Week 7 Flashcards

Question

Describe a complex partial seizure.

Answer 1

Motionless or moves automatically Responds inappropriately to time and place Extreme emotions Episode not remembered

Answer 2

Both hemispheres of brain cause whole body to react Intense contraction and relaxation of muscles Epileptic cry Incontinence of urine and faeces Unconsciousness Patient drowsy and confused, will sleep postictal

Answer 3

DRABCDE MET Provide privacy Bring patient to the floor if possible Protect head from injury Loosen constrictive clothing Remove risks such as furniture that may cause injury Remove pillows and raise bed rails if facility permits

Answer 4

DRABCD Recovery position Patent airway Reorientate patient Calm patient Vital signs Document in notes

Answer 5

Sum of volumes of brain, CSF and intracranial blood is constant. An increase in one should cause a decrease in one or both of the others. Compensation occurs until the body snowballs into ischaemia and oedema.

Answer 6

Manifestation of acute elevation of ICP Indicated imminent brain hernia ruin Increased BP Decreased HR Apnoea

Answer 7

Flexor posture - arms like 'c's | Indicates problems with cervical spinal tract or cerebral hemisphere

Answer 8

Extensor posture Arms like 'e's Indicates problems with midbrain and pons

Answer 9

``` Decreased LOC Decreased motor function Cushing's Triad Pupil changes Headache Seizures Vomiting Weakness Abnormal posturing Abnormal speech ```

Answer 10

Pharmacological intervention | Surgical intervention

Answer 11

``` Control and monitor BP Medication HOB 30 degrees Hourly NVO initially Monitor EVD output daily VTE prophylaxis - teds, heparin Analgesia Mouth care Hygiene Catheter care ``` Rehab/palliative care

Answer 12

Preventing injury Promote physical mobility Improve and promote self-care abilities Enhance bladder and bowel control

Answer 13

A way of communicating with those with cognitive impairment, by clear succinct instructions or questions. One main point at a time; One step process preferred: * pick up pen * now write your name "We need to order your lunch for tomorrow; do you feel like chicken? (yes/no) How about beef? (yes/no) Would you prefer a sandwich?" (yes/no) Two step process: *pick up the pen and write your name Multi-step question: *we need to order your lunch for tomorrow. Do you feel like chicken, beef or a sandwich?

Answer 14

Failure to act on elevated ICP - higher risk of mortality and permanent neurological impairment. Delayed treatment - worsening of tissue hypoxia within the brain. Further increases oedema and injury. Changes in ICP and BP may alter blood volume as a result of dilation or constriction of cerebral blood vessels. This causes further pressure. Compression of optic nerve due to oedema results in impaired pupillary responses. Causes pressure gradients between cranial vault compartments and shift of brain structures. Changes in BP, pulse and respiratory pattern are usually late signs of raised ICP in clinical practice. These are related to brain stem distortion, hernias ion or ischaemia.

Answer 15

The AVPU scale is a system easily applied to initially assess a patients neurological status. It can measure and record a patients responsiveness, indicating their level of consciousness. Following this initial assessment, a formal assessment of the GCS is performed. ``` A = Alert: is the patient alert and responsive? V = Verbal: does the patient respond to verbal commands? P = Pain: does the patient respond to painful stimulus? U = Unconscious: with no response to any of the above, the patient is considered unconscious. ```

Answer 16

``` Falls risk assessment and plan Mini-mental state exam Nom-slip socks Aids and equipment nearby - hearing aids, walking frames/sticks, glasses, urinal bottle Call bell within reach Bed lowered to the ground Supervised mobilisation Nurse near nursing station PCA/HAS guard if confused (1:1 special) Medication review and minimise agents known to cause falls - antidepressants, diuretics, sedatives, antihistamines ```

Answer 17

Progressive mental deterioration that can occur in middle or old age due to generalised degeneration of the brain. It is the commonest cause of premature senility.

Answer 18

Progressive disease involving damage to the myelin sheaths of nerve cells in the brain and spinal cord. Symptoms may include numbness, impairment of speech and of muscular coordination, blurred vision and severe fatigue.

Answer 19

Progressive degenerative disorder of the CNS mainly affecting the motor system. Also known as idiopathic or primary Parkinsonism, hypokinetic rigid syndrome (HRS) or paralysis agitans

Answer 20

Progressive disease involving degeneration of the motor neurons and wasting of the muscles

Answer 21

Genetic neurodegenerative disorder that affects muscle coordination and leads to mental decline and behavioural symptoms. Symptoms usually appear when a person is in their 40s. Behavioural problems are thought to be a combination of events, including damage to the brain as the disease progresses and the understandable frustration and depression that people feel when challenged by chronic illness.

Answer 22

"Chronic disorder of the brain characterised by recurring seizures" (WHO, 2012). Neurons carry messages by discharging electrochemical energy. Normal function impulses occur in bursts when the cell has a task to perform. Epilepsy continued firing of impulses after cell task is finished, causing erratic performance of body parts controlled by errant neurons. This results in dysfunction which ranges from mild to severe and incapacitating seizures which often cause unconsciousness. Causes are varied but categorised as idiopathic (unknown) and acquired.