Exam 2 Med-Surg
Neuro
Headaches/Migraines –
Smells, foods, hormones, stress can trigger, diary, sensitive to light
Abortive/prevention medications
Most common in male children and female adults
Epilepsy/Seizure – Every epilepsy is different based on person
Vitamins – Vascular, Infection, Trauma, Alzheimer, Metabolic derangements, Idiopathic, Neoplasm,
Psychiatric
Types of Seizures
Generalized – 2-5 mins jerking, loss of con, bit tongue, incontinence
Absence- staring, body movement, loss of consciousness
Patient Teaching –
Myoclonic- Sudden jerks, twitches, can maintain consciousness
Driving/ high reliable occupation
Atonic- loss of muscle, sudden collapse Rest/Stress reduction
Ketogenic Diet
Status Epilepticus – longer than 5 mins Medication complication
Follow up drug levels
Acute Seizure Management * Important SLIDE
Neurologist – Medical alert tag
- Record the time it began and ended Social Service
- Observe types of movements
- Ongoing observation
- Reorient Patient
- Bring Pt to floor
- Side-lying – suction any secretion
- No restraints
- Do not raise Head of the bed
- Never force anything into patients’ mouth
- No tongue blade EVER!
- Do not attempt to stop movements
Valproic Acid “Val is an old gal” – 50-125
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, Phenytoin – Phen is like BUN – 10-20 Carbamazepine - Can’t drive a car at – 8-12
If Epileptic – make sure you have Patent IV, suction, o2, padded siderails, pillow, privacy
Medication- Lorazepam, Diazepam, IV Phenytoin or cerbrex
Multiple Sclerosis
Chronic, progressive degenerative Affects the myelin sheath anywhere
disease – Very specific to each person along the brain, optic nerve, and
• Autoimmune spinal cord (sensory and motor)
• Inflammatory Can cause lesions on sheath
First sign - blindness
Cues, Clinical Manifestations, or Expected findings
- Tinnitus - Blurred vision -Diplopia - Partial loss of vision
- Hyperalgesia (Unnormal pain) - Vertigo - Paresthesia
- Facial Pain - Decreased Temp
- Motor weakness – tremors – Nystagmus (Eyes shake) - Dysarthria (Slurred speech)
- Decreased BM - Cognitive impairment
How to diagnose-
How do we recognize those symptoms?
Physical Examination, Neuro Exam, Med/Surg History, MRI, Cerebrospinal Fluid Analysis CSF
How do we treat?
Methotrexate (To lessen immune response), Autoimmune (Will continue to progress) , NSAIDS (For Pain)
Interferons – Watch Blood Glucose levels (Steroids interact with insulin)
Risk Factors – Physical injury, emotional stress, pregnancy, fatigue, Living in cold, Unknown
Ages 20-40, more common in women
Patient Teaching
Always recommend social services
-Eye Patch
-Minimize stress
-Avoid Infection & skin breakdown
-Safety (Fall, Visual, Aspiration, skin)
-Respiratory Failure over time
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