Exam 2 Nursing Exam Notes

Definition: Abnormal electrical signals in the brain.
Aura: Clients may sense a smell before a seizure.
Risk Factors: Meningitis, infections, autoimmune diseases, hyponatremia, stroke history, stress, lack of sleep.
Acute Seizure Management:
- Time the seizure duration.
- Monitor ABCs; do not place anything in the mouth.
- Place the patient in a side-lying position from standing or sitting to prevent aspiration.
- Types:
- Generalized seizures: Last 2-5 minutes.
- Myoclonic seizures: Sudden jerks/twitching in limbs.
- Absence seizures: Brief staring spells.
Patient teaching: No driving, ensure rest, a keto diet may help, consistency in medicating.
Safety: Use padded siderails for protection.
Medical Emergency: Prolonged seizures (>5 min) or repeated seizures (>30 min). Administer Ranitidine if seizures occur.

Definition: Autoimmune disorder leading to inflammation and attack of the myelin sheath in the CNS.
Signs/Symptoms: Tinnitus, diplopia, vertigo, blurred vision, unsteady gait, facial pain, paresthesia.
Diagnosis: Physical exam, neurologic exams, MRI, cerebrospinal fluid analysis.
Causes/Risk Factors: Infections, autoimmune response.
Treatment Options:
- Plasmapheresis: Blood filtration.
- Medications: Methotrexate, NSAIDs, Anticholinergics (for secretion), Intravenous Immunoglobulin to strengthen immune response.
- IV Natalizumab: To reduce inflammation and relapses.
Patient Precautions: Avoid sick people, take precautions. Successfully manage care.

Pathophysiology: Loss of dopamine leading to tremors, primarily impacts men.
Symptoms: Uncontrollable, asymmetric movements, rigidity, resting tremors, postural instability, pill-rolling tremors.
Risk Factors: Exposure to well water, lower estrogen levels, family history.
Treatment: Levodopa and Carbidopa (to prevent early conversion into dopamine), Benztropine for tremors.
Nursing Interventions: Timely medication, a high-calorie, high-fiber diet, small frequent meals, assess for fall and aspiration risks.

Definition: Permanent interruption of blood flow to the brain.
Risk Factors: Use of oral contraceptives, obesity, diabetes, smoking, irregular heartbeat, sickle cell disease.
Symptoms: Altered LOC, facial drooping, gait disturbances, difficulty in speech.
Nursing Assessments: CBC, PT, INR, PTT, spinal fluid analysis.
Scales for Assessment: NIH Stroke Scale, Glasgow Coma Scale.
Types of Stroke:
- Ischemic Stroke: Caused by a clot; treat with TPA (thrombolytic therapy) cautiously.
- Hemorrhagic Stroke: Caused by bleeding; do not administer TPA.
- Management: Monitor dysphagia, falls, and visual disturbances.
Timing and Interventions: Early treatment is critical (within 4.5 hours). Maintain patient safety and monitor signs of deterioration.

Symptoms: Foggy, cloudy vision; often require surgery.
Risk Factors: Age, smoking, diabetes, trauma.
Post-operative Care: Use prescribed eye drops, avoid actions increasing IOP (sneezing, straining).

Symptoms: Loss of peripheral vision, possible headaches.
Treatment: Medicines like Timolol (reduce aqueous humor production) and Pilocarpine (increases outflow).
Patient Instructions: Monitor VS and use caution to avoid systemic side effects.

Impact: Loss of central vision, more common in older adults; severe safety concerns.
Symptoms: Difficulty reading, dark spots in vision.
Treatment: PDT and laser therapy to prevent abnormal growth of blood vessels.

General Symptoms: Common signs of infection include fever, inflammatory redness, and swelling. Medications can range from NSAIDs to steroids.
RSV Risk: Smoking, age, travel history.
Diagnostics: CBC, ABG, chest X-ray, and sputum assessments.

Definition: Breathing pauses during sleep, primarily due to soft tissue obstruction.
Symptoms: Sweating, nocturia, poor sleep at night; irritability, memory loss during the day.
Treatment Options: Sleep study diagnosis and use of CPAP machines.

Definition: Chronic inflammation leading to bronchoconstriction.
Risk Factors: Allergen exposure, GERD.
Assessment: Wheezing, chest tightness, decreased breath sounds.
Medications: SABA (rescue inhaler) for immediate relief, LABA (maintenance). Corticosteroids for inflammation control.

Definition: Progressive, irreversible airway obstruction characterized by emphysema and chronic bronchitis.
Symptoms: Increased difficulty breathing, barrel chest appearance, crackling sounds.
Management: Hydration, frequent small meals rich in calories, and oxygen therapy when necessary.

Influenza: Presents with cold-like symptoms and is more contagious prior to symptom onset; vaccinations advised during flu season.
Pneumonia: Symptoms include decreased lung capacity, crakles, and increased tachycardia, with vaccinations recommended for the elderly.