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Med-Surg I

Chp. 45 Interventions for Cts w/ Problems of the CNS: The Brain

QuestionAnswer
Headaches common symptom; three most common types include: migraine, cluster, and tension
migraine episodic familial disorder, manifested by unilateral, frontotemporal, throbbing pain in the head, worse behind ears or eye; accompanied by sensitive scalp, anorexia, photphobia (ligh sensitive) nausea & vomiting
Aura sensation that signals onset of headache or seizure; occurs immediately before migraine
Migrane Interventions; Drug therapy mild migrane=tylenol;abortive therapy: goal to alleviate pain durign aura phase or soon after headache starts=NSAIDs(Acetaminophen-naproxin, ibuprofen)
Migrane Interventions; Drug therapy NSAIDs given w/ Compazine for nausea and vomiting or Reglan for gastric emptying to decrease vomiting
Migrane Interventions; Drug therapy Ergotamine tartrate(Cafegot) given at start of headache, may take up to 6 tabs in 42 hrs (oral or suppository);
Migrane Interventions; Drug therapyDihydroegotamine (DHE) given IV or IM with antiemetic if satisfactory pain relief and nausea are not achieved with other meds; should NOT be given within 24 hrs of a triptan med
Migrane Interventions; Drug Triptan preparations-Sumatriptan succinate (Imitrex) activate the 5-HT (serotonin) receptors on the cranial arteries baislar artery, adn vasculature of the dura mater to vasoconstrict; triptan drugs are contraindicated in ct's w/ heart disease, hypertension, peripheral vascular disease, and angina
Migrane Interventions; Drug Triptan preparations Reprot chest pain or tightness immediately!
Migrane Interventions; Preventive therapy NSAIDs, Beta Blockers - olol(s) and Calcium Chanenel Blockers
Migrane Interventions; Complementary and Alternative Therapies Yoga, meditation, message, exercise, biofeedback, and relaxation techniques; lying down in darkened room; acupunture; herbs; avoid triggers
Cluster Headache AKA histamine cephalalgia; Patho less common than migrane headache, more common in men ages 20-50, cause unknown, have been attributed to vasoreactivity and oxyhemoglobin desaturation
Cluster Headache AKA histamine cephalalgia; Patho pain radiates to forhead, temple, or cheek, ear occiput, and neck; ct paces, walks, or sits and rocks; onset of headache is relaxation, napping, or rapid eye movement REM sleep
Cluster Headache AKA histamine cephalalgia; Patho headache accompanied by ipsilateral (same side) tearing of eye, rhinorrhea (running of nose) or congestion, ptosis (drooping eyelid), eyelid edema, facial sweating, and miosis (abnormal constriction of pupils)
Factor that may TRIGGER MIGRAINE ATTACK Foods and drinks that contain tyramine;alcohol, aged cheese, caffeine in soda, tea, coffee, chocolate, artificial sweetners
Factor that may TRIGGER MIGRAINE ATTACK Medications:Tagament, Nitroglycerin, Procardia
Factor that may TRIGGER MIGRAINE ATTACK Other factors:Anger, conflict, fatigue, light glare, missed measl, stress, sleep problems, smells, travel to different altitudes
Nonsurgical Cluster Headache management same drugs for migraine
Nonsurgical Cluster Headache managementOther pain relief management During attack, wear sunglasses, sit facing away from window, avoid anger, prolong anticipation, excessive, physical activity, and excitemetn
Tension Headache (headaches w/out associate symptoms) characterized by neck and shoulder muscle tenderness and bilateral pain at the base of the skull in the forehead
Tension Headache treatment Non-opioid analgesics (acetaminophen, asprin, and NSAIDs), Ibuprofen plus caffeine; prophylactic treatment
Created by: prettydee1908
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