Unit 5: Disorders and Nursing Management Guidelines

Diseases to Study:

• Parkinson's Disease
• Myasthenia Gravis
• Hydrocephalus
• Encephalitis (similar to meningitis)

Diagnostic Tests:

• Related to aforementioned diseases, critical for accurate diagnosis and treatment evaluation. Tests may include imaging techniques such as CT or MRI scans, lumbar puncture for cerebrospinal fluid analysis, and electromyography for neuromuscular diseases.

Pharmacological Treatments:

• Focus on patient education regarding triggers for conditions, especially with Multiple Sclerosis. Include information on disease-modifying therapies, symptomatic treatments, and the significance of adherence to medication regimens to manage symptoms effectively.

Key Questions and Clinical Scenarios

• Question 1:
  • Patient presents with right-sided facial drooping, slurred speech, and severe headache.
  • First order expected?
  • Correct Answer: B, Non-Contrast CT Scan
  • This is to identify hemorrhagic vs ischemic stroke urgently, which is critical for determining immediate treatment options.
• Question 2:
  • Priority assessment for C3 spinal cord injury?
  • Correct Answer: C, Respiratory failure
  • Breathing compromised above C5/C6; thus, immediate respiratory assessment is crucial.
• Question 3:
  • Nursing priorities during preictal stage of seizure. Select all that apply.
  • Correct Answers: A (Assess for Aura), B (Left Side Lying Position), D (Loosen Restrictive Clothing), E (Ensure O2 & suction available)
  • These actions help ensure patient safety and prepare for potential seizure activity.
• Question 4:
  • Monitoring lab results for patient on IV Mannitol.
  • Correct Answer: A, Serum Osmolarity
  • Mannitol affects osmolarity; tracking is essential to prevent complications such as dehydration or overhydration.
• Question 5:
  • Information to share with a PD patient on Carbidopa/Levodopa?
  • Teach about risk of falls due to dizziness; best taken while in bed in the morning to manage absorption and effectiveness.
• Question 6:
  • First priority for step-down nurse with multiple patients?
  • Correct Answer: C, 24-year-old unconscious after accident.
  • Need early assessment for any LOC changes or signs of increased ICP to address potential life-threatening conditions.
• Question 7:
  • Common side effects of Alzheimer’s medications? Select all that apply.
  • Includes diarrhea, dizziness, nausea, and potential for cognitive side effects, which require monitoring.

High-Risk Groups for Diseases

• Encephalitis Risk Factors:
  • Infants and young children
  • Older adults
  • Immunocompromised individuals, who have increased vulnerability to infections.

Postictal State Observations

• Postictal Signs:
  • Drowsy or confused state following seizure; transient amnesia common, requiring careful monitoring and support.

Indications of Autonomic Dysreflexia

• Signs include:
  • A) Blurred vision
  • B) Elevated BP (hypertension)
  • C) Severe headache
  • D) Sweaty face and arms
• Action Needed:
  • Remove the stimulus prompting episode, which could be a full bladder, skin irritation, or other triggers.

Increased Intracranial Pressure Indicators

• Assessing for changes in pupil size, LOC, or other neuro signs important; maintain vigilance to prevent severe complications.
• Normal ICP is

Glasgow Coma Scale (GCS) Awareness

• Assessments:
  • GCS of <8 indicates severe neurological injury; prompt intervention required.

Essential Treatment Awareness

• Stroke Management:
  • AIRWAY is top priority; TPA (tissue plasminogen activator) for ischemic stroke but contraindicated for hemorrhagic stroke, emphasizing the importance of accurate diagnosis.

Teaching and Patient Education Guidelines

• Dietary Needs:
  • Low sodium and high nutritional value for patients post-stroke and with neuro disorders to aid recovery and manage health.
  • Emphasis on hydration and compliance with medication regimens
  • Especially with anti-seizure medications (monitor for efficacy and toxicity) to ensure optimal management of conditions.

Closing Notes

• Review Period: Ensure to review all questions for Units 4 and 5 thoroughly before the exam, including understanding of materials and practice application of knowledge in clinical scenarios.
• Next Steps: Quiz yourself on these critical points, engage in group discussions to clarify doubts, and prepare for the upcoming exams after spring break.