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wiscflor
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What problem is characterized by unilateral pain in the lips, gums, cheeks or forehead?
How is it triggered?
Trigeminal Neuralgia
Chewing, Touching face, Talking, Hot/Cold Exposure
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What are the anti-seizure drugs for trigeminal neuralgia?
- Carbamazapine (Tegretol)
- Gabapentin (Neurontin)
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Carbamazipine (Tegretol):
What are you monitoring for?
Therapeutic level?
S/S?
Bone marrow suppression
5-12mg/L
Sedation, Decrease LOC, Gait instability, Anemia
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Bell's Palsy is a unilateral paralysis of what cranial nerve?
VII (Facial Nerve)
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Bell's Palsy:
Associated with?
Typical recovery time?
Clinical presentation?
Herpes Virus
6 months
- Pain behind ear
- Inability to close eye/facial droop
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What are the drugs to treat Bell's Palsy?
- Anti-Virals:
- Acyclovir (Zovirax)
- Valacyclovir (Valtrex)
- Famiciclovir (Famvir)
Corticosteroids
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Guillain-Barre Syndrome is inflammation of _______ and is a cell-mediated immune reaction triggered by ______, ______, ______.
Peripheral nerves
- Viral Infection
- Neoplasms
- Immunizations
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Guillain-Barre Syndrome causes _______.
Demyelination
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Guillain-Barre Syndrome progression:
Starts as?
Then as?
Finally as?
Parathesias
Respiratory Paralysis
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The main complication with Guillain-Barre Syndrome?
Respiratory Failure
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What are the two main things to monitor for with Guillain-Barre Syndrome?
Respiratory Status
Swallowing and nutrition
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What is the difference between primary and secondary injury of the spinal cord?
Primary - Initial disruption of the cord
Secondary - Damage from ischemia, inflammation, toxic metabolites and edema
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Spinal vs. Neurogenic Shock
Spinal - Decreased reflexes and flaccid paralysis BELOW level of injury
- Neurogenic - Loss of vasomotor tone from sympathetic disruption
- (Causes bradycardia and hypotension)
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Incomplete Lesions:
Central Cord Syndrome characteristics
- Motor weakness and sensory loss
- Usually cervical
- Upper extremity loss > lower extremity loss
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Incomplete Lesions:
Anterior Cord Syndrome characteristics
- Loss of motor function
- Pain and temperature sensaiton below injury
- Sensation, touch, position and vibration intact
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Incomplete Lesions:
Brown-Sequard Syndrome characteristics
- Unilateral cord damage
- Ipsilateral loss of motor, position and vibratory sense
- Contralateral loss of pain and temperature below injury
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Incomplete Lesions:
Posterior Cord Syndrome characteristics
Loss of proprioception below injury
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What syndrome is damage to the lowest portion of cord and lumbar or sacral nerve roots?
Cauda Equina
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What high dose drug prevents secondary damage to the cord?
Methylprednisolone (Solu-Medrol)
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During emergent care, why do we need to maintain the MAP of 80-90?
What is used to maintain it?
To keep BP up to perfuse the cord
Dopamine
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Any injury above C4 requires ________
Mechanical Ventilation
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What problem is a stimulus below lesion causes an unopposed reflex sympathetic stimulation?
Autonomic Dysreflexia
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A 36y/o male has been admitted to the neuro unit for Guillain-Barre Syndrome. Which assessment should the nurse make?
A) Peripheral Strength
B) Respiatory Rate and Effort
C) Peripheral Sensation
D) Blood Pressure
B) Respiatory Rate and Effort (this multiple choice question has been scrambled)
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The nurse is preparing to administer Methylprednisolone (Solu-Medrol) to a patient with an acute spinal cord injury. The patient ask what the medicaiton is for. The nurse responds
A) To prevent infection
B) To reduce pain and fever
C) To speed the healing process and encourage regeneration of axons
D) To decrease the inflammatory response and prevent secondary cord damage
D) To decrease the inflammatory response and prevent secondary cord damage (this multiple choice question has been scrambled)
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