Exam 1 Med surg Galen
1. What are the three main types of headaches?: Migraine, Tension, Cluster
2. Steps to Pain Assessment: Provoking
Quality
Radiation
Severity
Time
3. Provoking: has anything made it better or worse
4. Quality: Sharp, dull, achy, throbbing
5. Radiation: Does it radiate to another part of the body
6. Severity: Pain scale, 1-10 scale, intense pain, Other symptoms: N/V, photophobia
7. Time: how long has it been going on? how long does it usually last?
8. Tension Headache: Bandlike, tightness
9. Describe a Migraine: Unilateral, supra and retro orbital, pulsating or throbbing, worse with movement, sensitivity with light
and sounds
10. Cluster: Lancinationg or stabbing, 5-30 minutes. Extreme pain
11. Migraine Pathophysiology: Pathophysiology - Not entirely clear.; theories?
Prevalence: May be seen in children and adults; Among children more common in boys; among adults more common in women.
History of patient with migraine: Otherwise healthy, usually female in 30's
Individualized triggers (stress, smells, foods, hormones, menses)
Tyramine rich foods- chocolate, cheeses, beer, wine, cigar, sweet and low.
12. Treatment for Migraine: Vasoconstriction works the best, irritation of the 5th cranial nerve, Estrogen hormone can causes
migraines.
13. Migraine Manifestations: Manifestations
Pain: Usually unilateral, supra/retro-orbital, pulsating. Worse with movement.
Accompanied by non-h/a symptoms: N/V, photophobia, phonophobia, Aura: (20% of
cases):
14. Migraine Interventions: Pain management
Symptom management
Ex. Pitch black, turn off all the lights, N/V causes dehydration
,15. Migraine Drug Therapy: APAP/Caffeine/ Butabital (Fioricet) NSAIDS : Naprosyn
CCBs and Beta- Blockers (Preventative therapy) : Verapamil
Triptans and ergotamine's: Sumatriptan and Cafergot
Anticonvulsants (Preventative therapy): Topiramate
Botox Injections (monthly)
Magnesium
16. Migraine Complementary and alternative therapies: Acupuncture, Yoga, Stress reduction activities, Supplemental mag,
Distraction sometimes works.
17. Pound acronym: P:Pulsating
O:Duration
U: Unilateral location
N: N/V
D: Disabling
18. Epilepsy: Chronic disorder with two or more seizures experienced by the client.
19. Epilepsy Assessment: Inquire about the seizure activity, frequency, precipitating factors, aura (pre-ictal phase). Family
history
Collateral medical conditions (hx stroke, HTN, TBI, drug/alcohol abuse)
20. Seizure risk factors: V: Vascular
I: Infection or Inherited conditions
T: Trauma
A: Alzheimers/Autoimmune
M: Metabolic derangements
I: Idiopathic
N: Neoplasm
S: pSychiatric
21. Epilepsy Triggers: Sleep deprivation
Stress
Alcohol/ Alcohol Withdrawl
MSG
pg 878 Chart 42-9
, Exam 1 Med surg Galen
22. Aura: Seizures often preceded by an aura; it is unique to that patient, not every patient has them. Somatic: rising
epigastric sensation
Hallucinations: Visual, gustatory, olfactory
Halos, Zig-zags, h/a, paresthesias, psychiatric phenomenon, deja-vu
23. Epilepsy Partial:: Partial (also called focal or local seizures): Occurs in a specific part of the brain. May be characterized by
automatism or tic. Ex: Jerk, reflex, lip smacking (complex)
24. Epilepsy Simple:: Client does not consciousness. Localized jerking/movement. Strange sensations. Autonomic symptoms.
Focal awareness they do not lose consciousness.
25. Epilepsy Complex: Involves altered LOC; may or may not have total loss of consciousness. Automatisms. Patient may
wander at start or have amnesia after. Most common among older adults and difficult to diagnose bc symptoms appear
similar to those of dementia, psychosis, or neurobehavioral disorder, esp post-ictal.
26. Generalized epilepsy: Affects brain as a whole, bilateral seizure; we differentiate them based on how they appear while
observing them.
27. absence epilepsy: (petit mal): Generalized seizure involving sudden, brief loss of consciousness. Usually diagnosed in
children. Appears as if they are staring off into space. Lasts seconds.
28. tonic-clonic epilepsy: "Grand mal." Stereotypical body convulsions. Lasts minutes, involves muscle rigidity and
convulsions. Tonic=stiffening, Clonic=jerking
29. Myoclonic Epilepsy: Brief muscle jerks, lasts seconds
30. Atonic (akinetic) Seizure (drop seizure): Involves brief loss of tone. May be confused with Fainting.
31. Acute Seizure Management (Observation): History (if reported)
Look for underlying cause!
Record time sz began and ended.
Duration
Types of movements
Ongoing seizure observations
Post-ictal assessment - often involves reorientation.
Patient safety
If the client is sitting or standing, place the client on the floor
Continual assessment of the ABCs
32. Acute Seizure Management (things to do): Patent IV, suction, oxygen, padded side rails, pillow, and privacy. Side-lying
position
1. What are the three main types of headaches?: Migraine, Tension, Cluster
2. Steps to Pain Assessment: Provoking
Quality
Radiation
Severity
Time
3. Provoking: has anything made it better or worse
4. Quality: Sharp, dull, achy, throbbing
5. Radiation: Does it radiate to another part of the body
6. Severity: Pain scale, 1-10 scale, intense pain, Other symptoms: N/V, photophobia
7. Time: how long has it been going on? how long does it usually last?
8. Tension Headache: Bandlike, tightness
9. Describe a Migraine: Unilateral, supra and retro orbital, pulsating or throbbing, worse with movement, sensitivity with light
and sounds
10. Cluster: Lancinationg or stabbing, 5-30 minutes. Extreme pain
11. Migraine Pathophysiology: Pathophysiology - Not entirely clear.; theories?
Prevalence: May be seen in children and adults; Among children more common in boys; among adults more common in women.
History of patient with migraine: Otherwise healthy, usually female in 30's
Individualized triggers (stress, smells, foods, hormones, menses)
Tyramine rich foods- chocolate, cheeses, beer, wine, cigar, sweet and low.
12. Treatment for Migraine: Vasoconstriction works the best, irritation of the 5th cranial nerve, Estrogen hormone can causes
migraines.
13. Migraine Manifestations: Manifestations
Pain: Usually unilateral, supra/retro-orbital, pulsating. Worse with movement.
Accompanied by non-h/a symptoms: N/V, photophobia, phonophobia, Aura: (20% of
cases):
14. Migraine Interventions: Pain management
Symptom management
Ex. Pitch black, turn off all the lights, N/V causes dehydration
,15. Migraine Drug Therapy: APAP/Caffeine/ Butabital (Fioricet) NSAIDS : Naprosyn
CCBs and Beta- Blockers (Preventative therapy) : Verapamil
Triptans and ergotamine's: Sumatriptan and Cafergot
Anticonvulsants (Preventative therapy): Topiramate
Botox Injections (monthly)
Magnesium
16. Migraine Complementary and alternative therapies: Acupuncture, Yoga, Stress reduction activities, Supplemental mag,
Distraction sometimes works.
17. Pound acronym: P:Pulsating
O:Duration
U: Unilateral location
N: N/V
D: Disabling
18. Epilepsy: Chronic disorder with two or more seizures experienced by the client.
19. Epilepsy Assessment: Inquire about the seizure activity, frequency, precipitating factors, aura (pre-ictal phase). Family
history
Collateral medical conditions (hx stroke, HTN, TBI, drug/alcohol abuse)
20. Seizure risk factors: V: Vascular
I: Infection or Inherited conditions
T: Trauma
A: Alzheimers/Autoimmune
M: Metabolic derangements
I: Idiopathic
N: Neoplasm
S: pSychiatric
21. Epilepsy Triggers: Sleep deprivation
Stress
Alcohol/ Alcohol Withdrawl
MSG
pg 878 Chart 42-9
, Exam 1 Med surg Galen
22. Aura: Seizures often preceded by an aura; it is unique to that patient, not every patient has them. Somatic: rising
epigastric sensation
Hallucinations: Visual, gustatory, olfactory
Halos, Zig-zags, h/a, paresthesias, psychiatric phenomenon, deja-vu
23. Epilepsy Partial:: Partial (also called focal or local seizures): Occurs in a specific part of the brain. May be characterized by
automatism or tic. Ex: Jerk, reflex, lip smacking (complex)
24. Epilepsy Simple:: Client does not consciousness. Localized jerking/movement. Strange sensations. Autonomic symptoms.
Focal awareness they do not lose consciousness.
25. Epilepsy Complex: Involves altered LOC; may or may not have total loss of consciousness. Automatisms. Patient may
wander at start or have amnesia after. Most common among older adults and difficult to diagnose bc symptoms appear
similar to those of dementia, psychosis, or neurobehavioral disorder, esp post-ictal.
26. Generalized epilepsy: Affects brain as a whole, bilateral seizure; we differentiate them based on how they appear while
observing them.
27. absence epilepsy: (petit mal): Generalized seizure involving sudden, brief loss of consciousness. Usually diagnosed in
children. Appears as if they are staring off into space. Lasts seconds.
28. tonic-clonic epilepsy: "Grand mal." Stereotypical body convulsions. Lasts minutes, involves muscle rigidity and
convulsions. Tonic=stiffening, Clonic=jerking
29. Myoclonic Epilepsy: Brief muscle jerks, lasts seconds
30. Atonic (akinetic) Seizure (drop seizure): Involves brief loss of tone. May be confused with Fainting.
31. Acute Seizure Management (Observation): History (if reported)
Look for underlying cause!
Record time sz began and ended.
Duration
Types of movements
Ongoing seizure observations
Post-ictal assessment - often involves reorientation.
Patient safety
If the client is sitting or standing, place the client on the floor
Continual assessment of the ABCs
32. Acute Seizure Management (things to do): Patent IV, suction, oxygen, padded side rails, pillow, and privacy. Side-lying
position
