MS CH 48 Nursing Care of Patients With Central Nervous System Disorders
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Questions and Answers

What is characterized by bruising of brain tissue possibly accompanied by hemorrhage?

  • Diffuse axonal injury
  • Cerebral contusion (correct)
  • Acute intraventricular hemorrhage
  • Subdural hematoma

What type of symptoms is associated with an acute subdural hematoma?

  • Gradual decline in cognitive function
  • Immediate loss of consciousness
  • Symptoms appearing within 24 hours following injury (correct)
  • Symptoms appearing more than 72 hours after injury

Which symptoms can indicate a brainstem contusion?

  • Diminished motor skills
  • Severe headaches
  • Altered level of consciousness (correct)
  • Persistent nausea

What can be a consequence of severe contusions that affects the overall brain function?

<p>Diffuse axonal injury (B)</p> Signup and view all the answers

What can be affected by edema or hypothalamic injury in patients with cerebral contusions?

<p>Autonomic nervous system (B)</p> Signup and view all the answers

What is the recommended head elevation to help reduce intracranial pressure (ICP)?

<p>30 degrees (C)</p> Signup and view all the answers

Why is hip flexion to be avoided in patients with increased ICP?

<p>It can increase intra-abdominal and thoracic pressure. (D)</p> Signup and view all the answers

Which of the following actions is recommended to prevent increased ICP?

<p>Minimize unnecessary noise (C)</p> Signup and view all the answers

What is a recommended measure to manage coughing and vomiting in a patient at risk for increased ICP?

<p>Administering antiemetics (B)</p> Signup and view all the answers

Which position should the head and neck be maintained to avoid obstructing venous outflow?

<p>Neutral position (D)</p> Signup and view all the answers

What is one of the types of headaches mentioned in the content?

<p>Secondary headaches (A)</p> Signup and view all the answers

What should be minimized to help prevent increased intracranial pressure?

<p>Suctioning procedures (C)</p> Signup and view all the answers

What is the role of describing the brain to significant others?

<p>To help understand symptoms of neurological disorders (B)</p> Signup and view all the answers

What is an aura in the context of seizure activity?

<p>A warning sensation that indicates a seizure may occur. (C)</p> Signup and view all the answers

What are automatisms in relation to partial seizures?

<p>Repetitive, purposeless behaviors exhibited during partial seizures. (C)</p> Signup and view all the answers

Which of the following techniques may help reduce tension headaches?

<p>Biofeedback and stress reduction techniques. (D)</p> Signup and view all the answers

What is the duration typically associated with simple partial seizures?

<p>Less than 1 minute. (B)</p> Signup and view all the answers

What is the main goal of recognizing seizure triggers for a patient?

<p>To lessen the frequency and intensity of seizures. (B)</p> Signup and view all the answers

What should patients be educated about concerning their medications?

<p>How to administer medications for effective control. (A)</p> Signup and view all the answers

What is a recommended measure for managing a migraine headache?

<p>Ensure the patient rests in a dark room. (D)</p> Signup and view all the answers

Why might patients exhibiting automatisms during seizures be misinterpreted?

<p>Their behaviors could resemble those of intoxication. (B)</p> Signup and view all the answers

What is indicated by a positive Brudzinski's sign?

<p>Flexion of the neck causes the hips and knees to flex (D)</p> Signup and view all the answers

What is a common cause of nausea and vomiting in patients with meningitis?

<p>Direct irritation of brain tissue and increased ICP (B)</p> Signup and view all the answers

Which type of meningitis generally has no lasting effects after resolution?

<p>Viral meningitis (D)</p> Signup and view all the answers

What therapeutic measure can be taken to control fever in meningitis patients?

<p>Using antipyretics such as acetaminophen (A)</p> Signup and view all the answers

What cognitive changes are typically seen in patients with meningitis?

<p>Disorientation and difficulty following commands (B)</p> Signup and view all the answers

What is a potential complication of bacterial meningitis?

<p>Cranial nerve damage leading to blindness or deafness (A)</p> Signup and view all the answers

What should be monitored closely when using cooling blankets for fever management?

<p>Risk of shivering that could increase metabolic demands (D)</p> Signup and view all the answers

When should a patient with meningococcal meningitis be isolated?

<p>For at least 24 hours after medication administration (A)</p> Signup and view all the answers

What are common bacteria associated with bacterial meningitis?

<p>Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b (A)</p> Signup and view all the answers

What is a common presentation of meningococcal meningitis?

<p>Petechiae on the skin (D)</p> Signup and view all the answers

Which sign is characterized by pain and stiffness when the neck is moved?

<p>Nuchal rigidity (A)</p> Signup and view all the answers

What is the correct method to elicit Kernig's sign?

<p>Flex the patient's knee and then try to extend the leg (D)</p> Signup and view all the answers

Which cranial nerves are commonly affected by meningitis?

<p>III, IV, VI (A)</p> Signup and view all the answers

What symptom often accompanies photophobia in meningitis patients?

<p>Severe headache (B)</p> Signup and view all the answers

Which route of entry can lead to a meningitis infection through the bloodstream?

<p>Insect bite and otitis media (B)</p> Signup and view all the answers

What does Brudzinski's sign indicate when observed in a patient?

<p>Meningitis (D)</p> Signup and view all the answers

What is the medical term for light sensitivity experienced by some meningitis patients?

<p>Photophobia (A), Photophobia (B)</p> Signup and view all the answers

Which bacterium is associated with pneumococcal meningitis?

<p>Streptococcus pneumoniae (B)</p> Signup and view all the answers

What is the primary recommended schedule for meningococcal vaccination in adolescents?

<p>Two doses at ages 11 or 12 and 16 (C)</p> Signup and view all the answers

Which of the following can increase a patient's vulnerability to infections such as meningitis?

<p>Chemotherapy and steroid administration (B)</p> Signup and view all the answers

What is a common cause of bacterial meningitis?

<p>Airborne transmission from respiratory discharge (A)</p> Signup and view all the answers

What is the most common symptom of meningitis?

<p>Severe headache (D)</p> Signup and view all the answers

Which of the following is considered viral meningitis?

<p>Aseptic meningitis (A)</p> Signup and view all the answers

Which group is not specifically recommended for meningococcal vaccination?

<p>Individuals over 65 years old (C)</p> Signup and view all the answers

What type of antimicrobial agents are recommended for chemoprophylaxis in meningitis exposure?

<p>Rifampin, quinolones, or sulfonamides (A)</p> Signup and view all the answers

How long does it typically take for patients recovering from viral meningitis?

<p>1 to 2 weeks (B)</p> Signup and view all the answers

What condition is indicated by weakness in all four limbs due to spinal cord injury?

<p>Quadriplegia (A)</p> Signup and view all the answers

Which of the following is a common risk factor for neurodegenerative disorders?

<p>Genetic predisposition (B)</p> Signup and view all the answers

What is a significant complication associated with bacterial meningitis?

<p>Cognitive impairment (D)</p> Signup and view all the answers

Which of the following diseases is not classified as a neurodegenerative disorder?

<p>Multiple sclerosis (B)</p> Signup and view all the answers

What is a primary nursing intervention for a patient with increased intracranial pressure (ICP)?

<p>Maintaining the head of the bed elevated (D)</p> Signup and view all the answers

Which symptom is commonly associated with central nervous system disorders?

<p>Transient paralysis (A)</p> Signup and view all the answers

What can be a consequence of untreated meningitis?

<p>Hearing loss (D)</p> Signup and view all the answers

Which vaccine is recommended for individuals over age 65 to help prevent meningitis?

<p>Pneumococcal (B)</p> Signup and view all the answers

What is the primary advantage of using a subarachnoid bolt?

<p>Provides ease of placement (C)</p> Signup and view all the answers

Which of the following is a disadvantage of external ventricular drainage?

<p>Clotting of the catheter (B)</p> Signup and view all the answers

What is a potential complication associated with an intraparenchymal monitor?

<p>Occlusion by brain tissue (C)</p> Signup and view all the answers

In what setting are patients with ICP monitors typically cared for?

<p>Intensive care unit (ICU) (C)</p> Signup and view all the answers

What is one of the challenges faced during the placement of a catheter for external ventricular drainage?

<p>Difficulty in locating the ventricle (A)</p> Signup and view all the answers

Which condition can lead to increased intracranial pressure (ICP)?

<p>Excess cerebrospinal fluid production (B)</p> Signup and view all the answers

Which of the following statements about a subarachnoid bolt is true?

<p>It may become occluded by brain tissue. (A)</p> Signup and view all the answers

Which monitoring method is believed to most accurately reflect the situation within the skull?

<p>Intraparenchymal monitor (B)</p> Signup and view all the answers

What symptom indicates increasing intracranial pressure in patients?

<p>Dilated pupil on affected side (D)</p> Signup and view all the answers

Which intervention is essential for a patient diagnosed with hyperthermia related to an infectious process?

<p>Assess temperature every 4 hours (B)</p> Signup and view all the answers

Which of these outcomes is expected for a patient with hyperthermia?

<p>Control body temperature (C)</p> Signup and view all the answers

How should patient education be tailored based on their condition?

<p>Include significant others when the patient is unable to participate (D)</p> Signup and view all the answers

What type of posturing may indicate severe neurological impairment?

<p>Decorticate then decerebrate posturing (A)</p> Signup and view all the answers

What is the rationale for assessing temperature regularly in patients with hyperthermia?

<p>To evaluate risk for seizures (D)</p> Signup and view all the answers

What physical sign is often observed in patients with decreased levels of consciousness?

<p>Decorticate posturing (A)</p> Signup and view all the answers

What physiological change may occur alongside rising systolic blood pressure in patients with increased intracranial pressure?

<p>Increased then decreasing pulse rate (A)</p> Signup and view all the answers

What is a significant risk factor during the weaning process off anticonvulsant therapy?

<p>Increased seizure frequency (D)</p> Signup and view all the answers

What immediate action is recommended when a seizure occurs?

<p>Assist in airway maintenance (A)</p> Signup and view all the answers

Which of the following medications is typically used to stop active seizures?

<p>Lorazepam (B)</p> Signup and view all the answers

What potential complication arises if cerebral metabolic needs are not met during seizures?

<p>Irreversible neuronal damage (B)</p> Signup and view all the answers

During the preoperative assessment for epilepsy surgery, what is a primary goal?

<p>Identify seizure foci (B)</p> Signup and view all the answers

What should be done to adequately assist a patient experiencing status epilepticus?

<p>Ensure proper positioning and airway management (B)</p> Signup and view all the answers

What is a key aspect of care during a seizure to prevent injury?

<p>Padding side rails and removing nearby furniture (B)</p> Signup and view all the answers

Why is intubation and mechanical ventilation sometimes necessary during status epilepticus?

<p>To ensure adequate oxygenation (A)</p> Signup and view all the answers

What may occur if there is an increase in one component of the skull without a decrease in others?

<p>Increased intracranial pressure (D)</p> Signup and view all the answers

Which symptom is NOT typically associated with increased intracranial pressure?

<p>Loss of appetite (D)</p> Signup and view all the answers

Which condition can lead to lasting cognitive disabilities after its occurrence?

<p>Herpes encephalitis (C)</p> Signup and view all the answers

What is the potential mortality rate if a patient becomes comatose from cerebral edema before treatment begins?

<p>70% to 80% (A)</p> Signup and view all the answers

Increased intracranial pressure can often be detected within what critical time frame after cerebral edema occurs?

<p>72 hours (A)</p> Signup and view all the answers

Which condition can cause a sudden and sharp increase in intracranial pressure?

<p>Subarachnoid hemorrhage (B)</p> Signup and view all the answers

Which of the following is a common immediate symptom of increased intracranial pressure?

<p>Photophobia (A)</p> Signup and view all the answers

What is the consequence of significant cerebral edema in herpes encephalitis?

<p>Increased intracranial pressure and potential herniation (A)</p> Signup and view all the answers

What should you do to help a patient during a seizure?

<p>Use padding and talk calmly to the patient. (C)</p> Signup and view all the answers

What might individuals with poorly controlled seizures experience regarding their job opportunities?

<p>Limited opportunities due to transport dependency. (B)</p> Signup and view all the answers

Why should patients with uncontrolled seizures avoid operating motor vehicles?

<p>It can be a legal requirement in some places. (A)</p> Signup and view all the answers

What is recommended for a patient after a seizure has ended?

<p>Let them come out of the seizure naturally. (D)</p> Signup and view all the answers

How can seizures affect a patient's self-esteem?

<p>Patients may experience embarrassment and fear. (D)</p> Signup and view all the answers

What is the significance of a state identification card for patients with seizure disorders?

<p>It serves as a replacement for a driver's license. (D)</p> Signup and view all the answers

Which of the following actions is NOT advised during a seizure?

<p>Sitting on or holding down the patient. (A)</p> Signup and view all the answers

What role can role-playing serve for patients dealing with seizures?

<p>It helps in understanding potential concerns when confiding in others. (D)</p> Signup and view all the answers

What happens to cerebral blood vessels during hyperventilation?

<p>They constrict, reducing blood flow. (B)</p> Signup and view all the answers

Which symptom is typically the earliest indication of increased intracranial pressure (ICP)?

<p>Restlessness and irritability. (B)</p> Signup and view all the answers

The compression of which nerve is associated with fixed and dilated pupils as ICP increases?

<p>Oculomotor nerve. (A)</p> Signup and view all the answers

What role does hyperventilation play in the body's response to increasing ICP?

<p>It decreases the amount of blood within the cranial vault. (B)</p> Signup and view all the answers

Which factor might worsen the symptoms of cluster headaches?

<p>Alcohol consumption (C)</p> Signup and view all the answers

Which of the following is a late indication of increasing ICP?

<p>Vital sign changes. (D)</p> Signup and view all the answers

What is a common description used by patients to characterize tension headaches?

<p>Dull and aching (B)</p> Signup and view all the answers

What is particularly important to monitor in a patient with signs of increased ICP?

<p>Pupil response and level of consciousness. (A)</p> Signup and view all the answers

Which symptom is typically associated with a headache that may indicate a need for caution in diagnosis?

<p>Nausea and vomiting (A)</p> Signup and view all the answers

What effect does increased ICP have on the oculomotor nerve over time?

<p>It can lead to compression resulting in fixed and dilated pupils. (C)</p> Signup and view all the answers

What is a potential alleviating factor for tension headaches?

<p>Resting in a dark room (D)</p> Signup and view all the answers

What is essential for effective data collection regarding a patient with possible ICP increases?

<p>Obtaining a complete history from the patient and significant others. (D)</p> Signup and view all the answers

What should be thoroughly ruled out before attributing headaches to psychosocial origins?

<p>Physical causes (C)</p> Signup and view all the answers

What is the primary purpose of administering acetaminophen or aspirin to patients with brain lesions or injuries?

<p>To lower fever and achieve comfort. (B)</p> Signup and view all the answers

Which intervention can be employed to enhance patient comfort during cooling therapy?

<p>Gradually cool the patient and wrap extremities in bath blankets. (D)</p> Signup and view all the answers

What pattern does the occurrence of cluster headaches typically follow?

<p>In clusters during a specific time span (A)</p> Signup and view all the answers

What assessment tool is recommended for evaluating level of consciousness in patients with suspected increased intracranial pressure?

<p>Glasgow Coma Scale or FOUR Score. (B)</p> Signup and view all the answers

Which psychosocial stressors are commonly associated with tension headaches?

<p>Anxiety and emotional distress (D)</p> Signup and view all the answers

What is an important consideration when asking about headache severity?

<p>Its consistency from headache to headache (B)</p> Signup and view all the answers

Why should nursing interventions include monitoring the patient's ability to follow simple commands?

<p>To assess reflexes independently from purposeful movement. (C)</p> Signup and view all the answers

How should a patient's orientation be assessed to ensure safety and effective care planning?

<p>Determining if the patient can identify their identity, location, and time. (B)</p> Signup and view all the answers

What is a common risk observed in patients as they engage in increased activities following a brain injury?

<p>Dizziness, imbalance, and confusion. (C)</p> Signup and view all the answers

Which safety measure should be implemented if a patient cannot be reoriented?

<p>Assess for safety and implement necessary safety measures. (B)</p> Signup and view all the answers

Which evaluation question assesses the effectiveness of using antipyretics in patients?

<p>Are antipyretics effective in normalizing the patient’s body temperature? (D)</p> Signup and view all the answers

What can result from severe cerebral contusions affecting brain function?

<p>Diffuse axonal injury (D)</p> Signup and view all the answers

How are acute subdural hematomas characterized?

<p>Symptoms appear within 24 hours post-injury (D)</p> Signup and view all the answers

Which of the following autonomic responses can occur due to hypothalamic injury?

<p>Rapid heart rate (B)</p> Signup and view all the answers

What effect can brainstem contusions have on a patient?

<p>Transitory level of consciousness (D)</p> Signup and view all the answers

What type of bleeding is typically associated with acute subdural hematoma?

<p>Venous bleeding (A)</p> Signup and view all the answers

What type of behaviors are characterized as automatisms during partial seizures?

<p>Repetitive, purposeless behaviors (D)</p> Signup and view all the answers

What is a common characteristic of an aura experienced before a seizure?

<p>An unusual sound or visual distortion (A)</p> Signup and view all the answers

Which strategy can assist patients in controlling headache symptoms?

<p>Practicing biofeedback and stress reduction (C)</p> Signup and view all the answers

What is the expected duration of a simple partial seizure?

<p>Less than 1 minute (B)</p> Signup and view all the answers

What might patients who experience automatism during a seizure be incorrectly labeled as?

<p>Mentally ill (A)</p> Signup and view all the answers

What is an important technique for patients to mitigate risks when they sense an impending seizure?

<p>Sitting or lying down (B)</p> Signup and view all the answers

How should patients manage medication administration for seizure control?

<p>Following appropriate dosages and understanding potential side effects (B)</p> Signup and view all the answers

What environmental adjustment can help reduce migraine headaches?

<p>Providing a dark room for rest (A)</p> Signup and view all the answers

What condition is most likely to occur weeks to months after a seemingly minor head injury?

<p>Chronic subdural hematoma (A)</p> Signup and view all the answers

What kind of injury occurs when a stationary head is struck by a moving object?

<p>Acceleration-deceleration injury (A)</p> Signup and view all the answers

Which group is particularly vulnerable to chronic subdural hematomas due to brain atrophy?

<p>Older adults and individuals with alcoholism (C)</p> Signup and view all the answers

What symptom might indicate an increase in intracranial pressure (ICP) after a head injury?

<p>Deterioration of consciousness (B)</p> Signup and view all the answers

When managing a patient with seizures, which action is essential to ensure the safety of the patient?

<p>Moving nearby objects to protect from injury (D)</p> Signup and view all the answers

Which of the following suggests that the care of a patient with epilepsy has been successful?

<p>Decrease in seizure frequency to the lowest possible level (B)</p> Signup and view all the answers

What type of injury is characterized as having the potential to cause lacerations and contusions due to shearing forces?

<p>Rotational injury (B)</p> Signup and view all the answers

Which factor is crucial to monitor in a patient who has experienced a head injury?

<p>Vital signs (C)</p> Signup and view all the answers

What phase is characterized by visual disturbances and numbness before a migraine headache occurs?

<p>Prodromal phase (B)</p> Signup and view all the answers

Which of the following triggers is least likely to contribute to the onset of a migraine headache?

<p>Low humidity (D)</p> Signup and view all the answers

Which option correctly describes the typical symptom associated with cluster headaches?

<p>Unilateral pain affecting the eye (C)</p> Signup and view all the answers

Which description of migraine pain is not commonly used by patients?

<p>Pulsating (D)</p> Signup and view all the answers

In addition to the headache, which symptom is often accompanied by migraines?

<p>Nausea (D)</p> Signup and view all the answers

During which phase of a migraine might a patient experience difficulty speaking?

<p>Aura phase (C)</p> Signup and view all the answers

Which of the following treatments is considered a prophylactic measure for migraines?

<p>Tricyclic antidepressants (D)</p> Signup and view all the answers

What is a common characteristic of migraine headaches in terms of their location?

<p>Unilateral and localized (B)</p> Signup and view all the answers

What is the primary concern when administering phenytoin to patients receiving tube feedings?

<p>Tube feedings should be held 1 hour before and 2 hours after the dose. (C)</p> Signup and view all the answers

What indicates a need to discontinue lamotrigine therapy?

<p>Development of a rash. (D)</p> Signup and view all the answers

Which therapeutic drug requires monitoring of vital signs during administration?

<p>Phenobarbital (C)</p> Signup and view all the answers

What is the typical therapeutic level range for valproic acid when treating seizures?

<p>15–40 mcg/mL (A), 50–100 mcg/mL (B)</p> Signup and view all the answers

Which emergency agent is administered to stop a seizure that has not resolved within 5 minutes?

<p>Lorazepam (C)</p> Signup and view all the answers

Which condition is characterized by at least 30 minutes of repetitive seizure activity?

<p>Status epilepticus (A)</p> Signup and view all the answers

What is a critical step in managing status epilepticus effectively?

<p>Identify and address the epileptic focus. (C)</p> Signup and view all the answers

Which laboratory tests should be assessed for patients on levetiracetam?

<p>WBC, RBC, and liver function tests (B)</p> Signup and view all the answers

What should patients with generalized seizures be instructed to do when they recognize an aura?

<p>Get to safety by lying down away from furniture. (C)</p> Signup and view all the answers

Which of the following is NOT an expected information patients should verbalize about their medications?

<p>Alternative therapies that are ineffective. (D)</p> Signup and view all the answers

What is a primary risk factor for traumatic brain injury in adults?

<p>Motor vehicle accidents. (D)</p> Signup and view all the answers

Which of the following best describes the expected outcome for a patient with a risk for injury related to seizure activity?

<p>The patient will remain free from injury. (D)</p> Signup and view all the answers

What can therapeutic drug levels help evaluate in patients taking anticonvulsants?

<p>Adherence to the medication regimen. (C)</p> Signup and view all the answers

What complications can arise from traumatic brain injury besides the primary insult?

<p>Cerebral edema and hydrocephalus. (A)</p> Signup and view all the answers

Which of the following might indicate that a patient has resources to purchase prescribed anticonvulsant medications?

<p>The patient has a steady income. (A)</p> Signup and view all the answers

What does the phenomenon of traumatic brain injury potentially range from?

<p>No detectable effect to a persistent vegetative state. (C)</p> Signup and view all the answers

What is indicated by a positive Kernig's sign during an examination?

<p>Stiffness in the neck (D)</p> Signup and view all the answers

What is typically revealed in the CSF analysis of a patient with encephalitis?

<p>Increased WBC count and normal glucose levels (B)</p> Signup and view all the answers

Which therapeutic intervention is essential for patients at risk of seizures related to encephalitis?

<p>Implementing seizure precautions (A)</p> Signup and view all the answers

Which factor must be realistically assessed when determining discharge plans for patients with encephalitis?

<p>Patient's behavioral control (C)</p> Signup and view all the answers

What might indicate the need for custodial care upon the patient's discharge?

<p>Severe functional impairment (C)</p> Signup and view all the answers

Which diagnostic test is commonly used to confirm viral encephalitis?

<p>CT scan (D)</p> Signup and view all the answers

Which symptom is unlikely to be present in a patient with encephalitis?

<p>Nasal congestion (D)</p> Signup and view all the answers

What is an important consideration for outpatient therapy in discharged patients?

<p>Consistency of therapy sessions (C)</p> Signup and view all the answers

What is the likely consequence if a chronic subdural hematoma persists or increases in size?

<p>Development of hemiparesis and pupillary changes (A)</p> Signup and view all the answers

Which characteristic is typical of a patient with an epidural hematoma following a severe brain injury?

<p>Regaining consciousness then decreasing responsiveness (A)</p> Signup and view all the answers

What immediate impact does a concussion have on an individual?

<p>Loss of consciousness for 5 minutes or less (B)</p> Signup and view all the answers

What common symptom might a patient with a chronic subdural hematoma exhibit?

<p>Irritability and forgetfulness (C)</p> Signup and view all the answers

During a motor vehicle accident, which of the following mechanisms could lead to damage to the reticular activating system?

<p>Twisting of the brainstem caused by lateral force (C)</p> Signup and view all the answers

What is a distinguishing feature of cerebral concussion compared to other types of brain injuries?

<p>No documented abnormalities on imaging tests (D)</p> Signup and view all the answers

What primary reason can cause individuals to delay seeking medical care after a brain injury?

<p>Failing to associate symptoms with a prior incident (B)</p> Signup and view all the answers

What is the typical nature of bleeding associated with an epidural hematoma?

<p>Arterial bleeding causing rapid accumulation (B)</p> Signup and view all the answers

What is the primary reason for using padding during a seizure?

<p>To protect the patient from injury. (C)</p> Signup and view all the answers

Which of the following actions should be avoided when a patient is having a seizure?

<p>Holding down the patient to prevent movement. (C)</p> Signup and view all the answers

What emotional impact can a seizure have on a patient regarding social interactions?

<p>Limited interpersonal relationships due to fear. (B)</p> Signup and view all the answers

After a seizure ends, which action is recommended for the patient?

<p>Allowing them to rest and recover. (A)</p> Signup and view all the answers

What potential issue may patients with poorly controlled seizures face in everyday life?

<p>Mobility limitations due to fear of seizure onset. (D)</p> Signup and view all the answers

Which identification document is recommended for patients who cannot drive?

<p>State identification card. (D)</p> Signup and view all the answers

Which experience might contribute to a patient's fear surrounding seizures?

<p>Witnessing another person having an unprotected seizure. (B)</p> Signup and view all the answers

What is the impact of seizures on a patient's self-esteem?

<p>Lowered self-esteem due to inability to drive. (C)</p> Signup and view all the answers

Flashcards

Meningitis

Inflammation of the membranes surrounding the brain and spinal cord.

Bacterial Meningitis

Meningitis caused by bacteria, often spread through respiratory droplets.

Viral Meningitis

Meningitis caused by a virus, usually milder and self-resolving.

Compromised Immunity

A weakened immune system makes a person more prone to infections, including meningitis.

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Chemoprophylaxis

Giving antibiotics to people who have been in close contact with someone with meningitis.

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Meningococcal Vaccine

A vaccine that protects against meningococcal bacteria, which can cause meningitis.

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Dura Mater

The tough outer layer surrounding the brain and spinal cord.

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Nasopharynx

An area behind the nose and throat where bacteria can reside.

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Nuchal Rigidity

A stiff neck or difficulty moving the neck.

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Kernig's Sign

A test used to assess for meningitis. The examiner flexes the patient's hip to 90 degrees and tries to extend the knee. Pain and resistance indicate a positive result.

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Brudzinski's Sign

A test used to assess for meningitis. The examiner flexes the patient's neck, and the patient's hips and knees involuntarily flex as well, indicating a positive result.

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Photophobia

Sensitivity to light.

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Petechiae

Small, pinpoint-sized red spots that appear on the skin and mucous membranes. Often associated with meningococcal meningitis.

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Neisseria meningitidis

A bacterium that commonly causes meningitis. Often associated with a characteristic rash.

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Streptococcus pneumoniae

A bacterium that commonly causes meningitis. Often associated with a characteristic rash.

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Haemophilus influenzae type b (Hib)

A bacterium that used to be a common cause of meningitis but has become less prevalent due to widespread vaccination.

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What is an MRI used for?

A medical test that uses magnetic fields and radio waves to create detailed images of organs and tissues inside the body. It's often used to diagnose meningitis.

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What is a CT scan?

A test that uses X-rays to create detailed images of bones, tissues, and organs. It's used to evaluate for complications of meningitis.

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What is Brudzinski's sign?

A sign of meningitis where the hips and knees flex when the patient's neck is flexed. It's a test, not a symptom.

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What is meningitis?

Inflammation of the brain's lining, the meninges. It can be caused by bacteria, viruses, or other infections.

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How is bacterial meningitis treated?

Medications, such as penicillin, vancomycin, and cephalosporins, are used to treat bacterial meningitis. They can help fight the infection.

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What is a common symptom of meningitis?

Fever is often a symptom of meningitis caused by the body's response to infection.

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Why is timely treatment important for meningitis?

It is important to treat meningitis quickly to prevent complications. Without treatment it can be serious.

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What are potential complications of meningitis?

Viral meningitis typically doesn't cause lasting problems, but bacterial meningitis can lead to long-term effects like deafness or seizures.

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Increased Intracranial Pressure (ICP)

A condition where pressure inside the skull increases, often due to swelling or fluid buildup.

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Head Elevation

Elevating the head of the bed can reduce ICP by improving venous drainage.

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Neck Flexion

Flexing the neck can hinder venous outflow, leading to increased ICP.

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Coughing & Vomiting

Activities like coughing and vomiting can increase ICP.

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Straining for Bowel Movement

Straining during bowel movements can increase abdominal pressure, indirectly increasing ICP.

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Suctioning

Suctioning can trigger a rise in ICP, so it should be minimized and done with care.

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Hip Flexion

Hip flexion can increase pressure within the abdomen and thorax, potentially leading to increased ICP.

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Noxious Stimuli

Loud noises and startling can cause an increase in ICP for some patients.

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Cerebral contusion

A type of brain injury characterized by bruising of brain tissue, potentially causing bleeding.

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Subdural Hematoma

A collection of blood that forms between the dura mater and arachnoid membranes, typically caused by a head injury.

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Unresponsive

A decrease in responsiveness to stimuli, often a sign of a serious medical condition.

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Hemiparesis

A type of neurological symptom characterized by weakness or paralysis on one side of the body.

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Seizure

A sudden, uncontrolled electrical discharge in the brain that can cause changes in behavior, sensation, or muscle activity.

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Aura

A warning sign that a seizure is about to happen, often involving visual, auditory, or sensory changes.

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Automatisms

Repetitive, meaningless actions that can occur during a partial seizure.

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Simple Partial Seizure

A seizure where the person remains conscious and may have unusual sensations or movements.

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Alleviating Techniques

Techniques like deep breathing and relaxation exercises to help manage seizures.

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Biofeedback

Strategies for using relaxation and stress reduction to manage seizures.

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Stimulation Reduction

Techniques like resting in a dark room to reduce stimulation during a migraine.

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Medication Administration

Understanding how medications work, their dosages, and potential side effects.

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Seizure Origin

The location in the brain where a seizure begins.

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Hib Vaccine

A vaccine available for infants and children to protect against Haemophilus influenzae type b (Hib), which is a common cause of bacterial meningitis.

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External Ventricular Drainage

Measures pressure and drains excess cerebrospinal fluid (CSF) to reduce intracranial pressure (ICP).

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Subarachnoid Bolt

A device inserted into the subarachnoid space to monitor intracranial pressure, but it cannot drain CSF.

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Intraparenchymal Monitor

A pressure monitor that detects changes in ICP by being placed directly into brain tissue.

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What can cause Increased Intracranial Pressure?

Any increase in brain tissue, blood, or CSF can lead to higher pressure inside the skull.

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What are the compensation methods for increased ICP?

These are mechanisms that the body uses to compensate for increased intracranial pressure, like increased heart rate or blood flow.

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What are activities that can further increase ICP?

These are things that can increase ICP, like coughing, vomiting, and straining during bowel movements.

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What kind of care is required for patients with ICP monitors?

Patients with ICP monitors require specialized care, including meticulous nursing interventions to prevent complications.

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Why are patients with ICP monitors often mechanically ventilated?

Patients with ICP monitors are often mechanically ventilated to manage breathing and prevent complications.

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Temporal Lobes

The most common locations for edema and necrosis caused by Herpes Encephalitis.

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Brain Herniation

A serious complication of ICP that can lead to brain damage and death. Happens when the brain tissue is pushed out of its normal space.

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Decreased Level of Consciousness

A decrease in the level of consciousness, often a sign of increased ICP.

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Abnormal Sleep Patterns

Abnormal sleep patterns, a potential symptom of increased ICP.

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Status Epilepticus

A serious condition where seizures continue without stopping, lasting for more than 5 minutes, or occurring repeatedly without recovery in between.

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Anticonvulsant Weaning

The process of gradually reducing or stopping anticonvulsant medications to identify seizure foci for epilepsy surgery.

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Emergency Care During a Seizure

The primary goal is to prevent injury during a seizure. This includes padding side rails, moving furniture out of the way, and turning the patient on their side to prevent aspiration if they vomit.

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Emergency Medications for Seizures

Drugs like diazepam (Valium) or lorazepam (Ativan) are given intravenously or rectally to stop ongoing seizures.

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Metabolic Demands During Seizures

This refers to the increased metabolic demands of the brain during a seizure, especially status epilepticus. The brain needs more glucose and oxygen than usual.

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Maintaining Oxygenation

Maintaining oxygenation is crucial, especially during status epilepticus. Patients may need intubation and mechanical ventilation to ensure adequate oxygen supply.

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Preventing Aspiration

Aspiration is a risk during seizures, especially if the patient vomits. The nurse helps with airway maintenance and suctioning to prevent this complication.

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Post-Seizure Drug Monitoring

After the seizure is stopped, serum drug levels are taken to adjust anticonvulsant therapy and achieve therapeutic levels.

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What is an aura?

A warning sign that a seizure is about to happen. It can involve changes in vision, hearing, or other senses.

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How to help during a seizure?

Protect the person during a seizure by using soft padding, keeping them safe, and talking calmly.

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Why are seizures scary for patients?

Seizures can be frightening for the patient and those observing. They may experience involuntary movements, sounds, or even incontinence.

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How are seizures a challenge in daily life?

Driving is often restricted for people with uncontrolled seizures. They may need to use public transportation more frequently, which can impact their independence.

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What can help someone cope with seizures?

Role-playing can help patients practice communicating their needs and understanding how to cope with seizures. It can help them feel more confident.

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What are the potential social impacts of seizures?

The involuntary movements, sounds, and potential incontinence during a seizure can be embarrassing for the patient.

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What financial support may be available?

Patients may need support exploring financial assistance options if their seizure condition affects their job or income.

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Why is open communication important for people with seizures?

The ability to communicate with others clearly about seizures can help patients feel more comfortable and supported.

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Decerebrate Posturing

A sign of increased intracranial pressure (ICP) where the patient's arms are stiffly extended, with the wrists and fingers flexed. This is a serious sign that the brain is being compressed.

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Decorticate Posturing

A sign of increased intracranial pressure (ICP) where the patient's arms are flexed at the elbows, with the fists clenched. The legs are extended and the feet are plantar flexed. It suggests damage to the brain above the brainstem.

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External Ventricular Drainage (EVD)

A procedure where a catheter is inserted into the brain's ventricle to drain excess cerebrospinal fluid (CSF) and reduce ICP.

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Activities that Increase ICP

Any action that can increase intracranial pressure (ICP), such as coughing, vomiting, straining during bowel movements, and even sucking. These actions should be minimized for patients with increased ICP.

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Intracranial Pressure (ICP)

Refers to the pressure inside the skull, which is caused by the brain tissue, blood, and cerebrospinal fluid (CSF).

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Compensatory Mechanisms for Increased ICP

The body's natural responses to increased ICP, like increasing heart rate or blood flow, in an attempt to maintain normal brain function. However, these are temporary solutions and not effective for sudden or severe ICP increases.

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Activities that Aggravate Increased ICP

Actions that can further escalate ICP, including coughing, vomiting, and straining during bowel movements. These actions put extra pressure on the brain.

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Glasgow Coma Scale and FOUR Score

Assessing a patient's level of consciousness using the Glasgow Coma Scale or FOUR Score helps determine the severity of brain injury and monitor for changes.

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Safety Measures for Disoriented Patients

A patient's safety becomes paramount when they cannot be reoriented due to brain injury. Implementing safety measures like padded side rails and constant supervision prevents potential harm.

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Cooling Measures for Fever

Cooling mattresses or tepid sponge baths help reduce fever by providing a cooling mechanism. These are often used alongside antipyretic medications.

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Maintaining a Stable Level of Consciousness

Maintaining a stable level of consciousness (LOC) is crucial for patients with brain lesions or injuries. Monitoring LOC using the Glasgow Coma Scale or FOUR Score helps identify any changes in brain function, which can indicate potential complications.

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Antipyretics for Fever Reduction

Administering antipyretic agents like acetaminophen or aspirin helps reduce fever, which can be a symptom of brain injury. These medications are typically given as orders.

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Reorientation for Brain Injury Patients

Orienting a patient to person, place, and time helps them regain awareness and reduces confusion. This simple intervention is particularly valuable in patients with brain injuries.

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Assessing Follow Simple Commands

Assessing a patient's ability to follow simple commands helps gauge their cognitive function and motor skills. Observing their responses to simple instructions, like 'raise your hand,' reveals how much brain function remains.

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Assessing Patient's Capabilities with Mobilization

Observing a patient's reaction to activities like sitting up or walking helps detect potential dizziness, imbalance, and confusion, which can be common after brain injury. This helps determine when assistance is needed for mobilization.

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Cluster Headache

A type of headache that occurs in clusters, lasting for several days or weeks, and then disappearing for months or even years. These headaches can be severe and debilitating.

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Tension Headache

A headache characterized by a steady, tight, and aching sensation, often described as feeling like a band is squeezing the head. It's usually related to stress, anxiety, or muscle tension.

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Menstrual Headache

A headache associated with the menstrual cycle, often occurring just before or during menstruation, related to hormonal fluctuations.

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Headache Triggers

Factors that can trigger or worsen headaches, such as stress, anxiety, depression, hormonal changes, and certain foods or drinks.

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Headache Relief Strategies

Actions or techniques that can help alleviate headache symptoms, such as lying down in a dark room, applying cold compresses, or taking over-the-counter medications.

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Pain Severity Scale (0-10)

A scale used to assess the intensity of pain, ranging from 0 (no pain) to 10 (worst imaginable pain). It helps doctors understand the severity of headaches.

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Headache Impact on Life

The impact of headaches on a patient's daily life, including how they interfere with work, social activities, and overall functioning.

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Headache Evaluation

A comprehensive evaluation of headaches by a healthcare professional to rule out serious underlying medical conditions and determine the best course of treatment.

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Deceleration Injury

A type of head injury where the head hits a stationary surface, often caused by tripping or falling.

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Acceleration-Deceleration Injury

An injury caused by a moving object hitting a stationary head, followed by the head striking a stationary surface. Think of a soccer player getting hit in the head and falling to the ground.

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Rotational Injury

A type of head injury that causes shearing damage due to the head rotating forcefully. This can be caused by a direct blow to the head.

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CSF Analysis for Encephalitis

Increased white blood cell count and protein levels, and normal glucose levels, in cerebrospinal fluid (CSF).

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MRI for Encephalitis Diagnosis

A test using magnetic fields and radio waves to produce detailed images of organs and tissues. It's used to diagnose encephalitis.

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Fever in Encephalitis

A common symptom of encephalitis but can also be caused by various other medical conditions..

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What is the prodromal phase of a migraine?

Migraines with aura are characterized by visual disturbances, difficulty speaking, or numbness/tingling. This is often the sign that a migraine is about to start.

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Describe the symptoms of a migraine headache.

A pounding headache, often on one side, that is worsened by noise and light. These are commonly described as throbbing, boring, and vise-like pain.

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What is a cluster headache?

Cluster headaches are recurring episodes of intense pain on one side of the head, concentrated around the eye area. These are severe, but brief.

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What is the prodromal phase of a migraine headache?

The pre-headache phase of a migraine can include visual disturbances, speech difficulties, or numbness/tingling. It's like a warning sign before the intense headache hits.

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Describe the typical duration of cluster headaches.

Cluster headaches are a quick-hitting type of headache. They can be very intense, lasting several days or weeks, then disappear for months.

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What are common migraine triggers?

Common triggers for a migraine headache include changes in barometric pressure, food sensitivities, stress, noise, alcohol, and even light.

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What is the appropriate treatment for a cluster headache?

If a patient is experiencing a cluster headache, a dark and quiet room, along with cold compresses, can help to reduce the pain. Over the counter pain relievers may also be helpful.

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How are migraine headaches treated?

Treatment for migraine headaches can be both preventive and immediate. Preventive treatment aims to reduce the frequency of headaches, while immediate treatment aims to lessen the intensity of the headaches.

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Traumatic Brain Injury (TBI)

A complex condition resulting from injury to the brain. It can range in severity from no noticeable effects to a persistent vegetative state.

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Primary Brain Injury

A primary insult to the brain caused by a direct blow, leading to bleeding, bruising, or tearing of brain tissue.

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Secondary Brain Injury

Secondary brain damage occurring after the initial injury, often due to swelling, blood clots, or fluid buildup in the brain.

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Motor Vehicle Accidents

A common cause of TBI, often involving collisions of vehicles or pedestrians with stationary objects.

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Level of Consciousness (LOC)

A vital part of a neurological assessment, evaluating a patient's ability to respond to stimuli and determine the severity of brain injury.

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Concussion

A mild brain injury characterized by a brief loss of consciousness (5 minutes or less), headache, dizziness, nausea, and vomiting. Amnesia may occur before or after the trauma.

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Contusion

A brain injury involving bruising or tearing of brain tissue due to movement within the skull. It can cause various neurological symptoms like weakness or paralysis.

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Epidural Hematoma

A collection of blood that forms between the dura mater and the skull, typically caused by an arterial bleed. It can lead to rapid deterioration of consciousness.

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Brainstem Twisting

The twisting of the brainstem, which can damage the reticular activating system, resulting in loss of consciousness.

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Brain Movement Within the Skull

The movement of the brain within the skull, which can cause bruising or tearing of brain tissue where it contacts the inside of the skull.

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Progressive Course of Symptoms in Epidural Hematoma

A condition where the patient loses consciousness immediately after the injury, regains consciousness briefly, and then deteriorates quickly with symptoms such as a dilated pupil and paralysis on the side of the hematoma.

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Study Notes

Nursing Care of Patients With Central Nervous System Disorders

  • This chapter covers nursing care for various CNS disorders, including infections, headaches, seizures, increased intracranial pressure, injuries to the brain and spinal cord, neurodegenerative disorders, and dementia.
  • CNS Infections: Meningitis and encephalitis are discussed, including their causes, risk factors, pathophysiology, nursing interventions, and preventative measures (vaccines and chemoprophylaxis). Routes of entry for CNS infections are detailed in a table. Bacterial meningitis is a serious infection spread by direct contact with discharge from the respiratory tract. Viral meningitis is also discussed, with a shorter duration and less severe course. Specific bacterial causes (Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae type b) are mentioned, with decreasing incidence of Hib due to immunization efforts. The role of meningococcal vaccines in prevention is highlighted. Chemoprophylaxis is also discussed as a preventative measure.
  • Headaches: Different types of headaches are differentiated, along with teaching strategies and interventions for patients. Causes and types of seizures are also listed, along with management strategies, including seizure precautions.
  • Increased Intracranial Pressure (ICP): Recognizing and preventing increased ICP, with focus on causes and nursing interventions. A table outlines ways that ICP can be increased. Manifestations of increased intracranial pressure (including headache, nuchal rigidity, positive Kernig's and Brudzinski's signs, and changes in vital signs) and related interventions are specifically included. The importance of prompt recognition of ICP increases for effective intervention is emphasized. The effects of ICP on the brain, blood, and CSF components are described.
  • Brain and Spinal Cord Injuries: Causes, risk factors, pathophysiology, and nursing interventions (including airway management and preventing complications) are discussed. Closed head injuries and open/penetrating injuries are addressed. The importance of preventing complications like aspiration pneumonia is emphasized.
  • Neurodegenerative Disorders: Parkinson's, Huntington's, and Alzheimer's are discussed, along with their causes, risk factors, pathophysiology, and nursing care, including specific nursing interventions. Specific symptoms, like tremors (resting tremor, pill-rolling tremor), rigidity, bradykinesia, and bradycardia, for Parkinson's are noted, along with methods of management such as deep brain stimulation, pallidotomy, and medication adjustments (including drug holidays). The variability of the disease process is covered. The complexities of diabetes insipidus and the psychosocial impact of these diseases on finances, employment and family relationships are addressed.
  • Dementia: Specific nursing interventions, including strategies for maintaining safety, are detailed for patients with dementia. Information about educating the patient and family about the disease process and treatment is included, as well as the necessity to determine patient's wishes while they are still capable. Different stages of dementia (early, middle, and late) are addressed with specific symptoms associated with each stage. Delirium is distinguished from dementia as a separate distinct condition. Detailed nursing interventions for the patient receiving care at home or in an inpatient facility related to the management of safety, behavior, and physical care are addressed, and the caregiver's role is highlighted.

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This quiz explores key concepts related to cerebral contusions, including their symptoms, potential complications, and management strategies to prevent increased intracranial pressure (ICP). Test your knowledge on the impact of head position and recommended interventions for patients at risk for ICP. Perfect for students and professionals in neurological health.

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