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NUR265 EXAM 3 / 231 QUESTIONS AND ANSWERS
/ 2025 - 2026/RATED A+
What is encephalitis? inflammation or infection of the brain What causes encephalitis? West Nile Virus Herpes What are the s/s of encephalitis? High fever, N/V, stiff neck Flu like symptoms change in LOC photophobia pupil changes (dilate & less responsive to light) What is used to dx encephalitis? lumbar puncture EEG CT (looks for mass) What are N/I for encephalitis? Neuro checks Monitor for s/s of ICP Suction only resp compromised HOB 30- 45 Decrease stimuli
What is the tx for encephalitis? acyclovir What are complications from encephalitis? ICP that leads to herniation of brain tissue or death What is myasthenia gravis? Autoimmune disorder that is characterized by weakness in the muscles What causes myasthenia gravis? lack of Ach receptor sites, leads to lack of nerve impulses What are s/s of myasthenia gravis? difficulty holding up head or brushing teeth double vision ptosis dysphagia loss of bowel & bladder control decrease sense of smell & taste How is myasthenia gravis diagnosed? tensillon test. s/s improve with Edrophonium. How does edrophonium work?
What is myasthenic crisis? too little cholinesterase inhibitor drug What is the priority with myasthenic crisis? resp function What are s/s of myasthenic crisis? increase HR, RR, BP decrease u/o no cough or swallow reflex dry What time should ChE inhibitor be given? 45 - 1hr before meals to avoid aspiration What can tensilon test cause? cardiac dysrhythmias, have atropine on hand What is nursing priority with myasthenic crisis? maintain airway, may require to intubate What is Guillain-Barre? an uncommon acute inflammatory disorder that affects axons and/or myelin sheath (neurons can't impulse)
where does Guillain Barre Syndrome start
- Starts in feet and hands (numbness, tingling) What are causes of Guillain Barre? bacterial infection influenza epstein barr zika What are s/s of guillain barre? loss of reflexes hypotension labile BP muscle weakness or paralysis (decreased DTR) numbness ataxia blurred or double vision palpitations pain tachycarida What are complications from guillain barre? resp & cardiac problems decreased mobility, DVTs What is tx for guillain barre? plasmapheresis asap IV immunoglobulin if can't do plasma right away
What are primary causes of SCI? hyperflexion hyperextension axial loading or vertical compression excessive rotation penetrating trauma What are s/s of SCI? bradycardia hypotension hypothermia SBP < What are N/I with SCI? ABCs cap refill assess for abd hemorrhage glascow coma scale sometimes need bowel & bladder retraining increase mobility monitor pulse strength and cap refill monitor for absent DTR
What are tx with SCI? methylprednisolone (inflammation) dextran (hypotension) atropine (bradycardia) muscle relaxers (with caution) tizanidine (muscle spasticity) intratheral baclofen What is a indication that spinal shock is resolving? muscle spasticity and reflexes below the level of injury What is the 1st priority with AD? sit them up check bowel or bladder distention call md insert foley or give enema give bp meds What is spinal shock? happens immediately as a response to injury lasting usually less than 48 hrs, or could last several weeks What are s/s of spinal shock?
diaphragm can become paralyzed What n/i do you do with AD? treat cause VAP prevention cough assist them if needed monitor cardio IV fluids monitor bp q 10-15mins nitrate What are secondary sci causes? hemorrhage ischemia hypovolemia impaired tissue perfusion from neuro shock local edema What is hyperflexion? like whiplash What is hyperextension? hits chin upward
What is axial loading or vertical compression? hit top of head or butt What is excessive rotation? turn head too far What is penetrating trauma? knife or bullet How do you prevent secondary SCI? stabilize the spine (c coloar) halo fixator What needs to be assessed with a halo? check pts skin be able to do one finger check neuro checks monitor for infection make sure wrench is with them can not drive eat high fiber & fluids
usually die within 3 hrs What is highest priority with ALS if still able to eat? aspiration What is tx for ALS? there is no cure comfort care is needed interdisciplinary care riluzole (just extends survival time) Teaching w/ riluzole? take on empty stomach look for s/s of liver toxicity (vomiting/jaundice) What is trigeminal neuralgia? compression or inflammation of the 5th cranial nerve What are s/s of trigeminal neuralgia? pain = sharp spasms only on one side of face
How is trigeminal neuralgia dx? ct scan What are trigeminal neuralgia triggers? light touch change in facial expression chewing air blowing on face hot drinks brushing teeth What are n/i with trigeminal neuralgia? priority is pain management chew on uaggected side avoid too hot or cold foods/fluids wash face gently What is tx for trigeminal neuralgia? meds: gabapentin carbamazepine pregabalin baclofen
How to tell if Bell's palsy vs stroke? ask to put both arms up, if stroke won't be able to do it What is tx for Bell's Palsy? corticosteriods- 30 - 60day during 1st week after onset of symptoms acyclovir- 7 - 10 days after resolves within few weeks What are n/i for bell's palsy? manually close the eyelid & instill drops ointment for moisture eye patch eat and drink on unaffected side increase calorie snacks facial exercises freq oral care What is meningitis? inflammation of the meninges What causes meningitis?
otitis media siniusitis tooth abscess tongue piercing What causes viral meningitis? herpes varicella HIV What causes bacterial meningitis? strep neisseria How is meningitis dx'ed? CSF testing (lumbar puncture)
- kernigs and brudzinski With bacterial the CSF will be? cloudy With viral the CSF will be?
What are N/I with menigitis? VACCINATE (11-12, booster @ 16) hand hygiene accurate doc of neuro checks monitor for increased ICP or seizures decrease stimuli What is tx for viral menigitis? acyclovir With viral menigitis defects are? temp & fully recoverable What is tx for bacterial menigitis? rifampin cipro ceftriaxone What is pre-op with lumbar puncture? Left side, can not be done w/ increased ICP, skin infection
What is post-op with lumbar puncture? pt on back & set up lots of fluids (2L w/ 1L caffeine) monitor 30 mins after What are lumbar puncture complications? HA relieved by side lying in supoine , worse when sit up--could be leaking fluid What is n/i with increased ICP? HOB 30- 35 Head midline log roll neuro checks 1-2hrs NO PEEP if on Vent do not hyperventilate limit suctioning or coughing NO CLUSTER CARE cooling blanket, but don't let shiver cardiac monitor alert MD w/ neuro deteration s/s What is tx with increased ICP? mannitol
