NUR 255
EXAM 2 STUDY GUIDE
(Covers Units 3, 4, & 5)
Concepts of Aging, Chronic Illness & Mental Health
Nursing - Galen College of Nursing
,Exam 2 Chronic
CNS Problems
Physiologic changes in nervous system with r/t aging:
- Slower processing time:
o It takes them time to understand and process what’s being said. They will automatically
say “What” when you ask something and then say “oh I heard that!”
- Recent memory loss
- Decreased touch sensation and pain perception.
o Older PT still feel pain though they will not admit it
- Change in perception of pain
- Change in sleep patterns
- Altered balance/coordination
o Same thing, they have a slower response time, so it effects many areas
- Increased risk for infection:
o Sepsis = poisoning, don’t have the products to clean out the things needed. The liver and
kidneys are decline and not as good as they use to be.
Nursing interventions to the changes in the nervous system:
- Give them time to respond to questions and directions, repetition and written teaching aides.
- Look where feet places when walking, adjust positions slowly, wear supportive shoes; assess for
ambulatory aids; change positions frequently.
- Monitor additional variables r/t chronic problems; infection; ask to describe nature &
characteristics of pain.
o Neupathy = Don’t feel feet well, watch what they are stepping on. Don’t know the cause
of the wound bc they don’t even know its there.
o Diabetic PT and Parkinson are good examples.
Good shoes, good circulation and where it isn’t tight. Wearing good shoes, good
circulation and where it isn’t tight. Wearing stockings for circulation also helps.
- Sleep patterns and preferences; interfere w/ ADLs. Adjust daily schedule as needed.
Seizures VS Epilepsy:
- Seizure:
o These are abnormal, sudden, excessive, uncontrolled electrical discharge neurons that
result in alteration
Consciousness
Motor sensory ability
Behavior
- Epilepsy:
, o 2 or more seizures experienced by an individual, disorder occurs with repeated
unprovoked seizure activity.
Absence seizure = don’t know what’s going on for moment
The 2 or more seizures can’t be febrile.
Understanding Primary/Idiopathic and Secondary epilepsy:
- Primary
o This isn’t associated with identifiable cause possibly metabolic and electrochemical
factors at cellular level, 50-70% unknow.
o Doesn’t have clear primary reason.
- Secondary
o Arise from another disorder
o Seizure from febrile or preeclampsia
o Other causes:
Head trauma
Alcoholism
Brain abscess or inflammation
Infectious/degenerative disease
Poisons
Hypoxic or metabolic encephalopathy
Blood infections
Electrolyte disturbances
High fever
Stroke/Heart disease
What are the different type of seizures?
- Generalized
o Tonic Clonic *Grand Mal*
Tonic = Stiffening or rigidity of muscles, mostly arms and legs with loss of
consciousness
Clonic = Rhythmic jerking and extremities follows, patient may bite tongue, and
often incontinent
o Absence seizures *Petit mal*
Brief periods of loss of consciousness and blank staring
Automatism *Performance or action without conscious thought or intention.
o Myoclonic Seizures
Brief jerking or stiffening of extremities; may be symmetric or asymmetric; lasts
1-2 seconds
o Atonic *Akinetic* seizures
Sudden loss of muscle tone for seconds; postictal confusion; most resistant to
drug therapy.
- Partial
, o Complex Partial
Loss of consciousness *syncope* for 1-3 minutes characteristics automatism;
amnesia
o Simple Partial
Remain conscious; aura *unusual sensation* - perception of an offensive smell,
or sudden onset of pain; experience unusual sensation; one sided movement of
an extremity; autonomic symptoms *change in HR, skin flushing, epigastric
discomfort*
****With both Grand mal and partial they will have some loss of respiratory function, if they do and
leave alone MOST of the time they will start breathing on their own***
- Unclassified
o AKA idiopathic seizure
o Account for about half of all seizure activity
o No known reason, do not fit into generalized or partial classifications.
What are the 3 stages of a seizure?
1. Aura Stage:
a. Knowing its coming, feeling or something that can alert the PT its coming.
2. Ictus Stage:
a. The seizure itself
3. Postictal Stage:
a. Confused and need some time to understand what’s going on again.
What are signs of the Aura stage?
- Know that they vary, R/T type of the seizures and area of the brain. They happen seconds before
the seizure and may alert the person its coming.
o Unusual feelings
o Abnormal sensations
o Forced thinking
o Déjà vu *Familiar* or Jamais *unfamiliar* vi
o Perceived sounds, tastes, or smells
o Dizziness, HA, Numbness, lightheadedness
o Nausea
o Distorted emotions *fear*
- Migraines can also have Aura’s
What are signs of the Ictus Stage?
- Tonic
o Unconscious, rigid muscle contraction, clenched jaw & Hands; eyes open, pupils dilated
- Clonic
EXAM 2 STUDY GUIDE
(Covers Units 3, 4, & 5)
Concepts of Aging, Chronic Illness & Mental Health
Nursing - Galen College of Nursing
,Exam 2 Chronic
CNS Problems
Physiologic changes in nervous system with r/t aging:
- Slower processing time:
o It takes them time to understand and process what’s being said. They will automatically
say “What” when you ask something and then say “oh I heard that!”
- Recent memory loss
- Decreased touch sensation and pain perception.
o Older PT still feel pain though they will not admit it
- Change in perception of pain
- Change in sleep patterns
- Altered balance/coordination
o Same thing, they have a slower response time, so it effects many areas
- Increased risk for infection:
o Sepsis = poisoning, don’t have the products to clean out the things needed. The liver and
kidneys are decline and not as good as they use to be.
Nursing interventions to the changes in the nervous system:
- Give them time to respond to questions and directions, repetition and written teaching aides.
- Look where feet places when walking, adjust positions slowly, wear supportive shoes; assess for
ambulatory aids; change positions frequently.
- Monitor additional variables r/t chronic problems; infection; ask to describe nature &
characteristics of pain.
o Neupathy = Don’t feel feet well, watch what they are stepping on. Don’t know the cause
of the wound bc they don’t even know its there.
o Diabetic PT and Parkinson are good examples.
Good shoes, good circulation and where it isn’t tight. Wearing good shoes, good
circulation and where it isn’t tight. Wearing stockings for circulation also helps.
- Sleep patterns and preferences; interfere w/ ADLs. Adjust daily schedule as needed.
Seizures VS Epilepsy:
- Seizure:
o These are abnormal, sudden, excessive, uncontrolled electrical discharge neurons that
result in alteration
Consciousness
Motor sensory ability
Behavior
- Epilepsy:
, o 2 or more seizures experienced by an individual, disorder occurs with repeated
unprovoked seizure activity.
Absence seizure = don’t know what’s going on for moment
The 2 or more seizures can’t be febrile.
Understanding Primary/Idiopathic and Secondary epilepsy:
- Primary
o This isn’t associated with identifiable cause possibly metabolic and electrochemical
factors at cellular level, 50-70% unknow.
o Doesn’t have clear primary reason.
- Secondary
o Arise from another disorder
o Seizure from febrile or preeclampsia
o Other causes:
Head trauma
Alcoholism
Brain abscess or inflammation
Infectious/degenerative disease
Poisons
Hypoxic or metabolic encephalopathy
Blood infections
Electrolyte disturbances
High fever
Stroke/Heart disease
What are the different type of seizures?
- Generalized
o Tonic Clonic *Grand Mal*
Tonic = Stiffening or rigidity of muscles, mostly arms and legs with loss of
consciousness
Clonic = Rhythmic jerking and extremities follows, patient may bite tongue, and
often incontinent
o Absence seizures *Petit mal*
Brief periods of loss of consciousness and blank staring
Automatism *Performance or action without conscious thought or intention.
o Myoclonic Seizures
Brief jerking or stiffening of extremities; may be symmetric or asymmetric; lasts
1-2 seconds
o Atonic *Akinetic* seizures
Sudden loss of muscle tone for seconds; postictal confusion; most resistant to
drug therapy.
- Partial
, o Complex Partial
Loss of consciousness *syncope* for 1-3 minutes characteristics automatism;
amnesia
o Simple Partial
Remain conscious; aura *unusual sensation* - perception of an offensive smell,
or sudden onset of pain; experience unusual sensation; one sided movement of
an extremity; autonomic symptoms *change in HR, skin flushing, epigastric
discomfort*
****With both Grand mal and partial they will have some loss of respiratory function, if they do and
leave alone MOST of the time they will start breathing on their own***
- Unclassified
o AKA idiopathic seizure
o Account for about half of all seizure activity
o No known reason, do not fit into generalized or partial classifications.
What are the 3 stages of a seizure?
1. Aura Stage:
a. Knowing its coming, feeling or something that can alert the PT its coming.
2. Ictus Stage:
a. The seizure itself
3. Postictal Stage:
a. Confused and need some time to understand what’s going on again.
What are signs of the Aura stage?
- Know that they vary, R/T type of the seizures and area of the brain. They happen seconds before
the seizure and may alert the person its coming.
o Unusual feelings
o Abnormal sensations
o Forced thinking
o Déjà vu *Familiar* or Jamais *unfamiliar* vi
o Perceived sounds, tastes, or smells
o Dizziness, HA, Numbness, lightheadedness
o Nausea
o Distorted emotions *fear*
- Migraines can also have Aura’s
What are signs of the Ictus Stage?
- Tonic
o Unconscious, rigid muscle contraction, clenched jaw & Hands; eyes open, pupils dilated
- Clonic
