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Med Surg > Neuro > Flashcards

Neuro Flashcards

1
Q

most common pain experienced

A

headache

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2
Q

what types of headaches are there

A

tension, migraine, cluster

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3
Q

describe a tension headache

A

typical headache

base of skull, forehead, neck/shoulder

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4
Q

tension headache relieved with what

A

rest, NSAIDS, OC meds

determine cause to alleviate

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5
Q

what are the precipitating factors of tension headaches

A

stress, hunger, lack of sleep, withdrawal from coffee, eye strain

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6
Q

what is the patho of migraines

A

“pathological cause”

  • vascular, genetic, chemical, trigemal vascular system (spasms, decreased blood flow), hypoxia, artery dilation (prostaglandin trigger)
  • these cause increase in swelling and sensitivity to pain
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7
Q

s/s of migraine

A

throbbing pain, worse behind one eye/ear, photophobia, anorexia, nausea, sensitive scalp, sound

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8
Q

three types of migraines

A

with aura, without aura, atypical

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9
Q

describe migraine with aura

A
  • sensation that indicates onset of migraine or seizure
  • develops over several minutes and lasts for less 1 hr
  • subjective feeling of doom
  • may consist of flashing lights, noises, distorted vision
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10
Q

describe migraines without aura and atypical

A

without aura: most migraines without aura

atypical: menstrual and cluster

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11
Q

stages of migraines

A

1) prodrome: specific s/s and mood change
2) aura: visual change, diplopia, flashing light
3) headache: lasts hrs-days
4) termination: intensity decreases
5) postprodrome: fatigue, irritability

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12
Q

what can be triggers of migraines

A

fatigue, anger, stress, hunger, irritability, chocolate, caffeine, alcohol, insomnia, hormones, meds, artificial sweeteners

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13
Q

what are the typical drugs for migraines

A

NSAIDS, beta blockers, calcium channel blockers,

antidepressants, opioids, Triptan preparatons serotonin (Imitrex*, Zomig, Relpax)

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14
Q

what abortive drugs are used for migraines

A

ASA and tylenol

taken during aura to prevent migraine from occurring

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15
Q

what is meningitis

A
  • inflammation of protective membrane covering the brain and spinal cord (meninges)
  • bacterial(most dangerous) and viral
  • medical emergency, high mortality
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16
Q

what do we vaccine against

A

meningococcal

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17
Q

s/s of meningitis

A

*nuchal rigidity, headache, fever, chills, photophobia, N/V, altered level of consciousness, tachycardia, seizures, red macular rash, Kernig’s sign, Brudzinski’s sign

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18
Q

what is a positive Kernig and Brudzinski

A

Kernig: resistance to extension of pt leg from flexed position
Brudzinski: flexion of extremities with deliberate flexion of pt neck

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19
Q

1 indicator of meningitis

A

have pt put chin to neck

positive for meningitis will NOT be able to do it, too painful

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20
Q

describe viral meningitis

A

occurs most often and resolves without treatment

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21
Q

describe bacterial meningitis

A

organisms enter CNS through BBB

results in inflammatory response

22
Q

what are the risk factors of bacterial meningitis

A

bacterial infection (ie/ resp infection), immunosuppression, invasive procedure, head injury, overcrowded living conditions (college dorms)

23
Q

how is bacterial meningitis diagnosed

A

cerebrospinal fluid analysis: obtained via lumbar puncture

*broad spectrum antibiotic given BEFORE puncture

24
Q

nursing care of meningitis

A
  • monitor ABC
  • neuro and VS check every 2-4 hrs
  • motor changes and I & Os
  • antibiotics (Rocephin and antiepileptics)
  • decreased environmental stimuli
  • isolation precautions (standard unless airborne bacteria identified)
25
Q

what complications of meningitis do you want to prevent

A
  • increased ICP (brain swelling would cause pupil changes)
  • vascular dysfunction
  • seizures, shock
  • fluid and electrolyte imbalance
26
Q

difference between Ach and dopamine

A

Ach: excitatory neurotransmitter
dopamine: inhibitory neurotransmitter

27
Q

what are the four signs of Parkinson’s

A

1) rigidity
2) slow movement (akinesia)
3) tremor at rest
4) impaired postural reflexes, fall forward

28
Q

what is akinesia

A

slow movement

29
Q

patho of Parkinson’s

A
  • neurotransmitter disease
  • balance of dopamine and Ach is disrupted
  • degeneration of dopamine(decreased) producing neuron
  • decreased norepinephrine also causes orthostatic changes
30
Q

when do symptoms appear in Parkinson’s

A

when 80% of basal ganglia are gone

31
Q

what are the risk factors of parkinson’s

A

increased with age
more common in men
genetics or brain injury may cause this

32
Q

what are the stages of Parkinson’s

A

1) symptoms on one side of body, tremors
2) bilateral limb movement, slow gait
3) shuffling, propulsive gait with flexed arms
4) akinesia, rigidity
5) complete dependence (may never reach this stage)

33
Q

Cogwheel

A

rhythmic movement

34
Q

dysarthia

A

slurred speech

35
Q

features of Parkinson’s

A
  • stooped posture
  • shuffling, propulsive gait
  • bradykinesia and cogwheel
  • dysarthia, echolalia, hypophobia
  • liable, mood swings
36
Q

what are the signs of Parkinson’s

A
  • cannot relax arms or face (masklike)
  • orthostatic hypotension (fall risk)
  • tremors at rest, lack inhibitory neurotransmitter (dopamine)
37
Q

diagnostic test of Parkinson’s

A

no specific test
diagnosis when 2 or 3 characteristics are present
triad (tremor, rigidity, bradykinesia)

38
Q

when is Parkinson’s confirmed

A

positive response to antiparkinonian drugs

39
Q

what is drug therapy for Parkinson’s

A
  • correct imbalance of neurotransmitters
  • enhance or release supply of dopamine
  • goal is to decrease symptoms
40
Q

drug that is a precursor to dopamine

given for Parkinson’s

A

Levodopa
cross BBB and turns into dopamine in basal ganglia
cannot give straight dopamine because it will NOT cross BBB

41
Q

what is given with Levodopa for Parkinson’s

A

Carbidopa

inhibits enzyme that breaks down levodopa before it reaches the brain

42
Q

why is Requip given to Parkinson’s pt

A

dopamine agonist
stimulates production of dopamine
BUT can cause hypotension and hallucinations

43
Q

why is Cogentin give to Parkinson’s pt

A

anticholinergic

decreases Ach, controls tremors, rigidity and sweating

44
Q

what do anticholinergics do (broadly)

A

dry the pt out

45
Q

other therapies for Parkinson’s

A

exercise and ambulation
injury prevention, counseling
OT and ADL and ST therapy
nutrition, soft food, thicken foods

46
Q

inability to use words or objects correctly

A

apraxia

47
Q

inability to find words

A

anomia

48
Q

inability to speak or understand

A

aphasia

49
Q

loss of sensory comprehension

A

agnosia

50
Q

agnosia, aphasia, anomia, and apraxia are found in what disease

A

Alzheimer’s

Med Surg (23 decks)

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