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CNS Ppt

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    CNS Ppt CNS Ppt Presentation Transcript

    • PERCEPTION & COORDINATION
    • NEUROSENSORY SYSTEM MUSCULOSKELETAL SYSTEM
    •  
    • ANATOMY & PHYSIOLOGY
      • NERVOUS SYSTEM (NS)
      • CENTRAL NS
        • BRAIN & SPINAL CORD
      • PERIPHERAL NS
        • CRANIAL & SPINAL NERVES
      • AUTONOMIC
        • SYMPATHETIC - THORACO- LUMBAR
        • PARASYMPATHETIC – S2,3,4
    • ANATOMY & PHYSIOLOGY
      • BRAIN:
      • CEREBRUM
      • DIENCEPHALON
      • BRAIN STEM
      • CEREBELLUM
    • ANATOMY & PHYSIOLOGY
      • CEREBRUM
      • HEMISPHERES
      • LOBES
      • CORPUS CALLOSUM
      • BASAL GANGLIA
      • FRONTAL
      • PARIETAL
      • TEMPORAL
      • OCCIPITAL
    • ANATOMY & PHYSIOLOGY
      • FRONTAL LOBE:
      • PERSONALITY, BEHAVIOR
      • HIGHER INTELLECTUAL FUNCTIONING
      • PRECENTRAL GYRUS: MOTOR FXN
      • BROCA’S AREA – MOTOR SPEECH
      WERNICKE’S AREA OF TEMPORAL: SENSORY SPEECH
      • PARIETAL LOBE:
      • POST CENTRAL GYRUS : GENERAL SENSATION
      • INTEGRATES SENSORY INFO
      BROO---M
    • ANATOMY & PHYSIOLOGY
      • TEMPORAL LOBE
      • HEARING, TASTE & SMELL
      • WERNICKE’S AREA – SENSORY SPEECH
      BROCA’S AREA OF FRONTAL LOBE – MOTOR SPEECH
      • OCCIPITAL LOBE
      • VISION
      • BASAL GANGLIA
      • REGULATE & INTEGRATE MOTOR ACTIVITY
      • PART OF EPS
    • ANATOMY & PHYSIOLOGY
      • DIENCEPHALON
      • THALAMUS
      • HYPOTHALAMUS
      • BRAINS STEM
      • MIDBRAIN, PONS, MEDULLA
      • NUCLEI OF CN’s - 12
      • VITAL CENTERS OF: REPIRATORY, VASOMOTOR & CARDIAC FXNS
      • CEREBELLUM
      • MUSCLE TONE & EQUILIBRIUM
      PRIMITIVE EMOTIONS: RAGE & FEAR CONTROL CENTER FOR PITUITARY REGULATION OF VITAL FXN : BP, SLEEP, FOOD INTAKE, BODY TEMP
    • ANATOMY & PHYSIOLOGY
      • SPINAL CORD
      • GRAY MATER
        • H SHAPED
        • INTERIOR
      • WHITE MATER
        • EXTERIOR
      • CENTER OF REFLEX ACTIONS
      • 31 SEGMENTS :
        • 8 CERVICAL
        • 12 THORACIC
        • 5 LUMBAR
        • 5 SACRAL
        • 1 COCCYGEAL
    • ANATOMY & PHYSIOLOGY
      • MENINGES
      • SEROUS MEMBRANE OF CRANIOSPINAL CAVITY
      • 3 LAYERS:
        • DURA
        • ARACHNOID
        • PIA
      -CS FLUID
    • ANATOMY & PHYSIOLOGY
      • NERVES
      • FIBERS WHICH EXTEND BEYOND CNS
      • NEURON
      -BASIC UNIT REFLEX ARC BASIC FXNAL UNIT OF N.S.
      • SENSORY/MOTOR
      • MIXED
      • PERIPHERAL
    • ASSESSMENT FACTORS
      • HEADACHE
      • SYNCOPE
      • VERTIGO
      • SEIZURES
      • NEUROLOGIC PAIN
      • INCREASED ICP
      • ABN BODY TEMP ALTERATIONS
      • APHASIA
    • HEADACHE/ CEPHALGIA
      • CAUSE:
      • TENSION
      • DISPLACEMENT/ INFLAMMATION/ DIRECT PRESSURE ON PAIN-SENSITIVE STRUCTURES
      • DILATATION OF ARTERIES
      • CLASSIFICATION:
      • MUSCLE CONTRACTION H/A
      • VASCULAR H/A
      • MUSCLE CONTRACTION HEADACHE
      • MTC
      • PSYCHOGENIC : ANXIETY / DEPRESSION
      • MANAGEMENT:
      • WARM COMPRESS
      • GENTLE MASSAGE
      • ANALGESICS, TRANQUILIZERS
      • VASCULAR HEADACHE
      • PRECIPITANTS:
      • ALLERGIES
      • TYRAMINE
      • EMOTIONAL STRESS
      • FATIGUE
      • VASODILATING DRUGS
      • TYPES:
      • 1. MIGRAINE 2. CLUSTER 3. INFLAMMATORY
      • MIGRAINE (SICK H/A)
      • PERFECTIONISTS & HARDWORKING
      • STRESS
      • CAUSE:
      • CONSTRICTION, THEN DILATION OF CEREBRAL VESSELS
      • TREATMENT:
      • VASOCONSTRICTORS – ERGOTAMINE TARTRATE
      • ICE PACK
      • QUIET, DARKENED ROOM
      • PSYCHOTHERAPY
      • CLUSTER HISTAMINE HEADACHE
      • SEVERE
      • ORGANIC IN NATURE
      • INFLAMMATORY/ TRACTION HEADACHE
      • VERY RARE
      • OCCURS IN AM
      • INVOLVES THE ENTIRE HEAD
    • SYNCOPE/FAINTING
      • TRANSIENT LOSS OF CONSCIOUSNESS
      • INADEQUATE BRAIN PERFUSION
      • CAN BE EVOKED BY :
      • EMOTION
      • PAIN
      • SUDDEN DECREASE IN CO OR VENOUS RETURN FROM ANY CAUSE
      • MANAGEMENT:
      • DANGLE FEET FOR 30 SEC BEFORE STANDING
      • SPIRITS OF AMMONIA
    • VERTIGO
      • SENSATION OF:
        • ROTATING SURROUNDINGS
        • CLIENT IS ROTATING
      • SEEN IN:
        • NEURO DSE
        • OTOLOGIC DSE
        • CARDIOVASC DSE
      • DIZZINESS
      • NYSTAGMUS
    • SEIZURE/EPILEPSY
      • TYPES:
      • GRAND MAL
      • PETIT MAL PSYCHOMOTOR
      • MYOCLONIC
      • FOCAL
      GRAND MAL CLINICAL SEQUENCE: AURA CRY LOSS OF CONSCIUOSNESS FALL TONIC-CLONIC CONVULSION INCONTINENCE
      • AFTER THE SEIZURE:
      • GROGGY & CONFUSED, DEEP SLEEP
      • PETIT MAL
      • LITTLE SICKNESS/ ABSENCE
      • MOMENTARY EPISODE OF L.O.C.
      • LASTS 10-20 SEC
      • CLIENT UNAWARE
      • CHILDREN & ADOLESCENTS
      • PSYCHOMOTOR SEIZURE
      • PERFORMANCE OF AUTOMATIC ACTIVITIES
      • IMPAIRMENT OF CONSCIOUSNESS:
        • LOC
        • AMNESIA
      • NO APPARENT CONVULSION
      • MYOCLONIC SEIZURE
      • SUDDEN INVOLUNTARY CONTRACTION OF A
      • SINGLE OR SMALL GROUPS OF MUSCLE
      • MAY OCCUR DURING PETIT MAL
      • FOCAL MOTOR/ JACKSONIAN
      • ARISE INITIALLY IN THE MOTOR AREAS
      • OF THE BRAIN
      • FROM LOCAL CLONIC MOVEMENTS TO
      • GENERALIZED SEIZURE
      • MEDICAL TREATMENT:
      • GENETIC COUNSELLING
      • ANTICONVULSANTS
      • - TAKEN FOR LIFE
      • FREQUENT CAUSES OF FAILURE IN TREATMENT:
      • POOR COMPLIANCE
      • INADEQUATE DOSAGE ( ACCORDING TO WEIGHT )
      • NURSING INTERVENTION:
      • PRIMARY RESPONSIBILITY:
        • PROTECT PATIENT FROM INJURY
        • OBSERVE & RECORD THE SEIZURE EPISODE
      • DO NOT RESTRAIN THE PATIENT
      • PADDED SIDE RAILS, NO PILLOWS
      • MAINTAIN AIRWAY
      • PATIENT EDUCATION
      • PATIENT EDUCATION:
      • CARRY ID CARD AS AN EPILEPTIC
      • REST, REGULAR MEALS, WELL-BALANCED DIET
      • AVOIDANCE OF:
        • EXTREME PHYSICAL EXERTION
        • INFECTION
        • EMOTIONAL STRESS
      • ALCOHOL
      • MODERATE COFFEE, TEA & COLA
      • STIMULANT DRUGS
    • NEUROLOGIC PAIN
      • ARISE FROM NEUROLOGIC LESIONS CONCERNING PAIN SENSATION
      • SURGERY:
        • NEURECTOMY – 5 TH NERVE RESECTON IN TRIGEMINAL NEURALGIA
        • RHIZOTOMY- RESECTION OF THE POSTERIOR NERVE ROOT
        • CORDOTOMY – LATERAL SPINOTHALAMIC TRACT
    • INCREASED INTRACRANIAL PRESSURE
    • INCREASED INTRACRANIAL PRESSURE
      • THE SKULL IS A CAVITY
      • CONTAINING THE
      • BRAIN TISSUE, CSF, & BLOOD…
      ALL OF WHICH MAINTAIN A NORMAL PRESSURE INSIDE THE SKULL. AN ELEVATION IN THE AMOUNT OF ANY OF THEM WOULD MEAN AN ELEVATION IN THE PRESSURE INSIDE THE CRANIUM CONSIDERING THAT THE SKULL IS RIGID..
    • INCREASED INTRACRANIAL PRESSURE
      • CAUSES:
      • TUMOR
      • HEAD INJURY
      • INFLAMMATORY DSES OF THE NERVOUS SYSTEM
      • CONDITIONS WITH ARTERIOLAR SPASM (e.g.MALIGNANT HPN)
      • ANYTHING THAT BLOCKS PARTLY OR COMPLETELY THE NORMAL COURSE OF CSF
    • INCREASED INTRACRANIAL PRESSURE
      • TREATMENT:
      • CONSERVATIVE:
      • HYPERBARRIC O2 / HYPERVENTILATION– VASOCONSTRICTION DUE TO HYPOCAPNIA
      • ELEVATE HOB
      • MEDICATIONS
        • MANNITOL
        • STEROIDS- DECADRON – ONLY STEROID THAT CAN CROSS THE BBB
      • 4. FLUID RESTRICTION
      • AGGRESSIVE: MECHANICAL DECOMPRESSION
        • CRANIOTOMY – BRAIN TISSUE EXPANSION
        • VENTRICULAR DRAINAGE
    • INCREASED INTRACRANIAL PRESSURE
      • MANIFESTATIONS:
      • HEADACHE
      • VOMITING
      • WIDENING PULSE PRESSURE
      • SLOWING OF RESPIRATION
      • FALLING PULSE RATE
      • PAPILLEDEMA
      • LOSS OF MOTOR FUNCTION
      • SEIZURE
      • LOSS OF SPHINCTER CONTROL
      • TEMPERATURE VARIATIONS
      • CHANGES IN LOC
      • BULGING OF FONTANELS
      • TENSION ON INTRACRANIAL
      • VESSELS
      • NURSING CARE:
      • KEEP HOB ELEVATED
      • POST: NO TRENDELENBERG
      • ASPIRIN AS ORDERED
      • NO NARCOTICS
        • ( PUPILLARY CHANGES)
      • UNRELATED TO MEALS
      • OR NAUSEA
      • PROJECTILE
      • PRESSURE STIMULATION OF
      • MEDULLA OBLONGATA
      • NURSING CARE :
      • I & O
      • WITHHOLD ORAL FLUIDS
      • SUCTION IF NEEDED
      • REFLEX EFFECT OF
      • CEREBRAL ANOXIA
      • NURSING CARE:
      • MONITOR VS HOURLY
      • REPORT WIDENING OF
      • PULSE PRESSURE
      • PRESSURE & ANOXIA
      • OF MEDULLA
      • UNCAL HERNIATION
      • NURSING CARE:
      • MONITOR VS HOURLY
      • RR IN 1 FULL MIN
      • REFLEX EFFECT OF RISING BP
      • NURSING CARE:
      • MONITOR VS HOURLY
      • PULSE IN 1 FULL MIN
      • UNCAL HERNIATION
      • CHOKED DISC
      • VISUAL IMPAIMENT
      • IRREGULAR SIZE & PUPILLARY
      • RESPONSE
      • PUPILS UNILATERALLY FIXED
      • DILATED & LATER, BILATERALLY
      • VENOUS ENGORGEMENT OF
      • CENTRAL RETINA
      • NURSING CARE:
      • PUPILLARY CHECKS : EQUALITY
      • & REACTION TO LIGHT
    • INCREASED INTRACRANIAL PRESSURE
      • HEADACHE
      • VOMITING
      • WIDENING PULSE PRESSURE
      • SLOWING OF RESPIRATION
      • FALLING PULSE RATE
      • PAPILLEDEMA
      • MANIFESTATIONS:
      • LOSS OF MOTOR FUNCTION
      • SEIZURE
      • LOSS OF SPHINCTER CONTROL
      • TEMPERATURE VARIATIONS
      • CHANGES IN LOC
      • BULGING OF FONTANELS
      • DECORTICATE
      • DECEREBRATE
      • PRESSURE ON MOTOR
      • CENTERS
      • NURSING CARE:
      • RECORD HEMIPARESIS
      • CN CXS
      • CHECK REFLEXES
      • INTRACRANIAL
      • STIMULATION TO BRAIN
      • NURSING CARE:
      • CARRYOUT SEIZURE
      • PRECAUTION
      • CEREBRAL PRESSURE
      • INTERFERE WITH
      • SPHINCTER INHIBITORY
      • CONTROL
      • NURSING CARE:
      • RECORD I & O
      • CHECK DISTENTION/
      • INCONTINENCE
      • CATHETERIZE
      • DAMAGE TO
      • HYPOTHALAMUS
      • METABOLIC CHANGES
      • DEVELOPMENT OF
      • MENINGITIS
      • NURSING CARE:
      • ANTIPYRETICS
      • ICE BAG
      • REMOVE EXCESSIVE
      • CLOTHING
      • PREVENT CHILLS
      • LETHARGY – EARLIEST SIGN
      • OF INCREASED ICP
      • PRESSURE ON CEREBRAL
      • CORTEX & RAS
      • NURSING CARE:
      • NOTE RESTLESSNESS
      • EVALUATE
      • CONSCIOUSNESS
      • RECORD DISORIENTATION
      • & HALLUCINATIONS
      • MECHANICAL PRESSURE
      • NURSING CARE:
      • REPORT CSF LEAKAGE
      • REINFORCE WITH
      • DRESSINGS
    • INCREASED INTRACRANIAL PRESSURE
      • GENERAL MEASURES:
      • AVOID STRAINING WITH DEFECATION
      • PREVENT COUGHING
      • REDUCE ENVIRONMENTAL STIMULI
      • RESTRAIN CLIENT PRN
      • ALWAYS ASSUME THAT CLIENT CAN HEAR
    • ABNORMAL BODY TEMPERATURE
      • HYPERTHERMIA/ HYPERPYREXIA
      • > or = 41 o C or 106 o F
      • The temperature-regulatory center in the hypothalamus can be disturbed by:
        • CEREBRAL EDEMA
        • CEREBROVASCULAR DISEASE
        • INTRACRANIAL SURGERY
        • HEAD INJURY
        • BRAIN TUMORS
      EACH O C OF RISE IN TEMP = 13 % INCREASE IN O 2 REQIREMENT OF BODY TISSUES… BRAIN TISSUE IS HIGHLY SUSCEPTIBLE TO HYPOXIA…..
      • NURSING MANAGEMENT:
      • MAINTAIN ROOM TEMP
      • INCREASE FLUIDS 3000 ML/DAY
      • ANTIPYRETICS
      • COMFORT MEASURES
      • MONITOR VS
      • ICE BAGS TO GROIN, AXILLA
    • APHASIA OR DYSPHASIA
      • ORGANIC DISTURBANCE IN LANGUAGE FROM CORTICAL TISSUE DAMAGE
      • TEMPORAL LOBE
      • HEARING, TASTE & SMELL
      • WERNICKE’S AREA – SENSORY SPEECH
      • FRONTAL LOBE:
      • PERSONALITY, BEHAVIOR
      • HIGHER INTELLECTUAL FUNCTIONING
      • PRECENTRAL GYRUS: MOTOR FXN
      • BROCA’S AREA – MOTOR SPEECH
      • NURSING CARE:
      • REHAB 6-12 WKS AFTER STROKE
      • FORMAL SPEECH THERAPY
      • VERBAL STIMULATION
      • TALK SLOWLY & IN A NATURAL TONE
      • SIMPLE WORDS & PHRASES
      • USE CARDS, PICTURES, SLATE BOARDS
    • DIAGNOSTIC ASSESSMENT
      • LUMBAR PUNCTURE
      • QUICKENSTEDT TEST
      • CISTERNAL & VENTRICULAR PUNCTURES
      • ISOTOPE SCANNING OF THE BRAIN
      • COMPUTERIZD AXIAL TOMOGRAPHY
      • EEG
      • ECHOENCEPHALOGRAPHY
      • EVOKED RESPONSES
      • RADIOLOGOC STUDIES
    • LUMBAR PUNCTURE
      • NEEDLE IS INSERTED BETWEEN L3-L4 OR L4-L5
      BELOW THE LEVEL OF THE SPINAL CORD
      • CONTRAINDICATION:
      • INCREASED ICP
      • SEPTICEMIA OR INFECTION
      • USE OF ANICOAGULANT
      • SPACE OCCUPYING LESION
      • NORMAL CSF CHARACTERISTICS :
      • PRESSURE : 6-13 mmHg
      • APPEARANCE : clear & colorless
      • RBC : none
      • WBC : 0-5 cells/mm
      • Protein: very little
      • Glucose: 40-80 mg /dl
      • Chlorides: 720-750 mg/dl
      • Complications:
      • HEADACHE
      • HYPOTENSION
      • MENINGITIS
      • SUBARACHNOID HEMATOMA
    • DIAGNOSTIC ASSESSMENT
      • LUMBAR PUNCTURE
      • QUICKENSTEDT TEST
      • CISTERNAL & VENTRICULAR PUNCTURES
      • ISOTOPE SCANNING OF THE BRAIN
      • COMPUTERIZD AXIAL TOMOGRAPHY
      • EEG
      • ECHOENCEPHALOGRAPHY
      • EVOKED RESPONSES
      • RADIOLOGOC STUDIES
      Assess CSF circulation & any obstruction in the subarachnoid space
      • Detect subarachnoid block
      • & increased ICP
      • Decrease danger of herniation
    • DIAGNOSTIC ASSESSMENT
      • LUMBAR PUNCTURE
      • QUICKENSTEDT TEST
      • CISTERNAL & VENTRICULAR PUNCTURES
      • ISOTOPE SCANNING OF THE BRAIN
      • COMPUTERIZD AXIAL TOMOGRAPHY
      • EEG
      • ECHOENCEPHALOGRAPHY
      • EVOKED RESPONSES
      • RADIOLOGOC STUDIES
      • Initial assessment of intracranial
      • lesion & vascular abnormalities
      • Client’s head is scanned @ various angles
      • Complete brain study
      • Dye
      • Record of electrical activity patterns of the
      • brain using Scalp electrode
      • Prep:
        • 1-2 days before: no tranquilizers, anticonvulsants,
        • stimulants including alcohol
        • Omit tea. Coffee & cola; regular meals & sleep
      • Use of ultrasonic waves to pick up
      • echoes from various intracranial tissues
      • Electrical responses of the brain to
      • external stimulus
      • Diagnosis of:
      • Multiple sclerosis
      • Localized brain lesion
      • Death
        • ANGIOGRAPHY
        • PNEUMOENCEPHALOGRAM
        • MYELOGRAM
        • DISCOGRAPHY
        • VENTRICULOGRAM
      • Injection of radiopaque dye
      • Study of cerebrovascular activity
      • Lumbar puncture
      • Injection of air into the subarachnoid space
      • Contrast picture of subarachnoid cisterns & ventricles
      • Films showing the outline of subarachnoid space
      • Dye or air contrast
      • Locate pathological dse of SC
      • Contrast media to the intervertebral disk
      • Locate abn configurations, characteristics & damages
      • Dye into lateral ventricles through burr holes
      • Detect blockade
    • VENTRICULOGRAM
      • NURSING CARE :
      • PRESURGICAL:
      • SEDATIVE
      • SHAVING
      • CAROTID/VERTEBRAL PUNCTURE: MX NECK CIRCUMFERENCE
      • RECORD BASELINE NEUROLOGIC DATA
      • EXPLAIN THE PROCEDURE
      • POST COMPLETION OF TEST:
      • FLAT OR SEMIFOWLER’S
      • FORCE FLUIDS – ABSORPTION OF CONTRAST MEDIA
      • INCREASED SALIVATION & PERSPIRATION IS NORMAL
      • REDUCE ENVIRONMENTAL STIMULI
      • PAIN RELIEF FOR HEADACHE
      • NO ANTIPYRECTICS : MAY MASK INFECTION
    •  
    • THE UNCONSCIOUS CLIENT
      • UNCONSCIOUSNESS:
      • STATE OF DEPRESSED CEREBRAL FUNCTION
      • NO REACTION TO STIMIULI
      • RESPONSES IS ON THE REFLEX LEVEL ONLY.
      • CAUSE:
      • INTERFERENCE WITH OXYGEN SUPPLY
      • INTERFERENCE WITH GLUCOSE SUPPLY
      • INTERFERENCE WITH TRANSMISSION OF NEURONS
      NURSING CARE:
      • MAINTAIN PATENT AIRWAY
      • HIGHEST PRIORITY
      • LOWER JAW & TONGUE FALLS BACKWARD
      • SUCTIONING
      • POSITIONING
      NURSING CARE
      • MONITOR VS & NEURO STATUS
      • ASSESS THE RATE, QUALITY & RHYTHYM OF
      • PULSE AND RESPIRATION
      • NO ORAL TEMP
      • NEURO CHECKS: LOC, PUPILS,MOTOR STRENGTH
      • & SENSORY FUNCTION
      • NURSING CARE:
      • MAINTAIN SKIN INTEGRITY
        • BLANCHING INDICATES ISCHEMIA
        • MORE FREQUENT POSITION CHANGE
      NURSING CARE
      • MAINTAIN JOINT MOBILITY
        • PROPER POSITIONING
        • FREQUENT TURNING & EXERCISE
        • USE MECHANICAL AIDS:
          • FOOTBOARD
          • TROCHANTER ROLLS
          • HAND ROLLS
      NURSING CARE
      • Maintain sensory function
        • Special ophthalmic solutions : loss of blinking reflex
        • Talk to client- hearing is the last faculty to be lost
      NURSING CARE
      • Maintain fluid & intestinal status
        • Unconscious period: 3L/day of fluid
        • Prolonged coma: NGT feeding
        • Observe client for incontinence, constipation
        • & impaction
        • DIARRHEA – early sign of fecal impaction
        • No rectal stimulation- increase ICP
      NURSING CARE
      • MAINTAINING PSYCHOSOCIAL FUNCTION
        • ASSESS CLIENT’S STATE
        • EXPLAIN IN SIMPLE TERMS
        • THE PROCEDURES & THERAPIES
    • CARE OF NEUROSURGICAL CLIENTS POSITIONING VITAL SIGNS FOODS & FLUIDS SEMIFOWLER’S FLAT ON EITHER SIDE KEEP OFF OPERA- TIVE SITE TURN Q 2H NO SPECIFIC OBSRVE FOR RESPIRATORY DIFFICULTY MONITOR VS OBSERVE FOR SHOCK & INCREASE ICP LIMIT TO 1.5L/DAY DAT AFTER RETURN OF SWALLOWING & GAG NPO X 24 HRS PO FLDS - DAT AFTER RETURN OF SWALLO WING & GAG I & O COMMONALI- TIES INFRA TENTORIAL SUPRA TENTORIAL
    • CARE OF NEUROSURGICAL CLIENTS
      • OTHER MEASURES :
      • DRESSING
      • SUCTION AS NECESSARY
      • DEEP BREATHING, NO COUGHING
      • ICE BAG TO HEAD
      • BOWEL & BLADDER ELIMINATION
      • ANALGESIC, ANTICONVULSANT, STIMULANTS, STEROIDS
      • EYE CARE
      • CLEAR DRAINAGE
      • RESTRAINT CLIENT
      • CATHETERIZE
      • AVOID ENEMA- MAY INCREASE
      • ICP
    • NEUROLOGIC DISORDERS
      • DEGENERATIVE DISEASES
      • CEREBROVASCULAR DISEASES
      • TRAUMATIC INJURIES
      • NEUROPATHIES
      • NEOPLASMS
        • PREMATURE SENESCENCE OF CELLS
      • MULTIPLE SCLEROSIS
      • PARKINSON’S DSE
      • MYASTHENIA GRAVIS
      • ARTERIOSCLEROSIS
      • ANEURYSM, HEMORRHAGE
      • INFARCTION
      • HEAD INJURY
      • SPINAL INJURY
      • TRIGEMINAL NEURALGIA
      • BELL’S PALSY
    • MULTIPLE SCLEROSIS
      • DEGENERATIVE, PROGRESSIVE
      • DEMYELINATION OF MOTOR NERVE FIBERS WITHIN THE BRAIN & SPINAL CORD
      • ETIOLOGY: UNKNOWN;
      • AUTOIMMUNE; VIRUSES
      • S/SX : CHARCOT’S TRIAD:
      • NYSTAGMUS
      • INTENTION
      • TREMOR
      • SCANNING
      • SPEECH
      • MANAGEMENT:
      • PREVENT & TREAT MUSCLE SPASTICITY
        • MUSCLE RELAXANT
        • SLEEP PRONE
      • AVOID SKIN PRESSURE & IMMOBILITY
        • DECUBITUS ULCERS
      • MANAGEMENT:
      • ASSIST TO OVERCOME EFFECTS OF
      • INCOORDINATION
        • WALK WITH FEET WIDER APART
      • SUPPORTIVE MEASURES FOR BLADDER
      • DISTURBANCE
        • ATROPINE & PROBATHINE
      • BLADDER PROGRAM
      • MANAGEMENT:
      • HELP PATIENT WITH OPTIC AND SPEECH
      • DEFECTS
        • CRANIAL NERVES FOR SIGHT &
      • SPEECH ARE AFFECTED BY MS
        • EYE PATCH
      • TRAIN IN ACTIVITIES OF DAILY LIVING
    • PARKINSON’S DISEASE
      • PROGRESSIVE
      • INVOLVES DYSFXN OF BASAL GANGLIA
      • BASAL GANGLIA
      • REGULATE & INTEGRATE MOTOR ACTIVITY
      • PART OF EPS
      • DEFICIENCY OF DOPAMINE FROM
      • SUBSTANTIA NIGRA
      DOPAMINE ACETYLCHOLINE
    • PARKINSON’S DISEASE
      • S/SX:
      • PILL ROLLING & MUSCLE RIGIDITY
      • MASKLIKE APPEARANCE
      • SHUFFLING PROPULSIVE GAIT (FESTINATING GAIT)
      • COGWHEEL MOTION OF JOINTS
      • MANAGEMENT
      • DRUG THERAPY
        • LEVODOPA
        • ANTICHOLINERGICS – COGENTIN, ARTANE
      • PHYSICAL THERAPY
        • COMBAT MUSCLE RIGIDITY
        • GAIT TRAINING
      • SURGICAL – THALAMOTOMY
        • ALLEVIATE TREMOR & RIGIDITY
    • MYASTHENIA GRAVIS
      • ACETYLCHOLINE DEFICIENCY
      • FAILURE OF IMPULSE TRANSMISION
      • WEAKNESS
      • CAUSE:
        • UNKNOWN
        • AUTOIMMUNE
        • INCREASED CHOLINESTERASE
      • SSX:
      • SKELETAL
      • MUSCLE
      • WEAKNESS
      • WEAKNESS OF THE MUSCLES OF :
        • EXTERNAL OCULAR
        • PHARYNGEAL
        • JAW
        • SHOULDER
        • ARM
      • DIAGNOSIS:
      • EDROPHONIUM
      • OR TENSILON
      • TEST
      • MANAGEMENT :
      • DRUGS
      • RADIATION OF THYMUS/ THYMECTOMY
      • QUININE, MORPHNE, NEOMYCIN, LARGE
      • DOSES OF BARBITURATES
    • MYASTHENIA GRAVIS
      • COMPLICATIONS:
      • MYASTHENIC CRISIS
      • CHOLINERGIC CRISIS
      • BRITTLE CRISIS
      MYASTHENIA CRISIS SUDDEN INABILITY TO SPEAK OR MAINTAIN PATENT AIRWAY
      • WEAKNESS OF THE MUSCLES OF:
        • RESPIRATION
        • LARYNX
        • PHARYNX
        • BULBAR
      RESPIRATORY DEPRESSION & AIRWAY OBSTRUCTION CEREBRAL HYPOXIA CNS INJURY & DEATH
      • CAUSES:
      • TEMPORARY RESISTANCE TO ANTICHOLINESTERASE
      • NEED FOR INCREASE IN DOSAGE
      • ACTH THERAPY
      • SIGNS & SYMPTOMS:
      • INITIAL: DYSPHAGIA
      • DIFFICULTY IN SPEAKING
      • EYELID PTOSIS
      • RESPIRATORY ARREST
      • CHOLINERGIC CRISIS
      • OVERMEDICATION WITH ANTICHOLINESTERASE
      • TOO MUCH ACETYLCHOLINE
      • SIGNS & SYMTOMS:
      • SE OF ANTICHOLINESTERASE DRUGS:
        • ABDOMINAL CRAMPS
        • DIARRHEA
        • INCREASE SALIVATION
        • INCREASE SWEATING
        • INCREASE BRONCHIAL SECRETION
      • BRITTLE CRISIS
      • INSENSITIVITY OF ACETYLCHOLINE RECEPTORS
    • CEREBRO-VASCULAR DISEASE CEREBRAL ARTERIOSCLEROSIS & ANEURYSM CEREBRAL INFARCTION & HEMORRHAGE CEREBROVASCULAR ACCIDENT
      • CEREBRAL ARTERIOSCLEROSIS
      • ATHEROMA IN TH BLOOD VESSELS
      • LOSS OF MEMORY FOR RECENT EVENTS
      • CONFUSION
      • PERSONALITY CXS
      • VERTIGO TIA’s
      • CEREBRAL ANEURYSM
      • LOCALIZED OUTPOUCHING OF THE WALL OF AN ARTERY
      • CEREBRAL EMBOLISM
      • OCCLUSION OF THE CEREBRAL VESSEL
    • CEREBROVASCULAR ACCIDENT
      • EFFECTS & MANIFESTATIONS:
      • PREMONITORY SYMPTOMS:
      • LOC
      • CONVULSION
      • HEADACHE & VOMITING
      • VITAL SIGNS CXS
      • MOTOR & SENSORY DEFICITS
      • SPEECH DEFECTS
      • HEADACHE
      • NUCHAL RIGIDITY
      • DIZZINESS
      • THICKENED TONGUE
      NURSING CARE:
      • EMERGENCY CARE:
      • TURNING TO SIDE
      • ELEVATE HEAD
      • QUIET ENVIRONMENT
      • GENERAL CARE:
      • ADEQUATE OXYGENATION
      • VS
      • FLUID & ELEC BALANCE
      • PROPER POSITIONING
      • ADEQUATE ELIMINATION
      • PROTECT EYES
      • MOBILIZATION & REHAB
      • WHEN CONSCIOUSNESS REGAINED
    • BIG…
    • HEAD INJURY
      • CLASSIFICATION:
      • LACERATION OF THE SCALP
      • SKULL INJURY
      • BRAIN INJURY
      • INTRACRANIAL
      • HEMORRHAGE
      • EPIDURAL
      • SUBDURAL
      • INTRACEREBRAL OR
      • SUBARACHNOID
        • CONCUSSION
        • CONTUSION
        • LACERATION
        • COMPRESSION
      • INTRACRANIAL
      • HEMORRHAGE
      • EPIDURAL
      • SUBDURAL
      • INTRACEREBRAL OR
      • SUBARACHNOID
      • RESULT FROM TEAR IN THE
      • WALL OF MIDDLE
      • MENINGEAL ARTERY
      • S/SX:
      • LOC
        • REGAIN CONSCIOUSNESS
        • (LUCID INTERVAL)
          • LOC
      • VENOUS IN ORIGIN
      • S/SX:
      • ACUTE
      • UNCONSCIOUSNESS
      • IMMEDIATELY AFTER
      • SURGERY
      • CHRONIC
      • CONSCIOUS FOR SEVERAL
      • WEEKS OR MONTHS, THEN
      • PATIENT SHOWS
      • NEUROLOGIC SIGNS
      MOST COMOON CAUSE: LEAKING CONGENITAL ANEURYSM
    • HEAD INJURY
      • NURSING CARE:
      • EMERGENCY CARE:
      • AIRWAY
      • SUPINE STRAIGHT, THEN TURNED TO LATERAL OR SEMIPRONE
      • POSSIBLE CERVICAL FX: NO NECK FLEXION & HYPEREXTENSION
      • KEEP PX COVERED, QUIET & UNDISTURBED
      • GENERAL CARE:
      • AIRWAY
      • PREVENT ASPIRATION
      • PN
      • CHECK CARDIOVASC
      • COMPLICATIONS
      • SEARCH EVIDENCE OF
      • SPINAL INJURY
      • CHECK SKULL & SCALP
      • INJURIES
      • PROPHYLACTIC TETANUS
      • OBSERVE CSF LEAKAGE:
        • OTORRHEA, RHINORRHEA
        • BATTLE’S SIGN
      • OBSERVE FOR S/SX OF INCREASED ICP
      • CONTROL RESTLESS-
      • NESS & PAIN: NO NARCOTICS
      • MAINTAIN F&E, ACID- BASE BALANCE
      CAUGHT
    • SPINAL CORD INJURIES
      • CAUSES:
      • TRAUMA
      • FALLS
      • GSW
      • TUMORS
      • TYPES:
      • CONCUSSION
      • COMPRESSION
      • CONTUSION & TRANSECTION
      • LACERATION
      • HEMORRHAGE
      • (HEMATOMYALIA)
      • COMPRESSION OF BLOOD SUPPLY TO THE CORD
    • CLINICAL EFFECTS OF SCI
      • SPINAL SHOCK
      • REFLEX ACTIVITY
      • WHIPLASH INJURY
      • HERNIATED NUCLEUS PULPOSUS
    • SPINAL SHOCK
      • IMMEDIATE FLACCID PARALYSIS & SENSORY LOSS BELOW THE LEVEL OF LESION
      • PRIAPISM
      • BULBOCAVERNOUS REFLEX IS LOST BUT REUTRNS AFTER A FEW HRS
      • OTHER REFLEXES REMAIN ABSENT
      • 3-6 WKS
      • AUTONOMIC DISTURBANCES:
      • SWEATING IS ABOLISHED
      • BELOW THE LEVEL OF INJURY
      • URINE & FECES RETAINED
      • GASTRIC ATONY
      • ORTHOSTATIC HYPOTENSION
      • SLOW, & STEADY PULSE
    • REFLEX ACTIVITY
      • REPLACE SPINAL SHOCK AFTER 2-3 WEEKS IF LUMBO-SACRAL SEGMENTS ARE UNDAMAGED
      • OCCURS IN ACUTE SPINAL INJURY, NOT IN PROGRESSIVE ONES
      • AUTOMATIC BLADDER; REFLEX SWEATING & DEFECATION
      • FIRST SIGN OF WEARING OFF:
        • CONTRACTION OF HAMSTRING
        • FLEXION/ EXTENSION OF TOES WITH PLANTAR STIMULATION
    • WHIPLASH INJURY
      • VIOLENT HYPEREXTENSION & FLEXION OF THE NECK
      • USUALLY WITH AUTOMOBILE ACCIDENT
      • CERVICAL SPINE DAMAGE:
        • MUSCLES
        • DISKS
        • LIGAMENTS
        • NERVOUS TISSUE
      • SIGNS & SYMPTOMS :
      • PALE
      • LOC
      • WEAK
      • GAIT DISTURBANCE
      • DIZZINESS
      • VOMITING
      • SEVERE OCCIPITAL
      • HEADACHE
      • PAIN RADIATES TO THE
      • ARMS
      • NUCHAL RIGIDITY
      MANAGEMENT: BED REST ANALGESIC HOT PACKS PLASTIC COLLAR FOR SEVERAL WEEKS
    • HERNIATED NUCLEUS PULPOSUS
      • CAUSE:
      • LIFTING OF HEAVY OBJECTS
      • FALL ON THE BACK
      • IMPROPER BODY MECHANICS – LUMBAR
      • S/SX :
      • BACK PAIN WITH RADIATION TO THE BACK OF THE
      • LEG
      • DIFFICULTY IN WALKING
      • MUSCLE SPASM
      • DISORDERS OF SENSATION
      • NEAR THORACIC OR CERVICAL REGION: NUCHAL
      • RIGIDITY RADIATING DOWN THE ARM TO THE
      • FINGER
    • VERTEBRA INTER- VERTEBRAL DISK SPINAL CORD HERNIATED DISK
      • MANAGEMENT:
      • CONSERVATIVE:
        • BRACE
        • CAST
        • TRACTION
        • PROLONGED BEDREST
        • PT
      • AGGRESSIVE:
      • SINGLE DISK:
      • REMOVAL WITHOUT
      • FUSION
      • SEVERAL DISKS:
      • SPINAL FUSION
      • WITH BRACE
    • TRIGEMINAL NEURALGIA
      • TIC DOULOREAUX
      • 5 TH CN : OPHTHALMIC, MAXILLARY, MANDIBULAR
      • AGONIZING PAIN
      • ETIOLOGY : UNKNOWN
      • PRECIPITAN T: PRESSURE ON TRIGGER POI NTS :
      • SHAVING
      • TALKING
      • WASHING
      • COLD WIND
      • MANAGEMENT
        • CONSERVATIVE:
          • AVOID SERVING TOO
          • HOT FOODS
          • DRUG TX:
            • ANTIEPILEPTIC
              • DILANTIN
            • CARBAMAZEPINE
              • TEGETROL
      • AGGRESSIVE
      • -SURGICAL
        • INTRACRANIAL
        • RESECTIONING
        • OF PAIN FIBERS
        • PERIPHERAL
        • INJECTION
        • WITH ALCOHOL
        • OF PAIN
        • GANGLIONS
    • BELL’S PALSY
      • CN 7
      • UNILATERAL
      • WEAKNESS & PARALYSIS
      • CAUSE: UNKNOWN
      • S/SX:
      • FACIAL NUMBNESS
      • DISTORTION
      • SPEECH DIFFICULTY
      • DIFFICULTY WITH EATING
      • PAIN BEHIND THE EAR OR FACE
      • MANAGEMENT:
        • RECOVERY : 3-5 WKS
        • FACIAL MASSAGE
        • PAIN RELIEF
        • PROTECT INVOLVED EYE
        • ACTH – MINIMIZE DENERVATION AND PERMANENT
        • SEQUELAE
        • TEACH PATIENT FACIAL EXERCISES :
          • WHISTLE
          • WRINKLE FOREHEAD
          • BLOWOUT & PUFF CHEEKS
      • Which of the following reduces cerebral edema by constricting the cerebral vessels?
      • Dexamethasone (Decadron)
      • Mechanical Hyperventilation
      • Mannitol
      • Ventriculostomy
    • RELAX….