Week 8 - Neurological, Gastrointestinal and Integumentary

Question 1

How does immobility impact the neurological?

Answer 1

• Lack of activity results in lower levels of endorphins (mood elevating substances).
• Boredom; lack of stimulation and communication patterns altered
• Self concept and esteem impacted due to reduced ability to carry out previous functions and roles which may lead to depression, withdrawal; ‘pyjama paralysis’
• Exaggerated responses and behaviours associated with frustration

Question 2

What are the nursing intervention for neurological?

Answer 2

• Holistic nursing care – person-centred approached; active participate in plan of care and decision making
• Spend time; active listening; promote social interaction, stimulate with purposeful activities – interests, hobbies, sunshine, outdoors, visitors

Question 3

How does immobility affect the gastrointestinal?

Answer 3

• Peristalsis impaired due to immobility
• Poor digestion, gastric reflux, indigestion
• Nausea, gas
• Constipation – weakening of muscles of skeletal and abdomen, peristalsis is aided by standing

Question 4

What are symptoms of gastrointestinal complications?

Answer 4

• Abdominal discomfort and pain
• Bloating
• Stomach cramps
• Painful bowel movements
• Rectal bleeding

Question 5

What is faecal impaction?

Answer 5

• Accumulation of hardened faeces in the rectum or sigmoid colon that cannot be expelled
• May result in faecal incontinence – overflow diarrhoea

Question 6

What are the nursing interventions for gastrointestinal?

Answer 6

• Removal of hard faeces – manually with lubricated glove
• Cleansing enemas; regular aperient
• High fibre diet (bulk) – caution not to ‘dry out’ faeces
• Hydration; promote exercise

Question 7

How can we prevent complications in the integumentary?

Answer 7

• Risk assessment using recognised tool
• Skin assessment
• Education of patient & family
• Regular repositioning – 2 hours
• Pressure reducing mattresses; support cushions
• High nutrition diet, protein rich