352 Final Exam Questions & answers
seizures - CORRECT ANSWER-resulting from a sudden, abnormal, uncontrolled
electrical discharge from cerebral neurons
seizures are acute and provoked
Convulsions - CORRECT ANSWER-MOTOR seizures
Epilepsy - CORRECT ANSWER-at least two or more unprovoked, recurring
seizures occurring more than 24 hours apart (chronic)
Pro discharge - CORRECT ANSWER-excitatory NTs (ACh, Asparate, and
Glutamate) stimulate the synchronous discharge
Anti discharge - CORRECT ANSWER-inhibitory neurotransmitters (GABA) limit
synchronous discharge in normal brain
seizures and epilpsy patho - CORRECT ANSWER-imbalance b/w excitatory and
inhibitory neurotransmitters (increased excitatory and decreased inhibitory)
Tonic seizures - CORRECT ANSWER-stiffening or rigidity of the muscles of the
arms and legs; person may fall
Clonic seizures - CORRECT ANSWER-rhythmic jerking of the body; alternate
b/w flexion and relaxation (convulsions)
Tonic-Clonic (grandmal) seizure - CORRECT ANSWER-tonic phase first then
clonic phase
Myoclonic seizure - CORRECT ANSWER-brief jerking of a muscle/extremities
lasts 2 seconds
atonic (drop attacks) seizures - CORRECT ANSWER-sudden momentary loss of
muscle tone the viticm may fall as a result of the seizure and at great risk of head
injury.
,*most resistant to drug therapy*
Absence seizures - CORRECT ANSWER-manifested as a brief staring spell that
lasts only a few seconds; the victim appears to be daydreaming; common in
children (petit mal seizures)
causes of seizures - CORRECT ANSWER-1. cerebrovascular disease (stroke)
2. hypoemia
3. fever (childhood)
4. head injury
5. hypertension
6. CNS infections
7. metabolic & toxic conditions (*decreased NA*, decreased CA, *hypoglycemia*,
and pesticide exposure)
8. brain tumor
9. allergies
10. drug & alochol withdrawal
Aura phase of a seizure - CORRECT ANSWER-sensation that warns the client of
the impending seizure
this can be visual, audiotry or olfactory
deja vu feeling
Ictal phase of seizure - CORRECT ANSWER-ACTUAL seizure
loss of motor activity, incontincince of urine or stool, loss of consiousness
Post ictal phase of seizure - CORRECT ANSWER-headache, confusion,
sleepiness, impaired speech
status epilepticus - CORRECT ANSWER-can be convulsive or nonconvulsive
time definition can cary >5 minutes to 30 minutes
occurs without full recovery of consciousness b/w seizures
status epilepticus medical emergancy why - CORRECT ANSWER-the brain can
be deprived of oxygen leading to irreversible brain damage
,status epilepticus precipitating factors - CORRECT ANSWER-inadaquete dosage
of anticonvulsant medications
ommiting anticonvulsant medicationbs
fever
concurrent infections
alcohol abuse/withdrawl
status epilepticus management - CORRECT ANSWER-IV: short cating
benzodizepam (diazepam, lorazepam)
seizures dx and complications - CORRECT ANSWER-1. EEG
2. CT scan
3. MRI
risk for injury, decreased O2 to the brain, falls risk.
seizure medication considerations - CORRECT ANSWER-long term therapy is
required (probably lifelong)
combination medications are required many times
many medications are CNS depressants
Epilepsy in women - CORRECT ANSWER-may experience increase in seizure
frequenct during menstraution
the effectiveness of OCP are decreased my anti-eplitic medications
anti-epiletic drugs have teratogenic effects
bone loss assoiciated wtih anti-epileptic drugs increases risk of osteoporosis
medications can decrease levels of folic acid in the body (AAN recommends
0.4-4 mg/day)
ICP - CORRECT ANSWER-the volume and pressure of CSF, brain tissue adn
blood are usually in a state of equillibrium and produce the ICP
Normal ICP - CORRECT ANSWER-5-15mm of HG
Normal CPP - CORRECT ANSWER-=MAP - ICP
optimum perfusion of brain tissues
, Key point about CPP and ICP - CORRECT ANSWER-when ICP increases, it can
decrease CPP
Monro-Kellie Hypothesis - CORRECT ANSWER-explains the dynamic
equilibrium of crainial contents (brain, blood and CSF)
bc of the limited space within the skull, an increase in any one complenet of the
skull will cause a change in the volume of the others.
brain tissue has limited space so compensation accomplished by: - CORRECT
ANSWER-1. decreasing/shifting CSF or
2. by decreasing cerebral blood flow by auto regulation
*without these changes, ICP is going to increase*
impaired autoregulation = increased ICP
Increased ICP pathophysiology - CORRECT ANSWER-1. decreased cerebral
blood flow
2. cerebral edema
3. herniation of the brain stem
*hernitated tissue exerts pressure on the rbain area into which it has shifted -->
decreased blood flow --> cerebral ischemia, infaraction and brain death
causes of increased ICP - CORRECT ANSWER-head injury, subarachnoid
hemorrhage, brain tumor, cerebral infections (menegitis and encephaltis)
early s/s of increased ICP - CORRECT ANSWER-headache, vomitting, blurred
vision, change in level of consiousness
late (cushings triad) s/s of increased ICP - CORRECT ANSWER-bradycardia,
irregular respirations, increased pulse pressure (difference between systolic and
dystlic bp)
seizures - CORRECT ANSWER-resulting from a sudden, abnormal, uncontrolled
electrical discharge from cerebral neurons
seizures are acute and provoked
Convulsions - CORRECT ANSWER-MOTOR seizures
Epilepsy - CORRECT ANSWER-at least two or more unprovoked, recurring
seizures occurring more than 24 hours apart (chronic)
Pro discharge - CORRECT ANSWER-excitatory NTs (ACh, Asparate, and
Glutamate) stimulate the synchronous discharge
Anti discharge - CORRECT ANSWER-inhibitory neurotransmitters (GABA) limit
synchronous discharge in normal brain
seizures and epilpsy patho - CORRECT ANSWER-imbalance b/w excitatory and
inhibitory neurotransmitters (increased excitatory and decreased inhibitory)
Tonic seizures - CORRECT ANSWER-stiffening or rigidity of the muscles of the
arms and legs; person may fall
Clonic seizures - CORRECT ANSWER-rhythmic jerking of the body; alternate
b/w flexion and relaxation (convulsions)
Tonic-Clonic (grandmal) seizure - CORRECT ANSWER-tonic phase first then
clonic phase
Myoclonic seizure - CORRECT ANSWER-brief jerking of a muscle/extremities
lasts 2 seconds
atonic (drop attacks) seizures - CORRECT ANSWER-sudden momentary loss of
muscle tone the viticm may fall as a result of the seizure and at great risk of head
injury.
,*most resistant to drug therapy*
Absence seizures - CORRECT ANSWER-manifested as a brief staring spell that
lasts only a few seconds; the victim appears to be daydreaming; common in
children (petit mal seizures)
causes of seizures - CORRECT ANSWER-1. cerebrovascular disease (stroke)
2. hypoemia
3. fever (childhood)
4. head injury
5. hypertension
6. CNS infections
7. metabolic & toxic conditions (*decreased NA*, decreased CA, *hypoglycemia*,
and pesticide exposure)
8. brain tumor
9. allergies
10. drug & alochol withdrawal
Aura phase of a seizure - CORRECT ANSWER-sensation that warns the client of
the impending seizure
this can be visual, audiotry or olfactory
deja vu feeling
Ictal phase of seizure - CORRECT ANSWER-ACTUAL seizure
loss of motor activity, incontincince of urine or stool, loss of consiousness
Post ictal phase of seizure - CORRECT ANSWER-headache, confusion,
sleepiness, impaired speech
status epilepticus - CORRECT ANSWER-can be convulsive or nonconvulsive
time definition can cary >5 minutes to 30 minutes
occurs without full recovery of consciousness b/w seizures
status epilepticus medical emergancy why - CORRECT ANSWER-the brain can
be deprived of oxygen leading to irreversible brain damage
,status epilepticus precipitating factors - CORRECT ANSWER-inadaquete dosage
of anticonvulsant medications
ommiting anticonvulsant medicationbs
fever
concurrent infections
alcohol abuse/withdrawl
status epilepticus management - CORRECT ANSWER-IV: short cating
benzodizepam (diazepam, lorazepam)
seizures dx and complications - CORRECT ANSWER-1. EEG
2. CT scan
3. MRI
risk for injury, decreased O2 to the brain, falls risk.
seizure medication considerations - CORRECT ANSWER-long term therapy is
required (probably lifelong)
combination medications are required many times
many medications are CNS depressants
Epilepsy in women - CORRECT ANSWER-may experience increase in seizure
frequenct during menstraution
the effectiveness of OCP are decreased my anti-eplitic medications
anti-epiletic drugs have teratogenic effects
bone loss assoiciated wtih anti-epileptic drugs increases risk of osteoporosis
medications can decrease levels of folic acid in the body (AAN recommends
0.4-4 mg/day)
ICP - CORRECT ANSWER-the volume and pressure of CSF, brain tissue adn
blood are usually in a state of equillibrium and produce the ICP
Normal ICP - CORRECT ANSWER-5-15mm of HG
Normal CPP - CORRECT ANSWER-=MAP - ICP
optimum perfusion of brain tissues
, Key point about CPP and ICP - CORRECT ANSWER-when ICP increases, it can
decrease CPP
Monro-Kellie Hypothesis - CORRECT ANSWER-explains the dynamic
equilibrium of crainial contents (brain, blood and CSF)
bc of the limited space within the skull, an increase in any one complenet of the
skull will cause a change in the volume of the others.
brain tissue has limited space so compensation accomplished by: - CORRECT
ANSWER-1. decreasing/shifting CSF or
2. by decreasing cerebral blood flow by auto regulation
*without these changes, ICP is going to increase*
impaired autoregulation = increased ICP
Increased ICP pathophysiology - CORRECT ANSWER-1. decreased cerebral
blood flow
2. cerebral edema
3. herniation of the brain stem
*hernitated tissue exerts pressure on the rbain area into which it has shifted -->
decreased blood flow --> cerebral ischemia, infaraction and brain death
causes of increased ICP - CORRECT ANSWER-head injury, subarachnoid
hemorrhage, brain tumor, cerebral infections (menegitis and encephaltis)
early s/s of increased ICP - CORRECT ANSWER-headache, vomitting, blurred
vision, change in level of consiousness
late (cushings triad) s/s of increased ICP - CORRECT ANSWER-bradycardia,
irregular respirations, increased pulse pressure (difference between systolic and
dystlic bp)
