Seizures
A nurse caring for patient with seizure disorder must include the following actions in plan of care...
What is turn patient to side, pad side rails, move nearby objects away, loosen clothing, note time,type and postictal symptoms * Use an oropharyngeal airway if the patient is unconscious and doesn't have gag reflex but ony after seizure is over.
A nurse is assessing a client with a suspected stroke. Which findings indicate the client has had a left hemisphere stroke?
What is right sided hemiplegia and expressive aphasia?
Epilepsy is characterized by these unpredictable events.
What are seizures?
What are the hallmark symptoms of Parkinson's?
What is mnumonic TRAP: T tremors (pill rolling), R Rigidity (stiffness), A Akinesia (slow movements) , P postural instability (stooped posture). Also watch for shuffling gait, masked facial expression, soft speech, and drooling.
The nurse is caring for a client with bacterial meningitis. What signs support the diagnosis of bacterial meningitis?
What are Positive Brudzinski's sign (neck flexion causes involuntary hip/knee flexion), and Positive Kernig's sign (pain/resistance when straightening the knee with hip flexed at 90 degrees). nuchal rigidity, seizures, nausea and vomiting, fever, a change in LOC.
A client with epilepsy has a known seizure disorder and is looking for clues that triggers this disorder. The nurse is correct by teaching trigger that may include....
What is lack of sleep, photosensitivity (flashing lights), stress, missed medications, alcohol or drug use, fever, infection, hypogycemia, hyperventilation, caffiene?
A resident had a stroke 6 months ago, the nurse notices the speech is hard to understand because the resident slurs the words. This condition is known as.
What is Dysarthria? A condition where there is damage to the nerves controlling the muscles of speech.
This is type of seizure is described as progressive muscle twitching on one side of the body that marches up limb across face/body with no loss of consciousness.
What is Jacksonian seizure?
Nurse notes that the older client has reduced facial expression, slowed movement and dragging one leg while walking. What should nurse suspect?
What is early Parkinsons?
What is 3-4.5 hour after the onset of stroke symptoms?
Client sitting at breakfast table and begins having a tonic clonic seizure. What should nurse do?
What is genty lower the client to the floor and protect the head.
A client with a stroke demonstrates expressive aphasia. What are the ways the nurse can communicate with this resident?
What is use simple yes/or no questions, encourage other methods like writing, use communication board or pictures, avoid finishing client's sentences, reduce distractions?
Patient with epilepsy has a seizure and hit his head. What is the most import aspect of nursing care for patient's with head injury?
What is monitoring the patient's LOC and vital signs.
When teaching a client with PD. What should the focus of her teaching be on?
What is Medications teaching (taking carbidope//levodopa as prescribed on empty stomach or with low protein foods, Fall prevention and Mobility by using assistive devises, rocking side to side to help get started when frozen, take small steps with wide base, Nutrition and swallowing: using thickener with liquids if hard to swallow, take small bites and elevated head during meals.
List the symptoms most characteristic of ALS (amyotrophic lateral sclerosis)?
What are A L S mneumonic: A=atrophy (progressive muscle weakness), areflexia (reduced reflexes) L= Loss of motor control (loss of ability to speak -dysarthria), (loss of ability to wallow-dysphagia, (loss of breathing muscle-respiratory failure) S= Spacticity & Speech difficulty (stiff muscles, slurred speech, shortness of breath) ALS wear body down physically but not mentally.
A nurse is caring for a school-age child experiencing brief episodes of staring into space lasting 10 seconds. The child does not respond when spoken to and afterward has no memory of the event. Which type of seizure is the child experiencing..
What is absence seizure?
How are transient ischemia and stroke different?
What is TIA symptoms resolve within 24 hours; stroke symptoms persist longer. In TIA there is no permanent brain injury; in stroke there is brain tissue injury. In TIA the clot is temporary; in stroke (ischemic) there is a persistent clot or (hemorrhagic stroke) there is bleeding. Treatment of TIA is preventative or control risk factors (antiplatelets, lifestyle); In stroke emergency treatment is tPa for ischemic stroke and surgery for hemorrhagic stroke.
There are different types of seizures. Absence seizures, previously known as petit mal seizures, are characterized by staring into space with or without subtle body movements such as eye blinking or lip smacking and only last between 5-10 seconds. These seizures may occur in clusters, happening as often as 100 times per day, and cause a brief loss of awareness. Of children, teens, young adults, or eldery, this type of seizure typically occurs in which age group?
What is children?
These emotional tensions can worsen symptoms of Parkinson's disease.
What is anxiety and stress?
Client has a cluster headache, What signs will nurse observe?
What is unilateral severe pain, usually around one eye?
Nursing is caring for a client having a continuous grand mal seizure for the past 7 minutes. What is happening and what is nurse's priority....
What is this is a medical emergency known as status epilepticus and the immediate intervention required to prevent brain damage is to stop the seizure by administration of Ativan IV
This can cause a stroke.
What is a blocked artery or leaking or bursting of a blood vessel. Thrombotic stroke due to Atherosclerosis (narrowed arteries), High cholesterol, DM, HTN
Embolitic stroke: a clot travels due to atrial fibrillation
Hemorrhagic stroke due to ruptured blood vessel due to uncontrolled htn, aneurysm rupture, arteriovenous malformation, trauma or head injury, anticoagulant overdose eg. warfarin, heparin. Cocaine use.
Remember Saved Heart for risk factors:
Smoking, Age(older adults), Vascular disease, Ethnicity(higher in African Americans), Diabetes, Hypertension, Elevated cholesterol, Atrial fibrillation, Recent TIA, Thrombophilia (clotting disorder).
What diagnostic test is used to diagnose Epilepsy?
What is Electroencephalogram (EEG) which detects abnormal brain activity. Important to wash hair before test. Client doesn't need to be NPO. No caffiene or stimulants prior to test.
The nurse is performing Passive Range of Motion exercises for Parkinson's disease client with rigidity. What nursing goal does this intervention address?
What is the patient will maintain joint mobility and gait stability by participating in passive range of motion program twice daily with no signs of stiffness x 1 week.
Client with Guillian Barre syndrome has what symptoms?
What is rapid onset of symmetrical weakness starting in the legs and ascending upward to trunk, arms and face. May progress to respiratory muscles causing respiratory failure?