Flashcards in T3 - Probs of CNS (Brain) (Josh) Deck (64):
Risk factors for Headaches
Intense odors / bright lights
Fatigue / Sleep Depr.
Emotional/Physical Stress; Anxiety
Menstrual Cycle; Oral Contraceptive use
Which foods increase risk for headaches?
- aged cheese, meats, etc
Describe the characteristics of a Migraine Headache.
Intense, UNILATERAL pain
Worsens w/ mvmt
Photophobia or Phonophobia
What are the categories of a Migraine?
Aura (classic migraine)
No Aura (most common)
What are the Phases of an Aura Migraine?
How long does a No Aura Migraine last?
How long does an Atypical Migraine last?
longer than 72 hrs
What are characteristics of a Cluster Headache?
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
What is the patho of a Cluster Headache?
vasoreactivity and neruogenic inflammation
- Tearing of eye w/ nasal congestion
- Facial sweating
Drooping eyelid (ptosis) and eyelid edema
- Facial pallor
- Pacing, walking, and rocking activities
What meds for Abortive treatment for Migraine?
- NSAIDs (ibuprofen; naproxen)
- Migraine specific OTC formulations
Which meds for Preventive treatment for Migraine?
Beta Blockers (propanolol; timolol)
What non-pharmacological treatments for Migraines?
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
Triggers for Migraines.
Tyramine foods (pickles, caffeine, ETOH, aged cheese, artificial sweeteners, NUTS)
Lack of sleep/rest
Triggers for Cluster Headaches.
Anxiety w/ prolonged anticipation
Excessive physical activity; fatigue
Altered sleep-wake cycles
What are the different types of Generalized Seizures?
Characteristics of a Tonic-Clonic Seizure.
Both cerebral hemispheres
Loss of consciousness
Biting of Tongue
Post-ictal period with fatigue, lethargy, and confusion
What is the Tonic stage and what is the Clonic stage?
Tonic = abrupt increase in muscle tone with loss of consciousness
Clonic = muscle contraction and relaxation
Which seizure involves staring off in space (looks like day-dreaming) and happens in kids?
Which seizure involves brief jerking or stiffening of extremities?
Which seizure involves a sudden loss of muscle tone?
What are the two classifications of Partial Seizures?
Characteristics of a Complex Partial Seizure?
Loss of consciousness for 1-3 mins
Automatisms can occur
Amnesia post seizure
AKA: Psychomotor or Temporal Lobe Seizures
***more common in older adults
Characteristics of Simple Partial Seizure?
Remains CONSCIOUS throughout
Aura may occur
One sided mvmt in extremities
Unusual sensations (DEJA VU)
Can have autonomic symptoms
Pain or offensive smell
Risk factors for Seizures
Acute ETOH withdrawal
What are some meds we can give for an Acute Seizure?
IV Phenytoin or Fophenytoin
Which med is the DOC for acute Seizure treatment?
***can be given IV
***few s/e than Diazepam
What do we need to remember about Phenytoin?
don't administer w/ Warfarin
What is Status Epilepticus?
prolonged seizure (5-30 mins) or repeated seizures over course of 30 mins
What is emergency treatment for Status Epilepticus?
IV push of lorazepam (or diazepam)
Loading dose of IV Phenytoin
Which type of Meningitis is most common?
Bacterial (due to overcrowded living conditions)
What are some risk factors for Viral Meningitis?
What are some risk factors for Bacterial Meningitis?
Otitis Media; Pneumonia; Sinusitis
Overcrowded living conditions
Step. pneumoniae; Neisseria meningitidis
Fungal Meningitis is the least common type. Who is most at risk?
S/S of Meningitis
Positive Kernigs and Brudzinskis
Decreased Mental Status
Focal Neuro Deficits
What is Kernig's Sign?
Kernigs = pain when leg extended and flexed at hip
Brudzinskis = involuntary flexion of knee when neck is flexed
Nursing Care for Meningitis
Isolation and Droplet precautions (w/ bacterial)
Dark, quiet environment
Bedrest; HOB elevated
Neuro Checks q 2-4 hrs
When doing neuro checks for Meningitis, which Cranial Nerves are we focusing on?
Medications for Meningitis
Broad spectrum antibiotic (bacterial)
Fever reducing agents (Acetaminophen; Ibuprofen)
Prophylaxis treatment for those in close contact w/ meningitis infected client
S/S of Encephalitis
Changes in Mental Status
Focal neuro deficits
Encephalitis can be caused by ---
mosquitoes and ticks
***Caused by arbovirus spread by mosquitoes and ticks
If Encephalitis is caused by Herpes, what do you treat it with?
Parkinson's is a degeneration in which area of the brain?
What does it result in?
results in decreased production of DA
In Parkinson's, there is a decrease in --- and an increase in ---
What are risk factors for Parkinson's Disease?
Exposure to environmental toxins
Chronic use of antipsychotic meds
S/S of Parkinson's Disease
What will posture of Parkinson's patient look like?
Fwd tilt of trunk
Rigidity and trembling of head
Reduced arm swinging
Shuffling gait w/ short steps
What will the face of a Parkinson's client look like?
mask-like facial expression
Medications used to treat Parkinson's
Catechol O-methyltransferase Inhibitors
What should we remmber about Parkinson's Meds?
most effective first 3-5 years
Need drug holidays
What are the structural changes in brain associated with Alzheimers?
Symptoms of Alzheimers
Gradual memory loss (short term first)
Eventually lose language and motor skills
Medication classes for Alzheimers
NMDA Receptor Antagonists
What are the Cholinisterase Inhibitors used for Alzheimers?
What are the NMDA Receptor Antagonists used for Alzheimer's?
***usually for late stages
***can be taken w/ one of the other classifications
Why do we take Cholinisterase Inhibitors with Alzheimer's?
prevent the breakdown of ACh, which increases the amount available for nerve impulses
Nursing Considerations for Donepezil (Cholinisterase Inhibitor)
Observe for frequent stools or upset stomach
Monitor for dizziness or headache
Use caution if they have COPD or Asthma
When does Huntington's Disease usually begin?
30-50 years old
What is the patho behind Huntington's?
decrease in GABA and increase in Glutamate
S/S of Huntington's
Progressive mental status change
***Brisk, jerky, purposeless mvmts
What medication for Huntington's
Which type of headache is familial?
Which type of headache can occur at same time every day?
Which medications can trigger migraines?
What are the Autonomic Symptoms of Simple Partial Seizures?
Changes in HR and abnormal flushing