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Adult Health 1 - (Josh) > T3 - Probs of CNS (Brain) (Josh) > Flashcards

T3 - Probs of CNS (Brain) (Josh) Flashcards

1
Q

Risk factors for Headaches

A

ETOH

Environmental allergies

Meds

Intense odors / bright lights

Fatigue / Sleep Depr.

Depression

Emotional/Physical Stress; Anxiety

Menstrual Cycle; Oral Contraceptive use

Foods

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2
Q

Which foods increase risk for headaches?

A

Tyramine
- aged cheese, meats, etc

Caffiene

MSG

Nitrites

Milk products

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3
Q

Describe the characteristics of a Migraine Headache.

A

Intense, UNILATERAL pain

Worsens w/ mvmt

Photophobia or Phonophobia

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4
Q

What are the categories of a Migraine?

A

Aura (classic migraine)

No Aura (most common)

Atypical

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5
Q

What are the Phases of an Aura Migraine?

A

Prodrome

Aura

Termination

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6
Q

How long does a No Aura Migraine last?

How long does an Atypical Migraine last?

A

4-72 hrs

longer than 72 hrs

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7
Q

What are characteristics of a Cluster Headache?

A

Trigeminal Autonomic Cephalalgia

Brief, Intense, UNILATERAL pain

Non-throbbing or BORING pain

30 mins to 2 hrs in length

Occurs daily for 4-12 wks

No warning

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8
Q

What is the patho of a Cluster Headache?

A

vasoreactivity and neruogenic inflammation

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9
Q

Which headache?

  • Tearing of eye w/ nasal congestion
  • Facial sweating

Drooping eyelid (ptosis) and eyelid edema

  • Miosis
  • Facial pallor
  • N/V
  • Pacing, walking, and rocking activities
A

Cluster Headache

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10
Q

What meds for Abortive treatment for Migraine?

A

Mild

  • Acetaminophen
  • NSAIDs (ibuprofen; naproxen)
  • Migraine specific OTC formulations
  • Antiemetics

Severe

  • Triptans
  • Ergotamines
  • Isometheptenes
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11
Q

Which meds for Preventive treatment for Migraine?

A

NSAIDs

Beta Blockers (propanolol; timolol)

CCBs (verapamil)

Antiepileptics (topiramate

Avoiding triggers

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12
Q

What non-pharmacological treatments for Migraines?

A

O2 Therapy (100% for short time)

Complimentary and Alternative Therapy (yoga, etc)

Consistent sleep/wake cycle

Review triggers such as bursts of anger or excessive physical activity

Deep brain stimulation or surgery as last resort

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13
Q

Triggers for Migraines.

A

Tyramine foods (pickles, caffeine, ETOH, aged cheese, artificial sweeteners, NUTS)

MSGs

Meds

  • Ranitidine
  • Estrogen
  • Nitro
  • Nifedipine

Anger

Lack of sleep/rest

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14
Q

Triggers for Cluster Headaches.

A

Anger outburst

Anxiety w/ prolonged anticipation

Excessive physical activity; fatigue

Altered sleep-wake cycles

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15
Q

What are the different types of Generalized Seizures?

A

Tonic-Clonic

Tonic

Clonic

Absence

Myoclonic

Atonic

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16
Q

Characteristics of a Tonic-Clonic Seizure.

A

Both cerebral hemispheres

2-5 mins

Loss of consciousness

Incontinent

Biting of Tongue

Post-ictal period with fatigue, lethargy, and confusion

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17
Q

What is the Tonic stage and what is the Clonic stage?

A

Tonic = abrupt increase in muscle tone with loss of consciousness

Clonic = muscle contraction and relaxation

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18
Q

Which seizure involves staring off in space (looks like day-dreaming) and happens in kids?

A

Absence

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19
Q

Which seizure involves brief jerking or stiffening of extremities?

A

Myoclonic

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20
Q

Which seizure involves a sudden loss of muscle tone?

A

Atonic

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21
Q

What are the two classifications of Partial Seizures?

A

Complex Partial

Simple Partial

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22
Q

Characteristics of a Complex Partial Seizure?

A

Loss of consciousness for 1-3 mins

Automatisms can occur

Amnesia post seizure

AKA: Psychomotor or Temporal Lobe Seizures

***more common in older adults

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23
Q

Characteristics of Simple Partial Seizure?

A

Remains CONSCIOUS throughout

Aura may occur

One sided mvmt in extremities

Unusual sensations (DEJA VU)

Can have autonomic symptoms

Pain or offensive smell

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24
Q

Risk factors for Seizures

A

Metabolic Disorders

Acute ETOH withdrawal

Electrolyte disturbances

Heart Disease

High Fever

Stroke

Substance Abuse

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25
Q

What are some meds we can give for an Acute Seizure?

A

Lorazepam (ativan)

Diazepam (valium)

Diastat

IV Phenytoin or Fophenytoin

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26
Q

Which med is the DOC for acute Seizure treatment?

A

Lorazepam (Ativan)

  • **can be given IV
  • **few s/e than Diazepam
27
Q

What do we need to remember about Phenytoin?

A

don’t administer w/ Warfarin

28
Q

What is Status Epilepticus?

A

prolonged seizure (5-30 mins) or repeated seizures over course of 30 mins

29
Q

What is emergency treatment for Status Epilepticus?

A

Establish Airway

ABGs

IV push of lorazepam (or diazepam)

Rectal diazepam

Loading dose of IV Phenytoin

30
Q

Which type of Meningitis is most common?

A

Bacterial (due to overcrowded living conditions)

31
Q

What are some risk factors for Viral Meningitis?

A

Mumps

Measles

Herpes

West Nile

32
Q

What are some risk factors for Bacterial Meningitis?

A

Otitis Media; Pneumonia; Sinusitis

Immunosuppression

Invasive Procedures

Overcrowded living conditions

Step. pneumoniae; Neisseria meningitidis

Haemophilus influenzae

33
Q

Fungal Meningitis is the least common type. Who is most at risk?

A

AIDS patient

34
Q

S/S of Meningitis

A

Fever

Headache

Photophobia

Increased ICP

Nuchal ridigity

Positive Kernigs and Brudzinskis

Decreased Mental Status

Focal Neuro Deficits

N/V

35
Q

What is Kernig’s Sign?

Brudzinskis?

A

Kernigs = pain when leg extended and flexed at hip

Brudzinskis = involuntary flexion of knee when neck is flexed

36
Q

Nursing Care for Meningitis

A

Isolation and Droplet precautions (w/ bacterial)

Fever reduction

Dark, quiet environment

Bedrest; HOB elevated

Seizure precautions

Neuro Checks q 2-4 hrs

37
Q

When doing neuro checks for Meningitis, which Cranial Nerves are we focusing on?

A

III: Oculomotor

IV: Trochlear

VI: Abducens

VII: Facial

VIII: Vesibulocochlear

38
Q

Medications for Meningitis

A

Broad spectrum antibiotic (bacterial)

Fever reducing agents (Acetaminophen; Ibuprofen)

Hyperosmolar Agents

Anticonvulsants (Phenytoin)

Steroids (CONTROVERSIAL)

Prophylaxis treatment for those in close contact w/ meningitis infected client

39
Q

S/S of Encephalitis

A

High Fever

Changes in Mental Status

Motor Dysfunction

Focal neuro deficits

Photophobia

Fatigue

Joint Pain

Headache

Increased ICP

40
Q

Encephalitis can be caused by —

A

mosquitoes and ticks

***Caused by arbovirus spread by mosquitoes and ticks

41
Q

If Encephalitis is caused by Herpes, what do you treat it with?

A

Acyclovir

42
Q

Parkinson’s is a degeneration in which area of the brain?

What does it result in?

A

substantia nigra

results in decreased production of DA

43
Q

In Parkinson’s, there is a decrease in — and an increase in —

A

DA

ACh

44
Q

What are risk factors for Parkinson’s Disease?

A

Age 40-70

Men

Genetic predisposition

Exposure to environmental toxins

Chronic use of antipsychotic meds

45
Q

S/S of Parkinson’s Disease

A

Tremor

Muscle Rigidity

Postural Instability

46
Q

What will posture of Parkinson’s patient look like?

A

Fwd tilt of trunk

Rigidity and trembling of head

Reduced arm swinging

Shuffling gait w/ short steps

47
Q

What will the face of a Parkinson’s client look like?

A

mask-like facial expression

48
Q

Medications used to treat Parkinson’s

A

DA agonists

Anticholinergics

Catechol O-methyltransferase Inhibitors

49
Q

What should we remmber about Parkinson’s Meds?

A

most effective first 3-5 years

Need drug holidays

50
Q

What are the structural changes in brain associated with Alzheimers?

A

Neuritic Plaques

Granulovascular Degenerations

Neurofibrillary Tangles

51
Q

Symptoms of Alzheimers

A

Gradual memory loss (short term first)

Behavior/Personality changes

Eventually lose language and motor skills

52
Q

Medication classes for Alzheimers

A

Cholinisterase Inhibitors

NMDA Receptor Antagonists

SSRIs

53
Q

What are the Cholinisterase Inhibitors used for Alzheimers?

A

Donepezil

Galatamine

54
Q

What are the NMDA Receptor Antagonists used for Alzheimer’s?

A

Memantine

  • **usually for late stages
  • **can be taken w/ one of the other classifications
55
Q

Why do we take Cholinisterase Inhibitors with Alzheimer’s?

A

prevent the breakdown of ACh, which increases the amount available for nerve impulses

56
Q

Alzheimers:

Nursing Considerations for Donepezil (Cholinisterase Inhibitor)

A

Observe for frequent stools or upset stomach

Monitor for dizziness or headache

Use caution if they have COPD or Asthma

57
Q

When does Huntington’s Disease usually begin?

A

30-50 years old

58
Q

What is the patho behind Huntington’s?

A

decrease in GABA and increase in Glutamate

59
Q

S/S of Huntington’s

A

Progressive mental status change

Choreiform movements
***Brisk, jerky, purposeless mvmts

60
Q

What medication for Huntington’s

A

tetrabenazine

61
Q

Which type of headache is familial?

Which type of headache can occur at same time every day?

A

Migraine

Cluster

62
Q

Which medications can trigger migraines?

A

Ranitidine

Estrogen

Nitro

Nifedipine

63
Q

What are the Autonomic Symptoms of Simple Partial Seizures?

A

Changes in HR and abnormal flushing

64
Q

Meningitis:

Which type has CLEAR CSF and which type has CLOUDY CSF?

A

Clear = Viral

Cloudy = Bacterial

Adult Health 1 - (Josh) (26 decks)

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