Deck 13_Neurologic Flashcards
Identify pre- & post procedure nursing considerations for patients scheduled for CT scan, PET scan, MRI, angiogram & lumbar puncture.
CT Scan considerations:
- *- Pre-scan:** check allergies to iodine, shellfish, dyes
- *- Know if kidney function is good** because of the dye
- Lie Still
- Patient IV
PET scan considerations:
- NPO 6-8 hrs prior to test
- Monitor Kidney Functions
No Caffeine, ETOH, or Tobacco for 24hrs.
MRI considerations:
- *Pre procedure**
- Remove metal objects
- Teach test will last about 50 minutes (a long time)
Angiogram considerations:
*- Monitor kidney function
- Ensure consent is signed*
- Teach test can cause a warm flushed feeling
- Teach test will last 1-2hrs
Lumbar Puncture Nursing Considerations:
Pre-Procedure
- Hold anticoagulants
- Insure informed consent is obtained
- Position in curved back
Post-Procedure
- Flat bedrest 4-6 hours to prevent spinal headache
Compare and contrast trigeminal neuralgia and facial palsy (i.e., cranial nerve impacted, signs/symptoms and management).
- Trigeminal Neuralgia :
(Chronic pain syndrome) (W>M) (>50)
- Trigger Zone
- Classic pain: Unilateral, excruciating pain, sharp, shooting, piercing, burning, jabbing.
- Provoked by minimal trigger point zone like brushing teeth
- *Management**
- Pain Management
- Chemical nerve block
- Meds
- Surgical
2.Facial Palsy (CN VII) (All ages)
- 1/2 of face has weakness
- May not be able to close eye
- inability to smile
- Asymmetrical smile
- Difficulty chewing
- *Management**
- Corticosteroids
- Patch eye
- Pain management
What are the contributing factors that cause a thrombotic ischemic stroke?
- African American
- >55 y/o
- Men
- HTN
- Smoking
- Atherosclerosis
What are the contributing factors that cause an embolic ischemic stroke?
Cardiac in nature:
- A-fib
- MI
- Endocarditis
- Cardiomyopathy
What is the difference between a migraine and a cluster headache?
1. Migraine Headache S/S:
- Intense Throbbing Pain
- Unilateral
- Photophobia/phonophobia
- N/V
2. Cluster headache S/S
- Severe pain
- Supraorbital
- Unilateral
- Ipsilateral conjunctival infection (watery eyes, swollen eye)
- Miosis (constriction of the eye)
- Ptosis
What are the nursing interventions for a patient who is having a seizure?
- Maintain airway
- Look at clock
- Protect from injury
- Create no harm
- Turn on side
- Protect from injury
- Loosen clothing
- Record duration of seizure
- Obtain vitals at the end
- Good documentation
What nursing interventions are used to manage the patient with Parkinson’s disease?
- Maintain as much functionality as you can
- Assess swallowing, bladder
- Fall and Aspiration Precautions
What nursing interventions are used to manage risk for injury and caregiver role strain with patients suffering from Alzheimer’s disease?
1. Caregiver Teaching for Alzheimer:
- Realistic Expectations
- Patient is not going to get better (Progressive Disorder)
- Use humor with the person with Alzheimer’s
- Promote caregiver’s self-care
- Respite Care
2. Nursing interventions for Alzheimers:
- Do not raise voice
- Non-confrontational
- Observe Well (watch out, they wander)
- Give simple directions
- Simple Questions
- Validate feelings
- Talk Softly
- *Medical Management:**
- Cognitive stimulation and memory training
- Structuring environment
- Bladder continence
- Promoting self-management
- Promoting communication
What nursing interventions should be implemented to manage chronic confusion and risk for injuring with Alzheimer’s disease?
Interventions to manage chronic confusion
- Give simple directions
- Simple Questions
- Validate feelings
- Talk softly
- Re-orient
- Don’t argue
With injury
- Do not change rooms
- Observe well
- Avoid Restraints
