NU 334 Exam 2 Questions and Answers| New Update with 100% Correct Answers
Migraine Headache Recurrent, episodic attacks of head pain (throbbing, unilateral)
Can be accompanied by associated symptoms
-nausea, sensitivity to light or head movement
Triggers - caffeine, wine, MSG, birth control hormones, stress
The priority of care is pain management
-drug therapy (abortive and preventive therapy)
-botox
-tylenol, NSAIDs
Causes generally unknown, combination of factors
Seizure Abnormal, excessive, sudden, uncontrolled electrical discharge of the brain
Changes in level of consciousness, drop in SPO2
Caused by genetic components, infection, brain tumor, or unknown causes
Generalized, Partial, and Unclassified
Diagnosed with EEG, CT scan, MRI
Focal Seizures Staring into space
Diagnosed often through inattentiveness in school in children
Common among adult women during menstrual cycle
Tonic-Clonic Seizure Both tonic and clonic phase
Head-to-toe
Generalized
Lasts 2-5 minutes
Tonic Phase Body becomes rigid, stiffening for no more than 30 seconds
,Breathing may stop, patient may bite tongue, and bowel and bladder control could be lost
Could lose consciousness
Clonic Phase State of alternating contraction and relaxation of muscles
Patient may bite tongue and become incontinent
Myoclonic Seizure Brief stiffening, jerking of extremities
Singular or in groups
Lasts just a few seconds
Contractions may be symmetric or asymmetric
Epilepsy Two or more patients
Primary or idiopathic (unknown causes).
Could be caused by an abnormality in electrical neuronal activity, an imbalance in
neurotransmitters, especially GABA, or a combination of both
During Seizure Move everything away
Keep suction close and prevent aspiration
Do not force anything in the mouth
Do not restrain
Observation and documentation (time seizure started and stopped)
Side-lying position or turn head to the side
No restraints
Loosen clothing
Redirect the patient's attention away from activity that could cause injury
Aura Warning signs before seizure occurs
,Service animal might help in everyday life
Reasons for Having a Seizure Epilepsy
Alcohol withdrawal (treat with Ativan, valium, alcohol)
Brain tumors
Hypoglycemia (metabolic disorders)
Stroke (hemorrhagic)
Head injury
Substance abuse
High fevers (infections, collect blood cultures at 102F, emergency at 105F)
-consider variations in age
Electrolyte disturbances (sodium
Heart disease
Seizure Precautions Oxygen
Suction equipment
Airway (oral airway, nasal trumpet)
-do not force into mouth during seizure
IV access
-Lorazepam/Ativan, Diazepam/Valium 1-2 mg
-sedation if nothing works
Side rails up and padded (blankets if no pads available)
Floor mats
NEVER use padded tongue blades
Acute Seizure Management Lorazepam (Ativan)
Diazepam (Valium)
, Diastat (given rectally)
IV phenytoin (Dilantin) or fosphenytoin (Cerebyx)
-IV phenytoin is a loading dose to boost therapeutic levels, will NOT abort seizure immediately
Postictal Stage Varies patient to patient - confusion, lethargy, and fatigue
May last up to an hour after seizure
After Seizure Take vital signs
Frequent neuro assessments
Keep on side
Apply oxygen
Allow patient to rest
Document seizure
Status Epilepticus Prolonged seizures that last more than 5 minutes or repeated seizures
over course of 30 minutes
-seizures lasting longer than 10 minutes can cause death
Causes - sudden withdrawal from AEDs, infection, acute alcohol or drug withdrawal, head
trauma, cerebral edema
Medical emergency
If untreated, results in hypoxia, hypotension, hypoglycemia, cardiac dysrhythmias, renal failure
Establish airway
ABGs
IV push lorazepam, diazepam (8 mg total)
Rectal diazepam
Loading dose IV phenytoin
Migraine Headache Recurrent, episodic attacks of head pain (throbbing, unilateral)
Can be accompanied by associated symptoms
-nausea, sensitivity to light or head movement
Triggers - caffeine, wine, MSG, birth control hormones, stress
The priority of care is pain management
-drug therapy (abortive and preventive therapy)
-botox
-tylenol, NSAIDs
Causes generally unknown, combination of factors
Seizure Abnormal, excessive, sudden, uncontrolled electrical discharge of the brain
Changes in level of consciousness, drop in SPO2
Caused by genetic components, infection, brain tumor, or unknown causes
Generalized, Partial, and Unclassified
Diagnosed with EEG, CT scan, MRI
Focal Seizures Staring into space
Diagnosed often through inattentiveness in school in children
Common among adult women during menstrual cycle
Tonic-Clonic Seizure Both tonic and clonic phase
Head-to-toe
Generalized
Lasts 2-5 minutes
Tonic Phase Body becomes rigid, stiffening for no more than 30 seconds
,Breathing may stop, patient may bite tongue, and bowel and bladder control could be lost
Could lose consciousness
Clonic Phase State of alternating contraction and relaxation of muscles
Patient may bite tongue and become incontinent
Myoclonic Seizure Brief stiffening, jerking of extremities
Singular or in groups
Lasts just a few seconds
Contractions may be symmetric or asymmetric
Epilepsy Two or more patients
Primary or idiopathic (unknown causes).
Could be caused by an abnormality in electrical neuronal activity, an imbalance in
neurotransmitters, especially GABA, or a combination of both
During Seizure Move everything away
Keep suction close and prevent aspiration
Do not force anything in the mouth
Do not restrain
Observation and documentation (time seizure started and stopped)
Side-lying position or turn head to the side
No restraints
Loosen clothing
Redirect the patient's attention away from activity that could cause injury
Aura Warning signs before seizure occurs
,Service animal might help in everyday life
Reasons for Having a Seizure Epilepsy
Alcohol withdrawal (treat with Ativan, valium, alcohol)
Brain tumors
Hypoglycemia (metabolic disorders)
Stroke (hemorrhagic)
Head injury
Substance abuse
High fevers (infections, collect blood cultures at 102F, emergency at 105F)
-consider variations in age
Electrolyte disturbances (sodium
Heart disease
Seizure Precautions Oxygen
Suction equipment
Airway (oral airway, nasal trumpet)
-do not force into mouth during seizure
IV access
-Lorazepam/Ativan, Diazepam/Valium 1-2 mg
-sedation if nothing works
Side rails up and padded (blankets if no pads available)
Floor mats
NEVER use padded tongue blades
Acute Seizure Management Lorazepam (Ativan)
Diazepam (Valium)
, Diastat (given rectally)
IV phenytoin (Dilantin) or fosphenytoin (Cerebyx)
-IV phenytoin is a loading dose to boost therapeutic levels, will NOT abort seizure immediately
Postictal Stage Varies patient to patient - confusion, lethargy, and fatigue
May last up to an hour after seizure
After Seizure Take vital signs
Frequent neuro assessments
Keep on side
Apply oxygen
Allow patient to rest
Document seizure
Status Epilepticus Prolonged seizures that last more than 5 minutes or repeated seizures
over course of 30 minutes
-seizures lasting longer than 10 minutes can cause death
Causes - sudden withdrawal from AEDs, infection, acute alcohol or drug withdrawal, head
trauma, cerebral edema
Medical emergency
If untreated, results in hypoxia, hypotension, hypoglycemia, cardiac dysrhythmias, renal failure
Establish airway
ABGs
IV push lorazepam, diazepam (8 mg total)
Rectal diazepam
Loading dose IV phenytoin
