Neurological Pathophysiology & Nursing

Question 1

stroke [pathophysiology, risk factors, clinical manifestations, management, nursing management, surgical interventions]

Answer 1

an acute focal neurological defect caused by a vascular disorder that injures brain tissue
Pathophysiology: central core of dying cells > receive marginal blood flow > cells continue to die unless adequate circulation returns
Risk factors: age, gender, history, hypertension, heart disease, smoking, high cholesterol, diabetes
Clinical manifestations: drooped face, muscle weakness to one side of the body, slurred speech,
Management: anticoagulant, BP management
Nursing management: investigations, vitals, GCS, 02, frequent neuro assessment, elevate bed head
Surgical intervention: carotid endarterectomy

Question 2

migraine [pathophysiology, risk factors, clinical manifestations, management, nursing management, surgical interventions]

Answer 2

Risk factors: illness, cranial neuralgias, musculoskeletal tension
Clinical manifestations: irritability, cold, visual disturbances, drowsiness, headache, nausea, exhaustion, mood changes
Management: medication, sleep, quiet dark environment
Nursing management: pharmacology, vitals, neuro obs, cold compress

Question 3

meningitis [pathophysiology, risk factors, clinical manifestations, management, nursing management, surgical interventions]

Answer 3

Pathophysiology: invading organism > endotoxins released from bacteria > inflammatory mediators released > increased production of CSF > endothelial lining becomes leaky protein and fluid leaks out > raised ICP cerebral oedema
Complications: increased ICP, residual neurological effect (eye movement, unequal pupils, sensory loses, facial paralysis), dysphasia, seizures
Risk factors: exposure to bacteria
Clinical manifestations: severe headache, fever, photophobia, neck stiffness, restlnessness
Management: antibiotics (bacterial only), antiemetics, anticonvulsant, IV hydration
Nursing management: lumbar puncture, blood culture, brudzinski sign, frequent neuro assessment, airway management, 02 therapy, isolation, hygiene, oral care