NUR 334 Exam 3 Practice Questions and
Correct Answers
Scleroderma 2 main categories ✅1) localized- leads to morphia isolated patches of
hardened skin. Linear scleroderma= lines of the thickened skin. Coup desepor= thick
skin on head
2) Systemic- Limited: insidious onset, skin of extremities distal to elbows and knees,
Raynaud's phenomenon may precede. Diffuse: Rapid onset, involves skin of extremities
and trunk, most likely affect organs, Raynaud's phenomenon occurs currently or after
diagnosis
Scleroderma clinical manifestations ✅patches of thickened (hardened) skin sometimes
itchy, especially early stages. Systemic with internal organ involvement has poorer
prognosis
Raynaud's Phenomenon ✅vasospasm in little vessels due to cold; digits become pallor
and cyanotic, causes damage to blood vessels leading to ischemia and amputation
Systemic Scleroderma manifestation in systems ✅GI- dysphagia, esophageal stricture
(b/c connective tissue), malabsorption diarrhea
Pulmonary- SOB, lung fibrosis (not compliant)
Cardiac- arrhythmias, HF, Pericarditis
Renal- insufficiency and failure
Musckuloskeletal- joint contractures, muscle pain, synovitis
Scleroderma diagnosis ✅presence of clinical manifestation and serum antibodies
Scleroderma treatment ✅no single treatment, no cure; systemic steroids
(glucocoticoids), amlipodine (vasodilator), anti-platelet, immunosuppresive agents, ACE
inhibtors
Scleroderma complications ✅infection, renal failure, HF, pulmonary fibrosis, and death
Scleroderma actions ✅administer meds, ROM, BUN and creatinine, counseling, teach
Assess skin, VS, GI (protein, vitamin levels and absorption), musculoskeletal, lungs
(oxygenation)
Systemic Lupus Erythematosus (SLE) patho ✅chronic inflammatory disease affecting
organ systems- may be triggered by factors including sunlight, illness, pregnancy, major
surgery
SLE clinical manifestations ✅Fatigue
,Alopecia, rash, photosensitivity
Joint pain
Proteinuria, hematuria (from leakage for vascular into tubules)
Stroke, seizure, neuropathy, depression (secondary to sx)
Pericarditis, increase CV disease (diffuse inflammation affecting all endothelium tissue)
Pleural effusion, interstitial lung disease
retinal lesions, dry eyes
Leukopenia, anemia, thrombocytopenia
SLE diagnosis ✅presence of anti-nuclear antibodies (ANA) (does not confirm),
4 out of 11 criteria (malar rash-butterfly, discord rash erythematous patches scar,
photosensitivity, oral ulcers, arthritis, pleuritis, renal disorder, neuro disorder,
hematological disorder, immunological disorder and antiulcer antibody)
SLE treatment ✅avoid prolonged sun exposure
well-balanced diet
antimalarial medications
glucocorticoids (anti-inflammatory)
SLE lab values ✅CBC, BUN, creatinine
SLE actions ✅administer anti-inflammatory meds, and other meds (NSAIDs,
glucocorticoids, immunosuppressives agents (methotrexate, thalidomide (drug causing
birth defects, helped nausea in pregnant women))
SLE teaching ✅educate disease, sunscreen, conservation, importance of
immunization
Headache patho ✅a result of a reaction of nociceptors to triggers, sending messages
to thalamus via the trigeminal nerve
can be secondary to infection, meds, neoplasm, or vascular abnormalities
Primary headache example ✅tension, migrane, cluster
Headache clinical manifestation ✅Tension headaches episodic or chronic in nature
Cluster are considered neurovascular (unilateral, in and around eyes)
Migraine are isolated into phases (post dromal phase- hangover) drowsy and confusion
after H/A
Headache management ✅Headache diary, neurological assessment, CBC (infection),
C-reactive protein (inflammation), CSF test (spinal tap/lumbar puncture), CT, MRI
Headache treatment ✅treat underlying disorder/disease (depression and anxiety
cause tension HA)
, NSAID, analgesic, caffeine, and muscle relaxant
Sedative, antiseizure (gabapentin), antidepressants (citalopram, fluoxetine)
Triptan meds appear most beneficial during moderate-severe migraine pain (increase
serotonin to relieve)
Headache age considerations ✅HA in children last longer
HA assessment ✅VS, pain, triggers, alleviation techniques, aura
HA actions ✅administer meds
NSAID for antiinflammatory; caffeine b/c blocks adenosine causing vasoconstriction
Dark, calm environment
teaching
What is a Seizure ✅uncontrolled, sudden, excessive discharge or electrical activity
results in range of manifests from behavioral changes to LOC
What is Epilepsy ✅chronic disorder defined by 2 unprovoked seizures more than 24
hours apart
Seizure patho ✅genetic or developmental mutation of synapses
ineffective activity (d/t mutation) of GABA
Types of seizures ✅Simple partial- remain conscious, sx vary, remembered, can lead
to general, all ages
Complex partial- psychomotor seizure, MOST COMMON, LOC, aura, 1-3 minutes, can
lead to general seizure, 3+ years old
Absence- onset 4-12 years old, brief LOC, unrecognized as daydream, 5-10 seconds,
no recal
Myoclonic- all ages, stay conscious, brief, symmetrical contraction
Tonic-Clonic- both brain hemispheres, all ages, LOC, tonic-phase rigidity, clonic phase-
rhythmic jerking, shallow breathing and apneic periods, 1-2 minutes, postictal period
Atonic- onset 2-5 years, may/may not LOC, sudden momentary loss of muscle tone (go
limp and fall on ground), high risk for injury
Non-epileptic/Provoked seizures ✅provoked by disorders of conditions:
Vascular, oxygen deprivation, metabolic, substance abuse, meds or toxins
Preictal seizure ✅just before the seizure, 20% of people experience an aura (odor,
deja vu, visualization)
Postictal seizure ✅period after the seizure 5-30 minutes that the patient feels drowsy,
confused, disoriented or with a HA
could be due to meds given for seizure
