NUR 170
EXAM 2 STUDY GUIDE
Concepts Of Medical–Surgical Nursing
Galen College of Nursing
, lOMoARcPSD|51648332
Med-Surg Exam 2 Notes
Care of patients with nervous system disorders, sensory disorders, respiratory disorders
Headache Disorders
o Migraine Headache
Supraorbital or retroorbital
Lasts 4-72 hours
Pain worsens with movement
S/S: N/V, photophobia, tingly scalp, 20% of cases have aura
POUND
P pulsatile quality
O one day duration
U unilateral location
N nausea/vomiting
D disabling intensity
Pathophysiology
Vascular Theory
o Vasodilation in the brain
o Medications to treat cause vasoconstriction (ex. Triptans,
caffeine)
o May be caused by irritation to Cranial Nerve V (Trigeminal)
Prevalence
o May be seen in children and adults
o More common among women or young boys
History
o May be caused by triggers (smells, dehydration, artificial
sweeteners, tyramine or MSG rich foods)
o Tyramine found in alcohol, aged meats and cheeses,
fermented foods, overripe fruit
Interventions
o Pain management, symptom management (antiemetic,
fluid bolus), shut off lights, cool, quiet environment
Medications
o Abortive taken after onset
NSAIDS, triptans, ergotamine drugs, CRGB
inhibitors
CGRP inihibtors (ubrogepant)
Inhibit a protein associated with migraine
pain
1
Downloaded by Benjamin Luca ()
, lOMoARcPSD|51648332
Triptans (sumatriptan) cause vasoconstriction
and raise serotonin levels
Cannot be used for pts with hx of CV
disease, uncontrolled HTN, history of CVA,
or if taking other serotonergic drugs (SSRIs,
SNRIs, St. John’s Wort)
o Prophylaxis taken daily for prevention
Anticonvulsants carbamazepine, topiramate,
gabapentin
Tricyclic Antidepressants amitriptyline,
nortriptyline
CGRP inhibitors
Beta Blocker propanolol
o Tension Headache
Feels like squeezing or pressure in a band around the head
Can last up to a week
o Cluster Headache
Stabbing pain through the eye
Sx like sweating or pain will only happen on affected side
Can last a few minutes to a few hours
Seizure Disorders
o Uncontrolled electrical activity in the brain
o Status Epilepticus multiple seizures back-to-back
#1 cause is nonadherence to antiseizure medication
ABGs, IVP lorazepam, intubation/mechanical ventilation
o Epilepsy chronic condition of recurrent seizures
Assessment
Inquire about frequency, seizure duration/activity, family history
Risk Factors
VITAMINS
o V Vascular (ex. History of CVA/HTN increases risk)
o I Infection or inherited condition
o T Trauma (hx of head injury)
o A Alzheimer’s/Autoimmune
o M Metabolic derangements (electrolyte imbalances,
hypermagnesemia, hypo/hypernatremia, low BG)
o I Idiopathic (unknown cause)/ingestion (alcohol &
drugs)
o N Neoplasm (brain malignancy)
2
Downloaded by Benjamin Luca ()
EXAM 2 STUDY GUIDE
Concepts Of Medical–Surgical Nursing
Galen College of Nursing
, lOMoARcPSD|51648332
Med-Surg Exam 2 Notes
Care of patients with nervous system disorders, sensory disorders, respiratory disorders
Headache Disorders
o Migraine Headache
Supraorbital or retroorbital
Lasts 4-72 hours
Pain worsens with movement
S/S: N/V, photophobia, tingly scalp, 20% of cases have aura
POUND
P pulsatile quality
O one day duration
U unilateral location
N nausea/vomiting
D disabling intensity
Pathophysiology
Vascular Theory
o Vasodilation in the brain
o Medications to treat cause vasoconstriction (ex. Triptans,
caffeine)
o May be caused by irritation to Cranial Nerve V (Trigeminal)
Prevalence
o May be seen in children and adults
o More common among women or young boys
History
o May be caused by triggers (smells, dehydration, artificial
sweeteners, tyramine or MSG rich foods)
o Tyramine found in alcohol, aged meats and cheeses,
fermented foods, overripe fruit
Interventions
o Pain management, symptom management (antiemetic,
fluid bolus), shut off lights, cool, quiet environment
Medications
o Abortive taken after onset
NSAIDS, triptans, ergotamine drugs, CRGB
inhibitors
CGRP inihibtors (ubrogepant)
Inhibit a protein associated with migraine
pain
1
Downloaded by Benjamin Luca ()
, lOMoARcPSD|51648332
Triptans (sumatriptan) cause vasoconstriction
and raise serotonin levels
Cannot be used for pts with hx of CV
disease, uncontrolled HTN, history of CVA,
or if taking other serotonergic drugs (SSRIs,
SNRIs, St. John’s Wort)
o Prophylaxis taken daily for prevention
Anticonvulsants carbamazepine, topiramate,
gabapentin
Tricyclic Antidepressants amitriptyline,
nortriptyline
CGRP inhibitors
Beta Blocker propanolol
o Tension Headache
Feels like squeezing or pressure in a band around the head
Can last up to a week
o Cluster Headache
Stabbing pain through the eye
Sx like sweating or pain will only happen on affected side
Can last a few minutes to a few hours
Seizure Disorders
o Uncontrolled electrical activity in the brain
o Status Epilepticus multiple seizures back-to-back
#1 cause is nonadherence to antiseizure medication
ABGs, IVP lorazepam, intubation/mechanical ventilation
o Epilepsy chronic condition of recurrent seizures
Assessment
Inquire about frequency, seizure duration/activity, family history
Risk Factors
VITAMINS
o V Vascular (ex. History of CVA/HTN increases risk)
o I Infection or inherited condition
o T Trauma (hx of head injury)
o A Alzheimer’s/Autoimmune
o M Metabolic derangements (electrolyte imbalances,
hypermagnesemia, hypo/hypernatremia, low BG)
o I Idiopathic (unknown cause)/ingestion (alcohol &
drugs)
o N Neoplasm (brain malignancy)
2
Downloaded by Benjamin Luca ()
