understanding medical surgical powerpoint

Linda S. Williams / Paula D. Hopper

Copyright © 2011. F.A. Davis Company

Understanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition

Chapter 47

Neurological Function, Assessment, and Therapeutic

Measures


Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition

Review of Normal A&P



Synapse



Cross Section of Spinal Cord



Brain



Cranial Nerves Olfactory Optic Oculomotor Trochlear Trigeminal Abducens

Facial Vestibulocochlear Glossopharyngeal Vagus Accessory Hypoglossal



Autonomic Nervous System



Aging



Basic Neurological Assessment

Level of Consciousness Vital Signs Pupil Response to Light Extremity Strength and Movement Sensation



History Symptoms Medication Use Surgical History Family History Life Style WHAT’S UP?



Subjective Data Mental Status Intellectual Function Thought Content Perception Language Ability Memory Pain



Physical Assessment Level of Consciousness Mental State Examination Pupillary Response Muscle Function Cranial Nerve Function



Glasgow Coma Scale Eye Opening Verbal Response Motor Response

Posturing



Abnormal Posturing



Pupil Assessment

Equal Round Reactive to Light Reactive to

Accommodation



Diagnostic Tests Laboratory Tests

Thyroid B12 ESR CBC Electrolytes

Hormone Levels Creatine Kinase VDRL Liver Function Renal Function



Lumbar Puncture Pre-Procedure Nursing Care

Verify Informed Consent Assist with Positioning

Post-Procedure Care Maintain Flat Bedrest 6 to 8 Hours Encourage Fluids Monitor Puncture Site Monitor Movement, Sensation, Headache



Lumbar Puncture (cont’d)



CT Scan Pre-Procedure

Administer Contrast if Ordered Check Allergies Check BUN, Cr

Request Order for Sedation if Indicated

Teach Contrast May Cause

Feeling of Warmth Signs and Symptoms

of Allergic Reaction to Report

Post Procedure Encourage Fluids if

Dye Used



MRI Pre-Procedure Nursing Care

Assure No Pacemaker or Metal on Patient Administer Analgesic or Sedative as Ordered Teach Relaxation

Post-Procedure Care No Special Care



Angiogram Pre-Procedure Nursing Care

Verify Informed Consent Give Clear Liquid Diet Insert IV Needle Check BUN/Cr Check PT and PTT Administer Sedation as Ordered



Angiogram (cont’d) Post-Procedure Care

Keep Flat in Bed 6 to 8 Hours Monitor

VS Catheter Insertion Site Pulses

Encourage Fluids



Myelogram Pre-Procedure Nursing Care

Check Allergies to Contrast Assess History of Seizures Verify Informed Consent

Post-Procedure Care Similar to LP Encourage Fluids HOB Elevated 30 Degrees



Electroencephalogram Pre-Procedure Nursing Care

Assure Hair Clean and Dry Check Medication Orders

Post-Procedure Care Wash Hair



Therapeutic Measures Moving and

Positioning Maintain Functional

Positions Avoid Injury Prevent Contracture Mobilize ASAP



Activities of Daily Living Encourage Independence Based on

Functional Level Maintain Routine Provide Assistance as Needed



Communication Problems

Dysarthria Expressive Aphasia Receptive Aphasia

Interventions Use Care with Yes-No

Questions Correct Substituted

Words Anticipate Needs Use Gestures Be Patient!



Nutrition Evaluate Swallowing Interventions for Impaired Swallowing

Thicken Liquids Position Upright for Eating Monitor Meals Tube Feedings

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understanding medical surgical powerpoint