Know the treatment for Addison's disease.
(occurs when adrenal glands don't make enough cortisol and aldosterone)
Fluid and electrolyte balance
Steroids: cortisone and hydrocortisone.
Hormone replacement therapy.
Know the classical signs of increased intracranial pressure
Changes in LOC
Change in Vital signs
Confusion/changes in behavior
As the ICP continues to increase the patient will manifest changes on the contralateral (opposite side of mass)
With painful stimuli the patient will
Know the signs signifying neurological change in a patient
Altered level of consciousness
Muscle weakness/involuntary muscle contractions
Rapid acting insulin:
Lispro, Aspart, Glulisin
Onset (hours): <0.5
Intermediate acting insulin:
Isophane (NPH), lente
Onset (hours): 1-3
Long acting insulin:
Onset (hours): 2-4
Know the basic functions of each of the endocrine glands covered in class
Thyroid: affects metabolism
Pituitary: secretes many different hormones, some of which affect other glands
Parathyroid: help regulate level of calcium in blood
Adrenal: help trigger the fight-or-flight response
Pancreas: regulates the level of sugar in bl
Know the teaching/education for a patient in Addisonian crisis
Know the common diagnostic neurological studies and indications
Lumbar Puncture (Insertion of needle under sterile technique into subarachnoid space): Cerebrospinal Fluid Analysis
Electroencephalography (EEG): Seizure
Electromyography (EMG) and Nerve Conduction Study: Neuromuscular disorders
Computed Tomography (CT)
Know your basic stroke emergency assessment
Face: Is one side of the face drooping? Ask the person to smile
Arms: does one arm drift downward? Have to person raise both arms
Speech: Are they slurring their speech or having difficulty getting the words out right? Have the person try to repea
Know the different presentations for the ischemic and hemorrhagic strokes
Ischemic: inadequate blood flow to a part of the brain
Hemorrhagic: bleeding into the brain that results in death of brain cells
Transient Ischemic Attack (TIA) transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal isc
Know the interventions for the Alzheimer patient
Alzheimer's Disease: Chronic progressive, degenerative disease. Common form of dementia. Cause unknown but genetic plays a role in certain cases.
Nursing Intervention: Assess mental status, re-orientation, safety, assistive with ADL and self-care
Know the expected lab and diagnostic findings in Cushing's disease
Elevated serum cortisol levels
Elevated blood glucose
Elevated sodium (Na+) or hypernatremia
Decreased serum potassium (k+) or hypokalemia
Hint: Extra "Cush" for Cushing's a disorder of excess therefore almost all labs elevated
Dexamethasone suppression t
Know the important objective and subjective data collection for Cushing's disease
Past medical and medication history (steroids)
Rheumatology patients, asthmatics, history of neuro-endocrine tumors
Changes in appetite
Speech, memory, or skin changes
Signs of depression
increase T3 and T4
decreased or undetectable TSH
Absent or minimal insulin production
More common in young people but can be at any age
Pancreas continues to produce some endogenous insulin but not enough insulin is produced OR body does not use insulin effectively
Know the causes of type 1 and type 2 diabetes
Type 1: Genetics, autoimmune, environment
Type 2: lifestyle, disease, medications
S/S for hypoglycemia:
shakiness, palpitations, nervousness, diaphoresis, anxiety, hunger, pallor
Altered mental functioning: difficulty speaking, visual disturbances, stupor, confusion, coma
Check blood glucose 1st: If < 70 mg/dL, immediately begin treatment
S/S for hyperglycemia:
Diabetic Ketoacidosis (DKA)
Poor skin turgor
Dry mucous membranes
Lethargy and weakness early
Skin dry and loose; eyes soft and sunken
Abdominal pain, anorexia
Know the care of the patient with Myasthenia gravis
Drug therapy: anticholinesterase drugs (Pyridostigmine (Mestinon) is the most successful drug of this group), alternate-day corticosteroids (Prednisone), and immunosuppressants
Up to 80% of patients who receive corticosteroids have complete cessation of s
Know the presentation of the patient with Parkinson's disease
Gradual degeneration of the midbrain affecting control and regulation of movement.
Attributed to a combination of environmental and genetic factors.
Symptoms: Slow shuffling gait, mask-like facial expressions, pill-rolling movements of hands, stooping pos
Know the care of the patient with Lou Gehrig's disease
Progressive, degenerative disorder involving both the upper and lower motor neurons. Coordination and muscle strength get progressively worse.
Usually no change in mental status or sensory function. Eventual paralysis of the motor system, except the eyes.
Know the nursing education for the patient with Multiple Sclerosis
Autoimmune disease that results in demyelination of the white matter of the nervous system.
Diplopia (double vision)
Muscle weakness and unsteady gait,
Intolerance of temperature extreme
Know the assessment of the patient with Huntington's disease
Degenerative disease with gradual onset of involuntary, jerking movements(chorea), and progressive decline in mental ability, resulting in dementia and behavioral changes.
Chorea: Abnormal involuntary movements-constant writhing, twisting, uncontrollable
controls speech articulation, behavior, moral decision making and emotional outbursts (Broca's area)
interprets sensory stimuli, pain, and touch
auditory processing, language interpretation (wernicke's area), memory formulation and storage
contains the visual cortex and is involved in interpreting visual stimuli
relays ascending sensory information from the body to the brain; and descending messages from the brain to the body
Integrates sensory impulses: recognition, variations in touch and temperature, sense of movement and position, size, shape and quality reco
works with the pituitary gland to maintain homeostasis. Site of hunger center. Regulates sleep, blood pressure, aggressive and sexual behavior, emotional responses
keeps the contractile tone of every muscle in the trunk and extremities in a constant state to control highly skilled movements that require precision without intentional thought
Situated between the midbrain and medulla and is a bridge between the halves of the cerebrum as well as between the medulla and the cerebrum. Contains sensory and motor pathways.
Connects the pons and the cerebrum with the cerebral hemispheres. Contains sensory and motor pathways and is the center for auditory and visual reflexes.
Transmits motor fibers from the brain to the spinal cord and sensory fibers from the spinal cord to the brain. Contains centers for controlling heart, respiration and blood pressure.