NUR 170 Unit 3 Lecture Notes on Neurological Disorders and Care | Questions and Answers | Latest Update | Correct Answers

Unit 3 Notes

Recorded Lecture Notes

Care of a Client with a Nervous System Disorder

Headache Disorders

oMay be symptomatic of an underlying disorder.

oThree main types of headaches that are commonly seen and affect quality of life:

Migraine h/a***

Tension h/a

Cluster h/a

Pain Assessment

oP: Provoking—Has anything made the pain better or worse

oQ: Quality—Sharp, dull, achy

oR: Radiation---Does it radiate to another part of the body?

oS: Severity—Pain scale

oT: Time--How long has it been going on?

Headaches




o

,Migraine Headaches

oPathophysiology – Not entirely clear; theories?

oPrevalence: May be seen in children and adults; Among children more common

in boys; among adults more common in women.

oWhy are migraines a problem?

oHistory of patient with migraine: Otherwise, healthy, usually female in 30’s

oIndividualized triggers (stress, smells, foods, hormones, menses)

Tyramine rich foods




o

oManifestations

Pain: Usually unilateral, supra/retro-orbital, pulsating. Worse with

movement.

Accompanied by non-h/a symptoms: N/V, photophobia, phonophobia,

Aura: (20% of cases):

oInterventions

, Pain management

Symptom management

oDrug therapy – abortive and preventative

APAP/Caffeine/Butalbital (Fioricet)

NSAIDS

Naprosyn

CCBs and Beta-Blockers (preventative therapy)

Verapamil

Triptans and ergotamine's

•Sumatriptan and Cafergot

Anti-convulsant (preventative therapy)

Topiramate

Botox injections (monthly)

Magnesium

oComplementary and alternative therapies

Acupuncture

Yoga

Stress reduction activities




Epilepsy

oChronic disorder with two or more seizures experienced by the client

oAssessment

, Inquire about the seizure activity, frequency, precipitating factors, aura

(pre-ictal phase).

Family history

Collateral medical conditions (hx stroke, HTN, TBI, drug/alcohol abuse)

oSeizure risk factors

V: Vascular

I: Infection or Inherited conditions

T: Trauma

A: Alzheimer’s/Autoimmune

M: Metabolic derangements

I: Idiopathic

N: Neoplasm

S: pSychiatric

oTriggers:

Sleep deprivation

Stress

Alcohol/alcohol withdrawal

oAura: Seizures often preceded by an aura; it is unique to that patient, not every

patient has them.

Somatic: rising epigastric sensation

Hallucinations: Visual, gustatory, olfactory

Halos, Zig-zags, h/a, paresthesia’s, psychiatric phenomenon, deja-vu