Chapter 18 Altered Mental Status, Stroke, And Headache

Front 1

Altered Mental Status

Back 1

A significant indication of an injury or illness in a patient.

Front 2

Coma

Back 2

An unconscious state in which patient does not respond to painful stimuli.

Front 3

Embolic Stroke

Back 3

The embolus lodges in a cerebral artery and occludes it

Front 4

Hemorrhagic Stroke

Back 4

Bleeding

Front 5

Ischemic Stroke

Back 5

Blockage

Front 6

Neurological Deficit

Back 6

When the patient loses some or all of the abilities. Alert and aware of surroundings, to speak, to feel Sensations, and are all functions of the brain and nervous system.

Front 7

Nontraumatic Brain Injury

Back 7

A medical injury to the brain that is not related to trauma (or stroke)

Front 8

Reticular Activating System (RAS)

Back 8

It's not an actual structure but a network of nerve cells in the brain stem that constantly transmit environmental and sensory stimuli to and from the cerebrum.

Front 9

Stroke

Back 9

A medical injury to the brain.

Front 10

Thrombotic Stroke

Back 10

A stroke resulting from thrombus formation.

Front 11

Transient Ischemic Attack (TIA)

Back 11

Key difference between a stroke and a TIA is that the signs and symptoms of a TIA disappear without any obvious permanent neurological deficits

Front 12

What are some structural causes of altered mental status?

Back 12

Brain tumor, Hemorrhage in the cranium but outside of the brain, hemorrhage in the brain tissue, direct brain tissue damage from trauma to brain, degenerative disease of brain, brain abscess or infection

Front 13

What are some toxic metabolic causes of altered mental status?

Back 13

Severe hypoxia or anorexia, abnormal blood glucose conditions, liver failure, kidney failure, and poisoning AKA carbon monoxide and cyanide

Front 14

What are some other causes of altered mental status?

Back 14

Shock, drugs that depress the central nervous system, post seizures, infection, cardiac Rhythm disturbance, and stroke

Front 15

Assessment based approach altered mental status

Back 15

Scene size up, primary assessment, secondary assessment, emergency medical care, and reassessment

Front 16

What questions can you ask during your secondary assessment?

Back 16

What were the signs and symptoms the patient was complaining of prior to the alteration in the mental status? Did signs and symptoms seem to progressively get worse or better? Does the patient have any known allergies? What medications, prescriptions, and non-prescription is the patient taking? What is the patient's past medical history? When was the last time he has seen a doctor for his medical condition? When did the patient last have something to eat or drink? What did he eat or drink? Did he take any drugs or ingest any alcohol? What was the patient doing prior to the onset of the altar mental status? Did the patient suffer from a seizure, severe headache, or confusion prior to the alteration in the mental status? How long has the patient been sick or suffering from the signs and symptoms? When was the patient last well?

Front 17

How to conduct a physical exam on a patient with an altered mental status?

Back 17

Check the head for any evidence of possible trauma.

Pupils for indication of a head injury drugs hypoxia.

Mouth and oral mucosa for cyanosis and Pallor indicating hypoxia and poor perfusion

Also check the chest, breath sounds, abdomen, lower and upper extremities, lower extremities, and posterior body.

Front 18

What are the signs and symptoms of altered mental status, associated with trauma?

Back 18

Obvious signs of trauma deformity, contusions, abrasions, punctures or penetrations, Burns, tenderness, lacerations, or swelling.

Abnormal respiratory pattern, increased or decreased heart rate, unequal pupils, high or low blood pressure, discoloration around the eye(late), discoloration behind the ears(late), pale, cool, moist skin, flexion or extension.

Front 19

What are the signs and symptoms of altered mental status, associated with a non-traumatic or medical condition?

Back 19

Abnormal respiratory pattern, dry or moist skin, cool or hot skin, pinpoint, mid-size, dilated, or unequal pupils, stiff neck, lacerations to the tongue indicating seizure activity, high systolic blood pressure and low heart rate, loss of bowel or bladder control, abnormally high or abnormally low blood glucose readings.

Front 20

What is the emergency medical care for altered mental status?

Back 20

1 maintained manual spinal stabilization if trauma is suspected.

2 maintain a patent Airway.

3 suction any secretions, vomitus, or blood.

4 maintain adequate oxygenation.

5 be prepared to assist ventilation.

6 position the patient.

7 transport.

Front 21

What is the pathophysiology of a stroke?

Back 21

Stroke was formerly known as a cerebrovascular accident. A stroke is similar to a heart attack. It is due to an adequate amount of blood being delivered to a portion of the brain caused by a blood clot obstructing a blood vessel in the brain or loss of continuiti of the blood vessel. Thus, the stroke is often described as a brain attack, to imply the same general cause and the same level of seriousness as a heart attack.

Front 22

What is thrombosis?

Back 22

It is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel is injured, the body uses platelets and fibrin to form a blood clot to prevent blood loss.

Front 23

What is an embolism.?

Back 23

An embolism is a sudden blocking of an artery. An embolism is the lodging of an embolus, a blockage causing piece of material, inside the blood vessel. The ambulance maybe a blood clot, a fat globule, a bubble of air or other gas, or foreign material.

Front 24

What is atherosclerosis?

Back 24

It is a fat deposits in the arteries.

Front 25

How long does a transient ischemic attack last?

Back 25

The signs and symptoms of the transient ischemic attack will typically resolved within 1 to 2 hours after the onset however, it may last up to 24 hours.

Front 26

What is ischemia?

Back 26

It refers to an oxygen deficient in the tissues, affects the brain and causes the stroke-like signs and symptoms to appear.

Front 27

Assessment based approach stroke and transient ischemic attack

Back 27

Scene size up, primary assessment, secondary assessment, and reassessment

Front 28

Why is it dangerous to administer too much oxygen in a stroke?

Back 28

A higher oxygen level in the blood results in Greater production of damaging free radical in Greater brain cells and tissue death this does not occur during the hypoxic state but rather occurs when blood flow has been restored and the brain cells are receiving oxygen again. The oxygen in the blood flowing to the Reperfused brain tissue increases the production of free radicals, which directly damage brain cell membranes and other cellular components and result and brain cell death.

Front 29

What is the emergency medical care?

Back 29

1 maintain a patent Airway.

2 suction secretions and vomitus.

3 be prepared to assist ventilation.

4 maintain adequate oxygenation.

5 position the patient.

6 check the blood glucose level.

7 protect any paralyzed extremity.

8 Rapid transport.

Front 30

What is a headache?

Back 30

A headache maybe a condition in itself or a symptom of another condition such a stroke, a brain tumor, or a brain infection. Pain associated with a headache can have a sudden onset, be constant, or continuously recur. The headache may be isolated to one area of the head or maybe generalized and felt throughout the head. It could be mild moderate or severe.

Front 31

What is a vascular headache?

Back 31

This occurs as a result of dilation or distention of vessels or inflammation within the cranium. Migraine headaches are thought to be caused by spasms of vessels followed by vasodilation and a change in the chemicals that transmit nervous impulses in the brain. They are throbbing. They are localized. The patient may experience sensitivity to light nausea vomiting and sweating.

Front 32

What is a cluster headache?

Back 32

These are similar to migraines because they are believed to have a vascular origin. The pain is usually found only on one side of the head or face and then temp or region or around the eye and is excruciating. The patient may complain of excessive tear production on the side of the pain, nasal congestion or runny nose, and nausea.

Front 33

What is a tension headache?

Back 33

This is thought to be caused by contraction of the muscles of the neck and scalp. It is described as tight or vice like. Is the most common headache found in children, adolescents, and adults. The headache may get worse throughout the day. The pain is usually felt in the frontal temporal or occipital regions of the head and often radiates to the neck and shoulders.

Front 34

What is an organic, attraction, or inflammatory headache?

Back 34

They are a result of tumors, infections, stroke, or inflammatory disorders within the cranium such as meningitis, hemorrhagic stroke, and tumor.

Front 35

What are some of the following signs or symptoms to expect a major underlying condition for headache?

Back 35

Altered mental status, motor or sensory deficits, behavioral change, seizure, first experience of this type of headache with an abrupt onset, worsening of pain with coughing, sneezing or bending over, fever stiff neck, and change and the quality of a chronic headache.

Front 36

What is the emergency medical care for a headache?

Back 36

1 establish and maintain an adequate Airway

2 be prepared to suction

3 assess and maintain adequate ventilation

4 maintain adequate oxygenation

5 place the patient in a position of comfort

6 always be prepared to treat for seizures and transport to a medical facility

Front 37

3. Altered mental status and the inability to speak or feel sensation or move are all signs or symptoms of

Back 37

Neurological deficit

Front 38

The process of clot formation is referred to as:

Back 38

Thrombosis

Front 39

The most common non traumatic brain injury is:

Back 39

Stroke

Front 40

Paralysis that affects both lower extremities is called:

Back 40

Paraplegia

Front 41

Transient ischemic attack will always resolve within a ___ hours:

Back 41

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