Exam 1 Med surg Galen exam with |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
correct answers |||\\\
What are the three main types of headaches? - correct answer✔✔Migraine, Tension, Cluster
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Steps to Pain Assessment - correct answer✔✔Provoking
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Quality
Radiation
Severity |||\\\
Time
Provoking - correct answer✔✔has anything made it better or worse |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Quality - correct answer✔✔Sharp, dull, achy, throbbing
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Radiation - correct answer✔✔Does it radiate to another part of the body
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Severity - correct answer✔✔Pain scale, 1-10 scale, intense pain, Other symptoms: N/V,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
photophobia
Time - correct answer✔✔how long has it been going on? how long does it usually last?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Tension Headache - correct answer✔✔Bandlike, tightness
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,Describe a Migraine - correct answer✔✔Unilateral, supra and retro orbital, pulsating or
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
throbbing, worse with movement, sensitivity with light and sounds |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Cluster - correct answer✔✔Lancinationg or stabbing, 5-30 minutes. Extreme pain
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Migraine Pathophysiology - correct answer✔✔Pathophysiology - Not entirely clear.; theories?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Prevalence: May be seen in children and adults; Among children more common in boys; among |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
adults more common in women.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
|||\\\ History of patient with migraine: Otherwise healthy, usually female in 30's
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Individualized triggers (stress, smells, foods, hormones, menses) |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Tyramine rich foods- chocolate, cheeses, beer, wine, cigar, sweet and low.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Treatment for Migraine - correct answer✔✔Vasoconstriction works the best, irritation of the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
5th cranial nerve, Estrogen hormone can causes migraines.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Migraine Manifestations - correct answer✔✔Manifestations |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Pain: Usually unilateral, supra/retro-orbital, pulsating. Worse with movement.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Accompanied by non-h/a symptoms: N/V, photophobia, phonophobia, |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Aura: (20% of cases): |||\\\ |||\\\ |||\\\
Migraine Interventions - correct answer✔✔Pain management |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Symptom management |||\\\ |||\\\
Ex. Pitch black, turn off all the lights, N/V causes dehydration
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Migraine Drug Therapy - correct answer✔✔APAP/Caffeine/ Butabital (Fioricet)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
NSAIDS : Naprosyn |||\\\ |||\\\
CCBs and Beta- Blockers (Preventative therapy) : Verapamil
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,Triptans and ergotamine's: Sumatriptan and Cafergot |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Anticonvulsants (Preventative therapy): Topiramate |||\\\ |||\\\ |||\\\
Botox Injections (monthly) |||\\\ |||\\\ |||\\\
Magnesium
Migraine Complementary and alternative therapies - correct answer✔✔Acupuncture, Yoga,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Stress reduction activities, Supplemental mag, Distraction sometimes works.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Pound acronym - correct answer✔✔P:Pulsating
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
O:Duration |||\\\
U: Unilateral location
|||\\\ |||\\\
N: N/V |||\\\
D: Disabling
|||\\\
Epilepsy - correct answer✔✔Chronic disorder with two or more seizures experienced by the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
client.
Epilepsy Assessment - correct answer✔✔Inquire about the seizure activity, frequency,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
precipitating factors, aura (pre-ictal phase). |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Family history |||\\\
Collateral medical conditions (hx stroke, HTN, TBI, drug/alcohol abuse) |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Seizure risk factors - correct answer✔✔V: Vascular |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
I: Infection or Inherited conditions
|||\\\ |||\\\ |||\\\ |||\\\
T: Trauma
|||\\\
A: Alzheimers/Autoimmune
|||\\\
M: Metabolic derangements
|||\\\ |||\\\
, I: Idiopathic
|||\\\
N: Neoplasm |||\\\
S: pSychiatric |||\\\
Epilepsy Triggers - correct answer✔✔Sleep deprivation |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Stress
Alcohol/ Alcohol Withdrawl |||\\\ |||\\\
MSG |||\\\
pg 878 Chart 42-9 |||\\\ |||\\\ |||\\\
Aura - correct answer✔✔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, paresthesias, psychiatric phenomenon, deja-vu
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Epilepsy Partial: - correct answer✔✔Partial (also called focal or local seizures): Occurs in a
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
specific part of the brain. May be characterized by automatism or tic. Ex: Jerk, reflex, lip
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
smacking (complex) |||\\\
Epilepsy Simple: - correct answer✔✔Client does not consciousness. Localized |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
jerking/movement. Strange sensations. Autonomic symptoms. |||\\\ |||\\\ |||\\\ |||\\\
Focal awareness they do not lose consciousness.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Epilepsy Complex - correct answer✔✔Involves altered LOC; may or may not have total loss of
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
consciousness. Automatisms. Patient may wander at start or have amnesia after. Most common |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
among older adults and difficult to diagnose bc symptoms appear similar to those of
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dementia, psychosis, or neurobehavioral disorder, esp post-ictal. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
correct answers |||\\\
What are the three main types of headaches? - correct answer✔✔Migraine, Tension, Cluster
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Steps to Pain Assessment - correct answer✔✔Provoking
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Quality
Radiation
Severity |||\\\
Time
Provoking - correct answer✔✔has anything made it better or worse |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Quality - correct answer✔✔Sharp, dull, achy, throbbing
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Radiation - correct answer✔✔Does it radiate to another part of the body
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Severity - correct answer✔✔Pain scale, 1-10 scale, intense pain, Other symptoms: N/V,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
photophobia
Time - correct answer✔✔how long has it been going on? how long does it usually last?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Tension Headache - correct answer✔✔Bandlike, tightness
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,Describe a Migraine - correct answer✔✔Unilateral, supra and retro orbital, pulsating or
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
throbbing, worse with movement, sensitivity with light and sounds |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Cluster - correct answer✔✔Lancinationg or stabbing, 5-30 minutes. Extreme pain
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Migraine Pathophysiology - correct answer✔✔Pathophysiology - Not entirely clear.; theories?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Prevalence: May be seen in children and adults; Among children more common in boys; among |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
adults more common in women.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
|||\\\ History of patient with migraine: Otherwise healthy, usually female in 30's
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Individualized triggers (stress, smells, foods, hormones, menses) |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Tyramine rich foods- chocolate, cheeses, beer, wine, cigar, sweet and low.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Treatment for Migraine - correct answer✔✔Vasoconstriction works the best, irritation of the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
5th cranial nerve, Estrogen hormone can causes migraines.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Migraine Manifestations - correct answer✔✔Manifestations |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Pain: Usually unilateral, supra/retro-orbital, pulsating. Worse with movement.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Accompanied by non-h/a symptoms: N/V, photophobia, phonophobia, |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Aura: (20% of cases): |||\\\ |||\\\ |||\\\
Migraine Interventions - correct answer✔✔Pain management |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Symptom management |||\\\ |||\\\
Ex. Pitch black, turn off all the lights, N/V causes dehydration
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Migraine Drug Therapy - correct answer✔✔APAP/Caffeine/ Butabital (Fioricet)
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
NSAIDS : Naprosyn |||\\\ |||\\\
CCBs and Beta- Blockers (Preventative therapy) : Verapamil
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
,Triptans and ergotamine's: Sumatriptan and Cafergot |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Anticonvulsants (Preventative therapy): Topiramate |||\\\ |||\\\ |||\\\
Botox Injections (monthly) |||\\\ |||\\\ |||\\\
Magnesium
Migraine Complementary and alternative therapies - correct answer✔✔Acupuncture, Yoga,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Stress reduction activities, Supplemental mag, Distraction sometimes works.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Pound acronym - correct answer✔✔P:Pulsating
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
O:Duration |||\\\
U: Unilateral location
|||\\\ |||\\\
N: N/V |||\\\
D: Disabling
|||\\\
Epilepsy - correct answer✔✔Chronic disorder with two or more seizures experienced by the
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
client.
Epilepsy Assessment - correct answer✔✔Inquire about the seizure activity, frequency,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
precipitating factors, aura (pre-ictal phase). |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Family history |||\\\
Collateral medical conditions (hx stroke, HTN, TBI, drug/alcohol abuse) |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Seizure risk factors - correct answer✔✔V: Vascular |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
I: Infection or Inherited conditions
|||\\\ |||\\\ |||\\\ |||\\\
T: Trauma
|||\\\
A: Alzheimers/Autoimmune
|||\\\
M: Metabolic derangements
|||\\\ |||\\\
, I: Idiopathic
|||\\\
N: Neoplasm |||\\\
S: pSychiatric |||\\\
Epilepsy Triggers - correct answer✔✔Sleep deprivation |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Stress
Alcohol/ Alcohol Withdrawl |||\\\ |||\\\
MSG |||\\\
pg 878 Chart 42-9 |||\\\ |||\\\ |||\\\
Aura - correct answer✔✔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, paresthesias, psychiatric phenomenon, deja-vu
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Epilepsy Partial: - correct answer✔✔Partial (also called focal or local seizures): Occurs in a
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
specific part of the brain. May be characterized by automatism or tic. Ex: Jerk, reflex, lip
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
smacking (complex) |||\\\
Epilepsy Simple: - correct answer✔✔Client does not consciousness. Localized |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
jerking/movement. Strange sensations. Autonomic symptoms. |||\\\ |||\\\ |||\\\ |||\\\
Focal awareness they do not lose consciousness.
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
Epilepsy Complex - correct answer✔✔Involves altered LOC; may or may not have total loss of
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
consciousness. Automatisms. Patient may wander at start or have amnesia after. Most common |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
among older adults and difficult to diagnose bc symptoms appear similar to those of
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dementia, psychosis, or neurobehavioral disorder, esp post-ictal. |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
