NEURO/

PSYCHNURSI
NGNOTES(
Par
t2)

1.Cerebrovascularacci dentorst rokeisa I

FTHI SQUESTIONPOPSI NYOURACTUAL
commoncauseofdeat h Riskf actorsare EXAM DAY, JUSTFOLLOW THESAME
highbloodpr essure,highchol esteroldi
et, MANAGEMENTFORSEI ZURESUCHAS
smokingand al cohol abuse, genet i
cs, PLACI NGTHECLIENTINSI DELYING
speci
ficrace( Afr
ican-Amer ican)and POSITION,
sedentaryl
ifestyl
e. RAISINGSIDERAILSUP, LOOSEN
RESTRI CTI
VECLOTHINGANDGI VE
MOSTACCURATEANSWERWHEN ANTI PYRETI
CS
DEALI
NGWI THTHISTYPEOFPATIENTI
S (PRIORITYMANAGEMENT) .
ADMINISTRATI
ONOFPRESCRIBEDANTI
-
HYPERTENSIVEDRUGS. 4.Commonant i
-convulsantdrugsar ethe
Al
so,REPORTPATIENTWITHSIGNOF fol
lowi ng:
RI
GIDFLEXIONOFARMSATTHEELBOWS ▪ CARbamazepi ne(Tegr et
ol)=Adv erse
ASTHAT effectismy elosuppression(Infecti
on)
SI
GNIFIESDECEREBRATE(
INDI
CATOROF DEpakene( Valproicaci
d)=t eratogenic
DETERI
ORATINGOFLEVELOF ▪ GAbapent in(Neuront i
n)=Mai ntenance
CONCIOUSNESS). drugf orpatientinICU
▪ LAmot r
igine(Lami ct
al)=Dr ugofchoi ce
2.Hy drocephal
usisacondi t
ionwher ein fortri
gemi nalneur al
gia
thereisanabnor malfl
uidcollecti
onof ▪ PHEny t
oin( Di
lanti
n)=FAVORI TEDRUG
cerebrospinalf
lui
dinsidethebr ai
n.Signand SAEXAM
sympt omsar e;I
NCREASEDI N
INTRACRANI ALPRESSURE( KEYWORDI S 1)LABVALUE=10- 20mcg/dL
HIGHPI TCHEDCRY) ,HEAD 2)Cancausehy potensi
on
CIRCUMFERENCEI S 3)Cancausebl eedi
ngandinfecti
on
LARGERTHANCHESTCI RCUMFERENCE, 4)Cancausedi scol
orat
ionoftheuri
ne
SUNSETEYESANDMACEWENSI GN 5.TOpi r
amate(Topamax)=Dr ugofchoi
ce
(CRACKED formi gr
aineandbuli
mianerv
osa.Side
POTSOUNDDURI NGPERCUSSI ON). effectis
WEI GHTLOSS.
3.Febri
leseizur
eisanalarmingsi
tuat
ionfor
pediat
ri
cclientbetween6monthsto6y ear
s 6.Leveti
racet
am (Keppr
a)=Newgenerat
ion
ol
d.Themai ncauseisst
il
lunknownupt o anti
-convul
sant.si
deeff
ect
:DROWSINESS!
now.
7.Chil
drenwit
hsi
cklecel
lanemi
aareatri
sk VITAL
forhavi
ngISCHEMICSTROKE.COMMON SIGNS,MUSCLERI
GIDITYANDSEIZURE.
MANI FESTATI
ONISSICKLECELLCRISI
S MANAGEMENTI SADMI NI
STRATI
ONOF
WITHSUDDEN- ONSETARM WEAKNESS. MUSCLERELAXANT( e.
g.DANTROLENE
COMMONEXAM ANSWER! SODIUM ANDSUCCINYLCHOLI
NE.
(COMMONEXAM QUESTI ON!
)
8.Commonant i-depressantmedicati
ons
arethef ollowing: 13.Level
ofanxi
etyaret
hef
oll
owi
ng:
Tri
cycli
cant i
depr essant s Mil
d:Incr
easel
earni
ngandf
ocus(
BEST
1)Pamel or(nor TRIPTYLI NE) KAPAGMAG- EEXAM)
2)Elavi
l (ami TRIPTYLI NE)
3)Anafrani l(Clomi PRAMI NE) Moderate:
Increaselear
ningbutnof
ocus
4)Tofrani l(I
mi PRAMI NE) Sever
e/panic:
NOLEARNI NGANDFOCUS;
Selectiveser otoninr euptakei
nhibi
tor NARROWI NGOFTHEMI NDPERCEPTION.
1)Prozac( FluoXETI NE) MANAGEMENTSARETO:
2)Zoloft( SerTRALI NE) STAYWI THTHECLI ENT,STAYCALM
3)Paxil(par oXETI NE) ANDDOSI MPLEI NSTRUCTIONS.
4)Escitalopram ( Cipralex)
PHARMACOLOGI
CALMANAGEMENT:
9.COMMONEXAM ANSWERSABOUTSSRI
ALLDRUGSCANCAUSEWEIGHTGAIN BENZODI AZEPI
NES(
"pam"
)
ALLDRUGSCANLEADTOINSOMNIA ☆Alprazolam
ALLDRUGSCANLEADTOSEXUAL ☆Midazol am
DYSFUNCTI
ON ☆Diazepam
AVOIDALCOHOLANDANTI
-HI
STAMINES ☆Lorazepam

10.Monoamineoxidasei
nhi
bit
or(
MAOI
) CHLORDI
AZEPOXI
DE(LI
BRI
UM)=USE
1)Par
nate(t
rany
lcypromi
ne) FORALCOHOLWITHDRAWAL
2)Nar
dil(
Phenel
zine)
3)Marpl
an(I
socarboxazi
d) 14.BENZODIAZEPI
NETOXICITY
MEDICATIONISFLUMAZENIL(COMMON
11.COMMONEXAM ANSWERSABOUT EXAM QUESTION!)
MAOI
1)NOTOTYRAMI NERI
CHFOODS 15.Ti
pst orememberwhenhandl i
ngpatient
2)NOTOALCOHOLANDSMOKI NG wit
hspinalcordinjuryacci
dent :
12.DONOTEVERCOMBI NEANYANTI Posi
tiontheclientonaf ir
m surface
DEPRESSANTS!!!I
TCANLEADTOAFATAL Uselogroll
i
ngt omov ethecl i
ent
DISEASE Spi
neshoul dbei nneutralposit
ionatall
KNOWNASSEROTONI NSYNDROME. ti
mes
MANI FESTATI
ONSAREINCREASEDALL Appl
yacer vicalcoll
artoimmobi li
zethe
spi
ne (AUTOMATI CFORCARCRASH, SPINE
SHOULD
16.Commonment al heal
thther
apiesinthe BEHANDLEDWI THCAUTI ON).
exam arethefol
lowi ng: Remov ethecl
ientfr
om thecarandplace
Mili
eut her
apy=Changi ngone’sok theclienti
naf i
rm sur
face.
envi
ronmentt oi
ncr easement alcl
ari
tyand Assessthecli
ent’
spulse.
tochange Checkcli
ent’
slevelofconsci
ousnessby
one’
sper cept
ioninl i
fe. usingGLASGOW COMASCALE.

Cognit
ivebehavi
oralt
herapy=Amet hod 20.Headi njur
yorconcussioni
sami nor
i
nat t
emptingtoreconnectthet
hought
st o neurologi
ccondi t
ionthati
nvol
vesatrauma
executeappropr
iat
eactioninacer
tai
n due
scenari
o. tobluntforceoran
accelerat
ion/deceler
ati
onmotion(
coup-
17.Groupt
herapy=f
orsel
f-awar
eness. countercoup).
MOSTCOMMONBENEFI CIARYFORTHI S
TREATMENTAREPATI ENTSWHOARE 21.COMMONSI GNANDSYMPTOMSARE
ALCOHOLICS. Lossofconsciousness
Headache
18.Met hyl
phenidate(
Rit
ali
n)isaCNS Amnesia(r
etrograde)
sti
mul antuseforpati
entwit
hattent
ion
defi
cit 22.Patientwithmaj ordepressionispr one
hyperacti
vedisorder(
ADHD) . forhavingimbalancef oodintakebecause
of
TI
PSTOREMEMBER: thei
rlowsel f
-est
eem.Asanur se, i
tisa
Si
deeffect
s:I
NSOMNIAANDWEIGHTLOSS. mustt oincl
udef oodst hatareHI GHI N
I
FONCEADAY, GIVETHEMEDICI
NE PROTEI N
BEFOREBREAKFAST. ANDCALORI ES.Exampl esarev egetables,
I
FTWI CEADAY,GIVEI
TBEFORE potat
oes, fi
shes,leanmeatandf r
uit
s.
BREAKFASTANDBEFORE
23.Autism i
sadev elopmentaldi
sordert
hat
LUNCH. i
nvolvesproblem incommuni cat
ionand
CHECKTHEPATI ENT’SHEIGHT/WEI GHT i
nteracti
on.Thedi seaseusuallystar
tsat
ANDVI TALSIGNS. age2, wherei
nt hereisanevidenceofan
SIGNOFEFFECTI VENESS: I
MPROVED i
nfant
SCHOOLPERFORMANCE bei
ngmut ewhenhe/ shecry
.Best
19.Tipstor
ememberwhenhandl i
ng managementf orthisdevi
ati
oni stohavea
unconsci
ouscli
entwithhi
storyofcarcrash STRUCTUREDROUTI NEAND
acci
dent: CONSI STENCY.
Placeacervi
calcol
laronthecli
ent
24.Buli
mianer vosaisanexampl eofan
eati
ngdisordercommoni nt eenagersand
those
whoar esuffer
ingfrom i
nsecurit
iesrelat
ed
toweightgain.Commonf i
ndingsinclude
BINGEEATI NG, PURGINGAFTEREATI NG,
IMPROPERDENTALHEALTHAND
CALLOUS
FORMATI ONOFTHEKNUCKLES.

Managementforthi
scondit
ionaret
he
f
oll
owing: [
BAM]
Becautioust
ohiddenfoodsunder
neat
h
t
hebed( VERYCOMMON)

Assesspati
ent’
sov er
allstat
ussuchas
vi
tal
signsandelectr
olyt
ei mbalances
Monitorcl
i
ent’
spostmeal acti
vit
yatleast
1-
2hour saf
tereat
ing.

25.Tipst orememberwhenadmi nisteri

ng
l
ithium t opatientwithmania:
Level=0. 6–1. 2mEq/ dL(1.5mEqst il
l
accept able)
I
ncreaseur i
neout put=atriskfor
DEHYDRATI ON
Toxicityeffect:Coarsetr
emor s,Kidney
fail
ure
Hand: Finet r
emor sisexpected
I
ncreasef luidintake:t
ofightoff
DEHYDRATI ON
Uu:Di arr
hea( HANAPI NMOYUNGWORD
NASTOMACHFLU)
Moni t
orsodi um levelandintake

note:
credi
tsposakayAngel16 na
nagbi
gaynginfor
mati
venursingnot
es
na'
to.
.