Term
|
Definition
| Draining sinuses throughout the brain. Drain into jugular vein. NO VALVES |
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Term
| Cerebral Vascular Accident |
|
Definition
| A neurological deficit caused by disruption of blood flow to the brain |
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|
Term
| Decrease in Mortality of CVA |
|
Definition
| Control of hypertension, improved tx of TIA's, improved intervention of the acute phase(TPa) and awareness of better diet and exercise & smoking cessation has led to? |
|
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Term
|
Definition
| HYPERTENSION, Heart Disease, DM, Sleep Apnea, Elevated Cholestorol, SMOKING,SUBSTANCE ABUSE and living in the stroke belt are all? |
|
|
Term
| Why does A Fib put you at risk of CVA? |
|
Definition
| Blood pools in the ventricles, clots form and can be pushed out on the next efficient stroke. |
|
|
Term
| Uncontrollable Risk Factors of CVA |
|
Definition
| Gender, Race, Previous TIA or Stroke and Family Hx |
|
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Term
|
Definition
| Socioeconomic (low income-inexpensive high-carb diet), excessive ETOH, Oral Contraceptive use, Pregnancy, Childbirth, Menopause, Migraine's w/Aura |
|
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Term
| Classifications of Stroke |
|
Definition
Ischemic 80%
Thrombotic & Embolic
Hemorrhagic 10% |
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|
Term
| Characteristics of Thrombotic Stroke |
|
Definition
| Develop during sleep or within 1 hr of awakening, gradual development of ischemia, block the artery where they are formed, No LOC but Confusion. TIA often a warning sign, Hypertension increases risk |
|
|
Term
| Characteristics of Embolic Stroke |
|
Definition
| Onset not r/t activity, consist of fibrin platelet clots that travel to the brain, Cardiac is the main source (A Fib), No LOC |
|
|
Term
| Clinical Manifestations of Ischemic Stroke |
|
Definition
| Variety of Neurological Deficits; Numbness or weakness, confusion, change in mental status, trouble speaking or understanding speech, difficulty walking, loss of balance |
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Term
|
Definition
| Caused by bleeding into the brain tissue, the ventricles or the subarachnoid space. The pathophysiology depends on the cause and type |
|
|
Term
| Causes of Hemorrhagic Stroke |
|
Definition
| Advancing age-vessels wear out, Hypertension, Aneurysm, Trauma, Erosion of vessels by Tumors, AV Malformations, Coagulation Disorders, Vasculitis,Drugs |
|
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Term
|
Definition
| Caused by a dilation of the walls of a cerebral artery that develop as a result of weakness in the wall |
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|
Term
| Arterial Venous Malformation |
|
Definition
| Caused by a abnormality in embryonic development that leads to a tangle of arteries and veins in the brain. |
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Term
| Clinical Manifestations of Hemorrhagic Stroke |
|
Definition
| Sudden Severe Headache, Neuro deficits, CHANGE IN LOC, Pain, Stiff Neck, Nuchal Rigidity, Visual Disturbances, Tinitis & Diziness |
|
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Term
|
Definition
| Temporary clog of artery. Most damaging strokes are not preceded by TIA's however of those who have had >1 a 1/3 will have a stroke. OCCUR RAPIDLY-GO AWAY QUICLY, LASTS<1HR (CT SCAN) |
|
|
Term
|
Definition
| Recovery is Total. Considered minor ischemic stroke, caused by thrombus or emboli in artery, subsequent infarction greater than TIA, S/S Last >1hr to few days, PT NEEDS TREATMENT |
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|
Term
|
Definition
| Continues until it is Complete. Progressive deterioration or pattern of inceasing neuro deficits occurring over time. Worsening within 7 days of onset. Develops over minutes or hours |
|
|
Term
|
Definition
| Patient is left with deficits--->rehab needed. Neuro deficits remain unchanged. Occurs over2/3days. |
|
|
Term
| T/F: Rule in ischemic stroke by ruling out hemorrhagic via CT Scan |
|
Definition
|
|
Term
| T/F: Patient with confirmed Hemorrhagic Stroke should be placed in SIM's position? |
|
Definition
| FALSE, due to intercranial pressure pt should remain in semi-fowler's |
|
|
Term
| S/S OF Increased Intercranial Pressure IICP |
|
Definition
| LOC, Headache, Abnormal RR, Increased BP w/widening pulse pressure, Bradycardia, Increase T, N/V projectile, Vision Problems, Pupil Changes, Blown Dilated, Pinpoint Pupils, Change in VS |
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|
Term
|
Definition
| Elevate head of bed 30 to 40 degrees, prevent flexion of neck, AVOID TRENDELENBERG, monitor respiratory status to prevent hypoxia, prevent shivering, instruct patient to avoid straining, AVOID VALSALVA'S MANEUVER, Medications, IMPROVED LOC & DIURESIS mean RX is working |
|
|
Term
|
Definition
| Tissue Plasminogen Activase for Ischemic Strokes ONLY. Reestablished flow to blocked arteries. Clot specific to be administered w/in 3hrs of CVA onset. |
|
|
Term
|
Definition
| Safety Issues, Impulsivity, Weakness on Left Sde |
|
|
Term
|
Definition
| Cautious, Emotionally Unstable, Aware of Deficits |
|
|
Term
| What do Early Stages of CVA resemble? Examples? |
|
Definition
Rag Doll-Flaccid Paralysis
Hypotonia, Hyporefelxia, Hip rotated externally & facial weakness. See changes from face downward. |
|
|
Term
| Nursing care Early Stages |
|
Definition
| Support the affected limbs side. Elevate the affected limb (distal to proximal), ROM exercises,Assist w/balance, work on weight bearing. Help pt feel secure and stable |
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Term
|
Definition
| Paralysis on one side. Think Rigor Mortis. Adductors and Flexors are stronger, hypertonia resistance. Increased resistance to motion, increased tone, spasticity. Deep tendon refelxes exagerated, limbs drawn to midline. Prop in extension position. Use Splints |
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|
Term
| T/F When Rehab of CVA pt, advance to sitting up Before ROM exercises |
|
Definition
FALSE:
Begin w/ROM then advance to sitting up. Monitor for orthostatic hypotension |
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|
Term
| Place CVA pt in prone positon for _ to _min daily to_________________? |
|
Definition
| 15 to 30 min daily to promote hyperextension of the hip joint. This prevents contractual deformaties of shoulders and knees. CHANGE POSITIONS Q2HRS |
|
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Term
|
Definition
Speech: sounds, utterances
Language: symbols connected with concrete objects |
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|
Term
|
Definition
| Broca's Aphasia-Difficulty speaking and writing. (Tom Brokaw) |
|
|
Term
|
Definition
| Wernicke's Aphasia- Difficulty understanding spoken/written word. Speech is Meaningless (Sam Witwicky TRNSFRM II college breakdown) |
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|
Term
|
Definition
| Expressive & Receptive combined |
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|
Term
|
Definition
| Disturbance in muscular control, not meaning of language, simply the mechanics do not work (lips) |
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Term
|
Definition
| Loss of field vision on the same side in both eyes. |
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|
Term
| Acute Care of H. Hemianopsia patient rehab |
|
Definition
| Place obects on the patients unaffected side. Place pt so that unaffected side is toward the door-so you won't startle them |
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|
Term
| Care of H. Hemianopsia Pt during active rehab. |
|
Definition
| Place objects necessary for ADL's on pt's affected side. This promotes scanning of the rooms to work at seeing |
|
|
Term
|
Definition
Rare but Serious; failure to perceive stimuli coming from one side of the brain. The stimuli may be auditory, visual or tactile.
CORPUS COLLUSUM DAMAGE |
|
|
Term
|
Definition
|
|
Term
| Elimination during Acute Phase |
|
Definition
| Pt is flaccid needs catheter, monitor I & O's & Bowel. Begin stool softener, laxatives. No enemas to patient @risk for IICP. |
|
|
Term
| Elimination during Late Phase |
|
Definition
| Remove catheter, bedside commode. Check for abdominal distention, bladder scan. Bladder training may be necessary 2 Q hrs |
|
|
Term
| What is # 1 leading cause of death after a CVA |
|
Definition
|
|
Term
|
Definition
| CONTROL HYPERTENSION, Smoking cessatio, Rx for hyperlipidemia, diet & weight loss, Anti platelet Rx for chronic A Fib, routine health exams |
|
|
Term
|
Definition
| Carotic Angioplasty and stenting for pt's at poor surgical risk. > 70% occlusion. PREVENTS STROKES IN PT'S WITH CAROTID STENOSIS |
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Term
|
Definition
| Makes and stores seminal fluid. Located b/t bladder and anterior to rectum. Encirlces upper part of urethra. REQUIRES MALE HORMONES TO FUNCTION PROPERLY |
|
|
Term
| Parts of body with androgen receptors will respond to? |
|
Definition
| Testostorone, converts to dihydrotestosterone; androgen responsible for stimulating prostate growth. |
|
|
Term
|
Definition
1.Age >50
2.Race-African American develop a decade earlier
3.Environment
4.Family Hx
5.Hx of Prostatitis |
|
|
Term
| Possible BPH Risk Factors |
|
Definition
Obesity- poor diet, avoid excessive fats, alcohol,caffeine.
OTC Medications: Decongestants, Antihistamines, Anticholinergics |
|
|
Term
|
Definition
| Weak Stream, Nocturia, frequency >2 Q hrs while awake, Anuria, Hematuria |
|
|
Term
| American Cancer Society Recommendations |
|
Definition
DRE annually ---> 50 &over
African American Men ---> 45
Family Hx of BPH ---> 40 |
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|
Term
|
Definition
| In MD's office. Measures the volume and pressure of urine in the bladder, how quickly bladder can be emptied, pressure in bladder during urination. EXAMINES THE PROCESS OF VOIDING |
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|
Term
| Emergency TX device for BPH |
|
Definition
| Coude Catheter, firmer curved tip. Warn pt of discomfort. |
|
|
Term
|
Definition
7<:watchful waiting
8-19:moderate, depends on man's ability to tolerate
>20:man almost always chooses tx
OFTEN A MAN'S PROFESSION THAT DICTATES HOW QUICKLY HE SEEKS TREATMENT(TX) |
|
|
Term
|
Definition
| Annual Exams, Avoid aggravating meds, avoid alcohol and coffee-ANY CAFFEINE. PRACTICE KEGEL'S |
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|
Term
| Medication's to treat BPH |
|
Definition
Alpha Reductase Inhibitor: size reduction by ANDROGEN SUPPRESSION- lower the levels of Testosterone. Finasteride/Proscar and Dutasteride/Avodart.
|
|
|
Term
| Contraindication's of Proscar |
|
Definition
| Pregnant woment should not handle Rx. Male should not donate blood for 6months post tx. Decreased libido, breast enlargement(gynecomastia) |
|
|
Term
|
Definition
Flomax-Alpha Adrenergic Blocker that decreases pressure in smooth muscle.
Hyrtin, Cardura, Minipress-Alpha Adrenergic Receptor Blocker Drugs: Blood Pressure Meds--->relaxes prostate smooth muscle
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|
|
Term
| Alpha Blocker Considerations |
|
Definition
Orthostatic hypotension
Cautious when changing positions, teach pt to report weakness and lighheadedness, NO VIAGRA (also lowers BP) |
|
|
Term
|
Definition
| Resect the overgrowth only, damges the urethra, leaves a prosthetic fossa |
|
|
Term
|
Definition
| EDUCATE, go home w/catheter, irrigation 24-48hrs post op, symptoms to report, post-op dribbling, pain mngt, signs of infection, exercise-NO SITTING, fluids 2-3L day, follow up with MD, sperm bank |
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|
Term
| Symptoms pt to Report post-op |
|
Definition
| Bright red bleeding, Pain, Bladder Spasms, Chills, Fever |
|
|
Term
| Post-Op Assessment for _, _, _? |
|
Definition
Hemorrhage, Pain, Infection.
Observe VS and maintenance of urinary drainage. |
|
|
Term
|
Definition
Closed continuous maintains asceptic system. Prevents clots forming in bladder. Q 1hr I & O documentation
|
|
|
Term
|
Definition
| 0.9 NS (3000cc) post op 1hr still bloody, increase drip rate, check hour later if no improvement call MD. |
|
|
Term
|
Definition
| Piston Syringe 60cc, open catheter irrigate vigorously to reestablish flow, if still blocked call MD. |
|
|
Term
| Dark Red vs Bright Red BLOOD |
|
Definition
Dark=Venous Blood (balloon traction)
Bright=Arterial Blood (back to OR) can be indicative of hemorrhage
CLOTS NORMAL POST-OP FIRST 24-36HOURS |
|
|
Term
| Transurethral Resection Syndrome |
|
Definition
| Rare, Caused by absorption of irrigation solution. Causes electrolyte imbalance due to overhydration. S/S lethargy, hypertension, tachycardia, N/V, collaspe, headache, muscle spasms, seizures |
|
|
Term
|
Definition
Pain-large cath
Leakage-blocked cath
Removal-document time and tell next shift |
|
|
Term
|
Definition
| Bleeding,Obstruction, Retention, Infection, Temp Intolerance, Bladder Retraining, Retrograde Ejaculation |
|
|
Term
|
Definition
| Cautious with catheter. Delay sexual activity until cleared by MD. Do not return to work until cleared by MD. KEGELS!!!!!!! |
|
|
Term
|
Definition
| occurs on outer lobes, often undetected due to lack of symptoms, contrasted by multiple symptoms in BPH. |
|
|
Term
| T/F:Race and AGE are factors in prostate cancer? |
|
Definition
TRUE:
72 and older high risk
&
African American Males are 2x as likely to develop prostate cancer |
|
|
Term
| T/F: BPH puts you at higher risk for developing Prostate Cancer |
|
Definition
|
|
Term
| Testing for Prostate Cancer |
|
Definition
Serum PSA & DRE
Normal PSA=0-4ng
|
|
|
Term
|
Definition
| New Screening Test Developed by Johns Hopkins, more accurate that the PSA |
|
|
Term
| Treatment Options of Prostate Cancer |
|
Definition
None-Watchful Waiting:older or seriously ill pt
TOTAL PROSTATECTOMY
-younger healthier man w/advanced cancer, surgery would be tx of choice |
|
|
Term
| Supra vs Retro Pubic Prostatectomy |
|
Definition
S=pt will have bladder spasms, abdominal wound, incontinence and erectile dysfunction risk,monitor for leakage into the ab wound around supra pub cath assess pain, hemorrhage, infection
R=external wound, post op dribbling, hemorrhage, 24HR IRRIGATION, SIDE TO SIDE POSITIONING |
|
|
Term
|
Definition
| Pt require rectal prep, will have perineal tissue drain, Foley, external wound, maintain fluid balance, prevent constipation, prevent pulmonary complication, Monitor for HEMORRHAGE, INFECTION. Turn, cough& deep breathe *URISPAS* |
|
|
Term
| Treatment of Prostate cancer |
|
Definition
Orchiectomy, anti-androgen therapy deprivation,estrogen hormonal therapy
&
Radiotherapy(w/surgery)
external beam & brachytherapy{permanent implantation/HDR temporary implantation}
--->provide local control, used alone for palliation
|
|
|
Term
| Precautions after Brachtherapy |
|
Definition
| wear condom during sexual intercourse for 2months, children should not sit on lap >5min daily 6months post implant, 3ft away from pregnant women |
|
|
Term
|
Definition
Abnormal sudden excessive uncontrolled electrical discharge of neurons within the brain. May occur for no known reason. CAN BE MOTOR, SENSORY, AUTONOMIC, PYSCHIC OR COMBINATION
SEIZURES CEASE WHEN THE UNDERLYING PROBLEM IS CORRECTED |
|
|
Term
|
Definition
Recurrent seizure activity or chronic disorder or recurrent seizures >2 is SEIZURE DISORDER (preferred term).
Epilepsy is at least 2 seizures without and identifiable cause |
|
|
Term
|
Definition
| birth trauma, neonatal asphyxia, acid/base imbalance, head injuries, FEVER >104 peds, D & ETOH intoxication, congenital malformations. ANY PROCESS THAT DISRUPTS THE STABILITY OF THE NEURONAL CELL MEMBRANE CAUSING HYPERACTIVITY. |
|
|
Term
| T/F Seizures often accompany stroke? |
|
Definition
| TRUE, due to cerebral vascular disease & polypharmacy |
|
|
Term
|
Definition
| Increased frequency during menses, caution during pregnancy, increased risk of osteoporosis due to AED's |
|
|
Term
|
Definition
-Generalized(Tonic/Clonic, Absence, Myoclonic, Atonic)
-Partial
-Unclassified |
|
|
Term
|
Definition
Tonic-Initial Phase, Rigid/Stiff, Immediate LOC
Clonic-Second Phase, rhythmic jerking of all extremities, incontinence, tongue biting |
|
|
Term
|
Definition
| Formerly known as Drop Attacks. Repetitive, characterized by loss of muscle tone, lasts for seconds, patients fall in most cases |
|
|
Term
|
Definition
| Idiopathic, account for >50%. Occur for no known reason, don't fit generalized or partial classification. |
|
|
Term
|
Definition
Prodomal-before, precedes, may last minutes-hours. Vague change in emotion or affect reponses
Aura/Pre-Ictal- brief sensory exp, feeling of weaknesss, dizziness, numbness, odor)@onset of seizure
Ictal-Tonic/Clonic Activity, Synonymous w/seizure stage
Post-Ictal-phase of Recovery after seizure. May include memory lapse, headache lethargy, LOC, sonorous breathing, confusion, disorientation. Pt may sleep for hours |
|
|
Term
| T/FMedications Cure Seizure disorder? |
|
Definition
| FALSE: Medication therapy controls |
|
|
Term
| Meds given during seizure |
|
Definition
| IV: Valium, Ativan, Dilantin also as rectal suppository |
|
|
Term
| Nursing the patient w/Seizure disorder |
|
Definition
Assessment!!!!!
GOOD HX, What precipitates it?, Is there an Aura (pre-ictal), what is the effect on your lifestyle?, how much does the patient know about his/her seizing? |
|
|
Term
| Nursing Management during seizure |
|
Definition
SAFETY FIRST!!!!!
provide privacy, ease pt to floor if possible, protect heat frm inj, loosen constrictive clothing, move furniture, raise side rails, do not restrain, place in sidelying position with head flexed forward, clear secretions if necessary, may need IV access administer prescribed tx |
|
|
Term
|
Definition
| Side lying one side w/head flexed forward, bed in low position, monitor disorientation, Monitor for apnea, reorient to environment upon awakening, Monitor for agigtation use calm persuasion |
|
|
Term
|
Definition
Acute prolonged seizure activity, without full recovery of conciousness between attacks. Produces cumulative effects. May cause irreversible brain damage
MEDICAL EMERGENCY= seiz > 10min may cause death |
|
|
Term
Causes & Tx of Status Epilepticus
|
|
Definition
sudden stop of AED, Acute D & ETOH w/drawal, headtrauma (IICP), Metabolic Disturbances.
&
Stop ASAP, establish and maintain oxgenation and airway, IV meds, Iv hydration, Labs&ABG's, transfer to ICU |
|
|
Term
|
Definition
Check CBC & Liver enzymes, Photobia & administer with food
|
|
|
Term
|
Definition
| Used for Status Epilepticus, Monitor BP(hypo), Bradycardia |
|
|
Term
|
Definition
| Gingival Hypeplasia. Meticulous Oral Hygiene,Monitor liver enzymes & Administer w/Food |
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|
