Neurology Review

Neurology Review : 

Neurology Review Lincoln Tech Mod V Ms. Ventre

Nervous System : 

Nervous System Functional Unit: Neuron (nerve cell) Conducts electrical impulses Central Nervous System (CNS) Brain Spinal Cord Cerebrospinal Fluid: circulates throughout the CNS Peripheral Nervous System Nerves in the periphery

Neurologic Assessment : 

Neurologic Assessment Evaluate Level of Consciousness (LOC) Pupillary size and response Coordination and balance Sensory function Reflexes Vital signs Increased intracranial pressure may impair cerebral tissue perfusion, resulting in ischemia & possibly respiratory arrest

Signs & Symptoms of Increased Intracranial Pressure & Impaired Cerebral Blood Flow : 

Signs & Symptoms of Increased Intracranial Pressure & Impaired Cerebral Blood Flow Decreasing Level of Consciousness (LOC) Pupil dilation with no response to light Motor defecits Abnormal posture Fever Increased blood pressure Bradycardia Respiratory depression

Measures to Decrease Intracranial Pressure : 

Measures to Decrease Intracranial Pressure Positioning Hyperventilation Fluid restriction Mechanical drainage Drug therapy

Seizures : 

Seizures Abnormal activity and behavior Caused by abnormal electrical impulses in the brain May be treated with anticonvulsant therapy If possible, measures to correct the cause is the treatment of choice

Nursing Diagnoses: Seizures : 

Nursing Diagnoses: Seizures Risk for injury Ineffective coping Knowledge defecit

Nursing Diagnoses: Head Injury : 

Nursing Diagnoses: Head Injury Ineffective tissue perfusion Ineffective breathing pattern Risk for injury Risk for infection Impaired physical mobility Disturbed body image Ineffective role performance

Infectious Processes : 

Infectious Processes Of the nervous system Meningitis Encephalitis Guillain-Barre syndrome Autoimmune response to a viral infection Characterized by ascending neurologic defecits In most cases, resolves

Nursing Diagnoses: Guillain-Barre : 

Nursing Diagnoses: Guillain-Barre Ineffective breathing pattern Decreased cardiac output Risk for disuse syndrome Imbalanced nutrition: less than body requirements Risk for injury Anxiety Knowledge defecit

Parkinson’s Syndrome : 

Parkinson’s Syndrome Progressive disorder Results in loss of control over involuntary movement Treated with: Physical therapy Drugs that increase dopamine levels in the brain

Nursing Diagnoses: Parkinson’s : 

Nursing Diagnoses: Parkinson’s Impaired physical mobility Risk for injury Imbalanced nutrition: less than body requirements Ineffective coping Knowledge defecit

Multiple Sclerosis : 

Multiple Sclerosis Progressive degenerative disease Disrupts motor pathways of CNS May lead to severe neurologic disability

Amyotrophic Lateral Sclerosos (ALS) : 

Amyotrophic Lateral Sclerosos (ALS) Lou Gherig’s disease Rapidly progressive Degenerative Usually results in death from respiratory complications Prognosis: 3 years The patient with ALS has increasing needs for nursing care, eventually becoming compeletely dependent for all aspects of care

Myasthenia Gravis : 

Myasthenia Gravis Caused by defect in impulse conduction Manifested as weakness of voluntary muscles Treated with anticholinesterase drugs Treated with corticosteroids

Trigeminal Neuralgia : 

Trigeminal Neuralgia Intense pain along a branch of the trigeminal nerve Treatment options: Drug therapy Surgical intervention

Cerebral Palsy : 

Cerebral Palsy Associated with a loss in motor coordination cause by cerebral damage

Cerebrovascular Accident (CVA) : 

Cerebrovascular Accident (CVA) Commonly called STROKE or BRAIN ATTACK Interruption of blood flow to part of the brain persisting for more than 24 hours Can be classified as: Transient ischemic attack Stroke in evolution Completed stroke

Risk Factors: : 

Risk Factors: Atherosclerosis Atrial fibrillation Hypertension Diabetes mellitis Cardiac disease Excessive alcohol consumption Smoking while taking oral contraceptives

Transient Ischemic Attack (TIA) : 

Transient Ischemic Attack (TIA) Sometimes considered a warning sign of impending stroke Treated with: Diet modification Exercise Drug therapy to prevent clot formation Surgery to clear or bypass

2 Types of Strokes : 

2 Types of Strokes Differentiated by process: Hemorrhagic Stroke Rupture of a blood vessel to the brain Ischemic Stroke Obstruction of a blood vessel to the brain By embolus By thrombus

Signs & Symptoms of Stroke : 

Signs & Symptoms of Stroke Dependent on: Type Location Extent of brain injury Weakness Numbness Visual problems Confusion Memory lapse Headache Dysphagia Speech problems

Resolution : 

Resolution Some symptoms improve Residual impairment may be present Speech impairment Language comprehension difficulties Decreased motor function Visual disturbance Cognitive defecits Bladder control issues Personality changes Emotional lability

Stroke Symptoms: Definitions : 

Stroke Symptoms: Definitions Aphasia: inability to understand words or respond with appropriate messages Dysarthria: inability to speak clearly due to neurologic damage that affects the muscles of speech Dysphagia: difficulty swallowing Hemiplegia: paralysis of one side of the body (the opposite side of the brain injury) Dyspraxia: partial inability to initiate coordinated voluntary motor acts in an unparalyzed extremity

Medical Treatment of CVA : 

Medical Treatment of CVA Oxygen therapy Diuretics Corticosteroids Anticoagulants Thrombolytics Diuretics Corticosteroids Anticoagulants Thromybolytics Intravenous fluids Dietary modifications Catheterization Treatment of risk factors

Stroke: Nursing Diagnoses : 

Stroke: Nursing Diagnoses Ineffective airway clearance Ineffective breathing pattern Risk for injury Fluid volume defecit Fluid volume excess Imbalanced nutrition: less than body requirements Disturbed sensory perception Disturbed thought processes Impaired verbal communication Impaired physical mobility Total urinary incontinence Functional urinary incontinence Constipation Bowel incontinence Ineffective coping Interrupted family processes

Post Stoke Recovery : 

Post Stoke Recovery The patient may: May regain complete independent functioning Partial recovery to previous abilities Complete loss of functional abilities The goal of rehabilitation after stroke is to enhance the recovery of functional abilities through a program of stimulation and practice

Spinal Cord Injury : 

Spinal Cord Injury Most often resultant from trauma Also my be caused by degenerative changes and tumors

Classification : 

Classification Location Open or closed Extent of injury to the cord

Assessment : 

Assessment Motor and sensory function Movement Muscle strength Sensation Reflex activity

Effects of Spinal Cord Injury : 

Effects of Spinal Cord Injury Respiratory impairment Spinal shock Autonomic dysreflexia Spasticity Impaired sensory & motor function Impaired bladder function Impaired bowel function Impaired temperature regulation Impaired sexual function Impaired skin integrity Altered self concept and body image

EMERGENT SPINAL CORD INJURIES : 

EMERGENT SPINAL CORD INJURIES Injuries at or above the 5th cervical vertibra may result in instant death because of interruption of the nerves that control respiration

Autonomic Dysreflexia : 

Autonomic Dysreflexia Exaggerated sympathetic response to stimuli Bladder distension Constipation Renal calculi Ejaculation Uterine contraction Produces severe hypertension with the potential for seizures & stroke

Neurological Stages of Spinal Cord Injury : 

Neurological Stages of Spinal Cord Injury Muscles are usually flaccid immediately after injury Spasticity develops when spinal shock resolves

Goals of Medical Care : 

Goals of Medical Care Sustain life Prevent further cord injury Repair cord damage Immobilization is essential to prevent further damage to the cord after injury

Spinal Cord Injury Nursing Diagnoses : 

Spinal Cord Injury Nursing Diagnoses Ineffective breathing pattern Risk for injury Disturbed sensory perception Risk for Autonomic Dysreflexia Risk for Disuse Syndrome Bowel incontinence Impaired urinary elimination Risk for infection Ineffective thermoregulation Hypothermia Self-care deficit: feeding/dressing/grooming Sexual dysfunction Ineffective coping Ineffective therapeutic regimen management Knowledge deficit

Rehabilitation : 

Rehabilitation Assists the patient to achieve the highest level of functioning, self-care, and independence Laminectomy is a surgical procedure that may be done for several reasons, including spinal cord injury