A client diagnosed with trigeminal neuralgia is experiencing intermittent, sudden, severe pain on the left side of the face. The nurse identifies which classification of medications is most effective in treating this pain.

Analgesics

Antihistamines

Antibiotics

Anticonvulsants

Answer and Explanation

The Correct Answer is D

Choice A reason: Analgesics are medications that relieve pain by blocking pain signals or reducing inflammation. They include nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and acetaminophen. However, analgesics are not very effective in treating trigeminal neuralgia, as they do not address the underlying cause of the pain, which is the compression or irritation of the trigeminal nerve.

Choice B reason: Antihistamines are medications that block the effects of histamine, a chemical that causes allergic reactions such as itching, sneezing, and swelling. They include diphenhydramine, cetirizine, and loratadine. Antihistamines are not effective in treating trigeminal neuralgia, as they do not affect the trigeminal nerve or its function.

Choice C reason: Antibiotics are medications that kill or inhibit the growth of bacteria that cause infections. They include penicillin, amoxicillin, and ciprofloxacin. Antibiotics are not effective in treating trigeminal neuralgia, as they do not target the trigeminal nerve or its pathology.

Choice D reason: Anticonvulsants are medications that prevent or reduce the frequency and severity of seizures by stabilizing the electrical activity of the brain. They include carbamazepine, gabapentin, and phenytoin. Anticonvulsants are the most effective medications in treating trigeminal neuralgia, as they reduce the abnormal firing of the trigeminal nerve that causes the pain. Anticonvulsants are considered the first-line therapy for trigeminal neuralgia and can provide significant relief for most clients.

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Correct Answer is A

Explanation

Choice A reason: Hypertension is a manifestation of increased intracranial pressure, as it reflects the body's attempt to maintain adequate cerebral perfusion pressure (CPP) and blood flow to the brain. CPP is the difference between the mean arterial pressure (MAP) and the intracranial pressure (ICP). When ICP rises, MAP must also rise to keep CPP constant and prevent cerebral ischemia. Hypertension is part of the Cushing's triad, which is a classic sign of increased ICP that also includes bradycardia and irregular respirations.

Choice B reason: Tinnitus is not a manifestation of increased intracranial pressure, as it does not affect the auditory system. Tinnitus is a ringing, buzzing, or hissing sound in the ears that can be caused by various factors, such as ear infections, noise exposure, medications, or aging. Tinnitus may be associated with other neurological conditions, such as Meniere's disease, acoustic neuroma, or multiple sclerosis, but not with increased ICP.

Choice C reason: Hypotension is not a manifestation of increased intracranial pressure, as it indicates a decrease in MAP and CPP, which can lead to cerebral ischemia and infarction. Hypotension can be caused by various factors, such as blood loss, dehydration, shock, or medications. Hypotension may worsen the outcome of increased ICP by reducing the oxygen and nutrient delivery to the brain.

Choice D reason: Tachycardia is not a manifestation of increased intracranial pressure, as it contradicts Cushing's triad. Tachycardia is an increase in heart rate that can be caused by various factors, such as anxiety, pain, fever, dehydration, or medications. Tachycardia may increase the oxygen demand and metabolic rate of the brain, which can exacerbate the effects of increased ICP.

A. Gradual onset of several hours B. Maintains consciousness C. Sudden severe headache D. History of neurologic deficits lasting less than 1 hr.

Correct Answer is C

Explanation

Choice A reason: Gradual onset of several hours is not a manifestation of a hemorrhagic stroke. A hemorrhagic stroke occurs when a blood vessel in the brain bursts, causing bleeding into the surrounding tissue. This usually happens suddenly and without warning, and can cause rapid deterioration of the client's condition.

Choice B reason: Maintains consciousness is not a manifestation of a hemorrhagic stroke. A hemorrhagic stroke can cause increased intracranial pressure, which can compress the brain and impair its function. This can lead to loss of consciousness, coma, or death.

Choice C reason: Sudden severe headache is a manifestation of a hemorrhagic stroke. A hemorrhagic stroke can cause intense pain in the head, neck, or face, due to the pressure and irritation of the bleeding. The headache may be described as "the worst headache of my life" or "thunderclap headache".

Choice D reason: History of neurologic deficits lasting less than 1 hr. is not a manifestation of a hemorrhagic stroke. This is a characteristic of a transient ischemic attack (TIA), which is also known as a mini-stroke. A TIA occurs when a blood clot temporarily blocks an artery in the brain, causing temporary symptoms such as weakness, numbness, vision loss, or speech difficulty. A TIA does not cause permanent damage to the brain, but it is a warning sign of a possible future stroke.

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A client diagnosed with trigeminal neuralgia is experiencing intermittent, sudden, severe pain on the left side of the face. The nurse identifies which classification of medications is most effective in treating this pain.

Nursing Test Bank

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Correct Answer is A

Explanation

A nurse is caring for a client who has had a hemorrhagic stroke following a ruptured cerebral aneurysm. Which of the following manifestations should the nurse expect?

Correct Answer is C

Explanation

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