VN 22 test 8 Flashcards
1) Medical Management of migraine headaches
o Mild analgesic
o Methysergide (Sanskrit), topiramate (Topamax)- prevent migraine
-Increase dose gradually; monitor drug levels
o Sumatriptan (Imitrex)- interrupt migraines that have already developed
-Oral, intranasal spray, or subcutaneous injection
2) Triggers for migraines
o Stress
o Flashing lights
o Food; Salt, tyramine, caffeine, aged cheese, wine, MSG
o Alcohol
o Hormones
o Odors
o Sleep interruption
3) Sumatriptan and zolmitriptan K,H,K
o Use for miragines
o Common side effects is facial flushing
o Taken at the first onset of symptoms to make it most affected; interrupted migraines
4) Medical treatment of strokes
o Thrombolytic is not for people who had a motorcycle accident, hemorrhagic, surgery ; only for Ischemic Stroke
-Given with 4.5hr of initial manifestation for client experiencing ischemic strike
o TPA is given for only ischemic stroke.
- Can be given within 3hours from onset fo stroke
5) Nursing interventions for strokes include: aphasia, dysphagia, hemianopsia
o Aphasia; not able to speak
-use a communication board/ imaging and be patient
o Dysphasia: difficulty swallowing
-Risk for Aspiration; place food on unaffected side and tuck in chin to chest while swallowing
o Hemianopsia:Limited vision in half of the visual field.
- You want to scan in the visual field side to side
6) Diagnostic tests for strokes
o CT and MRI to determine is a clot or a bleed; you want to them to get them in fast
7) Risks for stroke and hemorrhagic stroke
o Heart valve problems
o A-fib
o Brain aneurysm bursts
o Uncontrolled HTN
8) Types of headaches with descriptions
o Tension headache: pressure or steady constriction on both sides of the head
o Classic Migraine: Aura- prodromal period before the headache is marked by a change in mood, difficulty in mood, difficulty concentrating, unusual fatigue, throbbing or bursting pain, nausea, vomiting, vertigo, sensitivity to light, irritability (Ask for any Aura)
o Cluster Headache: pain on one side of the head, usually nasal congestion, rhinorrhea, tearing, redness of the eye.
9) Difference between TIA and stroke
o TIA: is a warning sign; symptoms are intermittent they come and go
o Stroke: happens suddenly.. needs to act FAST to save brain cells, call rapid response or 911 (NOTE: The time frame is 4-4 ½; to get the clot buster out)
10) Manifestations of TIA
ACT FAST
o Face dropping
o Arm numbness and weakness
o Speech difficulty
o Time
o Visual disturbance
o Dizziness
o Slurred speech
o A weak extremity
11) Manifestations of right side hemispheric stroke
o Left side weakness: Hemiplegia
o Impairment in creativity: arts & music
o Confused on date, time, place
o Cannot recognize faces or the person’s name
o Loss of depth perception
o Trouble staying on topic when talking
o Can’t see thing on the left side;
0. Left side Neglect: ignores left side of body
o Trouble with maintaining proper grooming
o Emotionally: not going to think things through…very impulsive
o Poor ability to make decisions and assessing spatial elements shapes
o Denial about limitations
o Not able to interpret nonverbal language or understand the hidden meaning if things
o Very shorty attention span
Cerebral Aneurysm nursing intervention
Avoid Valsalva maneuver: STRAINING, coughing, position changes, heavy lifting
Right side Action
-Attention span
-showing emotions
-ability and to solve everyday problems by making decisions/ plan
-Reasoning (understanding jokes…reading in between the lines)
-making judgement calls
-memory recall
-music/art awareness
-Controls the left side of the body
-depth reception
Postop for ischemic surgery
-removes the plaque
-you want to assess breathing and swallowing
Carotid Artery plaque
If they have plaque in the carotid artery you will listen in the neck for bruit
