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Chronic Neuro Problems
Terms in this set (25)
What is a seizure?
Paroxysmal, uncontrolled electrical discharge of neurons in the brain that interrupts normal function.
What is epilepsy?
What safety measures can be taken with seizure patients?
-side rails up and padded
-bed in lowest position
-maintain patent airway
-place in side lying position
-time the seizure
The nurse determines that teaching about management of migraine headaches has been effective when the patient says which of the following?
a. "I can take the (Topamax) as soon as a headache starts."
b. "A glass of wine might help me relax and prevent a headache."
c. "I will lie down someplace dark and quiet when the headaches begin."
d. "I should avoid taking aspirin and sumatriptan (Imitrex) at the same time."
It is recommended that the patient with a migraine rest in a dark, quiet area. Topiramate (Topamax) is used to prevent migraines and must be taken for several months to determine effectiveness. Aspirin or other nonsteroidal antiinflammatory medications can be taken with the triptans. Alcohol may precipitate migraine headaches.
While the nurse is transporting a patient on a stretcher to the radiology department, the patient begins having a tonic-clonic seizure. Which action should the nurse take?
a. Insert an oral airway during the seizure to maintain a patent airway.
b. Restrain the patient's arms and legs to prevent injury during the seizure.
c. Time and observe and record the details of the seizure and postictal state.
d. Avoid touching the patient to prevent further nervous system stimulation.
Because the diagnosis and treatment of seizures frequently are based on the description of the seizure, recording the length and details of the seizure is important. Insertion of an oral airway and restraining the patient during the seizure are contraindicated. The nurse may need to move the patient to decrease the risk of injury during the seizure.
A high school teacher who has just been diagnosed with epilepsy after having a generalized tonic-clonic seizure tells the nurse, "I cannot teach anymore, it will be too upsetting if I have a seizure at work." Which response by the nurse is best?
a. "You might benefit from some psychologic counseling."
b. "Epilepsy usually can be well controlled with medications."
c. "You will want to contact the Epilepsy Foundation for assistance."
d. "The Department of Vocational Rehabilitation can help with work retraining."
The nurse should inform the patient that most patients with seizure disorders are controlled with medication. The other information may be necessary if the seizures persist after treatment with antiseizure medications is implemented.
A 27-year-old patient who has been treated for status epilepticus in the emergency department will be transferred to the medical nursing unit. Which equipment should the nurse have available in the patient's assigned room (select all that apply)?
a. Side-rail pads
b. Tongue blade
c. Oxygen mask
d. Suction tubing
e. Urinary catheter
f. Nasogastric tube
A, C, D
The patient is at risk for further seizures, and oxygen and suctioning may be needed after any seizures to clear the airway and maximize oxygenation. The bed's side rails should be padded to minimize the risk for patient injury during a seizure. Use of tongue blades during a seizure is contraindicated. Insertion of a nasogastric (NG) tube is not indicated because the airway problem is not caused by vomiting or abdominal distention. A urinary catheter is not required unless there is urinary retention.
A patient with Parkinson's disease is admitted to the hospital for treatment of pneumonia. Which nursing interventions will be included in the plan of care (select all that apply)?
a. Use an elevated toilet seat.
b. Cut patient's food into small pieces.
c. Provide high-protein foods at each meal.
d. Place an armchair at the patient's bedside.
e. Observe for sudden exacerbation of symptoms.
A, B, D
Because the patient with Parkinson's has difficulty chewing, food should be cut into small pieces. An armchair should be used when the patient is seated so that the patient can use the arms to assist with getting up from the chair. An elevated toilet seat will facilitate getting on and off the toilet. High-protein foods will decrease the effectiveness of L-dopa. Parkinson's is a steadily progressive disease without acute exacerbations.
What is one medication that cause seizures?
What are some medications used to treat seizures?
What is a generalized seizure?
They involve both sides of the brain and are characterized by bilateral synchronous epileptic discharges in the brain from the onset of the seizure. Because the entire brain is affected at the onset of the seizures, there is no warning or aura. Patient usually losses consciousness for a few seconds to several minutes. Rigorous movements of the entire body.
What is a focal seizure?
Only occurs in one area of the brain and can be indicated on an EEG.
What can cause a seizure?
What is status epilepticus?
recurring seizures lasts over 30 minutes and is unresponsive to medications. This is life threatening because of the oxygen depletion to the brain and is considered a medical emergency.
What will be elevated in during a seizure?
What are clinical manifestations of seizures?
-loss of consciousness
-may have n aura
How to diagnose Seizure?
-ask if pt. had an aura, triggers, how often is occurs, how severe
What are the three stages of a seizure?
how to treat a seizure?
How do we treat status epilepticus?
migraine headache is
Types of stroke
ischemic and hemorrhagic
a stroke where the blood loss is caused by a blockage
when a blood vessel in the brain leaks
Risk factors of stroke
-history of TIAs
-history of MI