Neuro 3 Flashcards
describe Myastheria crisis
acute exacerbation of MG
breathing and throat muscle weakness
d/t little to no stimulus at junction (no Ach)
describe a Cholinergic crisis
presents similar to Myastheria crisis
severe weakness and resp failure
excessive stimulation at junction(too much Ach d/t high dosage of MG med)
how to differentiate Myastheria and Cholinergic crises
- perform Tensilon test with Edrophorium drug
- Myastheria: brief instant improvement of symptoms (muscle strength improved d/t extension of muscle stimulation)
- Cholinergic: symptoms do not improve with drug, will become worse
antidote of cholinergic crisis
atropine
meds of MG
anticholinesterase (Neostigmine and Pyridostigmine)
corticosteroids
plasmapharesis
thymectomy
nursing care of MG
assess resp function
eat 1 hr after ChE inhibitors to avoid aspiration
eye protection, nutritional support
describe trigeminal neuralgia
- 5th cranial nerve affected (above ear)
- unilateral facial pain (intense spasms)
- provoked by minimal stimulation of trigger zone
- extremely hyper sensitive
type of pain experienced by trigeminal neuralgia
sharp, shooting, burning, jabbing, piercing
management of trigeminal neuralgia
control pain
Dilantin or Tegretol
local anesthesia
*NSAIDS will not work on nerve pain
abnormal, sudden uncontrolled discharge of neurons
seizure
- chronic condition, recurrent seizures, may cause imbalance of neurotransmitters (GABA), and or electrical activity
- neural excitation, not orderly
epilepsy
which type of seizure happens to both hemispheres of the brain
generalized
describe tonic/clonic seizure
lasts 2-5 min, typical seizure
tonic: stiffen, rigid muscles
clonic: jerking of extremities
describe absence seizure
often in children
brief stares
loss of consciousness
describe myoclonic seizure
brief jerking, lasts few sec
describe atonic seizure
sudden loss of muscle tone, fall and confused
which type of seizure happens to just one hemisphere (local)
partial
what is a common part of partial seizures
aura: impending doom of seizure is felt
what are the types of partial seizure
simple: lose consciousness (1-3 min)
complex: remain conscious (unusual sensation)
early warning sign of impending attack/seizure
prodromal
visual disturbance, buzzing sounds before seizure
aura
the event (seizure)
ictus
maintained contractions r/t bombardment of motor impulses
tonus
contraction/relaxation of muscle
clonus
exhaustion (final stage of seizure)
postical
should you put something in someone’s mouth during seizure
NO
describe status eptilepticus
- life threatening
- brain in state of persistant seizure
- prolonged seizure > 5 min or repeated episodes >30 min
intervention for status eptilepticus
call 911 if lasts longer than 5 min
give O2- ensure patent airway
*ATIVAN-rescue drug OR Dilantin
these are sedative and hypnotic drugs to shut off brain activity
what to do during seizure
privacy, protect, pad side rails
ease to floor, protect from injury, loosen clothes
what to do after seizure
position on side check VS allow time to sleep re orient pt document and time seizure
what is another word for brain attack
stroke
describe what a cerebrovascular accident is (CVA)
- interruption in cerebral blood flow
- can be ischemia, hemorrhage, embolism
- syndrome of rapid onset characterized by neruologic defect lasting >24 hrs
- results in impaired brain circulation
what are stroke risk factors
HTN, DM, obesity, smoking, oral contraceptive, A fib, sickle cell, hyperlipidemia
describe an ischemic stroke
blood CLOT in artery of brain
80% of strokes
describe what TIA is
transient ischemic attack warning sign (first stroke) for MAJOR oncoming stroke
describe a hemorrhagic stroke
- rupture of vessel in brain with subsequent bleeding in the brain
- 20% of strokes
- proceeded by “worst headache of life”
- often die instantly d/t excessive cerebral bleeding
what is the biggest risk of hemorrhagic stroke
HTN-high pressure can lead to rupture of vessel in brain
what are the warning signs of stroke
- sudden weakness/numbness of face, arm, leg (esp one side)
- sudden confusion, trouble speaking/understanding speech
- sudden trouble seeing in 1 or 2 eyes
- sudden severe headache
recognition of stroke
FAST (face, arms, speech, time)
smile, make complete sentence, raise both arms