23 Pt's w/ brain disorders Flashcards
type of seizure affecting only one part of the brain leading to localized clinical symptoms
focal
type of seizure involving both sides (bilateral) of the brain and usually the whole body if motor symptoms are present, no warning or aura
generalized
absence
myoclonic
clonic
tonic
tonic-clonic
atonic seizures
infantile spasms (usually fever-induced)
generalized seizures
-prologed partial or generalized seizure w/o recovery between attacks
-rapid, unrelenting series of convulsive seizures w/o intervening periods of consciousness, and an absence of respiration
-irreversible brain damage can occur if seizures are not controlled
status epilepticus
diagnosing epilepsy
-Hx and actual signs and symptoms
-EEG, MRI
-electrolyte imbalances
-physical examination and tests
epilepsy treatment
-control or eliminate cause
-antiepileptic drugs & pt teaching
-keto diet
-biofeedback
-surgery (implanted vagus nerve stimulator for pt’s w/ epilepsy and uncontrolled seizures)
things to note during a seizure
-beginning and ending time
-what pt was doing just before
-where in the body seizure began; what parts of the body are involved
-which way the eyes are moving, whether they constrict or dilate, deviate to right or left or roll upward
-which side the head turns
-pt cry out or scream as it began
-evidence of repetitive movements: lip smacking, chewing, grimacing, tapping, or pill rolling
-movements are bilateral and symmetrical
-incontinence of urine or stool, vomiting, frothing at mouth, or bleeding
-pt become apneic or cyanotic
-changes in skin color or profuse perspiration
postictal assessment- after a patent airway is ensured
-length of time before regaining awareness
-presence of lethargy or confusion
-presence of ha
-presence of speech impairment
-presence of muscle soreness
-aura before seizure began
-effects of seizure of pt’s vital signs
patho of CVA
-cerebral thrombosis
-embolus
-intracerebral hemorrhage
-pressure on a blood vessel
two ways a stroke can happen
hemorrhagic or ischemic
congenital abnormality that is tangled mass of malformed, thin-walled, dilated vessels that form an abnormal communication between the arterial and venous system
arteriovenous malformation
Area of the brain:
sensory discrimination, eyes to opposite side; body awareness; writing
parietal lobe
Area of the brain:
motor activities (pyramidal)- leg, hip, trunk, arm, hand, neck, face
speech
frontal lobe
Area of the brain:
reading
memory (short-term)
hearing, smell, taste
temporal
diagnosis of this includes:
MRI or cerebral angiogram
EEG
brain scans
transcranial doppler flow studies
carotid artery doppler studies
testing for blood levels of glutamate
lumbar puncture
stroke
stroke treatment
-maintain open airway
-fluid and antihypertensives
-temp control
-alteplase or systemic tissue plasminogen activator and other meds
-surgical procedures
complications of stroke
-extension of hemorrhage or rebleed
-seizures
-hydrocephalus
-watch pt’s closely to detect deterioration of the pt’s condition for further bleeding and rise in ICP
what phase:
-maintain adequate airway
-establish baseline vital signs, LOC, neuromuscular function, and neurologic status
-preserve joint and muscle function
-prevent complications that may interfere with rehab
Phase 1
which side is the damage:
-slow and cautious in behavior
-speech problems, aphasia
-difficulty in following verbal commands
-apraxia
-difficulty in performing simple tasks
-right-sided hemiplegia
left-sided brain damage
which side is the damage:
-quick and impulsive in behavior
-short attn span
-neglects left side
-easily distracted
-left-sided hemiplegia
right-sided brain damage
brain tumor can begin in four places
-brain itself
-meninges
-cranial nerves
-pituitary gland
nursing management of brain tumors
-routine neurologic assessment, including ADL’s
-pain assessment and control
complications of brain tumors
-hydrocephalus (if blood has leaked into the ventricular system, it interferes with the resorption of CSF causing hydrocephalus)
-intercerebral hemorrhage
bacterial meningitis etiology and patho
-inflammation of the membranes covering the brain and spinal cord caused by an infectious agent
s/s of bacterial meningitis
-sudden onset of fever and severe and persistent ha greatly aggravated by moving the head
-nuchal rigidity
-Brudzinski sign
-Kernig sign
viral meningitis most common viruses
enteroviruses, arboviruses, HIV, herpes simples
most common types of viral encephalitis caused by
herpes simples virus 1, west nile virus, enteroviruses
trigeminal neuralgia
-rare facial pain syndrome related to pressure on the nerve root
-rarely affects both sides
-extends from midline of the face across the cheek and jaw to the ear
trigeminal neuralgia triggers
-exposure to drafts
-light touch or vibration
-washing the face
numbness and partial or total paralysis of facial muscles
edema and ischemia of facial nerve, herpes simplex virus, stress, exposure to cold, and pregnancy
bells palsy
Bells Palsy treatment
-patch over affected eye and artificial tears
-corticosteroids and acyclovir
