What is dysarthria?
What three conditions may present with stroke s/s?
- Postictal State
- Subdural or Epidural Bleeding
What is a postictal state or the postictal phase of a seizure?
The reset period of the brain.
Describe a Epidural bleed.
A LAC or tear of the middle meningeal artery usually caused by blunt trauma, causing bleeding b/w the dura mater and the skull.
Describe a Subdural bleed.
A venus tear or LAC below the dura mater usually caused by blunt trauma.
What is a seizure?
Sudden, erratic firing of the neurons of the brain.
What are the two classifications of seizures?
- Generalized - Affects a large portion of the brain.
- Partial - Affects a limited area of the brain.
What are the two generalized seizure types?
- Absence (Petit Mal)
- Tonic-Clonic (Grand Mal)
What are the two partial seizure types?
- Simple partial seizure
- Complex partial seizure
What is a tonic-clonic (grand mal) seizure?
A seizure characterized by severe twitching of all of the body's muscles that may last several min. or more.
What is the Aura phase of a seizure?
Sensations experienced before an attack occurs.
What is the Tonic phase of a seizure?
Steady, rigid muscle contractions with no relaxation.
What is the hypertonic phase of a seizure?
Arched back and rigidity
What is the Clonic phase of a seizure?
Rhythmic contraction of major muscle groups.
What is the post seizure phase?
Major muscles relax
What are the seven phases of a tonic-clonic seizure?
- Tonic phase
- Hypertonic phase
- Clonic Phase
- Post seizure
What is a absence (petit mal) seizure?
A seizure that may be characterized by a brief lapse of attention in which the pt. may stare and does not respond.
What is the most common pt. of a absence seizure?
What is a simple partial seizure?
A seizure involving movement or altered sensations in one part of the body; the movement may stay in one body part or may spread to another part in a wave.
What is a complex partial seizure?
A seizure that involves subtle changes in the LOC that may include confusion, less alertness, hallucinations, and inability to speak.
What is status Epilepticus?
A seizure that last more than 4 or 5 min. or seizures that recur without a pt. regaining consciousness b/w them.
What is hyponatremia?
Low sodium levels
Define FACTS (mnemonic for seizures)
- F - Focus (Generalized or Focal)
- A - Activity (Type of movements)
- C - Color or Cocaine (Cyanosis? Indications of cocaine use?)
- T - Time (How long did the seizure last)
- S - Secondary Information (Meds? Incontinence? Tongue/cheek biting? Events leading up to the seizure)
What is meningitis?
Inflammation of the meninges.
What is encephalitis?
Inflammation in the brain
What is a febrile seizure?
- A seizure that occurs as a result of a sudden high fever.
- **Its not how high the fever gets, but how fast it gets there**
What is hemiparesis?
Weakness on one side of the body.
What is lethargy?
Extreme fatigue or drowsiness.
Define Altered Mental Status (AMS)
Pt. is not thinking clearly or is incapable of being aroused.
Fainting - The sudden and temporary LOC with accompanying loss of postural tone.
Define AEIOU-TIPS (AMS Mnemonic)
- A - Alcohol, Acidosis
- E - Encephalitis, Epilepsy
- I - Insulin
- O - Overdose
- U - Uremia
- T - Trauma
- I - Infection
- P - Psychiatric
- S - Seizure
Name the two abnormal postures a pt. may demonstrate with painful stimuli that indicates increased ICP.
- Decorticate Posturing
- Decerebrate Posturing
What is decorticate posturing?
Pt. flexes the arms and curls them toward the chest, points toes, and flexes wrist.
What is decerebrate posturing?
Pt. points toes, flexes wrist, and extends arms outward.
What is trismus?
Fibrinolytics can be used in pt. with a CVA if given within __ hrs. of onset of symptoms.
Name and explain the three parts of the Cincinnati Prehospital Stroke Scale (CPSS).
- Facial Droop - Ask pt. to smile and show teeth.
- Arm Drift - Ask pt. to hold arms out with palms up and close eyes.
- Speech - Ask pt. to say "You can't teach an old dog new tricks"
What is hemiplegia?
Paralysis to one side of the body.
Pt. with increased ICP needs to maintain a SBP of at least ___.
110 - 120 mm Hg
What is normal Sp02?
95% - 100%
What 2 things should be checked with infants who are suspected of having increased ICP?
- "Cats eyes and cats crys"
- Pupil size - oval shape indicates increased ICP
- Crys - High pitched catlike cry indicates increased ICP
During a seizure, if the pt. is apneic for more than ___ sec, being ventilations.
What is a poison or toxin?
A substance that is toxic by nature, no matter how it gets into the body or in what quantities it is taken.
What is a drug?
A substance that has some therapeutic effect when given in the appropriate circumstances and in the appropriate dose.
What is a overdose?
When a drug (licit or illicit) is taken in excess.
What is toxicology?
The study of toxic or poisonous substances.
What are the four primary methods of entry for a toxin into the body?
What is a toxidrome?
The syndrome-like symptoms of a poisonous agent.
What is substance abuse?
The self administration of licit or illicit substances in a manner not in accord with approved medical or social practice.
What is drug abuse?
Any use of drugs that causes physical, psychological, economic, legal, or social harm to the user or to others affected by the drug users behavior.
What is habituation?
Psychological dependence on a drug.
What is physical dependence?
A physiological state of adaptation to a drug, usually characterized by tolerance to the drugs effect and a withdrawal syndrome if the drug is stopped.
What is psychological dependence?
The emotional state of craving a drug to maintain a feeling of well-being.
What is tolerance?
Physiologic adaptation to the effects of a drug such that increasing larger doses of the drug are required to achieve the same effect.
What is withdrawal syndrome?
A predictable set of s/s, usually involving altered CNS activity, that occurs after the abrupt cessation of a drug or after rapidly decreasing the usual dosage of a drug.
What is drug addiction?
A chronic disorder characterized by the compulsive use of a substance resulting in physical, psychological, or social harm to the user, who continues to use the substance despite the harm.
What is a antagonist?
Something that counteracts the action of something else.
What is potentiation?
Enhancement of the effect of one drug by another drug.
What is synergism?
- The action of two substances, in which the total effect is greater than the sum of the independent effects.
What is alcoholism?
A state of physical and psychological addiction to ethanol (ETOH).
What are delirium tremens (DTs)?
A severe withdrawal syndrome seen in people with alcoholism who are deprived of ethyl alcohol.
What is a narcotic?
A drug that produces sleep or AMS.
What are the two main classifications of narcotics?
What is a opiate?
Natural drugs derived from opium.
What is a opioid?
Non-opium derived synthetics.
What are stimulants?
An agent that produces an excited state.
What is marijuana?
The dried leaves and flower buds of the cannabis sativa plant that are smoked to achieve a high.
What is a hallucinogen?
An agent that produces false perceptions in any one of the five senses.
What is synthesthesias?
Crossing of the senses.
What is a sedative?
A drug that reduces anxiety and calms agitated pt.
What is a hypnotic?
A drug that produces drowsiness and sleep.
What are barbiturates?
What are benzodiazepines?
The family of sedative-hypnotics most commonly used to treat anxiety, seizures, and alcohol withdrawal.
What are organophosphates?
A class of chemical found in many insecticides used in agriculture and in the home.
Define SLUDGEM (mnemonic for nerve agents and organophosphates)
- S - Salivation, Sweating
- L - Lacrimation
- U - Urination
- D - Defecation, Drooling, Diarrhea
- G - Gastric upset and cramps
- E - Emesis
- M - Miosis, Muscle twitching
Define DUMBELS (mnemonic for nerve agents and organophosphates)
- D- Diarrhea
- U - Urination
- M - Miosis
- B - Bradycardia, Bronchospasm
- E - Emesis
- L - Lacrimation
- S - Seizures, Salivation, Sweating
What is carbon monoxide (CO)?
An odorless, highly poisonous gas that results from incomplete oxidation of carbon in combustion.
What are caustics?
Chemicals that are acids or alkalis.
What is gamma-hydroxybutyrate (GHB)?
- A sedative and CNS depressant
- Date rape drug
What are hydrocarbons?
Compounds made up principally of hydrogen and carbon atoms mostly obtained from the distillation of petroleum.
What are tricyclic antidepressants (TCAs)?
A group of drugs used to treat severe depression and manage pain.
What are monoamine oxidase inhibitors (MAOIs)?
Psychiatric medications used primarily to treat atypical depression by increasing norepinephrine and serotonin levels in the CNS.
What are selective serotonin reuptake inhibitors (SSRIs)?
A class of antidepressant that inhibits the reuptake of serotonin.
What is lithium?
The cornerstone drug for the Tx of bipolar disorder.
What are salicylates?
What are the top three food poison toxins?
What is dieffenbachia?
- A common house plant that resembles "elephant ears"; ingestion leads to burns of the mouth and tongue and possibly paralysis of the vocal cords and N/V.
- AKA Dumb Cane
What is behavior?
How a person functions or acts in response to his or her environment.
What is a behavioral crisis?
The point at which a persons reactions to events interfere with activities of daily living (ADL).
What are activities of daily living (ADL)?
- The basic activities a person usually accomplishes during a normal day.
- Ex: eating, dressing
What is depression?
A persistent feeling of sadness, despair, and discouragement.
What is a mental disorder?
An illness with psychological or behavioral symptoms that may result in impaired function.
What are the two categories of mental disorders?
- Organic (Physical)
- Functional (Psychological)
What is organic brain syndrome?
A temporary or permanent dysfunction of the brain, caused by a disturbance in the physical or physiologic functioning of brain tissue.
What is altered mental status (AMS)?
A change in the way a person thinks or behaves.
What is a functional disorder?
A disorder in which there is no known physiologic reason for the abnormal functioning of an organ or system.
What is psychogenic?
symptom of illness that is caused by mental factors as opposed to physical ones.
What is psychosis?
A mental disorder characterized by the loss of contact with reality.