Exam 5 Study Guide

This is all the topics for Exam 5 yuh.

Phases of a Seizure

Prodromal, Aura, Ictal, Postictal

Prodromal Stage

Early symptoms that appear = confusion, irritability, mood swings, headache

Aura

Involves a sensation = deja vu, weird taste, visual spots, ringing in ears

Ictal

Beginning of the seizure to the end

Postictal

After the seizure, recovery period

Types of Seizures

Generalized and Focal

Generalized

Affects the entire brain and results in loss of consciousness

Focal

Does not lose consciousness, occurs on one side of the brain

Tonic Clonic

Generalized = limb contraction and extension, back arch, ictal cry, last 2-3 min

Tonic

Sustained contraction w/ cyanosis

Clonic

Characterized by muscle shaking

Myoclonic

Muscle spasms in select groups or across the body

Absence

Little to no motor involvement, patient does not fall over, lasts 10 seconds

Atonic

Bilateral loss of muscle activity for more than 1 second

How to manage a seizure?

Secure involvement, management of the ABC’s, ALS/hospital can give meds

Status Epilpticus

A generalized or motor seizure that lasts 5 min or more than 2 seizures without a break in between

* Check the oxygen levels (SpO2)
* Check the blood sugar → AMS could b/c of AEIOU - TIPPSS

What can cause AMS?

Alcohol intoxication, Epilepsy, Insulin, Oxygen, Uremia, Trauma, Infection, Psychiatric, Poisoning, Shock, Stroke

How to treat AMS?

Consider C-spine, maintain ABC’s, suction secretions, maintain adequate oxygenation, position pt in recovery position, transport

Stroke Assessment as a cause of AMS

FAST VAN (Facial droop, arms, slurred speech, time, visual, aphasia, neglect)

Headaches → cause of AMS?

Cluster (occurs repeatedly), Tension (tight/vicelike), Vascular (migraines and hypertension)

Insulin is secreted when?

When the BGL is elevated

Glucagon is secreted when?

Secreted when the BGL is low

Hypoglycemia

< 70 mg/dL with S&S

Hyperglycemia

>200 mg/dL with S&S

Type 1 Diabetes

Pancreas does not secrete any insulin, younger diagnosis, prone to DKA and hypoglycemia

Type 2 Diabetes

Pancreas does not have enough insulin, older diagnosis, prone to HHNS

Oral Glucose is administered when?

Patient has an AMS, history of diabetes, can swallow

Hyperglycemic Emergencies

DKA and HHNS

DKA

Type 1, brain has excessive glucose and other cells are deprived, cells burn fat for energy leading to dehydration and acidosis

Will have Kuusmal respirations → deep and fast breathing

Hyperglycemic Hyperosmolar Nonketotic Syndrome

Type 2 with an extremely high BGL, No Kuusmal and higher mortality rate

To use a glucometer →

Prepare the meter, clean the finger, perform the finger stick, wipe away first drop of blood, and drop the second drop onto the strip and analyze

T or F. Unconsciousness is an AMS.

True

Hypothermia Predisposing Factors

Age, Ambient Temps, Med conditions, alcohol/drugs/poisons, duration of exposure

Frost Injuries

Frostnip (1st), Frostbite (2nd) - superficial, Frostbite (3rd) - necrotic,deep

Treatment for Hypothermia →

Dry sterile dressing, splint to immoblize after covering w/dressings, NO WALKING or MASSAGING, remove jewlery, transport and supportive care

Heat Emergencies

Cramps, Exhaustion, Stroke

Heat Cramps

Normally not called for but treatment → stretching, rehydrating with electrolytes

Heat Exhaustion S&S

Faint/dizzy, excessive sweating, cool/pale/clammy skin, N/V, rapid/weak pulse, muscle cramps

Heat Exhaustion Treatment

Shock treatment and IV fluids

Heat Stroke S&S

Throbbing headahce, confusion, NO SWEATING, body temp is over 103, red/hot/dry skin

Heat Stroke Treatment

Call ALS, remove patient from heated environment, active cooling measures (ice packs)

Exercise Induced Hyponatremia

Excessive water consumption with a decreased sodium content → increased intercranial pressure, pulmonary/cerebral edema

Lightning Types

Direct strike, contact strike, splash/side flash strike, ground current strike

Lightning Emergency Care

Scene safety, C-spine precaution, expect respiratory arrest, stabilize fractures, transport

Altitude Sickness Causes

Lower air pressure and decreasing amount of oxygen that occurs @ high altitude

3 Forms of Altitude Sickness

Acute mountain sickness, high-altitude pulmonary edema, high-altitude cerebral edema

Acute Mountain Sickness

S&S = headache, N/V, fatigue, insomnia, SOB, pins and needles

Pulmonary Edema

S&S = fever, persistent dry cough with sputum

Cerebral Edema

S&S = headache, loss of consciousness, dizziness, numbness, buildup of fluid in the brain

Poisionous Snakes

Triangle head, vertical slits, pit between mouth and eyes

Treat → wash area w/ water and soap, remove jewelry, watch for anaphylactic shock

Ticks

When removing → DO NOT SQUEEZE, hold with tweezers and pull up slowly and steadily

Fire Ants

S&S = red itchy bumps that will turn white with time

Can cause anaphylactic reaction

Black Widow

Super fatal to children, are a neurotoxin

S&S = muscle spasms, dizziness, N/V, rigid abdomen

Brown Recluse

Poison is necrotic → painless @ first and becomes bluish surrounded by white periphery and then bulls-eye pattern