Types of aphasia/dysarthria
Inability to comprehend the spoken word or written word. Wernicke’s area in the temporal lobe is associated with language comprehension
• Sensory aphasia, or receptive aphasia
What type of headache is preceded by an aura?
Patients with migraine often report experiencing an aura (prodromal signs that occur before the headache).
Auras most often are reported to occur in the half-hour preceding the attack but may occur up to 24 hours before the onset of pain.
Each patient’s aura is individualized but commonly includes visual field defects; unusual smells or sounds; disorientation; paresthesias; and, in rare cases, paralysis of a part of the body.
What is the first sign of increased ICP?
Why is status epilepticus a medcial emergency? What is the most common cause?
• Repeated seizures cause the brain to use more energy than can be supplied; the neurons become exhausted and cease to function, which may result in permanent brain damage or death.
• The most common cause of status epilepticus is sudden withdrawal of anticonvulsant medications
What are the 3 major signs of Parkinson's Disease?
bradykinesia, tremor, rigidity
Inability to speak or write, using symbols of speech.
Broca’s area in the frontal lobe mediates motor speech.
Motor or expressive aphasia
What medications are used to help control migraines? What medication is used daily as a prophylaxis to prevent migraines from occurring?
triptans:eletriptan (Relpax), almotriptan (Axert), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), zolmitriptan (Zomig)
Acetylsalicylic acid (aspirin), acetaminophen, or ibuprofen may be used
toprimate (Topmax)
• Other preventive drugs for migraine headaches include:
o beta-adrenergic blockers- propranolol [Inderal], atenolol [Tenormin]
o tricyclic antidepressants- amitriptyline
o selective serotonin reuptake inhibitors- fluoxetine [Prozac]
o calcium channel blockers- verapamil, divalproex (Depakote), clonidine (Catapres)
o thiazide diuretics
What is Cushing's Triad (Cushing's response)?
A rise in systolic pressure and an unchanged diastolic pressure, resulting in a widening pulse pressure, bradycardia, and abnormal respiration (Cushing’s Triad) are late signs of increased ICP and indicate that the brain is about to herniate.
What is the primary goal of the nurse while caring for a patient having a seizure?
protection from aspiration and injury and observation and recording of the seizure activity
• Never leave the patient alone.
• If the patient is sitting or standing, lower him or her to the floor in an area away from furniture and equipment
• Support and protect the head; if possible, turn the head to the side to maintain the airway.
What is a drug holiday?
• Hospitalization may be helpful, during which time all drugs are withdrawn for a time. This is called a drug holiday. The medications then are restarted, and often smaller doses produce favorable results.
• Complications such as aspiration can occur during this time because withdrawal of the drugs causes immobility and rigidity.
Inability to understand the spoken word or to speak.
Global aphasia
What are the triggering factors for cluster headaches?
• The triggering factors for cluster headaches are similar to those of migraine headaches but also include exertion, heat, and high altitudes
What are two objective signs of ICP?
Vomiting and singultus (hiccups)
The vomiting is often projectile and usually not preceded by nausea; this is called unexpected vomiting. Singultus is caused by compression of the vagus nerve (cranial nerve X) as brainstem herniation occurs.
What is the most common diagnostic study for a patient having seizures?
EEG
How do you make sure patients with Parkinson's disease has adequate nurition?
• Patients with dysphagia and bradykinesia need appetizing foods that can be chewed and swallowed easily. Food should be cut into bite-sized pieces before it is served.
• Eating six small meals a day may be less exhausting than eating three large meals.
• Allow ample time for eating to avoid frustration and encourage independence.
What is the cause of dysarthria? What is the difference between dysarthria and aphasia?
The general cause is damage to a central or peripheral nerve.
Dysarthria is difficult, poorly articulated speech that usually results from interference in control over the muscles of speech.
Aphasia is an abnormal neurologic condition in which the language function is defective or absent because of an injury to certain areas of the cerebral cortex.
Why are opioids avoided with patients that have headaches?
Opioids are avoided because these drugs are often subject to abuse; it is much better to counsel patients to develop other ways to relieve tension headaches.
• Three types of medications usually are administered to patients with increased ICP. What are they?
osmotic diuretics, corticosteroids, and anticonvulsants
post ictal phase
carbidopa-levodopa (Sinemet)
Sinemet is converted to dopamine and acts as a dopamine replacement.
A form of aphasia characterized by the inability to name objects.
• Anomic aphasia
What are some comfort measures other than medications that may help with headaches?
• Other treatments that may help a patient with a headache include cold packs applied to the forehead or base of the skull and pressure applied to the temporal arteries.
• People with migraine headaches are usually most comfortable lying in a dark, quiet room.
How should a patient with ICP be positioned?
• Place the neck in a neutral position (not flexed or extended) to promote venous drainage.
• Position the patient to avoid flexion of the hips, the waist, and the neck and rotation of the head, especially to the right. Avoid extreme hip flexion because this position causes an increase in intraabdominal and intrathoracic pressures, which can produce a rise in ICP.
What is the difference between epilepsy and having seizures?
Epilepsy is a group of neurologic disorders characterized by recurrent episodes that may include convulsive seizure, sensory disturbances, abnormal behavior, and changes in LOC
How is Parkinson's disease diagnosed?
A firm diagnosis can be made only when the patient has at least two signs of the classic triad: tremor, rigidity, and bradykinesia (slow or retarded movement