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
Nursing Management of migraine headaches
o Avoid triggers
o Fewfever prophlactically (herb non medicated OTC for cluster headache
o Massage
o Journal keeping (to keep track of patterns, triggers)
o Cool dark quite environment
o Elevated the head of the bed
Manifestations of left side hemispheric stroke
o Right side; Hemiplegia
o Aphasia
o Aware of their limits experience depression, anger, frustration
o Trouble understanding written text
o Issue with writing (Agraphia)
o Impaired math skills
o Memory intact
o Issue with seeing on the right side
o Short retention
