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PathoPharm 2 > ch 58 chronic neurologic problems > Flashcards

ch 58 chronic neurologic problems Flashcards

1
Q

three types primary headaches

A
  • tension
  • migraine
  • cluster
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2
Q

S+S tension headache (3)

A
  • bilateral
  • band like pressure
  • intermittent, episodic
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3
Q

red flags that would warrant imaging for headaches (7)

A
  • fever
  • recent weight loss
  • h/o cancer
  • waking from sleep with headache
  • headache first thing in morning
  • vomiting
  • new onset >50 yo
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4
Q

abortive meds for tension headache

A

tylenol

NSAIDs

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5
Q

preventative meds for tension headache (3)

A
  • tricyclic antidepressant (amitriptyline)
  • SSRIs (fluoxetine)
  • antiseizure (topiramate)
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6
Q

what is important to remember about topiramate (antiseizure med)

A

don’t stop abruptly

causes weight loss

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7
Q

S+S migraine headache (4)

A
  • unilateral throbbing pain
  • w/ or w/o aura
  • N/V
  • light/sound sensitivity
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8
Q

if someone has aura with migraines, what med should they not take that would put them at increased risk for DVTs

A

birth control pills

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9
Q

abortive meds for migraines (3)

A
  • NSAIDs
  • tylenol with caffeine
  • triptans (take at 1st sign migraine)
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10
Q

preventative meds for migraines (6)

A
  • topirimate (antiseizure)
  • b blocker
  • botox
  • SSRIs
  • calcium channel blocker
  • divalproex, clonidine, thiazides
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11
Q

contraindication to triptans for migraine treatment

A

uncontrolled HTN

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12
Q

S+S cluster headache (6)

A
  • unilateral
  • pain around eye
  • eye swelling
  • rhinitis
  • constricted pupil
  • periods of remission
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13
Q

risk factor for cluster headache (2)

A
  • heavy drinking

- smoking

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14
Q

treatment cluster headache (3)

A
  • give 100% O2 through nonrebreather mask
  • preventative meds
  • triptans
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15
Q

diagnostic for seizures

A

EEG

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16
Q

2 big categories of seizures

A

partial

generalized

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17
Q

2 types partial seizures

A

simple focal seizure

complex focal seizure

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18
Q

S+S simple focal seizure

A

vision changes

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19
Q

S+S complex focal seizure

A
  • altered LOC
  • period of confusion
  • vision changes
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20
Q

state of constant seizure

A

status epilepticus

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21
Q

S+S tonic seizures

A
  • stiffness

- fall backward

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22
Q

S+S atonic seizures

A

“drop attack”

fall forward

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23
Q

S+S absence seizures

A

spaced out

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24
Q

S+S myoclonic seizures

A

muscle jerks

often in clusters and in a.m.

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25
Q

S+S tonic clonic seizures

A 
stiff
unconscious
fall
shaking
foamy mouth
26
Q

types generalized seizures (5)

A
  • tonic
  • atonic
  • absence
  • myoclonic
  • tonic clonic
27
Q

how to stop status epilepticus

A

rectal suppository of benzodiazepine

28
Q

common side effect phenobarbital

A

drowsiness 2-3 weeks

29
Q

therapeutic level phenytoin

A

10-20

30
Q

nursing considerations for gabapentin (2)

A
  • assess for suicidal thoughts

- high fall risk

31
Q

common side effect topiramate

A

weight loss

32
Q

teaching for pt with phenytoin

A

use soft toothbrush

33
Q

what diet might seizure pt be put on before surgery

A

keto diet

34
Q

autoimmune CNS disorder in which antibodies attack acetylcholine receptors

A

myasthenia gravis

35
Q

S+S myasthenia gravis (3)

A
  • worsen throughout day
  • fluctuating weakness of head, neck, and resp muscles
  • ptosis
36
Q

what can myasthenia gravis cause that results in airway emergency

A

paralysis of diaphragm

37
Q

treatment myasthenia gravis (3)

A
  • anticholinesterase meds
  • corticosteroids
  • immunosuppressants
38
Q

treatment myasthenic crisis (2)

A
  • plasmapheresis

- stress dose steroids

39
Q

S+S restless leg syndrome

A
  • pain at night

- need to keep moving legs

40
Q

treatment restless leg syndrome

A
  • regular sleep habits

- meds: opioids, benzos, dopaminergic

41
Q

treatment for amyotrophic lateral sclerosis (ALS)

A

no treatment

palliative: riluzole slows progression of disease

42
Q

S+S ALS (3)

A
  • dysphagia
  • dysarthria (speaking)
  • weakness of upper extremities
43
Q

S+S huntingtons disease

A

-abnormal and excessive involuntary movements of face, limbs, and body (chorea)

44
Q

treatment huntingtons disease

A

no treatment

palliative: antipsychotic, antidepressant, antichorea meds

45
Q

CNS disorder more prevalent with increased age, slow onset, disrupts muscle response to dopamine

A

parkinsons disease

46
Q

S+S parkinsons disease (7)

A
  • tremor
  • joint rigidity (cogwheeling in passive ROM)
  • bradykinesia
  • shuffling gait
  • memory impairment
  • dysphagia
  • blank affect
47
Q

complications parkinsons disease (4)

A
  • constipation
  • insomnia
  • parkinsonian dementia
  • orthostatic hypoTN
48
Q

treatment parkinsons disease (4)

A
  • levodopa with carbidopa
  • dopamine receptor agonists
  • anticholinergics
  • surgery (deep brain stimulation)
49
Q

how does levodopa with carbidopa help treat parkisons

A

increase dopamine levels

50
Q

side effects levodopa with carbidopa (2)

A
  • orthostatic hypoTN

- nausea

51
Q

side effects anticholinergics (amantidine) (3)

A
  • dryness
  • urinary retention
  • constipation
52
Q

contraindication for deep brain stimulation for parkinsons

A

parkinsonian dementia

53
Q

nutrition considerations for parkinsons pt

A
  • combat malnutrition and constipation

- small frequent meals

54
Q

autoimmune degenerative CNS disease characterized by disseminated demyelination of nerve fibers of brain and spinal cord

A

multiple sclerosis (MS)

55
Q

S+S multiple sclerosis (5)

A
  • vague, relapsing remitting pattern
  • progressive muscle weakness/paralysis
  • difficulty with speech
  • decreased hearing and vision
  • spastic bladder and incontinence
56
Q

Dx MS

A

MRI of spine (shows multiple lesions)

57
Q

treatment for MS that slows progression of disease

A
  • corticosteroids
  • immunosuppressants
  • immunomodulators
  • anticholinergics
  • muscle relaxants
58
Q

two surgery options for MS

A
  • dorsal column stimulation

- intrathecal baclofen pump (muscle relaxant)

59
Q

nutrition considerations for pt with MS (2)

A
  • multivitamins

- low fat diet

60
Q

what can the UAP help with for seizures (4)

A
  • have emergency O2 equipment at bedside
  • pad side rails, remove potentially harmful objects
  • report any seizure activity to RN
  • obtain VS after seizure
61
Q

important admin teaching with levodopa

A

don’t take with food

PathoPharm 2 (33 decks)

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