Common Neurological Disorders
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| Headache Classifications and examples/causes of | Vascular / Tension / Traction-Inflammatory (Click Again) | Vascular - Migraine/Cluster/Hypersensitive || Tension - Psychological/Medical/Stress || TractionInflammatory - Intra/Extracranial/Occlusive Vascular/Infection/Temporal Arthritis
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| Sinus Headache pain is usually where | Behind the forehead and/or cheekbones. |
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| Cluster Headache pain is where | In and around one eye. |
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| Tension Headache pain is where | Like a band squeezing the head. |
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| Migraine pain is where | Classic forms are nausea and visual changes. |
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| Cephalalagia is | known as aching of the head. |
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| Where does the pain from headache come from? | Scalp's blood vessels and muscles / Dura Matter and its venous sinuses / Blood Vessels at base of brain / Cervical Cranial Nerves |
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| Migraine PRODROMAL signs | Visual Field Defects / Disorientation / Parathesias / Paralysis of part of body (rare) (Click Again) | Familial evidence
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| Migraine S/S | Hx of recurrent Severe Headaches lasting 1 day or more / nausea|vomit / photophobia / chilliness / fatigue / irritability / diaphoreses / edema (Click Again) | Abnormal metabolism of serotonin plays a major role. Hx of repeat migraines is known to cause Atherosclerosis.
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| Migraine Contributing Factors | Stress / Excess Carbs / Iodine Rich Diet / Alcohol / Chemical Additives / Fatigue / Caffeine |
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| Cluster Headache description | Episodic (30min-2hrs) / Occurs in clusters / 2-10 per day / Very Little time from onset to max pain (Click Again) | Attacks tend to occur same time of day / Affects Men more / Not Familial
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| Tension Headache description | 90% of headaches / described as a band of pressure around head / can be chronic or everyday (Click) | Response to: Emotional Stress, Eyestrain, Fixed position for long period.
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| Headache Assessment (Subjective & Objective) | Subjective: Pt understanding of headache and causes / OPQRST / Allergies / Family Hx | Objective: Behavior / Stress|Anxiety / ADL's / Temp / Neuro Exam
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| Headache Dx Tests | CT / MRI|PET / Lumbar Puncture (CT 1st) / X-ray / Brain Scan |
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| Managing the Headache | Diet: Reduce; MSG, Vinegar, Chocolate, Yogurt, Alcohol, Pork, Fermented|Marinated Food, Cured Sandwich Meat (Click) | Psychotherapy: Aware of stress factors / Improve Coping / Relax techniques
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| Nursing Interventions for pt w/ Headache | Teach; Meds / relax|rest techniques / Diet / Log Headaches / Comfort; (click) | Comfort Measures; Cold|Warm Packs / Pressure to tem arteries / reduce stimuli / cluster care for rest
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| You are assessing a Pt c/o migraine attack, your assessment should include? | Location / Intensity / Duration / Associated Symptoms (Photophobia, Phonophobia, nausea, vomiting) |
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| A Pt has been c/o headaches. Which of the following would the nurse expect to happen if these were migraine headaches? | (a)They are observed during times of stress / (b)They become worse toward the evening / (c)They cause the Pt to experience unusual smells or sounds before the pain begins (Click) | (D) Migraine headaches display PRODROMAL s/s before attack ie; smells/sounds
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| Opiods given to Pt w/ headaches | propoxyphene (Darvon) / propoxphene|Tylenol (darvocet-N) |
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| Pharmacological Management for headaches | Vascular Headache Supressants; Ergot Derivatives / Serotonin Receptor Agonist / Beta-Blockers |
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| Define Intractable Pain | Unbearable pain that does not respond to treatment (click) | Chronic / Debilitating / Limit ADL's
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| Assessment for Pt w/ suspected Neuropathic Pain (S&O) | Subjective: OPQRST / Stress? | Objective: Behavior / Muscle weakness|wasting / Vasomotor Response (flushing) / Neuro Exam
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| Dx Test for Neuropathic Pain | Electrical Stimulation Test / Psychological testing / Myelogram (back&neck pain) |
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| Non-Surgical Neuropathic Pain control | TENS / Spinal Stimulation / acupuncture / Nerve Block / Meds (gabapentin|tegretol) / Counseling |
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| Surgical Neuropathic Pain control | Neurectomy / Rhizotomy (cut spinal nerve root) / Cordotomy (cut nerve in SC) / Percutaneous Cordotomy (destroy nerve bundle by use of electrical current) |
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| Clinical manifestations of IICP | Deterioration of LOC (Earliest sign) / Pupil dysfunction / Visual Abnormalities / HA / LOMF (late sign) / Alteration of VS / Diplopia / Nausea |
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| Late signs of Brain stem involvement | Cushing's Response (wide pulse, ^sysP, bradycardia) / lose brain stem reflex / papilledema / Projectile Vomiting / Hiccup (singultus) |
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