Concpts Exam #2 Ch 42

Question 1

What are the two most common types of headaches that people seek medical attention for?

Answer 1

Cluster headaches and migraine headaches.

Question 2

Migraine Headache Signs and Symptoms

Answer 2

Typically described as throbbing pain.
May be with or without aura.
Sensitive scalp, photophobia, phonophobia, and nausea with or without vomiting.
More common in women than men.

Question 3

What should you encourage the patient with headaches to do?

Answer 3

Encourage the patient to keep a headache diary to identify the type of headache. Should include the response to medication or intervention, quality, intensity, or new or unusual visual changes.

Question 4

What is the priority of care for patient with migraines?

Answer 4

Pain management! Mild migraines can be relieved with Tylenol. More severe migraines can be treated with Triptan preparations.

Question 5

Cluster headache signs and symptoms

Answer 5

Brief (30 min-2 hrs) in duration.
Unilateral pain occurring in spring and fall with no warning.
Pain is excruciating and nonthrobbing
More common in men than women.
Related to an overactive and enlarged hypothalamus.

Question 6

Interventions for cluster headaches?

Answer 6

Educate about the importance of consistent sleep-wake patterns. Teach to wear sunglasses during attack to avoid exposure to light. Provide oxygen

Question 7

What is a seizure?

Answer 7

Abnormal sudden, excessive, uncontrolled electrical discharge of neurons within the brain that may result in a change in LOC, motor, sensory, and behavior.

Question 8

What is epilepsy?

Answer 8

Two or more seizures experienced by a person. Abnormality in electrical neuronal activity, imblance of neurotransmitters like GABA.

Question 9

Tonic-clonic seizure (type of generalized seizure)

Answer 9

Lasts 2-5 minutes. 1st phase is Tonic phase=causes stiffness and rigidity of muscles and loss of consciousness. 2nd phase is clonic phase= jerking of all extremeties.
Patient my bite tongue and become incontinent.

Question 10

Tonic seizure (type of generalized seizure)

Answer 10

abrupt increase in muscle tone, LOC, autonomic changes lasing from 30 seconds to several minutes.

Question 11

Clonic seizure (type of generalized seizure)

Answer 11

Lasts for several minutes and causes muscle contraction and relaxation.

Question 12

Myoclonic seizure (type of generalized seizure)

Answer 12

Causes brief jerking or stiffening of extremeties that may occur singly or in groups. Can be for just a few seconds, and may be symmetrical or asymmetrical.

Question 13

Atonic (akinetic) seizure (type of generalized seizure)

Answer 13

Sudden loss of muscle tone, lasts for seconds, followed by confusion after seizure. Causes patient to fall, most resistant to drug therapy.

Question 14

Generalized seizures

Answer 14

There are five types. These involve BOTH cerebral hemispheres

Question 15

Partial seizures

Answer 15

AKA Focal or Local seizures. Begin with one cerebral hemisphere. Generally less responsive to medication, and often seen in adults.

Question 16

New onset seizures in older adults are typically associated with what conditions?

Answer 16

Hypertension
Cardiac Disease
Diabetes Mellitus
Stroke
Dementia
Recent Brain Injury

Question 17

Teaching for patient with epilepsy

Answer 17

Proper drug therapy
Wear medical bracelet
Teach family to protect from injury/maintain airway
Avoid alcohol and excessive fatigue
Document date, time, duration

Question 18

Status epilepticus

Answer 18

Medical emergency! Lasts longer than 5 minutes or is repeated seizures over the course of 30 minutes.
Seizures that last longer than 10 minutes can cause death

Question 19

What is meningitis?

Answer 19

Inflammation of meninges, the pia mater and arachnoid.

Question 20

What are some signs and symptoms of meningitis?

Answer 20

Change in LOC
Photophobia/abnormal eye movements
Memory changes (short attention span)
General muscle aches and pains
Fever and chills
Tachycardia

Question 21

Nursing Care of patient with meningitis?

Answer 21

ABC's
Vital signs q 2-4 hrs
Cranial nerve assessment
Drug therapy
ACCURATELY DOCUMENT NEURO STATUS
TEACH TO OBTAIN VACCINATION

Question 22

What type of precautions should patient with meningitis be on?

Answer 22

Droplet Precautions in addition to Standard Precautions. Place in private room if possible. Stay at least 3 feet away unless wearing a mask.

Question 23

Hydrocephalus

Answer 23

Excessive accumulation of CSF within the brain ventricles.
A sixth cranial nerve deficit (inability to move eyes laterally) can indicate hydrocephalus. Other indicators are increased ICP and urinary incontinence.

Question 24

Encephalitis

Answer 24

Inflammation of brain tissue and surrounding meninges. Usually viral, but can be bacterial or fungal. Life threatening or leads to persistent neuro problems

Question 25

What is Parkinsons disease?

Answer 25

Progressive degenerative disease that is the most common neuro disorder in older adults.

Question 26

Characteristics of Parkinsons disease?

Answer 26

Bradykinesia/ Akinesia Tremors Muscle Rigidity

Question 27

Signs and symptoms of encephalitis

Answer 27

``` Changes in mental status (agitation) Motor dysfunctions High fever Nausea/vomiting Stiff neck Fatigue ```

Question 28

Key features of Parkinsons?

Answer 28

``` Stooped posture Flexed trunk Slow shuffling gait Slow movements (bradykinesia) Pill rolling movements Slurred speech Orthostatic hypotension ```

Question 29

What should you teach patients taking MAOIs?

Answer 29

Need to avoid food/beverages that contain tyramine like cheese and aged and smoked foods. Avoid red wine and beer to prevent headache and hypertension.

Question 30

What is dementia?

Answer 30

Loss of brain function that is chronic and progressive. Affects ability to learn new information. Impairs language, judgement, and behavior.

Question 31

Factors that can worsen Alzheimers Disease and

Answer 31

Stroke, subdural hematoma, MI, hypoglycemia, impaired renal function, infection, sudden changes in surroundings

Question 32

Huntington Disease

Answer 32

Hereditary disorder transmitted as an autosomal dominant trait at the time of conception. Symptoms are progressive mental status changes and (choreiform movements) rapid, jerky movements in the limbs, trunk and facial muscles.