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68wm6 p2 Com Neu Dis

Common Neurological Disorders

QuestionAnswer
What is Cephalalgia? Headache
What are the contributing factors to migrains? *Emotional stress *Excess carbohydrates *Iodine rich foods *Alcohol *Chemical additives *Fatigue
What are episodic headaches lasting 30 minutes to 2 hours occuring in groups? Cluster headaches
How often do cluster headaches occur? Occur over a 6 to 8 weeks period after onset with 2 to 10 headaches per day on one side of the head
How much time elapses between onset and reaching maximum pain in PTs with cluster headaches? "Very little time between onset and maximum pain"
What are the most common headaches? Tension (90% of all headaches)
Rapid reduction of intracranial pressure by lumbar puncture may result in what? Herniation
When is a lumbar puncture done in diagnosis of cause of extreme headaches? In the absence of a brain tumor or increased ICP (CT scan must be done 1st)
Why should ETOH (alchohol) be avoided in people with chronic headaches? it may become addictive and can trigger cluster headaches
List 4 comfort measures that can be provided for headache relief: *Cold/warm packs *Pressure applied to the temporal arteries *Stimuli reduction *Provide for rest and relaxation *Encourage regular physical exercise *Cluster care to allow adequate rest periods
What medication is given in Tx of vascular headaches for vascular control? Ergot derivatives (dihyroergotamine and ergotamine)
What is the action of Ergot derivatives (dihyroergotamine and ergotamine)? directly stimulate alpha-adrenergic and serotonin receptor, producing vascular smooth muscle vasoconstriction
What are Ergot derivatives (dihyroergotamine and ergotamine) commonly given in combination with? Caffeine, phenobarbital and belladonna
Why are vascular headache suppressants contraindicated in pregnant women? causes contractions of the uterine smooth muscle
What migrain medication should NOT be used in conjunction with ergot derivitaves? Zolmitriptan (Zomig)
What drug types are given in Tx of migraines? *Serotonin receptor agonists ('Triptans') *Beta-Blockers ('Olols') *Opiates/derivitives
When is medication for migraines administered? At first sign of headache, and only during headache
What is neurological pain? Transmission of pain impulses due to a disorder within the nervous system
What is Transcutaneous electrical nerve stimulation (TENS)? Tx in which electrodes are used to modify sensory input and change pain sensation in PTs with neurological pain
What is spinal cord stimulation (TENS)? Tx in which electrodes are used to modify sensory input and change pain sensation in PTs with neurological pain
How long can the effects of a nerve block last? months to years
What is a neurectomy? nerve excision
What is a Rhizotomy? Cut of a spinal nerve root
What is a Cordotomy? Cutting a nerve in the spinal cord
What is a Percutaneous Cordotomy? Destruction of a nerve bundle by means of an electric current
What is the MOST important nursing intervention for PTs with neurological pain? Patient Teaching
What life sustaining mechanisms become impaired in PTs with ICP? *Decreased LOC *BP (systolic increase as body attempts to increase profusion to brain—eventually ends in hypotension) *HR - Bradycardia *Temperature regulation
What is the early sign of increasing ICP? LOC
What are the pupillary changes in a PT with ICP? *Size changes occur on same side as lesion *Progresses from constriction to dilation
What causes the pupillary changes from ICP? *Results from loss of parasympathetic input from the CN III *Terminal stage is dilated, fixed pupils due to compression of CN III
What is cushings syndrome? A widened pulse pressure (120/60 -> 160/60), increased systolic BP and bradycardia
What regulates the temperature in the brain, and when it is in dysfunction due to ICP what happens to the PTs temperature? Hypothalamus, Increases
When is papilledema a first sign of ICP? If ICP elevated gradually
Who generally first finds papilledema? Physician upon exam
In a PT with ICP, where is the ventricular catheter placed? Placed on non-dominant side, anterior horn of lateral ventricle (allows for drainage of CSF to decompress brain)
What are the injuries secondary to ICP? neuronal ischemia and/or hypoxia
What is the hyperosmotic agent used in Tx of ICP? IV Mannitol
When does the effect of mannitol begin and how long does it last? 15 minutes, 5-6 hours
What is a craniotomy? bone flap removed and replaced
What is a craniectomy? bone flap removed and not replaced (often used in trauma to allow brain to swell out of hole)
How must the bed of a PT with/recovering from ICP be placed? HOB elevated 30-45 degrees
The PT with ICP shows polyuria. What condition that can be caused by cerebral edema from ICP would you suspect? Diabetes Insipidus
What is an Electromyogram? Applying surface electrodes or inserting needle electrodes into a muscle to observe electrical activity
How often should active/passive ROM excersizes be performed on a PT with motor function disturbances? At least 3 times a day
What is Proprioception? Ability to know the body position without looking directly at it
Foods containing what may instigate migraines? *Tyramine *Nitrates *Glutamates (I.e MSG)
What foods may instigate migraines? *Vinegar *Chocolate *Cheese *Yogurt *Alchohol *Caffeine
Created by: Shanejqb