Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
49 Cards in this Set
- Front
- Back
|
When do headaches occur?
|
when pain sensitive areas of the brain are stimulated
|
|
|
What is included in the assessment of a headache?
|
location, intensity, character, frequency, duration
precipitating factors change in vision any prodromal manifestations |
|
|
What are the three types of headaches?
|
Migraine
Tension Cluster |
|
|
Where is the pain with a migraine headache?
When (in life) does a person usually develop migraines? |
unilateral, frontotemporal
puberty |
|
|
What type of headache is a migraine?
Some people with migraine headaches experience this phenomenon prior to the onset of the headache. Some people do not. |
vascular headache
aura |
|
|
Along with unilateral pain in the frontotemporal area of the head, a migraine suffer may also experience these two manifestations.
|
GI upset (N/V)
chills |
|
|
How do you diagnose a migraine headache?
|
have the patient keep a history log. DX mainly by patient history
|
|
|
Although the lecture said a migraine is unilateral, the book says it can be bilateral
|
yep
|
|
|
Note that usually a migraine can be brought on by a __________ ________.
|
triggering event
(foods, hormonal fluctuation, head trauma, physical exertion, fatigue, stress, pharmacologic agents) |
|
|
What nerve is implicated in a cluster headache?
|
trigeminal nerve
|
|
|
Describe the pain of a cluster headache vs. a migraine headache.
|
sharp and stabbing (cluster)
pulsing, throbbing (migraine) |
|
|
These two types of headache do not have a prodromal phase.
|
tension headache
cluster headache |
|
|
Why would an angiography be used to diagnose a headache?
|
to see if it is vascular
|
|
|
What is the main treatment of a cluster headache? why?
|
oxygen 100% for 15 to 20 minutes at 7-9 l/min
causes vasoconstriction more useful than drugs b/c these headaches occur suddenly and at night |
|
|
Name some of the drug classes that are used to treat a tension type headache.
(treat=symptomatic) |
Nonopioid analgesics (ASA, NSAIDs, acetaminophen)
Analgesic combos (butalbital and aspirin) (butalbital and acetamin) Muscle relaxants |
|
|
What drug classes are used to prevent the three types of headaches?
|
NSAIDs
Betablockers Antidepressants Antiseizures Serotonin receptor agonists Corticosteroids |
|
|
Why would you use a corticosteroid to treat a headache?
|
decreases inflammation
|
|
|
Why would an antiseizure medication be affective to treat a headache?
|
works on the same area of the CNS - controlling firing and helping with pain
|
|
|
If relief of your migrain doesn't come from aspirin/acetaminophen/ibuprophen, what is the next line of drugs?
|
Triptans
(they are drugs that affect the serotonin receptors) and help through vasoconstriction |
|
|
Name some of the triptan drugs that are used to treat a migraine.
|
Imitrex, Axert, Relpax, Zomig
|
|
|
What type of drug is dexamethasone (Decadron)?
|
corticosteroid
(may be used in tx of migraine or cluster headache) |
|
|
Name two antiseizure drugs that are used to treat migraine headaches.
|
Depakene
Topamax |
|
|
Name two antidepressant drugs that are used to treat headaches (tension/migraine)
|
Sinequan
Elavil TOfranil |
|
|
A cluster headache is characterized by severe pain, _________ and __________ __________.
|
sweating and lacrimal production
|
|
|
Patient teaching for headaches include:
|
keeping a diary
avoiding food that trigger med education Imitrex subcut administration stress reduction regular exercise call MD if fever, vision changes or resistance to meds |
|
|
What is the difference between seizures and epilepsy?
|
seizures -general term for disturbance of electrical activity in the brain
epilepsy is a chronic problem with seizures |
|
|
What are the phases of a seizure?
|
prodromal - before, indicating a seizure, depressed, HA
aural ictal- in the seizure postictal-recovery |
|
|
What are the two main types of seizures?
|
partial - only one cerebral hemisphere involved
generalized- both hemispheres are usually involved |
|
|
Name the types of partial seizures.
|
simple partial
complex partial |
|
|
Describe patient memory of having a seizure in:
simple partial complex partial |
simple partial - they know they just had one. no loss of consciousness
complex partial - postictal confusion, alteration of consciousness, no recollection of just having the seizure |
|
|
How long do the following seizures usually last?
simple partial complex partial |
simple partial - less than one minute
complex partial - greater than one minute 2-15min |
|
|
What nervous system is affected by a simple partial seizure? What are the manifestations of this?
|
ANS - tachycardia, BP drops, flushing, sweaty
may just be a staring or recurrent muscle contraction (finger, face) |
|
|
What is a hallmark manifestation of a complex partial seizure?
|
automatisms - non purposeful movements (lip smacking, chewing, smacking head)
eyes are open |
|
|
Any tonic clonic seizure that is preceded by an aura is this type of seizure.
|
partial, (that generalizes secondary)
from book p 1535 |
|
|
What are the two types of generalized seizures?
|
absence
tonic clonic |
|
|
What did absence seizures used to be called?
what did tonic clonic seizures used to be called? |
petit mal
grand ma |
|
|
What type of seizure does an epileptic usually have?
|
tonic clonic
Tonic is tense clonic is ragdoll state |
|
|
Which seizure is most common in children?
|
absence (petit mal)
|
|
|
Why is it called an absence seizure?
|
b/c the manifestation of this seizure is usually they are "absent" or staring into space and you can't snap them back
|
|
|
Describe a tonic clonic seizure.
|
generalized
loss of consciousness drop to ground salivation, tongue/cheek biting incontinence no memory of the seizure exhausted after the seizure |
|
|
Other than hurting themselves, what are the physical concerns of a seizure?
|
cardiac and respiratory problems
hypoglycemia and hyperthermia systemic acidosis cardiac dysrhythmias |
|
|
What is status epilepticus?
|
seizures occuring in rapid succession without gaining function between
they do not stop brain damage is a concern from hypoxia and from exhaustion of neurons |
|
|
What are some diagnostics that you might expect to be done on a person that is having seizure issues?
|
history of seizures
eeg mri, ct, pet, c. angiogram lab work (blood and cerebral fluid - looking for infection) |
|
|
What are the things you need to do to assist a patient prior to eeg?
|
clean hair
avoid stimulant foods |
|
|
What are the antiepileptic drugs to know?
|
Tegretol (carbamazepine)
Depakote (divalproex) Neurontin (gabapentin) Dilantin (phenytoin) valproid acid (Depakene) |
|
|
What are three things to be on the alert for with Tegretol?
|
do not take with grapefruit juice
instruct patient to report visual abnormalities do not suddenly stop taking this drug |
|
|
What are the initial interventions for emergency management of a tonic-clonic seizure?
|
-ensure patent airway
-suction as needed -stay with patient -establish IV access -anticipate admin of meds: Dilantin, Valium, Versed, Ativan -loosen clothing if tight -place o2 on them -turn them on side |
|
|
If a patient has a history of seizures, what do you need to make sure you have in the patient room?
|
oxygen
special bed make sure you have orders for dilantin/or their normal medicine |
|
|
Antiseizure drugs have many side effects. List some common side effects and how you sould assess for them.
|
diplopia
drowsiness ataxia mental slowing (neuro assessment of eyes for nystagmus, hand and gait coordination, cognitive functioning and general alertness) |
