Neurologic Deficits Flashcards
-One or more functions of CNS or PNS are decreased, impaired, or absent.
-Often affects more than one body system
Neurologic Deficit
Examples of Neurologic Deficits
paralysis; muscle weakness; inability to recognize objects; impaired speech, memory, swallowing; abnormal gait, difficulty walking; abnormal bowel (stool softeners), bladder elimination
The 3 phases of Neurologic deficits
acute, recovery and chronic (not all phases may be experienced by all clients)
Acute Phase of Neurologic Deficit
most important is to keep them alive
-Sudden neurologic event: client critically ill (tpi, anyusma)
-Medical and Surgical Management: stabilization; prevent further neurologic damage
-Drug therapy, mechanical ventilation, surgical intervention
-Nursing Management: frequent neurologic (as often as ordered), physical assessments
-Glasgow Coma Scale; Mini-Mental Status Examination
-Basic rehabilitation interventions
-Prevent complications
when they have woken up and are starting to be able to move again
-Begins upon stabilization of client’s condition; lasts weeks to months
-Medical/Surgical Management: keeping the client stable
-Prevention and treatment: complications; neurologic impairment
-Nursing Management: Continual assessment of client’s abilities (are they improving or declining), potential
-Assessment tools
-Planning rehabilitation program
-can be very challenging for patients and family as their lives may never be the same. Allow them to show those emotions
Recovery Phase
Chronic Phase
this is where they will be for the rest of their lives
-Client exhibits little, no improvement; progressively worsens
-Medical and Surgical Management
-Rehabilitation rationale: prevent complications
-Surgery rationale: correct resulting problems
-Nursing Management
-Prevent physical, psychological complications (lots of emotions from patient here)
-Rehabilitation center therapy
-The focus of management during the acute phase is to stabilize the client and prevent further neurologic damage. Keep the client alive
-Medical management during the recovery phase aims at keeping the client stable and preventing or treating complications, such as pneumonia, and further neurologic impairment.
-Physical and psychological rehabilitation continues in the chronic phase to prevent complications, such as pressure ulcers and muscle contractures (if they don’t use them they loss them)
Primary Aims of Medical Treatment for neurologic deficit
Neurologic deficit healthcare team management
-Team Members
-Primary provider; nurse
-Nursing assistant; social worker
-Physical therapist; occupational therapist (help strengthen muscles that are under voluntary control)
-Speech therapist; prosthetist; dietitian
-Psychotherapist; pharmacist
-Vocational counselor
Neurologic Deficit: return to home issues
could be in a wheelchair, one less limb, no memory. Family will also have these.
-Fear
-Increased need for support
-Caregiver burden
-Financial strain
-Home adaptation
-Relearning of employment skills
Identification of problems and needs and give support, Evaluation of client’s abilities, Assessment of assistance
-Individual coping
-Reassurance; emotional support
-Empathy; support groups
-Solutions; possible alternatives
-listen to them, they may just need someone to hear them
-Socialization: health team; family; occupational, recreational therapies (see Nursing Guidelines 40-1)
-Family processes
-Changes: acceptance; processing
-Communication; venting
-Rehabilitation participation (really push them to get to rehab)
-Client and family teaching
Neurologic deficit nursing management
Neurologic Deficit Nursing Process
-Assessment
-Thorough history; general neurologic assessment
-Specific systems; emotional, mental status
-Diagnosis, Planning, and Interventions
-Impaired: physical mobility, etc.
-Risk: impaired skin, tissue integrity; disuse syndrome, etc.
-Elimination issues
-Evaluation of expected outcomes
-No signs of skin breakdown
