MOD 3 Neurology Flashcards
follows a sudden neuro event
the client is critically ill
focus on stabilizing the patient
prevent further damage
respiratory support
Acute Phase of neurological deficit
Pharmacological management
–Agitation - Lorazepam; Haldol
–Dementia - Aricept
Nutrition
–Finger foods; frequent feedings; encourage fluids
Safety
Alzheimer’s Disease - Nursing / Medical Management
Early Stage
–Mild Memory lapse
–Decreased attention span
Second Stage
–obvious memory lapse
Third Stage
–Total disorientation to person, place, time
–Apraxia, wandering
Terminal Stage
–Severe mental and physical deterioration
Alzheimer’s Disease - S/S
No Cure, palliative treatment
Pharmacological management
–Antipsychotics
–Antidepressants
–Anti-choreas
Safe environment
Emotional support
High-calorie diet
Huntington’s Disease - Nursing / Medical Management
Inflammation process involving the facial nerve
Herpes Simplex Virus
Bell’s Palsy - Etiology / Pathophysiology
Pharmacological Management
–Corticosteroids
–antiviral medication
Electrical stimulation
Moist heat
Massage of the affected area
Facial exercise
Bell’s Palsy - Nursing / Medical Management
Facial numbness or stiffness
Drawing sensation of the face
Unilateral weakness of the facial muscle
Reduction of saliva
Pain behind the ear
Ringing in the ear or other hearing loss
Bell’s Palsy - S/S
Accumulation of pus within the brain tissue
Brain Abscess - Etiology / Pathophysiology
Antimicrobial therapy
Supportive care
Brain Abscess - Nursing / Medical Management
Headache
Fever
Drowsiness
Changes in LOC
Seizures
Brain Abscess - S/S
some neuro events are chronic and progressive
prevent complications
environmental changes
home care
facility placement
coping
socialization
Chronic Phase of neurological deficit
No specific treatment
–Meds to enhance function as long as possible
Symptoms management
–Baclofen (Lioresal)
–Steroids
Nutrition
Skincare
Activity
Environmental controls
Patient teaching
Multiple Sclerosis - Nursing / Medical Management
Aura
Status Eplilepticus
Postictal period
Epilepsy / Seizures - S/S
Viral or Autoimmune Reaction
Schwann cells are attacked
Guillain-Barre Syndrome - Etiology / Pathophysiology
Plasmapheresis
Supportive therapy
–Neurontin
–Mechanical Ventilation
–Gastrostomy Tube
–Meticulous skincare
–ROM exercises
–Monitor respiratory distress
Guillain-Barre Syndrome - Nursing / Medical Management
Progressive paralysis
Starts in the lower extremities
Moves upward
May stop at any point
Respiratory failure
Difficulty swallowing, breathing, and speaking
Guillain-Barre Syndrome - S/S
Overactivity of dopamine
Genetically transmitted - 50%
Huntington’s Disease - Etiology / Pathophysiology
Chorea (involuntary, irregular, and brief muscle contractions)
Ataxia to immobility
Hallucinations, delusions present
Huntington’s Disease - S/S
Drowsiness
Confusion
Restless
Personality changes
Dull headache
Vomiting
Increased Intracranial Pressure - ICP
Early S/S
Increase in any content of the cranium
–Tumor or Hemorrhage
Space-Occupying lesions
Cerebrospinal problems
Cerebral edema
NEEDS TO BE DETECTED EARLY
Increased Intracranial Pressure - ICP
Etiology/Pathophysiology
Unresponsive
Dilated pupils
Seizures
No response to painful stimuli
Cushing Triad
Increased Intracranial Pressure - ICP
Late S/S
Elevate HOB 30-45
Neck in neutral position
Restrict fluid intake
Administer stool softener
Place Foley
Suction only as necessary
O2 as necessary
Monitor body temp
Limit coughing
Communicate with family
Increased Intracranial Pressure - ICP
Nursing Management
Treat cause (if possible)
Pharmacological Management
–Osmotic Diuretic
–Corticosteroids
–Anticonvulsants
–Benzodiazepines
Mechanical decompression
–Craniotomy/Craniectomy
Internal monitoring device
Increased Intracranial Pressure - ICP
Medical Management
Pharmacological management
–Manage ICP
–Antibiotic
—-Massive Doseses
—-Multiple Types
—-IV or intrathecal
–Antipyretics
Dark, quiet room
Meningococcal Vaccine
Meningitis - Nursing / Medical Management
Motor neurons in the brain stem and spinal cord gradually degenerate.
Electrical and chemical messages originate in the brain do not reach the muscles to activate them
Lou Gehrig’s Disease - ALS
Etiology / Pathophysiology
NO CURE
Rilutek (Riluzole)
Emotional support
Lou Gehrig’s Disease - ALS
Nursing / Medical Management
Weakness of the upper extremities
Dysarthria
Dysphagia
Muscle wasting
Compromised respiratory function
Lou Gehrig’s Disease - ALS
S/S
Acute infection of the meninges
Bacterial or aseptic
Increased incidence in winter and fall months
Meningitis - Etiology/Pathophysiology
Headache
Stiff neck
irritability
restlessness
Malaise
Nausea / Vomiting
Delirium
Elevated
–Temp
–Pulse
–Respirations
Kernig’s and Brudzinski’s signs
Meningitis - S/S
Autoimmune Disease
Triggered by a defective gene
Degenerative with permanent demyelination of the myelin sheath
Multiple Sclerosis - Etiology / Pathophysiology
Blurred vision
Muscle weakness
Incontinence
Incoordination - Dysmetria
Dysphasia
Multiple Sclerosis - S/S
Autoimmune
Weakness during activity
Strength restored with rest
antibodies attack acetylcholine receptor sites
Myasthenia Gravis - Etiology / Pathophysiology
Pharmacology Management
–Plasmapheresis
–Anticholinesterase drugs
—-Prostigmin
—-Mestinon
–Corticosteroids
–Immunosuppressants
May require mechanical ventilation
Myasthenia Gravis - Nursing / Medical Management
Ptosis(eyelid drooping)
Diplopia
Mask-like facial expressions
Bowel and bladder incontinence
Weakness with repetitive movements
Myasthenia Gravis - S/S
Muscle relaxants
Protect from falls
Assess skin integrity
Positioning
Sit up and tuck chin when eating
Encourage patient to assist with ADLs
Emotional Support
Neurological Deficit - Nurse/Medical Management
Flaccid
Hyperreflexic
clumsiness/incoordination
abnormal gait
Neurological Deficit - S/S
Pharmacological management
–Sinemet (levodopa-carbidopa)
Surgery
–Deep brain stimulation
Activity
Nutrition
Parkinson’s Disease - Nursing / Medical Management
Muscular tremors
Bradykinesia
Rigidity
Propulsive gait
Emotional instability
Heat intolerance
Decreased blinking
“Pill-rolling” motions of fingers
Parkinson’s Disease - S/S
keep client stable
environmental changes
prevent complications
rehabilitation
Recovery Phase of neurological deficit
Spinal shock
Autonomic dysreflexia
Pressure ulcers
Respiratory infections
Urinary and fecal Impactions
Spasticity and contractures
Calcium depletion
Urinary calculi
Pain
Spinal Cord Injury - Complications
Automobile / Motorcycle accidents
Athletic Accidents
Violence
Falls
Fracture of vertebra
Cord Compression
Hematoma
Complete vs. Incomplete cord injury
Spinal Cord Injury - Etiology / Pathophysiology
Long term Management
–Functional Electrical stimulation
–Treadmill training
–Tendon transfer surgery
–Cell transplantation
Spinal Cord Injury - Medical / Surgical management
Initial Treatment
–Immobilization; cervical; collar; traction, halo
–Realignment for fractures or dislocations
–Surgery for spinal decompression
–Corticosteroids
Spinal Cord Injury - Medical / Surgical management
Anticonvulsant medication
Surgery
–Removal of brain tissue where seizure occurs
Epilepsy / Seizures - Medical Management
Protect pt
Adequate rest
Good nutrition
Avoid alcohol
Avoid operating machinery
Avoid swimming
Good oral hygiene
Medic alert tag
Epilepsy / Seizures - Nursing Management
Thrombosis
Embolism
Cerebral Aneurysm
ISCHEMIA OF THE BRAIN TISSUE
Stroke - Etiology / Pathophysiology
Thrombosis or embolism
–Thrombolytics - TPA
–Heparin and Coumadin
Decadron
Stroke - Medical Management
Neurological checks
Nutritional alterations
Physical therapy
Occupational therapy
Speech therapy
Communicating with patients
Stroke - Nursing Management
Headache
Sensory deficit
Hemiparesis
Hemiplegia
Aphasia
–Expressive
–Receptive
Stroke - S/S
Involuntary contractions of a group of muscle
Partial Seizures
–Dont usually lose consciousness
Generalized Seizures
–Involve the entire brain
Epilepsy / Seizures - Etiology / Pathophysiology
Tegretol
Surgical resection of the trigeminal nerve
Avoid stimulation of the face on the affected side
Trigeminal Neuralgia - Nursing / Medical Management
Acute Phase
Recovery Phase
Chronic Phase
What are the phases of neurological deficit?
Pressure on the trigeminal nerve
Trigeminal neuralgia - etiology / pathophysiology
Excruciating burning facial pain
Trigeminal neuralgia - S/S
