Treatments for Benign Paroxysmal Positional Vertigo
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Dizziness/Lightheadedness & Vertigo:
Treatment
(In a Page: Signs and Symptoms)
- Treat the underlying disorder of lightheadedness
–Rehydrate patient as necessary
–Compensate for heart failure with inotropic agents,
diuretics, and ACE inhibitors
–Surgical intervention for valvular incompetence
–Treat prodromal stroke (TIA) with aspirin or warfarin
–Carotid endarterectomy for significant carotid stenosis
–Acute migraine treatment with NSAIDs or triptans (e.g.,
sumatriptan); prophylaxis with valproate or tricyclic antidepressants;
–Phenytoin or carbamazepine for seizures and auras
- Vertigo
–Meclizine and/or reassurance and time are usually sufficient for benign positional vertigo
–Modified Epley and/or particle repositioning maneuvers
for positional symptoms
–Diuretics and/or surgery for Ménière's disease
–Central causes require disease-specific therapy
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Vertigo:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
If the vertigo is accompanied by nausea and vomiting, supportive care with fluid and electrolyte replacement
-
Migraine aura associated vertigo: Analgesics and vestibular suppressants such as sumatriptan, propranolol, amitriptyline, diazepam; avoid triggers
-
Acute viral labyrinthitis: Bedrest, antiemetics, IV fluids, diazepam, antihistamines
-
Control of hypertension, diabetes, cardiac arrhythmia
-
Cerebellopontine angle tumors: Surgical resection
-
BPPV/ Ménière disease: Positioning procedure; brief treatment with diazepam, meclizine, or dimenhydrinate
-
Perilymph fistula: Pneumatic otoscopy reproduces symptoms; often heals spontaneously
-
Vertebrobasilar stroke: Neurology consultation
-
Cerebellar hemorrhage: Emergent neurosurgical consult for question of posterior fossa decompression
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Fever – Recurrent:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Repeated viral illnesses
–Reassurance of the parents
–Advice on antipyretics
–Encourage fluid intake
–Limit of sick exposure if possible
-
UTI
–Antibiotics based on bacteria and sensitivity
–Prophylactic antibiotics if underlying cause is present
-
-
-
Bacterial infections: Bacteria-specific antibiotic
-
JRA, Behçet, or IBD
–Prednisone or immunosuppressive medications
-
TRAPS
–Prednisone and etanercept
-
Familial cold urticaria and Muckle-Wells syndrome
–Prednisone may be used
–If amyloidosis is present, colchicine may be required
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Dizziness:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient complains of dizziness, first ensure his safety by preventing falls, and then determine the severity and onset of the dizziness. Ask the patient to describe it. Is it associated with headache or blurred vision? Next, take the patient’s blood pressure while he’s lying, sitting, and standing to check for orthostatic hypotension. Ask about a history of high blood pressure. Determine if the patient is at risk for hypoglycemia. Tell the patient to lie down, and recheck his vital signs every 15 minutes. Start an I.V. line, and prepare to administer medications as ordered.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Decorticate posture [Decorticate rigidity, abnormal flexor response]:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Obtain vital signs and evaluate the patient’s level of consciousness (LOC). If his consciousness is impaired, insert an oropharyngeal airway, and take measures to prevent aspiration (unless spinal cord injury is suspected). Evaluate the patient’s respiratory rate, rhythm, and depth. Prepare to assist respirations with a handheld resuscitation bag or with intubation and mechanical ventilation if necessary. Also, institute seizure precautions.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Dizziness:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Prepare the patient for diagnostic tests, such as blood studies, arteriography, computed tomography scan, electroencephalograph, magnetic resonance imaging, and tilt-table studies.
Patient teaching
Teach the patient ways to control dizziness. If he’s hyperventilating, have him breathe and rebreathe into his cupped hands or a paper bag. If he experiences dizziness in an upright position, tell him to lie down and rest and then to rise slowly. Advise the patient with carotid sinus hypersensitivity to avoid wearing garments that fit tightly at the neck. Instruct the patient who risks a TIA from vertebrobasilar insufficiency to turn his body instead of sharply turning his head to one side.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Decorticate posture [Decorticate rigidity, abnormal flexor response]:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Monitor neurologic status and vital signs every 30 minutes to 2 hours. Be alert for signs of increased ICP, including bradycardia, increasing systolic blood pressure, and widening pulse pressure.
Patient teaching
Instruct the patient and his family about the signs and symptoms of decreased LOC and seizures. Explain to the family or caregiver how to keep the patient safe, especially during a seizure. Discuss quality of life concerns, if appropriate. Provide referrals to other health care services and professionals, as indicated.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Dizziness:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient complains of dizziness, first ensure his safety by preventing falls. Then determine the severity and onset of the dizziness. Ask the patient to describe it. Find out if the dizziness is associated with headache or blurred vision. Next, take the patient’s blood pressure while he’s lying, sitting, and standing to check for orthostatic hypotension. Ask about a history of high blood pressure. Determine if the patient is at risk for hypoglycemia. Tell him to lie down, and recheck his vital signs every 15 minutes. Start an I.V. line, and prepare to administer medications as ordered.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Vertigo:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient is experiencing vertigo, tell him not to get out of bed or walk without assistance. Instruct the patient not to make sudden position changes and to avoid tasks that can be dangerous such as driving.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Decorticate posture:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Obtain vital signs and evaluate the patient’s level of consciousness (LOC). If consciousness is impaired, insert an oropharyngeal airway and take measures to prevent aspiration (unless spinal cord injury is suspected). Evaluate the patient’s respiratory rate, rhythm, and depth. Prepare to assist respirations with a handheld resuscitation bag or with intubation and mechanical ventilation. Also, institute seizure precautions.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Dizziness:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for diagnostic tests, such as blood studies, arteriography, a computed tomography scan, EEG, magnetic resonance imaging, and tilt-table studies.
▪ Ensure safety measures.
Patient teaching
▪ Teach the patient how to control dizziness.
▪ Discuss safety measures.
▪ Teach the patient about his underlying disorder and its treatment.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Vertigo:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Place the patient in a comfortable position.
▪ Monitor vital signs and LOC.
▪ Take measures to provide for the patient's safety.
▪ Darken the room and keep the patient calm.
▪ Administer drugs to control nausea and vomiting and decrease labyrinthine irritability.
▪ Prepare the patient for diagnostic tests, such as electronystagmography, EEG, and X-rays of the middle and inner ears.
Patient teaching
▪ Explain to the patient the underlying cause of vertigo and its treatment.
▪ Explain safety measures to the patient.
▪ Tell the patient to avoid sudden position changes and dangerous tasks.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Decorticate posture [Decorticate rigidity, abnormal flexor response]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Assess the patient frequently to detect subtle signs of neurologic deterioration.
▪ Monitor his neurologic status and vital signs every 30 minutes to 2 hours.
▪ Be alert for signs of increased ICP, including bradycardia, an increasing systolic blood pressure, and a widening pulse pressure.
Patient teaching
▪ Explain the signs and symptoms of decreased LOC and seizures to the patient and his family.
▪ Discuss the patient's and family's quality-of-life concerns.
▪ Explain to the family how to keep the patient safe, especially during a seizure.
▪ Explain to the patient or family his diagnosis and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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