Neurological Disorders

Question 1

what are meningitis and encephalitis?
signs and nursing management?

Answer 1

dangerous infections which cause inflammation of spinal cord and brain
- debilitating and potentially life threatening

signs
- ataxia/disorientation/walking in circle
- nystagmus
- confusion
- weakness
- worse case = seizures/coma/death

nursing management
- antibiotics/antivirals/antiprotozoals
- steroids and analgesia
- IVFT
- nutritional therapy

Question 2

clinical signs of a brain injury?
diagnostics and nursing care?

Answer 2

signs
- nystagmus
- epistaxis
- ataxia
- confusion/disorientation
- vomiting/nausea
- abnormal pupillary light reflex
- seizures/unconsciousness

diagnostics
- physical examination of signs
- x-rays and CT - fractures to skull
- rhinoscopy

nursing care
- medications
- supportive care - eg. recumbency and raised food/water
- injury management - eg. padding
- quiet and dark room
- may need u. catheter - management

Question 3

causes and classifications for epilepsy and seizures?

Answer 3

causes
- within the brain - tumours, trauma, infection, congenital
- outside the brain - toxins or metabolic

focal (partial) seizures = part of brain
- focal twitching, salivation, excessive rubbing of face

generalised seizures = both sides of brain
- most common is tonic-clonic (grand mal)
- tonic = loses consciousness, muscles go rigid - 10-30 seconds
- clonic = rhythmical movements like paddling and chewing

Question 4

Diagnostics and nursing care for epilepsy and seizures?

Answer 4

diagnostics
- monitoring/filming - seizure diary
- history and neurological examination
- blood tests
- CSF tap
- MRI and CT

Nursing care
- monitor vital and seizures - diary
- regular check-ups
- protect during seizures - safe position, dark and no sensory stimuli
- medications/IVFT/O2 therapy
- lubricate eyes

Question 5

signs of the stages of epilepsy?

Answer 5

Pre-Ictal Signs
- unsettled movements - pacing, licking/chewing, twitching
- excessive salivation and urination
- heightened anxiety - vocalisation and glazed eyes

Ictal Signs
- muscle stiffening - may fall to the floor
- stretched out legs with rigid, jerking or paddling movements
- heavier and faster breathing
- vocalisation
- eyes rolled back
- passing urine or faeces

Post-Ictal Signs
- may lie motionless for some time
- disorientation/ataxia - sometimes aggression
- temporary loss of sight
- excessive hunger/thirst
- uncontrolled bowel/bladder

Question 6

what is tetanus?
signs, diagnostics and nursing care?

Answer 6

an aggressive toxin which attacks the nerves which control muscles
- usually picked up through cuts/dirty wounds or contaminated food sources and soil

signs
- lockjaw and progressive difficulty to move around
- 3rd eyelid protusion
- anxious expression with stiff neck and pricked ears
- muscle spasms and tail raised
- extreme sensitivity and pain

diagnostics
- physical examination for clinical signs
- signs of injury/wounds
- history - eaten anything?

nursing care
- tetanus toxoid and antibiotics
- keep warm and calm
- IVFT to flush bacteria
- massage and physio
- may need tube feeding