A 65-year-old male complains of a headache that feels "like a knife is cutting into his head." He also reports feeling right-sided scalp and facial pain and "seeing double" at times. He has a history of hypertension and hyperlipidemia
His medications include beta blocker, statin drug, and an ACE inhibitor. On physical examination, you note palpable tenderness over the right side of the forehead. There are no neurological deficits. Vision is 20/20 with lenses. No weakness of extremities. CN II to XII are intact. The history corresponds to which of the following disorders?
A. Drug toxicity
B. Giant cell arteritis
C. Cluster headache
D. Migraine headache
ANS: B
Temporal arteritis is also referred to as giant cell arteritis or cranial arteritis. It is characterized by chronic inflammation and the presence of giant cells in large arteries, usually the temporal artery, but can occur in the cranial arteries, the aorta, and coronary and peripheral arteries. It affects the arteries containing elastic tissue, resulting in narrowing and eventual occlusion of the lumen. It occurs more among persons over 50 years of age and is slightly more common in females than in males. The cause is unknown, but there seems to be a genetic predisposition. If left untreated, arteritis can rapidly lead to blindness that is often irreversible. The most common chief complaint is head pain that is lancinating, sharp, or "ice pick" in nature. Patients often complain of visual changes, including amaurosis, diplopia, blurred vision, visual field cuts, eye pain, periorbital edema, and intermittent unilateral blindness. Other common presenting symptoms include scalp and/or jaw tenderness, facial pain, and tenderness to palpation over the affected artery. The pain is generally hemicranial but can be bilateral or diffuse. There may be eye pain, which is usually bilateral; periorbital edema may be present. Other potential associated symptoms include an intermittent fever (generally low grade), nausea, and/or weight loss.
You might also like to view...
A nurse has established intravenous access in a patient whose infection necessitates treatment with IV cefazolin. What potential adverse reaction is most likely during this patient's course of treat?
A) Gastrointestinal upset B) Dry skin and pruritus C) Drowsiness D) Orthostatic hypotension
An LP/VN has recently graduated and secured a position on a subacute medical unit of a hospital. A large component of the nurse's orientation on the unit has focused on the nurse's scope of practice
What factors contribute to the definition of a nurse's scope of practice? (Select all that apply) A) The quality of the nurse's clinical placements while a student B) State laws such as nurse practice acts C) The regulations and policies of the hospital D) The nurse's learning style and preferences E) The professional standards of the profession
MC The nurse assesses the father's role within the family to be primarily formal. Which of the following might the father use to describe formal roles? (Select all that apply.)
A. Confidant B. Comforter C. Financial manager D. Chauffeur E. Caregiver
The physician orders glipizide 10 mg oral twice a day for a patient with diabetes. Glipizide is available in 5-mg tablets. How many tablets would the nurse administer with each dose? _______
Fill in the blank(s) with correct word