NEUROLOGIC EMERGENCIES

NEUROLOGIC EMERGENCIES - NEUROLOGIC EMERGENCIES Grossmont...

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NEUROLOGIC EMERGENCIES Grossmont Emergency Education Department
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OBJECTIVES Identify the causes of headaches, hypertension, seizures, Bell’s palsy, subarachnoid hemorrhage and CVA. List current methods of treatment, including drugs, surgery, and diet. Describe appropriate nursing interventions during a neurologic emergency.
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TYPES OF NEUROLOGIC EMERGENCIES SEEN IN ED HEADACHES HYPERTENSION SEIZURES BELL’S PALSY COMA SUBARACHNOID BLEED CVA/STROKE
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HEADACHES Most common C/C of patients in the ED Symptom of some underlying disorder, not a diagnosis Can range from minor to major, such as subarachnoid bleeding
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QUESTIONS TO ASK ABOUT HEADACHES Is this the first headache? When did this headache start? Did the patient sustain any trauma? Does the patient have personality changes?
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QUESTIONS ABOUT HEADACHES Has the patient exhibited any memory loss? Has the patient had: Recent infection Eye problems Recent neuro problems History of HTN Emotional problems Taking medication Seizure disorder
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PQRST MNEUMONIC P (Provoking Factor) Q (Quality) R (Radiates, Recurrent) S (Severity) T (Time
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MIGRAINES Diagnosis made on the basis of a patient’s history Headache is never the only symptom of a migraine, nor is it a required feature of a migraine attack 90% of patients report a family history
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COMMON TRIGGERS FOR MIGRAINE Changes in sleep patterns Physical exertion Sudden weather changes Increased stresses of daily life Dieting and certain foods Cyclic estrogen levels
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PHARMACOLOGIC THERAPY FOR MIGRAINES Analgesics Anti-inflammatory Beta-adrenergic blockers Vasoconstrictors Anti-depressants Anti-emetics
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TYPES OF HEADACHES Classic migraine Common migraine Classic headache Traumatic headache
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IS HTN CONSIDERED AN EMERGENCY? If the patient has HTN and also has one or more of the following, the condition should be considered an emergency: CVA MI Angina CHF Aortic dissection Renal insufficiency
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Headache Epistaxis Syncope Tinnitus Unconsciousness
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COMPARISON OF PRIMARY AND SECONDARY HTN PRIMARY No specific cause Treated with diet and lifestyle changes Treated and responds to medication SECONDARY About 10% of HTN population Identifiable underlying disease Underlying cause may be treated
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CLASSIFICATION OF HYPERTENSION BY ARTERIAL PRESSURE LEVELS Normal blood pressure < 130 < 85 High normal blood pressure 130-139 85-89 Hypertension Stage 1 (mild) 140-159 90-99 Stage 2 (moderate) 160-179 100-109 Stage 3 (severe) 180-209 110-119 Stage 4 (very severe) >= 210 >= 120
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Gestational Hypertension previously known as pre-eclampsia high blood pressure that occurs during the last trimester of pregnancy or immediately after delivery. Patients are often previously normotensive
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This note was uploaded on 03/25/2010 for the course PAR 100 taught by Professor Alan during the Spring '10 term at Miramar College.

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NEUROLOGIC EMERGENCIES - NEUROLOGIC EMERGENCIES Grossmont...

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