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
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
