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NUR 2755 - MDC 4 Exam 1 Study Guide
NUR 2755 - MDC 4 Exam 1 Study Guide /NUR 2755 - MDC 4 Exam 1 Study Guide /NUR 2755 - MDC 4 Exam 1 Study Guide
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NUR 2755 - MDC 4 Exam 1 Study Guide 2024-2025NUR 2755 - MDC 4 Exam 1 Study Guide 2024-2025
NEURO MIGRAINES
◆SYMPTOMS
● Classic Migraine (w/ aura)
○ First/Prodrome phase
◆Aura that develops over period of several minutes and last
no longer than 1 hr
◆Transient focal neurologic dysfunction
◆Visual disturbances, flashing lights, lines or spots,
shimmering or zigzag lights
◆Numbness, tingling of lips or tongue, acute confusional state,
aphasia, vertigo, unilateral weakness, drowsiness
○ Second phase:
◆HA accompanied by N/V
◆Pain beginning in temple, increase in intensity and becomes
throbbing w/in 1 hr
○ Third phase
◆Pain changing from throbbing to dull
◆HA, N/V lasting 4-72 hrs
● Common Migraine (W/O aura)
○ Migraine before onset of HA
○ Pain aggravated by performing activities
○ Unilateral and pulsating
○ N/V, photophobia, phonophobia, HA lasting 4-72 hrs
○ Migraine in early morning, during stress, or in premenstrual
tension or fluid retention
● Atypical Migraine
○ Migrainous: HA lasting longer than 72
hrs
○ Migrainous infarction: neurologic symptoms not completely
reversible w/in 7 days
◆Ischemic infarct noted on imaging
○ Unclassified: HA not fulfilling all the criteres to be classified a
migraine
◆TREATMENT
● Abortive Therapy
○ Acetaminophen, Ibuprofen, Naproxen,
Exedrin
, ○ Triptan preparations (as soon as migraine S/S start)
◆Sumatriptan (Imitrex)
◆Eletriptan (Relpax)
◆Naratriptan (Amerge)
◆Almotriptan (Axert)
○ Ergotamine preparations
◆Cafergot (Ergotamine)
◆Dihydroergotamine (DHE)-Migranal
◆Midrin
◆MOA: constrict (vasoconstriction reduces blood flow in
cerebral arteries)
● Preventative Therapy
○ Beta Blockers: Propranolol (Inderal), Timolol
◆Do not stop abruptly
○ CCB: Verapamil (Calan)
○ AntiepilepticsL Topiramate (Topamax)
○ Tricyclic Antidepressant (Nortriptyline (Pamelor)
○ Botox
● DIETARY RESTRICTIONS (SATA)
○ Avoid tyramine-containing products (pickled products, aged
cheese, caffeine, beer/wine, preservatives, artificial sweeteners)
○ Chocolate
○ Food w/ yeast (pastry and fresh breads)
○ MSG
○ Nitrates (meats), pickled or fermented foods
○ Nuts
○ Smoked fish
○ Yogurt
➔SEIZURES
◆PHASES:
● Preictal: Events that patient experiences before a seizure (aura)
○ Feeling of something not being right or about to happen
● Postictal: Time immediately after seizure
○ Sleeping long periods after a seizure
○ Motor functions to return to baseline
● Status epileptic: Seizure lasting more than 5
min
◆TYPES:
● Tonic/clonic: Incontinence, breathing cessation followed by post-octal state
◆TREATMENT:
● Initial goal is to control seizure activity
● Ativan (during active seizure)
● Antiepileptic drugs (AED’s)
○ Phenytoin
, ●
◆Take same time everyday
◆NURSING CARE:
● Protect client privacy and from injury
● Seizure precautions (suction, pad railings)
● Position to promote airway and prevent aspiration (side)
● Be prepared to suction oral secretions
● Loosen restrictive clothing
● Do not restrain, open jaw, or insert anything into airway
● Document onset, duration, and symptoms (LOC, apnea, cyanosis, motor
activity, incontinence) prior to, during, and after
● Maintain in side-lying position post seizure
● Check VS, neuro assessment, check for injuries, reorient/calm patient
● Determine if aura was experienced and possible trigger
● Allow client to rest
Status Epileptic: (SATA)
○ Suction, bed rails up and padded, IV access
○ Nothing in mouth (tongue blade/fluids)
○ Maintain bedrest
➔CONTRAINDICATION TO CT W/ CONTRAST
◆Renal impairment/failure
◆Allergy to shellfish or iodine
➔PARKINSONS
◆STAGES:
● One: Unilateral limb involvement, minimal weakness, hand/arm trembling
● Two: bilateral limb involvement, mask like face, slow, shuffling gait
● Three: postural instability, increased gait disturbances
● Four: Akinesia, rigidity ● Five: Complete ADL dependence
◆SYMPTOMS:
● 4 Cardinal signs
○ Tremor (upper extremities first)
○ Muscle Rigidity
◆Cogwheel: rhythmic interruption of muscle movement
◆Plastic: mildly restrictive movement
◆Lead pipe: total resistance to movement
○ Bradykinesia or akinesia
○ Postural instability
○ Slow shuffling gait w/ propulsive fwd movement
○ Mask Like expression
○ Slow, monotonous speech
● Lack of dopamine interferes with movement and decreases influence of
sympathetic nervous system
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