Disorders/FX
What are the S/S of HYPERglycemia?
-increased thirst
-headaches
-trouble concentrating
-frequent urination
-fatigue, weak, tired
-weight LOSS
What is the Glasgow Coma Scale used to assess?
used to assess the pt.'s LOC; eye-opening response, verbal response, motor response; all 1-5, higher the score the better (best score is 15).
Name the different types of seizures -->
-Simple Partial Seizure (Partial)
-Complex Partial Seizure (Partial)
-Absence Seizure (Generalized)
-Tonic-Clonic seizure (Generalized)
-Myoclonic seizure (Generalized)
-Atonic seizure (Generalized)
Osteoporosis--
Pathophysiology, Complications, Modifiable/Non-modifiable risk factors, client education-home safety, diet recommendations.
Patho- homeostatic bone turnover is altered, leads to loss of total bone mass.
Complications- loss of height, loss of bone mass
Modifiables Risk Factors- Exercise, diet/nutrition, lifestyle choices, medication, low weight/low BMI.
Non-modifiable risk factors- genetics, age, gender, comorbidities
Client Edu- TX regimen education, regular exercise, may need stool softeners, relieve pain (short periods or rest)
Diet recommendations- high calcium and vitamin D, vitamin K, high fiber diet, increase fluids, stool softeners.
What is some client education for an MRI?
-May hear knocking sounds
-Allergies to the contrast
-NO METAL!!!
-Contraindications
Pathyphysiology, Manifestations, Nursing Interventions, Client/Family education, Client coping
Patho- the structure and chemistry of the brain become increasingly damaged over time.
Manifestations- ability to remember/understand/communicate/reason gradually declines; later stages leads to memory loss.
Interventions- long-term consistent caregivers, low stimulation, give fewer choices to limit irritability.
Client/Family Ed- disease is progressive and the pt. may forget them/important things, weight loss will occur in later stages, need help/encouragement with eating/drinking, chewing/swallowing becomes a problem, incontinence.
Client Coping- Advanced Directives- allow pt. to choose how they want to be cared for.
Bell's Palsy--
Pathophysiology and Manifestations
Patho- facial paralysis caused by unilateral inflammation of the seventh cranial nerve.
Manifestations- unilateral facial muscle weakness/paralysis with facial distortion, increased lacrimation, and painful sensations in the face; may have difficulty with speech and eating.
List the different Period/Stages of seizures -->
-Prodromal Phase: starts a few hours/days before the seizure. S/S: insomnia, headache, irritability, ill-temper, increased agitation, depression
-Aura: Beginning of the seizure; lasts a few seconds to a few minutes and is seen in partial seizures. S/S: feelings of extreme fear, sensations in the stomach.
-Ictus: Seizure is occurring; see stiffening, loss of consciousness, violent shaking, jerky movements.
-Post-ictal: The phase that follows the seizure; may be brief or could last several hours/days. S/S: tiredness, irritable, vomiting, confusion, balance problems.
What is the Pathophysiology, Manifestations, Client Education, Prevention of relapses, and Nursing Interventions of Multiple Sclerosis?
Patho- demyelination of the CNS resulting in loss of many functions.
Manifestations- fatigue, weakness, numbness, difficulty in coordination, loss of balance, pain, and visual disturbances.
Client Edu.- prevent flare ups, prevent infections, avoid stress, periods of rest (tolerable exercises/avoid extreme heat), DO NOT SMOKE!!!
Prevent Relapses- symptoms management of muscle spasms, fatigue, & amp; bowel & amp; bladder control.
Interventions- symptom management of muscle spasms, fatigue, bowel and bladder control; Program daily activity and daily exercise, relaxation, coordination exercises, avoid very strenuous activities and extreme fatigue.
What is a Arthroscopy used for? And list 2 Nursing Interventions.
Interventions--
-wrap joint after procedure with compression dressing to control the swelling
-monitor neuro status
Rheumatoid arthritis--
Pathophysiology, Treatment and Dietary/Supplement recommendations, Recommended consults
Patho- immune system does not work properly and attacks the body; causes pain and swelling in the wrist and small joints of the hands and feet.
TX- medications (Prednisone), regular low-impact exercise, erethropoeitin???
Dietary/supplement recommendations- Calcium/Vitamin D
Recommended consults- Rheumatologist
Traction--
Care of the pt. in traction, assessments, purpose of each type and what traction does? When can weights be removed?
The application of pulling force to a part of the body.
Care of the pt.- assist with self care, anxiety, pressure ulcers, atelectasis/pneumonia, constipation, anorexia, urinary stasis, infection, DVT.
Assessments- proper application/maintenance of traction, monitor for skin breakdown/nerve damage/circulatory impairment, palpate traction tapes for tenderness, assess sensation/movement.
Purpose of each type- Skin traction: Buck Extension Traction (pulls away from the body to extend), Cervical Head Halter (Halo), Pelvic Traction; Skeletal Traction.
What does traction do? Reduces muscle spasms; reduce, aligns and immobilize fractures; reduce deformity; increase space between opposing forces.
When can weights be removed- when intermittent traction is prescribed.
What kind of care is needed DURING a seizure, for the pt. ?
-provide privacy
-ease the pt. to the floor if possible
-protect the head of the pt.
-loosen constrictive clothing and remove glasses
-push aside objects that could injure the pt.
-remove pillows and raise the side rails of the bed
-do not put anything in the pt. mouth, and don't restrict the pt.
-place the pt. on one side with the head flexed forward (may need to use suction)
What is an Arthrocentesis? List 3 Nursing Interventions. Explain what is done post procedure to help with healing.
Joint aspiration to obtain synovial fluid to be examined or relieve pain d/t effusion.
Interventions--
-remove hair from the procedure site
-administer analgesics
-apply ice 24-48 hrs. post procedure
Post procedure--
-antibiotics are prescribed
-take all medications as prescribed
What is an Electroencephalography (EEG)? List some education for the pt.
Provides information about the electrical potential of the muscles and the nerves leading to them.
Client Education:
-make sure the pt. washes their hair (better for the electrodes)
-NO HAIRSPRAY
-avoid stimulants/alcohol for 24-48 hours before the test
TYPES OF FRACTURES:
Closed/Simple Fracture- no break in the skin
Open/Compound/Complex- wound extends through the bone
Comminuted Fracture- the bone has splintered into several fragments
Compression Fracture- bone has been compressed (vertebrae).
Greenstick Fracture- one side of the bone is broke and the other side is bent.
Spiral fracture- twists around the shaft of the bone
Transverse fracture- straight across the bone shaft
Casts--
Types, Client Edu., Assessments- most significant, Assessments (Neuromuscular, skin, etc.) Fractures
A rigid, external immobilizing device.
Types- long arm or short leg.
Client Ed.- educate on the pressure areas and s/s of pain in pressure areas; impact to ADLs, activity, exercise, rest, medications, techniques for case drying, controlling of swelling/pain, care of minor skin irritation (cool air from blow dryer).
Required follow-up care and After Care Assessments (Most significant)- pressure areas that the case covers (skin).
Neuro Assessment- pulses, capillary refill, skin color, temp, sensation, and motor function (6 P's)
CNS check- circulation, motor ability, and sensation
What kind of care is needed for the pt. AFTER the seizure occurs?
-keep the pt. on their side to prevent aspiration
-reorient the pt. to the environment
-if the pt. is confused/wandering, guide the pt. back to bed.
-if the pt. is agitated, keep a distance, but remain close to help prevent injury until the pt. is fully aware.
What are acquired seizures?
What is a bone scan used for ?
Done to detect metastatic and primary bone tumors, osteomyelitis, some fractures, and aseptic necrosis, and monitor the progression of degenerative bone diseases.
Strategies to reduce back pain & Diagnostic tests -->
Strategies to reduce pain: pain management, exercise, body mechanics- sleep on side with knees flexed, avoid prolonged sitting, stress reduction, health promotion, padded shoe insoles, dietary plan and encouragement of weight reduction.
Diagnostic Tests: CT scan, MRI, X-Ray, Ultrasound
Parkinson Disease--
Pathophysiology, Manifestations, Client/Family Education:
Patho- causes nerve cells in a part of the brain (substantia nigra) to die; this part controls movement; decreased availability of dopamine.
Manifestations- Tremors, stiffness of the arms/legs/trunk, slowed movement (bradykinesia), trouble with balance and coordination, pill rolling, muscle rigidity, shuffling gait.
Client/Family Education- progressive disease- symptoms get worse over time, need supervision for safety, healthy eating can ease S/S, regular exercise will boost strength/flexibility/balance
What are some seizure precautions?
-bed rails up with padding
-suction set up in the room
-IV access
-bed in low position
-low lights!!!
Osteomyelitis---
What's the pathophysiology, risk factors for development, common causative organisms, and the treatment?
Patho- infection of the bone d/t soft tissue infection, direct bone contamination, bloodborne infection.
Risk Factors- break in sterile technique in surgery, existing infection that spreads, contamination of bone, bloodborne infection.
Common Causes Organisms- MRSA, Proteus & Pseudomonas app., E. coli
TX-pain relief, priority antibiotics, improve mobility w/ physical therapy, control/eradicate infection
AIRWAY/BREATHING- high risk for aspiration after surgery.