus has a good prognosis for most people

Medication adherence does not guarantee no flare ups

Factors that increase lupus flare up:

fatigue

sun exposure

emotional stress

infection

drugs

surgery

Abruptly stopping a drug

Know everything about Type 1 and Type 2 Diabetes and DKA

Good luck