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6200 Adult /Older Adult II > Chronic Neuro > Flashcards

Chronic Neuro Flashcards

1
Q

This type of a headache is often described as a feeling of a weight in or on the head and/or a band squeezing the head.

A

Tension headache

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2
Q

This type of a headache is described as an intense, throbbing or pounding pain that involves one temple. The pain usually is unilateral (on one side of the head), although it can be bilateral.

A

Migraine headache

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3
Q

headache pain is focused in and around one eye, and is often described as sharp, penetrating, or burning.

A

Cluster headache

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4
Q

General management of headaches?

A
  • Daily exercise, relaxation periods, and socializing help reduce recurrence
  • Suggest alternative pain management such as relaxation, meditation, yoga, and self-hypnosis
  • Massage and heat packs can help with tension-type
    Written tracking of medications
  • Teach patient about prophylactic treatment
  • Avoid triggers – dietary counseling
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5
Q

Specific Management of a tension-type headache?

A

Nonopioid analgesic, massage and hot packs

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6
Q

Specific Management of a mild/moderate migraine headache?

A

aspirin, acetaminophen, caffeine combination

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7
Q

Specific Management of a moderate/severe migraine headache?

A

triptans (sumatriptan)

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8
Q

Preventive treatment for migraine headaches?

A

anti-seizure meds

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9
Q

Specific Management of a cluster headache?

A

oxygen

prophylactic tx

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10
Q

Seizure classification flowchart: Partial Seizures

A

Alert = Simple partial seizures

Altered consciousness = complex partial seizures

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11
Q

Nursing considerations for antisizure drugs?

A
  • don’t d/c abruptly, may precipitate seizures

- monitor drug serum levels

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12
Q

Side effects of antiseizure meds?

A
  • CNS: diplopia, drowsiness, ataxia and mental slowing

- Non-CNS: rashes, hyperplasia of gingiva

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13
Q

Drug therapy for generalized tonic/focal seizures?

A

phenytoin, carbamazepine, phenobarbital, divalproex, primidone

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14
Q

Drug therapy for absence/myoclonic seizure?

A

ethosuximide, divalproex, clonazepam

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15
Q

What is Status Epilepticus?

A

Constant or rapid succession seizures without return to consciousness

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16
Q

Tonic-clonic status epilepticus complications?

A

ventilatory insufficiency, hypoxemia, cardiac arrhythmias, hyperthermia, and systemic acidosis

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17
Q

Medications for status epilepticus?

A
  • IV lorazepam (ativan) and diazepam (valium)

- follow with long-acting drugs

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18
Q

Nursing Implementation: Prevention

A
  • Wear helmet if risk for head injury
  • Assist to identify events or situations precipitating seizures, and avoid if possible
  • Instruct to avoid excessive alcohol, fatigue, and loss of sleep
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19
Q

Observation and treatment of seizure?

A
  • Maintain patent airway, support head, turn to side, loosen constrictive clothing, ease to floor
  • Patient may require suctioning or oxygen after seizure
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20
Q

T/F: Newer antiseizure medications offer better treatment for older adults?`

A

True

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21
Q

What are the branches of the trigeminal nerve?

A

opthalmic, maxillary and mandibular

22
Q

Meds to treat trigeminal neuralgia?

A

Antiseizure& Tricyclic antidepressants

23
Q

Trigeminal Neuralgia Interprofessional/Nursing Care?

A
  • Avoid stimuli that worsen
  • Meds:
    • Antiseizure
    • Tricyclic antidepressants
  • Good oral care
  • Nutrition
    • Easy to chew
24
Q

Bell’s Palsy Interprofessional/Nursing Care?

A
  • Moist heat, massage, exercise
  • Meds:
    • Corticosteroids – prednisone
    • Anitiviral may be used – acyclovir
  • Avoid cold and drafts-hypersensitivity
  • Chew on unaffected side
  • May use artificial tears
  • Reassure patient will likely improve
25
Q

Guillain-Barre Syndrome Interprofessional/Nursing Care?

A
  • Supportive care:
    • Ventilatory support – may need
    • Nutrition-may need supplemental, watch hypomotility
    • Urinary retention may occur
  • Plasmapheresis
  • Immunoglobiulin therapy
26
Q

How is Bell’s Palsy Diagnoses?

A

by pattern/onset of symptoms

27
Q

Bells’s Palsy S/S?

A
  • inability to wrinkle brow, close eye, puff cheeks, smile or pucker
  • drooping eyelid and mouth, no muscle tone
28
Q

Symptoms of Guillain-Barre Syndrome?

A
  • fast onset, resolves quickly
  • develops weakness in the LE from distal to proximal
  • may have residual weakness
29
Q

What is the most common site for lesion formation in patients with multiple sclerosis?

A

optic nerve, causing diplopia and nystagmis

30
Q

Common symptoms of MS?

A
  • speech & swallowing difficulties
  • numbness, paresthesia
  • pain
  • bladder/bowel issues
  • sexual dysfunction
31
Q

Initial tx of MS?

A
  • Immunomodulators
    • Interferon B-1b (Betaseron)
    • Interferon B-1a (Avonex, Rebif)
    • Glatiramer (Copaxone)
  • immunosupressants
32
Q

Tx for an acute exacerbation of MS?

A

corticosteroids

33
Q

Symptomatic management of MS: drugs?

A
  • Anticholinergic (oxybutynin)

- Muscle relaxants (baclofen)

34
Q

(1) What is baclofen and (2) why is it given to tx MS?

A

1) a muscle relaxant

2) used to treat secondary muscle spasms

35
Q

Ways to avoid/minimize the effects of MS?

A

Avoid fatigue, extremes of hot and cold, exposure to infection

36
Q

Patient teaching for MS?

A
  • balance of exercise and rest
  • nutrition, include dietary fiber
  • avoiding the hazards of immobility
  • self-catheterization if necessary
37
Q

S/S of Parknison’s disease?

A
  • resting tremors
  • cogwheel rigidity
  • bradykinesia
  • postural instability
  • blank facial expression
  • short shuffling gait
38
Q

Tx for Parkinson’s disease?

A
  • dopamine (DA) precursor

- Levodopa-Carbidopa

39
Q

Where are dopamine precursors converted to DA within the body?

A

in the basal ganglia

40
Q

What decreases the absorption of levodopa?

A

protein and vitamin B6 ingestion

41
Q

Side effects of Levodopa?

A

dyskinesia and wears off over the years

42
Q

Why is carbidopa added to levodopa?

A

inhibits enzyme that breaks down the levodopa, but still looses effectiveness over time

43
Q

Steps of Deep Brain Stimulation (DBS)?

A

1) surveying

2) placement of permanent electrodes into the basal ganglia.

44
Q

Main target areas of the brain DBS?

A

globus pallidus internal & subthalamic nucleus

45
Q

Parkinsons’ Nursing Management and Implementation - diet?

A
  • Promote balanced diet, exercise, sleep
  • Need food that
    • is easily chewed and swallowed
    • cut into bite-sized pieces
  • Several small meals to prevent fatigue
  • Give ample time to avoid frustration
46
Q

Parkinsons’ Nursing Management and Implementation - exercise & movement?

A
  • Finger exercises (typing), ROM
  • Bradykinesia - problems can be alleviated by
    • Consciously thinking about stepping over a line on the floor
    • Lifting toes when stepping
  • Chair - use arms and place the back legs of chair on small blocks to assist in rising
  • Remove rugs and excess furniture
  • Simplify clothing from buttons and hooks
  • Use elevated toilet seats
47
Q

Meds for Myasthenia Gravis?

A

Pyridostigmine (Mestinon) - an Anticholinesterase or cholinesterase inhibitor

48
Q

Nursing implementationfor Myasthenia Gravis?

A
  • Maintain adequate ventilation-monitor respiratory status
  • Supportive care:
    • extreme weakness with repeated movement – improves with rest
    • monitor for choking/aspiration of food
49
Q

Drug therapy for Amyotrophic Lateral Sclerosis?

A

Rilutek (slows progression of disease)

50
Q

Nursing care for Amyotropic Lateral Sclerosis?

A
  • Supportive/symptomatic
    • Nutrition
    • Physical therapy; adaptive equipment
  • Recognize as progressive, terminal disease
51
Q

Non-drug management of Restless Legs Syndrome?

A
  • Regular sleep and exercise

- Eliminate aggravators - caffeine, alcohol

52
Q

Medications for Restless Legs Syndrome?

A
  • Dopamine receptor agonists (requip, mirapex)
  • Dopamine precursors (carbidopa/levodopa)
  • Anti-seizure (neurontin)

6200 Adult /Older Adult II (17 decks)

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