Exam 1 Flashcards
What type of disorders fall under the nervous system?
Seizures
Meningitis
Encephalitis
Parkinson’s
Multiple sclerosis
Migraine and cluster headaches
Cerebral vascular accident (CVA)/stroke
What is a seizure?
An abnormal electrical discharge in the brain. It interrupts normal brain function
Alters awareness, abnormal sensation, focal involuntary movements, or convulsions
What is epilepsy?
A chronic seizure disorder
What are the two different types of seizures?
Generalized
Partial
What is a generalized seizure?
Discharges occurs throughout the entire brain
Typically loss of consciousness
What is a partial seizure?
Only one half of the brain is affected.
Also called a focal seizure
Typically manifest as one structural abnormality
What are causes of seizures?
Genetics
Metabolic disorders
Mitochondrial diseases
Single gene mutation
Structural abnormalities (tumors, edema, increased ICP) ***brain stress
What are the phases of a seizure?
1) prodromal : mood or behavior starts to change (seizure may come in hours or days)
2) aura: premonition of impending seizure (visual, auditory, or gustatory)
3) ictal : seizure activity (usually musculoskeletal)
4) postictal : period of confusion / somnolence/ irritability that happens after the seizure
Manifestations of seizures
-aura
-short duration (1-2 minutes)
-postictal state
-Todd paralysis : in some people, one side of the body is weak and weakness last longer than the seizure
-Visual hallucinations
-Convulsions
How do you diagnose a seizure?
-head CT
-MRI
-EEG
-Lumbar puncture
-Electrolyte study
-Prolactin levels
What medications are used to manage seizure disorders?
Made medication is an anticonvulsant
Examples:
Levetiracetam (Keppra)
Carbamazepine
Oxcarbazepine
Lamotrigine
Phenytoin
Valproic
Fosphenytoin
Gabalentin
What are non-medication options to help manage seizure disorders
-Special diet (ketogenic/Atkins)
-Vagal nerve stimulation
-Implantable neurostimulator
-Lobectomy/lesionectomy
-activity modification/restrictions (driving, climbing, ladders, cooking, power tools/dangerous equipment, swimming, baths)
Nursing diagnoses (risks associated with) seizures
-Risk for trauma or suffocation
-Risk for an effective airway clearance
-Situational, low self-esteem
-Deficient knowledge
-Risk for injury
What history needs to be gathered during a nursing assessment for seizures
-Age they were at onset
-Frequency
-treatments they’ve had
-What are symptoms/manifestations are
What are nursing interventions for a seizure disorders?
-prevent injury
-Maintain airway
-educate patient and family (safety, triggers, compliance with meds)
What is meningitis?
Inflammation (swelling) of the protective membranes, covering the brain and spinal cord. Can lead to ICP
What are the causes of meningitis?
Usually caused by an infection:
Bacterial
Viral
Fungal
Parasitic
Amebic
What are the manifestations of meningitis?
Fever
Seizure
Neck stiffness
Positive Kernig’s sign
Positive brudzinski sign
Neurologic symptoms
Photalgia (photophobia)
What is Positive brudzinski sign?
Lift head up to put chin to chest, with involuntary flexing of hips and knees *a reaction to the stretch)
What is a positive Kernig’s sign?
(inability to extend knees more than 135 degrees)
What is the worst kind of meningitis?
Bacterial meningitis
Specifically; meningococcal
Where is Meningococcal meningitis commonly seen
Communal living situation
College dorm
Military barracks 
What are signs and symptoms of bacterial meningitis?
Fairly sudden onset of the following symptoms
Fever
Headache
Stiff neck
Rush
What are other possible signs of bacterial meningitis?
Nausea/vomiting
Sensitivity to light
Confusion
Drowsiness
Convulsions
Joint pain
Cold hands and feet
,coma