MRCP UK EXAMINATIONS

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NEUROLOGY

HEMIPARESIS

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
The nurse is caring for a client who was diagnosed with a glioma 5 months ago. Today, the client was brought to the emergency department by his caregiver because he collapsed at home. The nurse suspects late signs of rising intracranial pressure (ICP) when which blood pressure and pulse readings are noted?
A
BP = 150/90 mm Hg; HR = 90 bpm
B
BP = 90/50 mm Hg; HR = 75 bpm
C
BP =130/80 mm Hg; HR = 55 bpm
D
BP = 175/45 mm Hg; HR = 42 bpm
Explanation: 

Detailed explanation-1: -Temozolomide Chemotherapy Temozolomide (TMZ), or Temodar, is the only FDA-approved therapy with a survival benefit for adult patients with glioblastoma. It is an oral chemotherapy pill and standard therapy that starts two to six weeks after surgery for tumor biopsy or resection.

Detailed explanation-2: -Radiation therapy The radiation kills any glioma cells that might remain after surgery. Radiation is often combined with chemotherapy.

Detailed explanation-3: -For people with glioblastoma and high-grade glioma, the latest standard of care is radiation therapy with daily low-dose temozolomide (Temodar). This is followed by monthly doses of temozolomide after radiation therapy for 6 months to 1 year.

Detailed explanation-4: -The nurse should avoid flexing or extending the client’s neck or turning the head side to side. The head of the bed should be raised to 30 to 45 degrees. Use of proper positions promotes venous drainage from the cranium to keep intracranial pressure down.

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