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Health restoration I


Focal/partial Seizure No LOC / incontinence Usually processor of a tonic clonic sz
Grand Mal seizure(tonic – clonic) Altered LOC w/o memory of sz Stiffening/jerking of body
Acute Seizure Care Dilantin (phenytonin)
Medication used to terminate sz 1 mg Lorazepam (Ativan) 5mg Diazepam (Valium)
Tonic Stiffening of muscles
Clonic Jerking of body
Cluster HA External Etiology unknown Ipsilateral above eyebrow – nasal congestion Deep tense stabbing non pulsating pain Ocular ∆’s =miosis ptosis
Tension HA External bilateral pain – pressing/tightening last minutes –days Non pulsating starts w/shoulders
Migraine HA Internal (cerebral) (constriction release prostaglandins) last 4 – 72 hrs Steady throbbing pulsating pain
Migraine w/aura Complex of neurological syndromes e.g. bright lights patchy blindness hearing voices sounds strange smell paralysis weakness (sensory(visual/hearing) motor
Migraine w/aura Occur in 10% of migraine HA episodes signal onset last 1 min- 1 hr prior to migraine
Migraine w/aura phases Elderly present w/o pain – “visual migraine” Phase I prodromal visual/hearing sensory Phase II nausea vomiting pain(temple)/throbbing Phase III constant dull sensation hrs- days
Treatment of cluster HA O2 5-12L 5-10 min. Imitrex SQ (vasoconstrictor) Verapamil (vasodilator)
Treatment of tension HA Caffeine helps NSAID ASA stress management
Triptan (when are they used) Migraine HA medication Axert Frova Amerge Imetrex Cannot mix these medications
Sprain Rotator cuff injury – drop arm test (pain/inability to abduct arm above shoulder) Ligament (bone to tendon) injury TWISTING Same as strain (classification) R.I.C.E wrap e.g. ACL (most common; snap sensation instability of knee (PT or surgery))PCL
Strain aka pulled muscle classification 1-3 greater number =severity of injury Excessive stretching of a muscle tendon Most occur w/ lg muscles e.g. low back calf hamstring ice/heat 24 hr limit activity anti-inflammatory muscle relaxant severe=surgery
6 p’s (compartment syndrome) Pain ↑=edema Pallor = 0 o2 Paralysis = Parethesia = Pressure =edema Pulselessness pain w/passive motion
Compartment syndrome ↑ pressure on nerve ↓Oxygen to tissue Complications →tissue damage w/in 4-6º (possible amputation)
Skin traction 48-72 hrs (short term treatment) Tape boots splints applied directly to skin to maintain alignment assist in reduction & diminish muscle spasms
Skeletal traction Metal thru bone – not a cure (stabilization) Align bones/joints Bucks traction most common for hip/femur fractures
Assessment w/any fx Check circulation sensation motion for nerve function
Complications of open fx ↑chance of developing osteomyelitis
Complications of pelvic fx (big bone) High risk for DVT PE r/t fat embolism (FES)or blood embolism. Hypovolemia r/t excess blood loss Do not ambulate
Complications of femur fx (big bone) High risk for DVT PE r/t fat embolism or blood embolism. Hypovolemia r/t excess blood loss
Assessment of big bone fx Color temperature (skin) capillary refill distal pulses edema sensation motor function pain
Osteoporosis “Silent disease” = bone loss w/o painful symptoms Porous bone (fragile bone disease) Low bone mass/bone deterioration Chronic progressive metabolic bone disease
Who’s @ risk for osteoporosis? Women ≥65 r/t (White Asian) Post menopausal Smokers Inactive lifestyle Family hx Low body wt Excessive alcohol use ≥ 2 drink/day Long term use- corticosteroids thyroid replacement heparin sedatives anti seizure medication
Prevention (for osteoporosis) (w/o use of drugs) Wt bearing exercise & fluoride Vit C&D ingestion
What drugs can be given? (for osteoporosis) Biophosphonates: Didronel Fosamax actonel Boniva HRT – Evista Reclast
What does the “T” score mean for(for osteoporosis) DEXA results are based on the statistical unit of the standard deviation. • Normal bone: T-score better than -1 • Osteopenia: T-score between -1 and -2.5 • Osteoporosis: T-score less than -2.5 • Established (severe) osteoporosis
Pathology of RA Autoimmune disease/Genetic factor Affects the body bilaterally (both hands) EBV stress smokers coffee dringking
RA- what are the ∆’s in the hand called? RA nodules
Effects of RA Joints liquefy (destroy joints and synovial lining muscle tendons and blood vessels) Destroyed blood vessels→vasculitis→↓ blood flow to body→multi organ failure→ Death
RA- how is it dx? Labs ↑ ESR/CRP levels ANA titer SPE IgG
RA- treatment process? DMARDS NSAIDS ASA (last resort plasmapheresis) Water aerobics Heat/Ice herbal therapy Education – self care; exercise to point of pain then stop and rest Surgery
Pathology of OA Idiopathic ≥40 yrs Stiffness for 30mins Rest of joints relieves pain
What is OA? Slow progression non inflammatory joint synovial (diarthrodial) disorder Unilateral one hand or joint affected (dominant side)
OA- what are the ∆’s in the hand called? Heberden nodes – 1st joint ( ∆ r/t cycleooxygmase production) Bouchard nodes – 2nd joint Both are from osteophyte formation (bone spurs) and loss of joint space
OA – treatment of pain? Tylenol Flexeril NSAID Heat/cold applications Complementary therapy Water aerobics 90% of patient will have crepitus
Atrophy Muscle flabby ↓ function and tone e.g. contracture immobilization (prolonged disuse) muscle denervation (muscle wasting)
Contracture Resistance of muscle/joint movement r/t fibrosis of supporting soft tissue e.g. incorrect positioning of immobilized extremity shortening of muscle/joint
Crepitus Audible crackling sound & palpable grating w/movement e.g. OA fracture dislocation TMJ dysfunction
Myalgia General muscle tenderness & pain e.g. chronic rheumatic syndrome
Paresthesia Numbness/tingling (pins/needles) e.g. compressed sensory nerves r/t edema in a closed space e.g cast or bulky dressing
Subluxation Partial dislocation of the joint e.g. trauma arthritis (RA)
Tenosynovitis Superficial swelling pain tenderness along tendon sheath e.g. Carpal tunnel (repetitive motion)
Troticollis (Wryneck) neck twisted in unusual one sided position Born with (congenital) or acquired
R.I.C.E Rest Ice Compress Elevate
C.S.M (assessment of bone fx) Circulation Sensation Motion (assess joint above and below)for nerve function
Osteoblast Bone forming cell – build bones
Osteoblast Ostesoclast Bone destroying cell – breakdown bone
Postictal care 1 Assess cause e.g dehydration water intoxication hypoglycemia hyperkalemia metabolic acidosis/alkalosis
Postictal care 2 Integumentary e.g. bitten tongue soft tissue damage cyanosis diaphoresis (postictal)
Postictal care 3 Respirations e.g abnormal rate rhythm absent/abnormal breath sounds
Postictal care 4 Cardiovascular e.g. HTN tachycardia
Postictal care 5 GI/GU e.g bowel/urinary incontinence excessive salivation
Postictal care 6 Neurologic e.g T.C – LOC dilated pupils hyperventilation Partial – aura consciousness
Postictal care 7 Musculoskeletal e.g. weakness paralysis ataxia
Pathology of RA 2 Stiffness 1 hr/all day RF positive WBC ≥ 20,000 Osteoporosis r/t to corticosteroid use Subluxation
Osteomyelitis Severe infection of the bone, bone marrow and surrounding soft tissue Most common infecting microorganism – staphylococcus aureus
Common w/osteoporosis Women Less bone mass Less Ca+ consumption Osteoclast begin earlier & accelerated @ menopause Pregnancy/ breast feeding deplete Ca+ Longevity
Created by: tgrady