Exam 3 Neuro: Problems of the Central Nervous System: The Brain (12 questions) Flashcards

1
Q

Risk factors for migraines and clusters

A
  • Alcohol
  • Environmental allergies
  • Medication
  • Intense odors, bright lights
  • Fatigue, sleep deprivation
  • Depression
  • Emotional/physical stress, anxiety
  • Menstrual cycle, oral contraceptive use
  • Foods (Tyramine, caffeine, MSG, nitrites, milk products)
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2
Q

Migraine symptoms

A
  • Intense pain, unilateral
  • Throbbing
  • Worsens with movement,
  • Photophobia or phonophobia
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3
Q

Migraine categories

A
  • Aura (classic migraine)
  • No aura (common migraine)
  • Atypical
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4
Q

Aura migraine phases

A
  • Prodrome phase
  • Aura phase (Second Phase)
  • Termination phase (Third phase)
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5
Q

No aura migraine duration

A

4 to 72 hours

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6
Q

Atypical migraines

A
  • Status (longer than 72 hours)
  • Migrainous infarction
  • Unclassified
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7
Q

3 Steps to managing a migraine

A
  • Recognize migraine symptoms
  • Respond and health care provider
  • Relieve pain and associated symptoms
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8
Q

Abortive migraine therapy: mild

A
  • Acetaminophen
  • NSAIDS
    Ibuprofen, naproxen
  • Migraine specific OTC formulations
  • Antiemetics

-Stops migraines

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9
Q

Abortive migraine therapy: Severe

A
  • Triptan preparations
  • Ergotamine preparations
  • Isometheptine combination
  • Stops migraine
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10
Q

Preventative migraine therapy

A
  • NSAID
  • Beta blocker
    Propranolol, timolol,
  • Calcium channel blocker
    verapamil
  • Antiepileptic drugs
    Topiramate
  • Avoid triggers (risk factors)

-prevents migraines

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11
Q

Complementary & Alternative therapy for migraines

A
  • Yoga
  • Meditation therapy
  • Massage
  • Exercise
  • Biofeedback
  • Acupuncture
  • Herbal remedies
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12
Q

Observation and documentations during seizures

A
  • TIme
  • Description (Tonic, clonic, absent)
  • Whether more than one type of seizure occurs
  • Sequence of seizure progression (Where it began)
  • Changes in pupil size and eye deviation
  • LOC
  • Whether the seizures are preceded by an aura (dizziness)
  • What patient does after seizure
  • How long it takes for patient to return to pre-seizure status
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13
Q

Acute Seizure Management

A
  • Lorazepam (Ativan)
  • Diazepam (Valium)
  • Diastat
  • IV phenytoin (Dilantin) or fosphenytoin (Cerebyx)
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14
Q

Status Epilepticus

A

Prolonged seizures that last more than 5 min or repeated seizures over course of 30 min – medical emergency!

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15
Q

Status Epilepticus treatment

A
  • Establish airway
  • ABGs
  • IV push lorazepam, diazepam
  • Rectal diazepam
  • Loading dose IV phenytoin
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16
Q

Viral meningitis risk factors

A

Viral illnesses: mumps, measles, herpes, West Nile

17
Q

Fungal meningitis risk factors

A

AIDS

18
Q

Bacterial meningitis risk factors

A
  • Otitis media, pneumonia, sinusitis
  • Immunosuppression
  • Invasive procedures
  • Overcrowded living conditions
  • Streptococcus pneumoniae & Neisseria meningitidis
  • Haemophilus influenzae
19
Q

Viral meningitis unique characteristic

A
  • There is no vaccine against it
20
Q

Meningitis symptoms

A
  • Fever
  • Headache
  • Photophobia
  • Indications of increased ICP
  • Nuchal rigidity
  • Positive Kernig’s, Brudzinski’s signs
  • Decreased mental status
  • Focal neurological deficits
  • Nausea and vomiting
21
Q

Meningitis Nursing care

A
  • Bacterial
    Isolation: droplet precautions
  • Fever reduction
  • Dark, quiet environment
  • Bedrest, HOB elevated
  • Seizure precautions
  • Neuro checks q 2-4 hours
    Cranial nerves III, IV, VI, VII, VIII
22
Q

Meningitis Drug therapy

A
  • Broad-spectrum antibiotic
  • Fever-reducing agents
  • Acetaminophen, ibuprofen
  • Hyperosmolar agents
  • Anticonvulsants
  • Phenytoin
  • Steroids (controversial)
23
Q

Meningitis prevention

A

Prophylaxis treatment for those in close contact with meningitis-infected patient

24
Q

Parkinson’s Disease Pathophysiology

A
  • Degeneration of the substantia nigra results on decreased production of dopamine
  • Overstimulation of the basal ganglia by acetylcholine
25
Q

Parkinson’s Disease Symptoms

A
  • Tremor
  • Muscle rigidity
  • Bradykinesia
  • Postural instability
26
Q

Parkinson’s Disease Medications/medication therapy

A
  • Dopamine agonists
  • Anticholinergics
  • Catechol O-methyltransferase inhibitors
  • Most effective in the first 3 to 5 years of use
  • Monitor levels
  • Drug holiday
27
Q

Parkinson’s Disease Nursing care

A

Collaborative

  • Mobility
  • Nutrition
  • Psychological
  • Speech therapy
28
Q

Huntington’s Disease pathophysiology

A
  • Hereditary disorder
  • Autosomal dominant
  • Decrease in the GABA (inhibitory transmitter in the basal ganglia
  • Increase in glutamate
29
Q

Huntington’s Disease Patient Teaching

A

Health teaching – include psychosocial support resources

30
Q

Huntington’s Disease medications

A

tetrabenazine

31
Q

Alzheimer’s Pathophysiology

A
  • Chronic progressive
  • Structural changes in brain
    Neuritic plaques, granulovascular degeneration,
    Neurofibrillary tangles
32
Q

Alzheimer’s Symptoms

A
  • Gradual memory loss, short term first
  • Changes in behavior & personality
  • Eventual language, motor skills lost
33
Q

Alzheimer’s medication

A
  • Cholinesterase inhibitors
    donepezil (Aricept)
    galantamine (Reminyl)
    rivastigmine (Exelon)
  • N-methyl-D-aspartate receptor antagonist (NMDA)
    memantine (Namenda)
  • Antidepressants
    SSRIs
    Avoid tricyclic antidepressants
34
Q

Alzheimer’s nursing care/safety measures

A
  • Interventions and support (patient and caregiver)
  • Cognitive stimulation and memory training
  • Structuring the environment
  • Orientation and validation therapy
  • Promoting self-management
  • Promoting bowel and bladder continence
  • Promoting communication