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NSG 4100 Exam 4 Q&A

HEAL100 Health Care — exam and revision material · Other

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Health Care exam material, 7 pages. Originally published on StudyMerit.

Pages
7
Academic year
2025/2026
Language
English

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NSG 4100 Exam 4 High Blood pressure is priority over a high heart rate!!! Unit 8 Complex Neurological Problems Head trauma – prioritize care, what would require immediate intervention? • CSF FROM EAR= EMERGENCY Bruising over mastoid bone Temp OVER 100. 4 -Changes in pupils - not PERLA -Sluggish -Uneven -Greater or less than 2-4 s/s of posturing: -Decerabit -Decorticate *** a patient that is peeing a lot in a short amount of time, is a concern (DILUTE URINE) -Nursing care- Neuro assessment (GCS SCALE) any decrease in number = Increased ICP! Traumatic brain injury (TBI) – prioritize care, what would require immediate • intervention? What would you do if someone came in non-responsive and all you could do is assess them? -Check pulse -Utilize Glasgow coma scale (GCS) -Give prophylactic or propofol to prevent seizures Increased intracranial pressure (ICP) • - DO NOT let the systolic BP get above 130!!! and no big jumps, they’re indicative of a brain bleed or increased ICP . (Most likely needs to go back to the OR) -KEEP HOB at 30-40 DEGREES -Sudden restlessness without reason • Increased ICP nursing intervention o Seizure precautions, BP/ICP monitoring o HOB 30-40 degrees o Medication - mannitol or hypertonic saline o Reducing metabolic demands Downloaded by Amber Kelly (ambercanuteson@hotmail.com) lOMoARcPSD|54995859

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Craniotomy - plan of care post op, assessment post op • -(Headaches and periorbital edema are common with these procedures) - If the drain has 50- 100 ml per shift that is too much, call the MD. - Can lead to DI and SIADH, keep an eye on urine output. Everyone automatically gets a foley. -Post op goal of these procedures is to reduce the edema, control their pain, prevent seizures, monitor BP -Leaking can happen in places you wouldn’t suspect such as nose, ear, mouth (salty taste), postnasal drip. -Patient will be on anticonvulsant to reduce post op seizure risk -MONITOR FOR INFECTION, CSF , AND SEIZURES Meningitis – what patients are more susceptible to opportunistic variations of • meningitis? -College or military -Immunocompromised -Prevention (Meningococcal immunization at 11 years old with a booster at 16) -Droplet precautions Care of the client with encephalitis. • Nursing interventions: o Comfort measures - cluster care, dim lights, low noise, limit visitors - candidate for farther away from nurses station o Seizure precautions o Neuro checks Q1 HOUR -Give acyclovir for 3 weeks (HSV type 1) Huntington’s disease – plan of care when other conditions exist. Pyridostigmine for myasthenia graves – expected outcomes o Pyridostigmine (acetylcholinesterase inhibitor) - increase muscle strength Myasthenia graves treatment and client education • -Medical management -Teach eyelid taping -Avoid sedatives -Stress reduction techniques -Sit upright for meals, soft foods -Large meal in the morning, small meals in evening o Assessment of swallowing, teaching swallowing techniques -Risk for aspiration o Myasthenic crisis - airway support, ABGs, avoiding sedatives (create further concern of airway), chest physiotherapy Downloaded by Amber Kelly (ambercanuteson@hotmail.com) lOMoARcPSD|54995859

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Fibromyalgia assessment fi ndings • -CNS ascending and descending pathways causing amplification of pain signals -Woman more than men s/s: o Trigger points o Predictable pain response o Fatigue o Pins/needles sensitivity to pain o Generalized achiness/stiffness o Sleep disturbances o Functional impairment ** difficult to pin point and diagnose Multiple Sclerosis lifestyle to promote quality of life • -Safety - r/t weakness, fatigue, coordination, impairments/deficits -Fall precautions - using walking aid, using a wide stance with gait , remove rugs Spinal cord injury – expected outcomes depending on level of injury • -Autonomic dysreflexia is a complication -Severe HTN o Sit them up o Notify provider o Address cause -Most common cause is distended bladder Drain the bladder - in & out catheter o Administer antihypertensives o Closely monitor BP Guillain Barre syndrome - plan of care • -In fl ammatory demyelination of peripheral nerves s/s: o Ascending weakness - starts lower and moves up • Worry about respiratory function • Medical management o Airway support - mechanical support and respiratory therapy o Anticoagulation - clot preventions • Bleeding precautions • Other things that are non-pharm that will help decrease clots -SCDs o Continuous telemetry • Keep leads on and in the right location Downloaded by Amber Kelly (ambercanuteson@hotmail.com) lOMoARcPSD|54995859

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