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NUR 2755 / NUR2755 Exam 1: Multidimensional Care IV / MDC 4 Exam 1 Concept Guide (2021/2022) Rasmussen $12.49
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NUR 2755 / NUR2755 Exam 1: Multidimensional Care IV / MDC 4 Exam 1 Concept Guide (2021/2022) Rasmussen
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  • Course
  • NUR2755 Multidimensional Care IV (NUR2755)
  • Institution
  • Rasmussen College

NUR 2755 / NUR2755 Exam 1: Multidimensional Care IV / MDC 4 Exam 1 Concept Guide

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  • April 6, 2022
  • 19
  • 2021/2022
  • Other
  • Unknown

Subjects

  • mdc 4 exam 1
  • mdc4 exam 1
  • nur2755 exam 1
  • nur 2755 exam 1
  • nur 2755 nur2755 exam 1 multidimensional care iv mdc 4 exam 1 concept guide 20212022 rasmussen
  • multidimensional care iv exam 1

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  • Rasmussen College
  • NUR2755 Multidimensional Care IV (NUR2755)
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MDCIV EXAM 1 CONCEPT GUIDE

Neuro
 Migraine signs/symptoms, medications and action of meds, dietary restrictions

o S/S
o Mild migraine:
 Acetaminophen, NSAIDS (ibuprofen and naproxen)
 Excedrin migraine has acetaminophen, ASA, and caffeine (causes
vasoconstriction)
o Severe migraine:
 Triptan preparations
 Sumatriptan (Imitrex)
 Ergotamine preparations
 Cafergot
 Dihydroergotamine (DHE)
 Isometheptene and dichloralphenazone combo (Midrin)
o Migraine WITH aura
 1st/Prodromal:
 Several hours to days before onset
 Irritability, depression, food cravings, diarrhea, constipation, frequent
urination
 Aura develops over several minutes and lasts no longer than 1 hour
 2nd:
 Severe, incapacitating, throbbing, intensifies over several hours, N/V,
drowsiness, and vertigo
 3rd (4-72 hours):
 Dull HA, pain and aura subside, muscle aches, contraction of head and neck
muscles, physical activity worsens and client might sleep
o Migraine w/OUT aura

 “Common” migraine
 Pain is aggravated by physical activity
 Unilateral, pulsating pain with one or more s/s
 Photophobia, phonophobia, nausea, vomiting
 Lasts 4-72 hours
 Often occurs in the morning, during stress, with premenstrual tension, or fluid
retention
o Atypical Migraine

 Also called “status migrainous”
 Lasts longer than 72 hours
 Migrainous infarction:
 Neuro symptoms are not reversed within 7 days
 Ischemic infarct noted on neuroimaging (stroke after migraine)
 Unclassified:
 Any headache that does not fulfill all the criteria
o MEDS
o Given if headache occurs more than twice a week, interferes with ADLs
 NSAIDS

, MDCIV EXAM 1 CONCEPT GUIDE


 Beta-blockers and calcium channel blockers reduce the activity of hyperactive
excitable neurons
 Beta-adrenergic: Propranolol and timolol
 Calcium channel blocker: Verapamil
 Antiepileptic: Topiramate
 Onabotulinumtoxin A: Used for chronic migraines, injected into specific areas for
5 treatment cycles
o
 Seizure, phases and treatment, interventions

o TYPES
o Tonic
 Stiffening and rigidity of muscles especially arms and immediate loss of
consciousness
 Lasts 30 seconds or several minutes
 Bite tongue or become incontinent, confusion and lethargy
o Clonic
 Rhythmic jerking/relaxing of all extremities, follows tonic (Tonic-clonic seizure)
 Muscle contraction and relaxation
o Myoclonic
 Brief twitches, jerking, or stiffening of extremities, can occur in one area or in
groups, lasts just a few seconds, contractions may be symmetric or asymmetric
o Atonic
 Sudden loss of muscle tone lasting a few seconds, followed by postictal
confusion
 May cause pt to fall
 Most resistant to drug therapy
o Postictal
 After the seizure, brain is recovering, may last minutes to hours
o MEDS
o Antiepileptic drugs (AED)
 Carbamazepine (Carbatrol, Tegretol, others)
 Phenytoin (Dilantin, Phenytek)
 Valproic acid (Depakene)
 Oxcarbazepine (Oxtellar, Trileptal)
 Lamotrigine (Lamictal)
 Gabapentin (Gralise, Neurontin)
 Topiramate (Topamax)
o Phenobarbital
o Introduced one at a time & doses adjusted until they med(s) control seizures
o Want therapeutic levels without major side effects
o DURING SEIZURE INTERVENTIONS

 Position pt. to provide a patent airway.
 Protect from injury. Move furniture away, hold head in lap if on the floor
 Suction secretions (If your patient has a hx of seizures, you should have the
suction READY
 Turn to side (drain oral secretions and avoid aspiration)

, MDCIV EXAM 1 CONCEPT GUIDE


 Loosen restrictive clothing.
 Do not attempt to restrain the client.
o AFTER SEIZURE INTERVENTIONS

 Maintain side-lying position
 Suction and oxygen as needed
 Check vital signs and assess for injuries.
 Perform neurological checks.
 Allow patient to rest if necessary.
 Reorient and calm the patient, who might be agitated or confused.
 DO NOT restrain
 The patient my become incontinent
 Determine if they experienced an aura, which can indicate the origin of seizure
in the brain.
 Contraindication for CT with contrast
o Reaction to contrast agent
o Pregnancy
o Treatment of thyroid disease w/ radioactive iodine
o Use of metformin
o Anti-inflammatory meds
o Diuretics
o Chronic or acutely worsening renal disease
 Parkinson’s signs and symptoms, treatment, medications, nursing interventions, clinical
manifestations
o STAGES

 1/Initial: Unilateral limb movement, minimal weakness
 2/Mild: Mask like face, slow shuffling gait
 3/Moderate: Postural instability
 4/Severe: Akinesia (loss of motor function
 5/ Worse stage
o S/S
 Nervous system disfunction
 Fatigue
 Changes in handwriting
 Decreased manual dexterity
 Stooped posture
 Slow, shuffling fait
 Slow, monotonous speck
 Tremors/pill-rolling tremor of the fingers
 Bradykinesia, akinesia
 Orthostatic hypotension, flushing, diaphoresis
 Bowel and bladder dysfunction
 Muscle rigidity
 Cogwheel: rhythmic interruption
 Plastic: Mildly restrictive
 Lead pipe: total resistance
 Mast like: Wide open, fixed, staring eyes

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