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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher
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58 - Chronic Neurologic Problems

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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher | Registered Nurse (RN) School Study Aid

58 - Chronic Neurologic Problems
37 Picmonics to Learn | 1 hr 8 mins
CN V
Trigeminal Nerve
Sensory
Facial Sensation
Motor Function (Via Mandibular Nerve)
Mastication Muscles
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1 min
CN VII
Facial Nerve
Lacrimation
Salivation
Sensory
Taste from Anterior 2/3 of Tongue
Motor
Facial Movement
Stapedius Muscle
Eyelid Closing
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1 min
CN IX
Glossopharyngeal Nerve
Sensory
Taste from Posterior 1/3 of Tongue
Monitoring Carotid Body and Sinus
Motor
Stylopharyngeus
Swallowing
Salivation
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1 min
CN X
Vagus Nerve
Sensory
Aortic Arch Chemoreceptors and Baroreceptors
Taste from Epiglottic Region
Motor
Swallowing
Palate Elevation
Talking
Coughing
Midline Uvula
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1 min
Calcium Channel Blockers (Verapamil and Diltiazem)
Mechanism of Action
Slows AV Conduction
Indications
Angina Pectoris
Arrhythmias
Essential Hypertension
Side Effects
Bradycardia
Hypotension
Constipation
Peripheral Edema
Gingival Hyperplasia
Nursing Consideration
Medication Education
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2 mins
Sumatriptan
Mechanism of Action
Short Half-Life
5-HT Agonist
Inhibits Trigeminal Nerve Activation
Induces Vasoconstriction
Indications
Migraine
Cluster Headache
Side Effects
Increased Risk of Serotonin Syndrome
Paresthesias
Coronary Vasospasm
Contraindication
Prinzmetal's Angina
Coronary Artery Disease (CAD)
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3 mins
Gabapentin
Primary Indication
Seizure Treatment
Secondary Indications
Peripheral Neuropathy
Postherpetic Neuralgia
Bipolar Disorder
Migraine Prophylaxis
Characteristics
Inhibits Voltage-Gated Ca2+ channels
Designed as a GABA Analog
Side Effects
Ataxia
Sedation
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2 mins
Valproic Acid (Depakote)
Mechanism
Blocks Na+ Channels
Increases GABA Concentration
Indications
Tonic-clonic Seizures
Bipolar Disorder
Migraine Prophylaxis
Side Effects
Hepatotoxicity
Blood Dyscrasias
GI Distress
Tremor
Pancreatitis
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1 min
Fluoxetine (Prozac)
Mechanism of Action
Inhibits Reuptake of Serotonin
Indications
Depression
Side Effects
Sexual Dysfunction
CNS Stimulation
Weight Changes
Serotonin Syndrome
Contraindications
No MAO-Is
No Anticoagulants / Antiplatelets
Considerations
Suicide Risk
Delayed Onset of Action
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2 mins
Selective Serotonin Reuptake Inhibitor (SSRI) Overview
Indications
Depression
Anxiety
Mechanism of Action
Selective Serotonin Reuptake Inhibitors
Drugs
Paroxetine
Sertraline
Escitalopram
Fluoxetine
Side Effects
Sexual Dysfunction
Serotonin Syndrome
Treat with Cyproheptadine
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2 mins
Types of Seizures
Tonic-Clonic
Tonic
Clonic
Absence (Petit Mal)
Myoclonic
Atonic
Partial (Focal) Seizure
Focal Aware (Formerly Called Simple Partial)
Focal Impaired Awareness (Formerly Called Complex Partial)
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3 mins
Phenobarbital (Barbiturates)
Mechanism
Barbiturate
Indications
Seizures
Side Effects
Ataxia
Paradoxical Excitement
Fatigue/Drowsiness
Considerations
Monitor Plasma Levels
High Potential for Abuse
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1 min
Phenytoin (Dilantin)
Mechanism
Blocks Na+ Channels
Indications
Tonic-clonic Seizures
Side Effects
Ataxia
Nystagmus
Sedation
Gingival Hyperplasia
Purple Glove Syndrome
Hirsutism
Rash
Anemia
Considerations
Individualized Dosing
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2 mins
Carbamazepine (Tegretol)
Mechanism
Inactivates Na+ Channels
Indications
Seizures
Bipolar Disorder
Trigeminal Neuralgia
Side Effects
Nystagmus
Ataxia
Hepatotoxicity
Blood Dyscrasias
Water Retention
Stevens-Johnson Syndrome
Considerations
Avoid Grapefruit Juice
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2 mins
Seizure Interventions
Maintain Airway
Side-lying Position
Support Head
Move to Floor
Benzodiazepines
Considerations
Never Restrain
No Objects in Mouth
Document Details
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2 mins
Ethosuximide (Zarontin)
Indications
First Line Absence Seizure
Mechanism of Action
Blocks Thalamic T-Type Ca2+ Channels
Side Effects
Stevens-Johnson Syndrome
Fatigue
Diarrhea
Blood Dyscrasias
Considerations
Do Not Stop Abruptly
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2 mins
Diazepam (Valium)
Indications
Anxiety
Seizures and Status Epilepticus
Muscle Spasms
Alcohol Withdrawal
Side Effect/Assessment
Dizziness/Vision Changes
Confusion/Amnesia
Urinary Incontinence
Behavioral Changes
Respiratory Depression
Antidote
Flumazenil (Romazicon)
Nursing Considerations
Fall Precaution
Do Not Stop Abruptly
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2 mins
Pregabalin (Lyrica)
Mechanism
GABA Analog
Indications
Seizures
Neuropathic Pain
Fibromyalgia
Side Effects
Headache
Dizziness
Somnolence (Fatigue)
Weight Gain
Angioedema
Rhabdomyolysis
Considerations
Dependence
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1 min
Lamotrigine (Lamictal)
Mechanism
Blocks Na+ Channels
Indications
Seizures
Bipolar Disorder
Side Effects
Diplopia
Stevens-Johnson Syndrome
Headache
Aseptic Meningitis
Nausea and Vomiting
Considerations
Screen for Suicide Risk
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2 mins
Multiple Sclerosis Assessment
Cause/Mechanism
Nerve Fiber Demyelination
Assessment
Motor Issues
Cerebellar Signs
Fatigue
Paresthesias
Spasticity
Urinary Incontinence
Optic Neuritis
Considerations
Women Between 20-50 Years Old
Relapse and Remission of Symptoms
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2 mins
Multiple Sclerosis Interventions
Drug Therapy
Corticosteroids
Interferon Beta
Dimethyl Fumarate (Tecfidera)
Fingolimod (Gilenya)
Mitoxantrone (Novantrone)
Natalizumab (Tysabri)
Considerations
Increase Exercise
Identify Triggers
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2 mins
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
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2 mins
Parkinson's Disease Assessment
Assessment
Decreased Dopamine
Older Adult
Cogwheel Rigidity
Bradykinesia
Shuffling Gait
Resting Tremor
Pill-Rolling
Mask-Like Face
Cognitive Decline
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2 mins
Chlorpromazine (Thorazine)
Mechanism
Low Potency Antipsychotic
Indications
Schizophrenia
Hiccups
Side Effects
Sedation
Weight Gain
Orthostatic Hypotension
Anticholinergic Effects
QT Prolongation
Neuroendocrine Effects
Caution in Seizure Patients
Corneal Deposits
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2 mins
Lithium
Mechanism of Action
Mood Stabilizer
Unknown Mechanism
Indications
Bipolar Disorder
Side Effects
Nephrogenic Diabetes Insipidus
Hypothyroidism
Tremor
Heart Block
Contraindication
Pregnancy
Considerations
Monitor Plasma Levels
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2 mins
Haloperidol (Haldol)
Mechanism
High Potency Antipsychotic
Indications
Migraine
Schizophrenia
Side Effects
Extrapyramidal Symptoms
Weight Gain
QT Prolongation
Restlessness
Considerations
Caution in Seizure Patients
Neuroleptic Malignant Syndrome
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2 mins
Levodopa/Carbidopa (Sinemet)
Mechanism
Increases Dopamine in Brain
Indications
Parkinson's Disease
Side Effects
Nausea and Vomiting
Arrhythmias
Dyskinesia
Psychosis
Orthostatic Hypotension
Considerations
Report Uncontrolled Movements
Darkened Sweat or Urine
Off and On Phenomenon
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2 mins
Parkinson's Drugs
Parkinsons Characteristics
Decreased Dopamine
Increased Acetylcholine
Drug Names
BALSA Acronym
Bromocriptine
Amantadine
Levodopa
Selegiline
Antimuscarinics
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2 mins
Parkinson's Disease Interventions
Medications
Levodopa/Carbidopa (Sinemet)
Entacapone (Comtan)
Selegiline (Eldepryl)
Amantadine (Symmetrel)
Bromocriptine (Parlodel)
Benztropine (Cogentin)
Considerations
Allow Extra Time
Ensure Patient Safety
Surgery As Last Resort
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2 mins
Monoamine Oxidase Inhibitors (MAO-Is)
Indications
Atypical Depression
Mechanism of Action
Increase Levels of Amine Neurotransmitters
Drugs
"Takes Pride In Shanghai"
Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline
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1 min
Anticholinergics
B.O.AT.S Acronym
Benztropine
Parkinson's Disease
Oxybutynin
Decrease bladder spasms
Atropine
Mydriasis and Cycloplegia
Scopolamine
Motion Sickness
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1 min
Benztropine (Cogentin)
Mechanism
Anticholinergic
Indications
Parkinson's Disease
Acute Dystonia
Side Effects
Mydriasis
Dry Mouth
Urinary Retention
Tachycardia
Constipation
Psychosis
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1 min
Prevention of Falls
Risk Factors
Physical Aging
Polypharmacy
Environmental
Hospital / Facility Prevention
Call Light within Reach
Assistive Devices Available
Bed Alarms
Home Prevention
Improve Lighting
Remove Home Hazards
Priority Nursing Interventions
Promote Exercise
Fall Risk Assessment
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2 mins
Myasthenia Gravis Assessment
Weakness with Muscle Use
Diplopia
Ptosis
Dysphagia
Difficulty Speaking
Fatigue
Complications
Cholinergic Crisis
Overmedicated
Myasthenic Crisis
Not Enough Medication
Respiratory Muscle Paralysis
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2 mins
Cyclosporine (Sandimmune) Overview
Mechanism
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Prevent Transplant Rejection
Psoriasis
Rheumatoid Arthritis
Considerations
Monitor Plasma Levels
Avoid Grapefruit Juice
Increased Risk of Lymphoma
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2 mins
Amyotrophic Lateral Sclerosis (ALS)
Assessment
Progressive Muscle Weakness
Systemic Muscle Wasting
Fasciculations
Spasticity
Fatigue
Considerations
Riluzole (Rilutek)
Stretching
Little to No Cognitive Decline
Respiratory Support
Palliative Care
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2 mins
Huntington's Disease Assessment and Interventions
Assessment
Decreased GABA
Appears around Age 40
Slow Cognitive Decline
Choreiform Movements
Non Repetitive Jerks
Interventions
Neuroleptics
Tetrabenazine
Genetic Counseling
Considerations
Stages of Disease
High Calorie Diet
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2 mins

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