med surg exam 1 blueprint

reinforce drug therapy regimen, take medicine as soon as symptoms begin, lie in bed in a dark room and minimize noise and other stimuli

rest and drug therapy mainstays, mild analgesics ineffective, methysergide(sansert) or sumatriptan(imitrex) aborts migraines, antiemetics, biofeedback

cant touch chin to chest, classic symptom meningitis(headache, fever, nuchal rigidity),pain in neck

allow drainage to flow onto porous gauze, clear drainage that separates from bloody drainage suggests spinal fluid

wet a dextrostick or testape with drainage from nose or ear, observe if color change indicates presence of glucose

paralysis below neck, impaired breathing, bowel bladder incontinence

ventillator support required, no sensation below clavicle

diaphragmatic breathing, elbow upper arm wrist movement

paralysis below waist, control of hands, abdominal breathing

trunk and abdominal control

hip adduction impaired

knee and ankle movement impaired

varying bowel and bladder control and sexual function

managing the clients drug therapy, levodopa is associated with periods of breakthrough or end of dose wearing off in which symptoms are exacerbated when a consistent level is not maintained, work with pt & ot on gait, balance, adl's

implement eating and swallowing techniques that reduce potential for aspiration, perform heimlich, speech pathologist, remove throw rugs, clutter, and electrical cords at home, perform regular exercises, change position frequently, apply braces or splints

cerebral aneurisms usually occur in circle of willis(ring of arteries that supply brain),ct mri safer for locating site, lumbar puncture bloody csf, hunt hess classification

experience tia days weeks before stroke, signs of impending stroke numbness on one side of the face,arm, leg
mental confusion, difficulty speaking and understanding, impaired walking, severe headache, large hemmorhage unconscious, breathing noisy labored, cheek blows out on exhalation, eyes deviate toward affected part of brain, pulse slow, full bounding,

remove throw rugs, clutter, electrical cords, get walker, bedside commode

blow to head that jars brain, complete recovery within short time, brief lapse of consciousness, headache, double vision, dizzyness, mri rule out more serious injury, mild analgesia(acetominophen) relieves headache. watch for signs of iicp(behavioral alteratioins, sleepiness, personality changes, vomiting,speech gait disturbances

more serious than concussion leads to gross structural injury to brain

loss of sympathetic reflex activity below the level of injury within 60 minutes, hypotension, bradycardia, warm dry skin, bladder and bowel distension, no perspiration below injury, poikilothermia(body temperature of environment), lasts 1 week to months

record time client voids over several weeks establish voiding pattern, plan voiding schedule, encourage increased fluid intake, note any sensation that precedes voiding, void every 2hrs awake, bend at waist or press inward and downward, place hand in basin of water, paralyzed clients tap skin above pubis bone