316 test 2: bell’s palsy, trigeminal neuralgia, and NG tubes: ch. 40 and 61 – Flashcards

anthropometric measurements, physical assessment, hx, diet hx, labs, functional status: handgrip strength

dry mouth, bags under eyes, sunken eyes, bones may stick out, dry skin, poor skin turgor, losing weight, dentures not fitting,

total protein, albumin, fluid loss, rbc and hb indicate anemia if low.

fatty stools may be observed low fat soluble vitamins

imbalance of essential nutrients. normal bmi 18.5 to 24.9. 30 obese, between 25-29.9= overweight

Starvation,Chronic Illness: ex. Organ failure, cancer, rheumatoid arthritis, obesity and metabolic syndrome,Acute Illness: trauma/inflammation

dementia, depression, chronic alcoholism: depletes all nutrients, electrolytes and vitamins. excessive dieting, swallowing disorders, decreased mobility, malabsorption issues, steroid/oral antibiotics, hyper-metabolic state.

decrease in digestive enzymes or in bowel surface area can quickly lead to a deficient state.

chronic illness: depression, dementia, appetite changes, problems with swallowing: dysphagia, limited income, functional limitations. Discharge from hospital.

infusion by bump. intermittent infusion by gravity, intermittent bolus by syringe, cyclic feedings by pump. short term: less than 4 weeks. nasoduodenal, or nasojejunal

Explain rational to client, Place client in high fowlers, Inspect nares, Determine length of tube, Gently insert tube,Check aspirate/pH, Secure tube to nose, XRAY!!

gastrostomy, jejunostomy

pneumonia, fluid overload, heart failure, vomiting or aspiration. dehydration, diarrhea (massive isn't normal, soft is), constipation, skin care, EN misconnection

fluid and electrolyte imbalance, hyperglycemia, compromised cardiac function. GERD, home setting factors

indicated: cannot use GI tract. given IV, complications: infection , metabolic problems. catheter related problems. usually is a CVT line.

Dextrose 25-35 cal/kg/day,Amino acid (protein): 45-65g,Fat emulsion: 10-30%,Vitamins: Zin, Iron, Copper, Chromium,Electrolytes: Na, K, Cl, Mg, Ca, Ph,This normally comes all in one bag Milk and looks like milk.

infection, metabolic problems

iron-deficiency anemia, hct, hb, elevated BUN (intravascular volume depletion and abnormal renal function. low: K, Mg,Na, low phosphate, hypoglycemia, leukopenia

hypokalemia, elevated serum amylase from vomiting

sudden, usually unilateral, severe, brief, stabbing recurrent episodes of pain in the distribution of the trigeminal nerve

burning knife-like pain in lips, upper or lower gums, cheek, forehead or side of nose. eye twitch 'tic', facial sensory loss, 'attacks', triggers: tooth brushing, chewing, washing face

pain (won't eat), imbalanced nutrition (some food may trigger attacks), ineffective coping, knowledge deficit, self care deficit

Client will report pain is less than 3 out of 10, Client will maintain adequate nutrition,Client will verbalize any psychosocial concerns, Client will identify triggers for attacks, Client will participate in activities of daily living

nerve blocks, acupuncture, biofeedback, vitamin therapy, nutritional therapy, electrical stimulation therapy

client is free of pain, client demonstrates good hygiene, client identifies triggers and appropriate management, client maintains adequate nutrition, client verbalizes understanding of medication regimen

antiseizure medications: carbamazepine (tegretol), gabapentin (neurontin), phenytoin, or antispasmodic medication baclofen (lioresal)

nerveblock with local anesthetic agent. glycerol rhizotomy, microvascular decompression of the trigeminal nerve, radiofrequency rhizotomy, gamma knife radiosurgery

surgical procedure to sever nerve roots in the spinal cord

• Client education related to pain prevention and treatment regimen • Measures to reduce and prevent pain; avoidance of triggers • Care of the client experiencing chronic pain • Measures to maintain hygiene: washing face, oral care • Strategies to ensure nutrition; soft food, chew on unaffected side, avoid hot and cold food • Recognize and provide interventions to address anxiety, depression, and insomnia • If client has residual effects after surgery: • Chew on unaffected side • Avoid hot foods • Check oral cavity after meals • Practice meticulous oral hygiene • Protect face from temperature extremes • Use electric razor • Wear protective eyewear • Examine eye regularly for symptoms of infection/irritation • Have a patient make a journal, • Patient may intensify that it happens every time they brush their teeth. So take meds right before. Or use a softer tooth brush. • Nuerotin, daily med that helps. • Not a narcotic though. • Make sure patients use eyewear to help. Sun could trigger attack, wear sunglasses.

• Facial paralysis caused by unilateral inflammation of the seventh cranial nerve • Manifestations: unilateral facial muscle weakness or paralysis with facial distortion, increased lacrimation, and painful sensations in the face; may have difficulty with speech and eating • Most patients recover completely in 3 to 5 weeks, and the disorder rarely recurs. • Linked to herpes virus: unilateral • Often accompanied by herpes • vesicles near ear • Decreased muscle movement • Pain • Drooping of affected side

viral (herpes), lyme disease, trauma

unilateral facial muscle weakness or paralysis with facial distortion. increased lacrimation (dry eye), painful sensations or numbness in face (near ear), may have difficulty with speech and eating. loss of ability to tase, often accompanied by herpes vesicles near ear, decreased muscle movement, pain, drooping of affected side

• Alteration in comfort: Pain • Imbalanced nutrition • Body image • Potential for corneal injury • Knowledge deficit • Will have this for 2-3 months. • Still can work, • May drool a lot. • Could be embarrassing, • Corneal injury- increased lacrimation

client will: be relieved of pain, regain normal facial appearance, verbalize understanding of disease process, consume adequate amount of food

most people recover in 1-2 months without treatment, corticosteroid therapy may be used to reduce inflammation and diminish severity of disorder. antiviral med (acyclovir)

facial care: moist heat, gentle massage, facial sling protect face from extreme temps, nutrition, eye care, mouth care, provide and reinforce information and reassurance that stroke hasn't occurred. pain relief: corticosteroids help w/ inflammation, antivirals if herpes related. facial sling, protect face from hot/cold temp, monitor nutrition, may have dysphagia, could get percocet to help w/ muscle pain

client reports that pain is relieved, appearance has returned to normal, maintained adequate nutrition, client's eye on affected side has no complications

muscle weakness, cardiac dysrhythmia, and renal failure. Monitor this for the anorexia nervosa patient.