neurologic disorders Flashcards
Intracranial vasoconstriction followed by vasodilation
migraine headaches
migraine headaches are triggered by
Triggered by menstruation, ovulation, alcohol, some foods, stress
mi grain headaches pain is
Pain usually unilateral, often begins in the temple or eye area and is very intense
other s/s of migraine headaches are
Tearing and nausea and vomiting may occur
Hypersensitive to light and sound; prefers dark, quiet environment
migraine headaches are treated with
Mild migraines treated with acetaminophen or aspirin; severe ones with ergotamine (Cafergot) or sumatriptan (Imitrex) tablet or autoinjector for self-injection
Occur in a series of episodes followed by a long period with no symptoms
cluster headache
cluster headache pain is usually related to
stress and anxiety and usually have no warning symptoms
treatment of cluster headache include
Treatment may include cold application, indomethacin (Indocin), and tricyclic antidepressants
Result from prolonged muscle contraction from anxiety, stress, or stimuli from other sources, such as a brain tumor or an abscessed tooth
tension headache
tension headache s/s including pain
Pain location may vary; may have nausea and vomiting, dizziness, tinnitus, or tearing
treatment for tension headache include
Treatment: correction of known causes, psychotherapy, massage, heat application, and relaxation techniques
medication treatment for tension headache
Analgesics, usually nonopioid, may be prescribed to reduce anxiety
An uncontrolled discharge of neurons in the cerebral cortex, interferes with normal CNS function, altering sensation/movement/perception or consciousness
Seizure Disorder
Epilepsy is
recurrent seizures, not a disease but a CNS disorder
Electrical impulses in the brain are conducted in a
highly chaotic pattern that yields abnormal activity and behavior
seizure disorder is related to
Related to trauma, reduced cerebral perfusion, infection, electrolyte disturbances, poisoning, or tumors
medical diagnosis of seizure disorder
Accurate history of the seizure disorder
Electroencephalogram (EEG)
Part of one cerebral hemisphere; consciousness not impaired
partial seizure (simple)
Consciousness impaired; may exhibit bizarre behavior
partial seizure (complex)
Generalized seizure involve what?
and types
Involve the entire brain from the onset
Consciousness lost during the ictal (seizure) period
Types: tonic-clonic, absence, myoclonic, and atonic
Status epilepticus
Medical emergency: continuous seizures or repeated seizures in rapid succession for 30 minutes or more
Aura
Dizziness, numbness, visual or hearing disturbance, noting an offensive odor, or pain may precede a seizure
medical treatment for seizure disorders
Resolution of the underlying condition
Anticonvulsant drug therapy
surgical treatment of seizure disorder
Removal of seizure foci in the temporal lobe and pallidotomy (removal of the globus pallidus of the brain) or vagal nerve stimulator
Assessment
Describe the seizure episode (time it); including the postictal period (following the seizure); aura just before onset of seizure; eyes deviating to a particular side; or blinking; Irregular breathing with spasms; LOC with tonic-clonic muscular contractions; orientation to time, place; P/A drowsiness; lack of coordination; and document drug therapy administered
Risk for Injury
Side rails of bed up and padded, suction machine readily available, bed maintained in the low position
Quickly move objects away from the patient
Do not attempt to restrain the patient
Ineffective Coping and Deficient Knowledge
Teach family and patient about the seizure disorder and the therapy
Teaching must be directed toward helping the patient and family adjust to a chronic condition
Encourage questions and concerns
Lacerations, contusions, abrasions, and hematomas
Scalp injuries
Trauma with no visible injury to the skull or brain; Mild brain injury; LOC (loss of consciousness) <5 min; Headache, dizziness, n/v, amnesia
Concussion
Bruising and bleeding in the brain tissue; symptoms determined by area involved; when brain stem affected causes loc, respirations, pupil reaction, motor response to stimuli can be affected
Contusion
Subdural hematoma or epidural hematom; symptoms occur up to 24 hr post-injury; Bleed occurs b/w dura mater and arachnoid membranes; forgetful, irritable, lethargic, can develop hemiparesis and HA
Hematoma
From lesions within the tissue of the brain itself
Intracerebral hemorrhage
Sharp objects penetrate the skull and brain tissue
Penetrating injuries
Directed at evacuating hematomas and débriding damaged tissue
Surgical treatment
nursing interventions for head injury
LOC, VS, movement and strength, PERRLA, HA, visual disturbance, vomiting, seizures, respiratory depression, I & O, inspect dressing for bleeding and/or cerebral spinal fluid (CSF classic appearance pink stain surrounded by a lighter ring), HOB elevated at all times, neuro checks as prescribed by Dr or surgeon, report changes immediately!
wake every hour during noc
risk factors for brain tumors
Some congenital; others may be related to heredity
Drug/environmental factors may play a role in development
Abnormal mass found in brain resulting from unregulated cells growth & division
Primary (non-cancerous, but malignant) or Secondary (metastasis from cancer)
Primary classified by tissue origin: gliomas, meningiomas, astrocytomas
Can cause compression of blood vessels, producing ischemia & increased ICP
s/s of brain tumors
Directly related to area of brain invaded by the tumor
Tumor in any area: deficits in cerebral function, headache, and visual disturbances
Tumor in frontal lobe: aphasia, memory loss, personality changes
Tumor in temporal lobe: aphasia, seizures
Tumor in parietal lobe: motor seizures, sensory impairment
Tumor in occipital lobe: homonymous hemianopsia, visual hallucinations, visual impairment
Tumor in cerebellum: impaired coordination, impaired equilibrium
Most common new-onset finding: auras, seizure activity or difficulties with balance and coordination
medical treatment of brain tumors
Surgery often followed by radiation with or without
chemotherapy
Inflammation of the meningeal coverings of the brain and spinal cord caused by either viruses or bacteria
Meningitis
Meningitis s/s
Headache, nuchal rigidity (stiffness of the back of the neck), irritability, diminished level of consciousness, photophobia (sensitivity to light), hypersensitivity, and seizure activity
Positive Kernig’s sign and Brudzinski’s sign
medical diagnosis of menigitis
Lumbar puncture to obtain CSF for lab analysis
when reflex contraction and pain in the hamstring (tendons that for the medial and lateral boundaries of the popliteal space) muscles when attempting to extend the leg after flexing the thigh upon the body
Kernig’s sign
flexion of the hips when the neck
is flexed from a supine position
Brudzinski’s sign
medical treatment for meningitis
Bacterial infections usually respond to antimicrobial therapy, but no specific drugs effective against most viral infections
Anticonvulsants used to control seizure activity if necessary
nursing assessment for meningitis
Assess vital signs and neurologic status frequently to determine further deterioration or onset of complications
