DELUSIONS.pptx
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A false belief is held to be true even when there is evidence to the contrary TYPES GRANDEUR – The false belief that one is a powerful and important person. JEALOUSY – The false belief that one’s partner or mate is going out with other persons. PERSECUTION- The thought that one is being singled out for harm by others. INTERVENTIONAsk the client to describe the delusion. Be open and honest in interactions to reduce suspiciousness. Focus the conversation on reality-based topics rather than on the delusion. Encourage the client to express feelings and focus on the feelings that the delusion generates. If the client obsesses on the delusion, set firm limits on the amount of time for talking about the delusion. Do not dispute with the client or try to convince the client that the delusions are false. Validate if part of the delusion is real.
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BLOOD DONATION.
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INTRODUCTION
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A temperature of 106 F which increases the cerebral metabolism and increases the risk of hypoxia
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The temperature of 106 F
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Nausea and vomiting
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MEDICATION TO PREVENT HYPERTHERMIA
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HEAD INJURY.pptx
Head injury is trauma to the skull resulting
in mild to extensive damage to the brain
Immediate complication include
cerebral bleeding , hematomas
, uncontrolled increased ICP , infections
and seizures
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deficits depend on the area of the brain
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TYPES OF HEAD INJURY
OPEN
Scalp lacerations
Fractures in the skull
Interruption of the dura mater
CLOSED
Concusions
Contusions
Fracture
HEMATOMA
INTERVENTION
HALLUCINATIONS.pptx
A sense perception for which no external stimuli exist; can have an organic or functional cause.
TYPESAUDITORY – Hearing voices when none are present.
GUSTATORY – Experiencing taste in the absence of stimuli.
OLFACTORY – Smelling smells that do not exist
TACTILE – Feeling touch sensations in the absence of stimuli.
VISUAL – Seeing things that are not there.
INTERVENTION
Ask the client directly about the hallucination.
Avoid reacting to the hallucination as if it were real.
Decrease stimuli or move the client to another area.
Do not negate the client’s experience.
Focus on reality based topics.
Attempt to engage the client’s attention through a concrete activity.
Respond verbally to anything real that the client talks about.
Avoid touching the client.
Monitor for signs of increasing anxiety or agitation, which may indicate that the hallucinations are increasing.
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ASSESSMENT
INTERVENTION
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PREOPERATIVE INTERVENTION
POSTOPERATIVE INTERVENTION
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require an injection of a dye
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detect intracranial bleeding,
space-occupying lesions, cerebral edema,
infarctions, hydrocephalus, cerebral atrophy
and shifts of brain structures.
PREPROCEDURE INTERVENTION
POSTPROCEDURE INTERVENTION
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Surrounding cerebral edema and congestion cause further dysfunction
Diagnosis is determined by computed tomography scan, electroencephalogram, and cerebral arteriography
The permanent disability cannot be determined until the cerebral edema subsides
The order in which function may return is facial swallowing , lower limb, speech , and arms
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CAUSES
RISK FACTORS
ASSESSMENT
CEREBRAL ANGIOGRAPHY.pptx
Injection of contrast through the femoral artery
into the carotid arteries to visualize the
cerebral arteries and assess for lesions
PRE-PROCEDURE INTERVENTIONS
Obtain an informed consent
Assess the client for allergies to iodine and shellfish
Encourage hydration for 2 days before the test
Maintain the client on NPO status 4 to 6 hours
before the test as prescribed
Obtain a baseline neurological assessment
Mark the peripheral pulses
Remove metal items from the hair
Administer premedication as prescribed
POSTPROCEDURE INTERVENTION
Monitor neurological status and vital signs frequently until stable
Monitor for swelling in the neck and for difficult swallowing and notify the physician if these symptoms occur
Maintain bed rest for 12 hours as prescribed
Elevate the head of the bed 15 to 30 degrees only if prescribed
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Assess peripheral pulses
Apply sandbags and a pressure dressing to the injection site as prescribed
Place ice on the puncture site as prescribed
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Headache
Pain
Diplopia
Blurred vision
Tinnitus
Nausea
Hemiparesis
Nuchal rigidity
Irritability
Seizures
INTERVENTION
Maintain a patent airway ( suction only with a physician’s order)
Administer oxygen as prescribed
Monitor vital signs and for hypertension or dysrhythmias
Avoid taking temperature via the rectum and initiate aneurysm precautions
A. Maintain bed rest in semi-fowler or side-lying position
B. Maintain a darkened room without stimulation
C. Limit visitors
D. Maintain fluid restrictions
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eighth cranial nerve and aids in the diagnosis
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Patency of the external auditory canal is confirmed
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MANIA
Becomes angry quickly
Delusional self-confidence
Distracted by environmental stimuli
Extroverted personality
Flight of ideas
Grandiose and persecutory delusions
High and unstable affect
Inability to eat or sleep because of involvement
in more important things.
Inability to sleep yet still active
Inappropriate affect
Inappropriate dress
Initiation of activity
Pressured speech
Restlessness
Sexually promiscuous
Significant decrease in appetite
Unlimited energy
Urgent motor activity
Inappropriate dress
Initiation of activity
Pressured speech
Restlessness
Sexually promiscuous
Significant decrease in appetite
Unlimited energy
Urgent motor activity
DEPRESSSIONDecrease in activities of daily living
Decrease emotion and physical activity
Easily fatigued
Inability to make decisions
Internalizing hostility
Introverted personality
Lack of energy
Lack of initiative
Lack of self–confidence
Lack of sexual interest
Withdrawn from groups
INTERVENTION
Remove hazardous objects from the environment.
Assess the client closely for fatigue.
Use comfort measures to promote sleep.
Provide frequent rest periods.
Monitor the client’s sleep patterns
Provide a private room if possible
Administer a hypnotic or sedative medication as prescribed.
Encourage the client to ventilate feelings.
Use calm, slow interactions.
Help the client focus on one topic during the conversation
Ignore or distract the present reality of the client
Do not argue with the client
Limit group activities to assess the client’s tolerance level
Provide high–calorie finger foods and fluids
Supervise the client’s choice of clothing
Reduce environmental stimuli
Set limits on inappropriate behaviors
Provide physical activities and outlets for tension
Avoid competitive games
Provide gross motor activities such as walking and writing
Provide structured activities or one-to-one activities with the nurse
Provide simple and direct explanations for routine procedures
Supervise the administration of medication.
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DESCRIPTION
Bell’s palsy is caused by a lower motor neuron
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ASSESSMENT
Flaccid facial muscles
Inability to raise the eyebrows, frown ,
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Upward movement of the eye when attempting
to close the eyelid
Loss of taste
INTERVENTION
Encourage facial exercise to prevent the loss of muscle tone ( face sling may be prescribed to prevent stretching of weak muscles )
Protect the eyes from dryness and prevent injury.
Promote frequent oral care
Instruct the client to chew on the unaffected side
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Autonomic dysreflexia also is known as autonomic hyper reflexia
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Autonomic dysrreflexia is a neurological emergency and must be treated immediately to prevent a hypertensive stroke
Autonomic dysreflexia generally occurs after the period of spinal shocks resolved
Autonomic dysreflexia generally occurs with lesions or injuries above T6 and in cervical lesions
ASSESSMENT
Hypertension
Bradycardia
Flushing of the face and neck
Severe , throbbing headache
Nasal stuffiness
Piloerection (goose flesh)
Sweating
Nausea
Restlessness
Dilated pupils and blurred vision
INTERVENTIONNotify the physician if signs of autonomic dysreflexia occur
Assess for the potential cause and remove the stimulus
Raise the head of the bed to high fowler ‘s position
Loosen tight clothing
Monitor vital signs , particularly blood pressure , every 15 minutes
Assess for bladder distention , and prepare for urinary catheterization
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EFFECTS OF SPINAL CORD INJURY
QUADRIPLEGIA :- injury occurring from C1 through C8. Paralysis involving all four extremities
PARAPLEGIA :- injury occurring from T1 through L4 . Paralysis involving only the lower extremities
Dependent on the level of the cord injury
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Respiratory status changes
Motor and sensory changes below the level of injury
Total sensory loss and motor paralysis below the level of injury
ASSESSMENT AND EMERGENCY INTERVENTION OF SPINAL CORD INJURIES.pptx
EFFECTS OF SPINAL CORD INJURY
QUADRIPLEGIA :- injury occurring from C1 through C8. Paralysis involving all four extremities
PARAPLEGIA :- injury occurring from T1 through L4 . Paralysis involving only the lower extremities
Dependent on the level of the cord injury
The level of spinal cord injury : the lowest spinal cord segment with intact motor and sensory function
Respiratory status changes
Motor and sensory changes below the level of injury
Total sensory loss and motor paralysis below the level of injury
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The cerebrum governs thought and learning
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BASAL GANGLIA
DIENCEPHALON
BRAINSTEM
CEREBELLUM
SPINAL CORD
MENINGES
CEREBROSPINAL FLUID
VENTRICLES
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NEURONS
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AUTONOMIC NERVOUS SYSTEM
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Abnormal thought processes displayed by the mentally ill client and occurring as a psychiatric disorder
BLOCKING - A sudden cessation of a thought in the middle of a sentence ; the client is unable to continue the train of thought; often sudden new thoughts come up unrelated to the topic
CIRCUMSTANTIALITY – Before getting to the point or answering a question , the individual gets caught up in countless details and explanations.
CONFABULATION – Filling a memory gap with detailed fantasy believed by the teller ; the purpose of confabulation is to maintain self esteem ; seen in organic condition such as korsakoff’s psychosis .
FLIGHT OF IDEAS – A constant flow of speech in which the individual jumps from one topic to another in rapid succession ; a connection between topics exists, although it is sometimes difficult to identify ; seen in manic states.
LOOSENESS OF ASSOCIATION – Haphazard , illogical, and confused thinking and interrupted connections in thought ; seen mostly in schizophrenic disorders.
NEOLOGISMS – Words that an individual makes up that only have meaning for the individual ; often part of a delusional system.
WORD SALAD- A mixture of words and phrases that have no meaning.
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- 1. DELUSIONS
- 2. DESCRIPTION • A false belief held to be true even when there is evidence to the contrary
- 3. TYPES • GRANDEUR – The false belief that one is a powerful and important person. • JEALOUSY – The false belief that one’s partner or mate is going out with other persons. • PERSECUTION- The thought that one is being singled out for harm by others.
- 4. INTERVENTIONS • Ask the client to describe the delusion. • Be open and honest in interactions to reduce suspiciousness. • Focus the conversation on reality-based topics rather than on the delusion. • Encourage the client to express feelings and focus on the feelings that the delusion generate. • If the client obsesses on the delusion , set firm limits on the amount of time for talking about the delusion. • Do not dispute with the client or try to convince the client that the delusions are false. • Validate if part of the delusion is real.