Terms
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| Focal/partial Seizure | No LOC / incontinence
Usually processor of a tonic clonic sz
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| Grand Mal seizure(tonic – clonic) | Altered LOC w/o memory of sz
Stiffening/jerking of body
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| Acute Seizure Care | Dilantin (phenytonin)
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| Medication used to terminate sz | 1 mg Lorazepam (Ativan)
5mg Diazepam (Valium)
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| Tonic | Stiffening of muscles
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| Clonic | Jerking of body
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| Cluster HA | External Etiology unknown Ipsilateral above eyebrow – nasal congestion
Deep tense stabbing non pulsating pain
Ocular ∆’s =miosis ptosis
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| Tension HA | External bilateral pain – pressing/tightening last minutes –days
Non pulsating starts w/shoulders
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| Migraine HA | Internal (cerebral) (constriction release prostaglandins) last 4 – 72 hrs
Steady throbbing pulsating pain
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| Migraine w/aura | Complex of neurological syndromes
e.g. bright lights patchy blindness hearing voices sounds strange smell paralysis weakness
(sensory(visual/hearing) motor
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| Migraine w/aura | Occur in 10% of migraine HA episodes signal onset last 1 min- 1 hr prior to migraine
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| 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
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| Treatment of cluster HA | O2 5-12L 5-10 min.
Imitrex SQ (vasoconstrictor) Verapamil (vasodilator)
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| Treatment of tension HA | Caffeine helps NSAID ASA stress management
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| Triptan (when are they used) |
Migraine HA medication
Axert Frova Amerge Imetrex
Cannot mix these medications
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| 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
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| 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
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| 6 p’s (compartment syndrome) | Pain ↑=edema
Pallor = 0 o2
Paralysis =
Parethesia =
Pressure =edema
Pulselessness pain w/passive motion
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| Compartment syndrome | ↑ pressure on nerve ↓Oxygen to tissue
Complications →tissue damage w/in 4-6º (possible amputation)
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| Skin traction | 48-72 hrs (short term treatment)
Tape boots splints applied directly to skin to maintain alignment assist in reduction & diminish muscle spasms
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| Skeletal traction | Metal thru bone – not a cure (stabilization)
Align bones/joints
Bucks traction most common for hip/femur fractures
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| Assessment w/any fx | Check circulation sensation motion for nerve function
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| Complications of open fx | ↑chance of developing osteomyelitis
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| 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
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| Complications of femur fx (big bone) | High risk for DVT PE r/t fat embolism or blood embolism. Hypovolemia r/t excess blood loss
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| Assessment of big bone fx | Color temperature (skin) capillary refill distal pulses edema sensation motor function pain
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| Osteoporosis “Silent disease” = bone loss w/o painful symptoms | Porous bone (fragile bone disease)
Low bone mass/bone deterioration
Chronic progressive metabolic bone disease
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| 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
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| Prevention (for osteoporosis) (w/o use of drugs) | Wt bearing exercise & fluoride
Vit C&D ingestion
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| What drugs can be given? (for osteoporosis) | Biophosphonates: Didronel Fosamax actonel Boniva
HRT – Evista
Reclast
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| 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
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| Pathology of RA | Autoimmune disease/Genetic factor
Affects the body bilaterally (both hands)
EBV stress smokers coffee dringking
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| RA- what are the ∆’s in the hand called? | RA nodules
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| 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
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| RA- how is it dx? | Labs ↑ ESR/CRP levels
ANA titer
SPE
IgG
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| 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
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| Pathology of OA | Idiopathic ≥40 yrs
Stiffness for 30mins
Rest of joints relieves pain
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| What is OA? | Slow progression non inflammatory joint synovial (diarthrodial) disorder
Unilateral one hand or joint affected (dominant side)
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| 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
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| OA – treatment of pain? | Tylenol Flexeril NSAID
Heat/cold applications
Complementary therapy
Water aerobics
90% of patient will have crepitus
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| Atrophy | Muscle flabby ↓ function and tone
e.g. contracture immobilization (prolonged disuse) muscle denervation
(muscle wasting)
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| Contracture | Resistance of muscle/joint movement r/t fibrosis of supporting soft tissue
e.g. incorrect positioning of immobilized extremity
shortening of muscle/joint
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| Crepitus | Audible crackling sound & palpable grating w/movement
e.g. OA fracture dislocation TMJ dysfunction
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| Myalgia | General muscle tenderness & pain
e.g. chronic rheumatic syndrome
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| Paresthesia | Numbness/tingling (pins/needles)
e.g. compressed sensory nerves r/t edema in a closed space e.g cast or bulky dressing
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| Subluxation | Partial dislocation of the joint
e.g. trauma arthritis (RA)
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| Tenosynovitis | Superficial swelling pain tenderness along tendon sheath
e.g. Carpal tunnel (repetitive motion)
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| Troticollis | (Wryneck) neck twisted in unusual one sided position
Born with (congenital) or acquired
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| R.I.C.E | Rest
Ice
Compress
Elevate
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| C.S.M (assessment of bone fx) | Circulation
Sensation
Motion
(assess joint above and below)for nerve function
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| Osteoblast | Bone forming cell – build bones
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| Osteoblast Ostesoclast | Bone destroying cell – breakdown bone
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| Postictal care 1 | Assess cause e.g dehydration water intoxication hypoglycemia hyperkalemia metabolic acidosis/alkalosis
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| Postictal care 2 | Integumentary e.g. bitten tongue soft tissue damage cyanosis diaphoresis (postictal)
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| Postictal care 3 | Respirations e.g abnormal rate rhythm absent/abnormal breath sounds
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| Postictal care 4 | Cardiovascular e.g. HTN tachycardia
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| Postictal care 5 | GI/GU e.g bowel/urinary incontinence excessive salivation
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| Postictal care 6 | Neurologic e.g T.C – LOC dilated pupils hyperventilation Partial – aura consciousness
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| Postictal care 7 | Musculoskeletal e.g. weakness paralysis ataxia
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| Pathology of RA 2 | Stiffness 1 hr/all day
RF positive
WBC ≥ 20,000
Osteoporosis r/t to corticosteroid use
Subluxation
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| Osteomyelitis | Severe infection of the bone, bone marrow and surrounding soft tissue
Most common infecting microorganism – staphylococcus aureus
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| Common w/osteoporosis | Women
Less bone mass
Less Ca+ consumption
Osteoclast begin earlier & accelerated @ menopause
Pregnancy/ breast feeding deplete Ca+
Longevity
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