- TIA = manifestations, its is a mini stroke, temporary, resolves itself
- Left brain stroke = right side paralysis, right side body manifestations, language is
affected (wernicke, broca) communication strategies: write stuff down, pictures, face
them so they can see gestures, pictorial board, common phrases on a board
- Tell patient to scan the environment when a patient has hemianopsia so that they know it
still exists
- ICP: hemorrhagic stroke = bleed, severe headache, monitor ICP (causes: brain
aneurysms, hypertension, AVM)
- Thrombotic = carotid, plaque clot
- Manifestations of ICP: nausea, vomiting, headache, changes in pupillary action
- Ischemic stroke manifestations: edema after 24 hrs
- Reduce ICP: sit them up, decrease BP, make sure sensory input is lower like sounds,
lights, limit visits, keep neck aligned
- LSN = last, seen, normal = thrombotic stroke, to know the onset because we need to
time it, give alteplase within 4.5 hours
- You can tell difference between thrombotic or hemorrhagic stroke by getting a CT scan
without contrast
- Grand mal seizures = tonic clonic = phases 1. Aura, 2. Tonic 3. Clonic 4. Postictal (deep
sleep)
- Seizures: Turn them on their side, monitor airways, protect their head, have suctioning,
TIME IT, monitor airway
- Seizure precautions: suction, pad side rails, make sure bed is in lowest position and
locked, trigger procedures (audio, bright lights)
- Meds: fenatone = anticonvulsant (anti-epileptic)
- KNOW THE 4 MEDS AND THEIR THERAPEUTIC LEVELS***
- If the med level is too high or too low, ask how they have been taking their meds, when
they take it and how often, dose, other meds, changing from generic to generic they still
need to check with the provider
- Anticonvulsant for epilepsy, they are medically clear after 6 months after seizure free and
with medications
- Complication of epilepsy: status epilepticus (continuous seizure) give diazepam and
lorazepam through IV
- Parkinsons is lack of dopamine (give dopamine, it helps with movement, educate peak
levels to do movements, buddy system, s/s: bradykinesia, mask face, shuffling gait,
freezing, fall risk, constipation, difficulty swallowing, walkers, dysphagia diet, risk for
orthostatic hypotension, falls, aspiration, pneumonia)
- Bells palsy = paralysis in one side of the face, drooping, can’t close eye so lubricate it,
maintain muscle tone by massaging the face or it atrophies bc it lasts 4-6 weeks
- Trigeminal = painful
- What triggers pain? Eating, chewing, cold air, brushing teeth
- Contraindicated atriptin?? Correct me on that drug (contraindicated: beta blocker, alcohol
bc it is a vasodilator and dilates pupils, anything that dilates is contraindicated)
- Hearing impairment: stand in front of them, normal speech and normal tone, face patient,
reduce distracting noise in environment
- Left brain stroke = right side paralysis, right side body manifestations, language is
affected (wernicke, broca) communication strategies: write stuff down, pictures, face
them so they can see gestures, pictorial board, common phrases on a board
- Tell patient to scan the environment when a patient has hemianopsia so that they know it
still exists
- ICP: hemorrhagic stroke = bleed, severe headache, monitor ICP (causes: brain
aneurysms, hypertension, AVM)
- Thrombotic = carotid, plaque clot
- Manifestations of ICP: nausea, vomiting, headache, changes in pupillary action
- Ischemic stroke manifestations: edema after 24 hrs
- Reduce ICP: sit them up, decrease BP, make sure sensory input is lower like sounds,
lights, limit visits, keep neck aligned
- LSN = last, seen, normal = thrombotic stroke, to know the onset because we need to
time it, give alteplase within 4.5 hours
- You can tell difference between thrombotic or hemorrhagic stroke by getting a CT scan
without contrast
- Grand mal seizures = tonic clonic = phases 1. Aura, 2. Tonic 3. Clonic 4. Postictal (deep
sleep)
- Seizures: Turn them on their side, monitor airways, protect their head, have suctioning,
TIME IT, monitor airway
- Seizure precautions: suction, pad side rails, make sure bed is in lowest position and
locked, trigger procedures (audio, bright lights)
- Meds: fenatone = anticonvulsant (anti-epileptic)
- KNOW THE 4 MEDS AND THEIR THERAPEUTIC LEVELS***
- If the med level is too high or too low, ask how they have been taking their meds, when
they take it and how often, dose, other meds, changing from generic to generic they still
need to check with the provider
- Anticonvulsant for epilepsy, they are medically clear after 6 months after seizure free and
with medications
- Complication of epilepsy: status epilepticus (continuous seizure) give diazepam and
lorazepam through IV
- Parkinsons is lack of dopamine (give dopamine, it helps with movement, educate peak
levels to do movements, buddy system, s/s: bradykinesia, mask face, shuffling gait,
freezing, fall risk, constipation, difficulty swallowing, walkers, dysphagia diet, risk for
orthostatic hypotension, falls, aspiration, pneumonia)
- Bells palsy = paralysis in one side of the face, drooping, can’t close eye so lubricate it,
maintain muscle tone by massaging the face or it atrophies bc it lasts 4-6 weeks
- Trigeminal = painful
- What triggers pain? Eating, chewing, cold air, brushing teeth
- Contraindicated atriptin?? Correct me on that drug (contraindicated: beta blocker, alcohol
bc it is a vasodilator and dilates pupils, anything that dilates is contraindicated)
- Hearing impairment: stand in front of them, normal speech and normal tone, face patient,
reduce distracting noise in environment
