Ch 6-9

Question 1

What is status epilepticus?

Answer 1

Refers to the identification/correction of any reversible precipitating factors such as metabolic abnormalities or withdrawl from alchohol or drugs

Question 2

What is the first line of defense for providing rapid seizure control?

Answer 2

Benzodiazopines.

Question 3

What are some challenges that individuals with PTE face? (post traumatic epilepsy)

Answer 3

Independence/employment. QOL concerns over 50%.
Employment. 16% working or in school
Driving 60% endorsed concern, 30% most important concern

Question 4

What are the most common pain pathways associated with TBI?`

Answer 4

Nociceptive (related to peripheral nerve fibers) and neuropathic (primary lesion of disfunction of the nervous system)

Question 5

When is a diagnosis of post-traumatic headache (PTH) more prevalent?

Answer 5

Following mild TBI; 95% vs 22% mod/severe

Question 6

What is confidentiality, and what is a staffs role?

Answer 6

Respect to individual privacy; protect clients right to privacy

Question 7

How do you build and maintain trust with clients?

Answer 7

Tell a little bit about yourself. give them trust and respect. be consistent and reliable - it’s a process

Question 8

What are the general expectations when it comes to disclosures?

Answer 8

Get in writing where the info can and cannot be shared.

Disclosure without consent is only acceptable if there is a police subpoena or disclosure danger to self or others

Question 9

What are the guidelines when it comes to sharing and disclosures?

Answer 9

That it’s relevant, that it is the intended recipient and, where is it going to be shared?

Question 10

What is the HIA and what are its guidelines?

Answer 10

The Health Information Act - protects information.

Right to know why its being collected
Right to request reviews/revisions
Response is mandatory within 60 days.

Question 11

What is the PIPA and what are its guidelines?

Answer 11

Personal Info Protection Act; can be over ridden if:

• it is clearly in their best interest and they wouldn’t be expected to withhold consent
• if there is legal proceedings, or an emergency
• contacting next of kin
• if the info is stored in a registry, otherwise publicly available ie; phone book
• some kind of media coverage
• only if there is reasons to need support

Question 12

What is considered an incident?

Answer 12

Anything outside of the norm.
Anything that requires intervention (police, fire, ambulance)
Anytime there is destruction or damage
Anytime the safety of the individuals or others has been compromised

Question 13

What is the difference between on objectively written incident report, and a subjectively written one?

Answer 13

Objective is based on unbiased facts, not feelings

Subjective is based on your opinion

Question 14

What are the guidelines for writing an incident?

Answer 14

Verification of who said what
Were there any behaviors? How did we help?
What did we do/see?
Don’t assume

Question 15

What is considered a behaviour of concern?

Answer 15

A behaviour of intensity

Mental health and/or issues with medications ruled out before rules/restrictions for behaviours

Question 16

What is a restrictive procedure?

Answer 16

Any act that restricts an individual

Objective; reduce/eliminate undesireable behavior

Question 17

What is a positive approach?

Answer 17

Actions, or natural supports that respect the dignity and rights of individuals while enhancing their quality of life

Question 18

What medications are used most regularly for PRN?

Answer 18

Anti-anxiety, sedatives, anti-psychotics

Question 19

What are some of the undesirable affects of anti psychotics

Answer 19

Sedation, skin sensitivity, tardive dyskinesia , neuroleptic malignant syndrome , cardiac arrythmias , extrapyramidal syndrome, orthostatic hyper tension, dry mouth, constipation, movement of mouth, rapid body movements, face and eyes

Question 20

What is the role of the autonomic nervous system?

Answer 20

Controls/regulates all vital organs

Question 21

What do you consider when analyzing an incident report?

Answer 21

The 5 W’s. Patterns of behavior. Antecedents. Goal/consequence of behavior.

Question 22

What do you consider when analyzing an incident report?

Answer 22

The 5 W’s. Patterns of behavior. Antecedents. Goal/consequence of behavior.

Question 23

What does assessment provide information about?

Answer 23

Nature of behavior
Triggers
Environmental triggers
What else can be triggers?

Question 24

When completing a seizure report what do you include?

Answer 24

Was protocol followed? Is there protocol? What type of seizure was it? Tonic-clonic, absence, myoclonic or grand mal?

Question 25

What are the rules when addressing a seizure?

Answer 25

Put the individual into recovery positiion
Keep onlookers away
Dont put anything in mouth
No water, pills or food until fully alert
If longer than 5 minutes, call 911
Be sensitive/supportive and ask the same of others

Question 26

What are the rules when addressing a seizure?

Answer 26

Put the individual into recovery positiion
Keep onlookers away
Dont put anything in mouth
No water, pills or food until fully alert
If longer than 5 minutes, call 911
Be sensitive/supportive and ask the same of others

Question 27

What should you do after an incident?

Answer 27

Take some time to calm
Ensure writing is unbiased
Proofread spelling/punctuation
Take the time to spell properly*
What is measurable and verifiable? Writer for someone that knows nothing about the situation

Question 28

What is included in an accurate incident/documentation

Answer 28

Date/time/location

Antecedent/behaviour/consequence

Question 29

Where are the periphreal receptors located?

Answer 29

Back of head/neck, very sensitive to pain. Located on the ends of nerves that initiate near the spinal cord and communicate with specific pain centers in the brain this is “peripheral nociception”

Question 30

Which primary, nociceptive afferent nerves are involved with post-traumatic headache?

Answer 30

Cranial nerve, CN V or trigeminal nerve
CN IX, or glossopharyngeal nerve
CN X, or vagus nerve
Greater and lesser occipital nerve (c1 and c3 root)