NUR 2755 EXAM 1 STUDY GUIDE

Migraines – what foods might be a trigger? Migraine and seizure get Arul too. Take beta blocker daily. - Foods with yeast - MSG - Nitrates (meats), marinated foods - Pickled / fermented foods - Nuts - Artificial sw ...

Migraines – what foods might be a trigger? Migraine and seizure get Arul too. Take beta blocker daily. - Foods with yeast - MSG - Nitrates (meats), marinated foods - Pickled / fermented foods - Nuts - Artificial sweeteners - Smoked fish ✓ Chocolate, Cheese, yogurt ,Caffeine, nicotine, ice cream, alcohol, stress, fatigue ✓ Lunch/cured meat, hot dogs, smoked meats, Vinegar, Onions ✓ Caffeine, nicotine, ice cream, alcohol, stress, fatigue Mechanism of action for ergotamine? Use for migraine Contraindicated with coronary - Ergotamine selectively binds and activates serotonin (5-HT) 1D receptors located on intracranial blood vessels, including those on arterio-venous anastomoses, thereby resulting in vasoconstriction and reducing the blood flow in cerebral arteries that may lead to relieve of vascular headaches. - Ergotamine has a complex mechanism of action that involves a variety of receptors, including 5-HT-1B/1D, dopamine, and alpha-adrenoreceptors. By activating 5HT-1B and 5HT-1D receptors on intracranial blood vessels, ergotamine induces vasoconstriction and relief of migraine headaches. - Ergotamine also inhibits norepinephrine uptake and stimulates alpha-adrenergic receptors at therapeutic doses, leading to prolonged vasoconstriction. S/S of Parkinson’s? Guillain-Barre? With GB what are they most at risk for?? What will kill them first? Parkinson’s Guillain – Barre paralysis(distal to proximal) - Falls (require sx carry risk infection, Heart failure and blood clots and immobility and PNA, - Tremors (upper extremities first, worsen with stress)^ fatigue, slow movement - Change in handwriting - “Freezing” / stuck to floor - Rigidity(rigor). Loss of movement(Akinesia) - Resistance to PROM Cogwheel - Rhythmic interruption of movement Plastic - Mildly restrictive movement Lead pipe - Total resistance to movement - Masklike face with wide open, fixed eyes - Uncontrollable drooling - Excessive perspiration - Orthostatic hypotension - Speech changes: Bradykinesia – slowness of voluntary movement and speech • Speak softly. Med only treat the symptoms • Slur / repeat words • Monotone voice • Halting speech - B&B incontinence - postural instability. - Motor Manifestations: exposure to zika virus - Risk for infection with campylobacter (bacteria un-cook poultry) Influenzas virus. cytomegalovirus • Ascending symmetric muscle weakness • /ascendingFlaccid paralysis without atrophy • Decreased / absent DTRs • Respiratory compromise suction HOB 45 degree. Paralysis of the muscle of lung, blood infection, clot in lungs, or cardiac arrest • B&B incontinence • Ataxia - Sensory Manifestations: • Parasthesias • Pain (cramping) Cranial nerve Manifestations: • Facial weakness • Dysphagia • Diplopia • Difficulty speaking - Autonomic Manifestations: • Labile BP • Cardiac dysrhythmias / tachycardia What condition closely resembles a stroke but isn’t? migraine, seizure, Hypoglycemia, Bell Pals What is GCS? A brain injury severity scale that assesses depth and duration of impaired consciousness and comaWhat does it tell you? - Glasgow Coma Scale 9-12 moderate 13-15 mild. If score changes please let the provider know - Used to establish baseline data in the following categories • Eye opening eye open 4, sound 3, pain 2, no open 1 • Motor response command follow 6, localize pain 5, w/drawal from pain 4, flexion(decorticate) 3, abnormal extension(decerebrate) 2, nothing q • Verbal response orient 5, confusion 4, word inappropriate 3, incomprehensible sound 2 nothing 1 - Determines neurologic function - Less than 8 INTUBATE, 3 is brain death, maintain perfusion and care to allow for organ donation What is autonomic dysreflexia? If a patient has a T6 fracture. Look for headache. - A potentially life-threatening condition caused by noxious visceral or cutaneous stimuli. GI: bowel impaction, irritation of hemorrhoids Gynecologic / genitourinary: Bladder/bowel distention, UTI, epididymitis, scrotal compression Vascular symptomsinclude: * Sudden rise in BP if patient has it , please sit patient up.x * Profuse sweating above level of injury * Goose bumps above level of injury * Flushing of skin above level of injury * Blurred vision, spots in visual field * Nasal congestion, stuffy nose * Sudden severe throbbing HA * Feeling of apprehension Safe feeding practices to teach post stroke? (think select all that apply). Safe swallowing tips? Dietary needs – ➔ Assess swallowing and gag reflex ● Speech-language pathologist may request swallowing study ● Liquid-consistency regimen as needed ● Small sips of water to determine choking ● Initial feeding by RN to assess for choking ◆ Eat in an upright position and swallow with the head and neck flexed slightly forward ◆ Small amounts of food and sips ◆ Place food in back of the mouth on unaffected side and assess for pocketing on affected side ◆ Have suction on standby ◆ Maintain a distraction-free environment during meals ◆ Collaborate w/ dietitian to ensure appropriate caloric intake, because weight loss is common following stroke ● Assessment if thickening agent is necessary