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Chapter 11

Unit 2: Nursing care of clients with neurosensory disorders

Headaches (Pg. 113) Acute, chronic, temporary, life threatening -Primary (no cause, i.e. migraines, cluster) -Secondary (from organic cause; i.e. brain tumor)
Risk factors for migraines or cluster headaches: Alcohol, env't allergies Intense odors, bright lights, meds Fatigue, sleep deprivation, depression, emotional/physical stress, anxiety Menstrual cycles/OC use Foods with tyramine, MSG, nitrites, milk
Migraine headaches (Pg. 113) -S/s Photophobia & phonophobia (sensitive to sounds) Nausea/vomit Stress/anxiety Unilateral pain, often behind the ear/eye -health & fan hx
Classifying migraines: Categories & stages -With aura -Without aura -Atypical
Migraine w/ aura: -Stages Prodromal stage, aura stage, second stage, third stage
What is the prodromal stage of an aura? (Pg. 114) Awareness of findings for hours to days before onset: irritability, depression, food cravings, diarrhea/constipation, frequent urination
What is the aura stage? Develops over minutes to an hour -neuro findings* numb,tingles of mouth, lips, face, hands -visual disturbances; light flashes/bright spots
Second stage? Severe, incapacitating, throbbing headache over several hours -nausea/vomit/drowsiness/vertigo
Third stage? (4-72 hours), headache is dull
Migraine w/o aura: How is pain aggravated? Uni or bilateral? common symptoms? how long? Physical activity aggravates pain Unilateral, pulsating Photo/phono phobia, nausea/vomit (one or more) 4-72 hours long, AM, PMS, stress, dehydration
Atypical migraine: >72 hrs Neuro symptoms longer than 7 days Ischemic infarct may be seen on neuro imaging
Nursing care for migraines: (Pg. 114) env't, hob, meds Cool, dark, quiet env't HOB ^ 30 Meds
Meds for mild migraines: NSAIDs (ibuprofen, naproxen), acetaminophen (tylenol), OTC advil migraine capsules
Metoclopramide (Reglan) Antiemetics for nausea/vomit
Meds for severe migraines: Triptan preparations Produce a vasoconstrictive effect (Pg. 115)
Severe migraine meds: Ergotamine preparations W/ caffeine (cafergot) -Narrow BVs & reduce inflammation
Preventive therapies for headaches: NSAIDs w/ beta blocker, CCB, beta-adrenergic blocker or AED -check pulse
What are the three R's? Recognize symptoms Respond & seek provider Relieve pain & symptoms
Foods w tyramine that can be triggers: Pickles, caffeine, beer, beer/wine, aged cheese, artificial sweeteners, nuts
Meds that can induce migraines: Ranitidine, estrogen, nitroglycerin, nifedipine
Cluster headaches: (Pg. 116) Brief episode of intense, unilateral, non throbbing pain lasting 30 min to 2 hr -Can radiate to the forehead, temple, cheek
When do they occur? Daily at about the same time for 4-12 weeks Followed by a period of remission for up to 9-12 months -No warning signs -less common than migraines
What seasons are cluster more frequent in? Spring & fall
S/s: gender, age, eyes/nose, eyes, color, walking Men 20-50 yrs Tearing eyes w runny nose/congestion Facial sweating drooping eyelid & eyelid edema Miosis Facial pallor Nausea/vomit Pacing, walking, sitting, rocking activities
Meds (Pg. 116) See meds for migraines
What may be helpful at the onset of the headache? Home oxygen therapy 7-10 l/min for 15-30 min
Created by: mary.scott260!