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Causes of ICP Brain tumors Infectious and inflammatory disorders
Pathophysiology of ICP Dilation or constriction of cerebral blood vessels in response to changes in blood pressure leafs to ICP
Assessment findings for ICP Decreasing LOC, lethargic, stuperous, semi comatose, confusion, restlessness, periodic distortion. Headache that's worse in the morning
Cushing ' s triad A pulse rate that increases initially but then decreases. Systolic BP that rises with a widening pulse pressure, And a respiratory rate that is irregular.
Other signs of ICP Vomiting without nausea Decorticate or decerbrate posturing Cheyne stokes breathing
Goals for tx of ICP Maintain Bp,prevent hypoxia, and ensure cerebral perfusion
Avoid IV Solutions containing Glucose
Medical Mgmt For ICP bed should be: Midline HOB elevated to 30 degrees
Drug given for ICP Mannitol Which is an osmotic diuretic
Other med surg Mgmt for ICP Avoid hypothermia/hyperthermia Control seizures Versed for restlessness indwelling cathader monitor I/O NG tube Stool softener Pepcid to prevent stress ulcers
Meningitis Caused by infectious bacteria, viruses, fungi,or parasites Damages CN responsible for seeing and hearing
Assessment findings for meningitis Headache, fever, nuchal rigidity, N/V,photophobia, restlessness, irritability, seizures, purpura on face and hands
Meningitis diagnostics Cloudy LP CT scan shows inflammation CBC shows an increase in WBC'S
Encephalitis Inflammation of white and gray matter 48 to 72 hours after being infected from vector
Assessment findings for encephalitis Sudden fever, headache, stiff neck, vomiting, drowsiness, tremors, seizures, spastic or flaccid paralysis, irritability, lethargy, delirium, coma, incontinence, visual disturbances
Medical Mgmt For encephalitis Antipyretic, anticonvulsant, anti inflammatory, and analgesic Monitor VS and LOC frequently I/O Bowels (eenema or stool softener)
Guillain Barre synd Antibodies attack the Schwann cells that make up the mylin sheath surrounding the axon nerves
Assessment findings for guillain Barre synd Weakness, numbness, tingling in the arms and legs progressive weakness that starts at feet and goes to hands Difficulty chewing, swallowing, and talking. May need iv or tpn feedings Increased protein levels in LP
Tx for guillain Barre synd If resp muscles are involved mechanical vent Plasmapheresis shortens the course of the disease Assess signs of respiratory distress Skin care change positions every 2 hours ROM exercises to prevent atrophy
Brain abscess infection in nearby structure Bacterial endocarditis Pulmonary or abdominal Infection
Assessment findings for brain abscess Increased ICP Fever Headache Paralysis, seizures, muscle weakness Lethargy
Diagnostic findings for brain abscess Neuro changes depending on location Increase in WBC'S Mri or xray to determine the location
Ms Causes permanent destruction of the myelin sheath Made worse by infection, stress, and emotional upset
Assessment findings for ms Blurred vision, diplopia, nystagmus, weakness, clumsiness, and numbness and tingling of arms and legs, intention tremor, and slurred hesitant speech,and mood swings
Nursing management for ms Assess emotional status Identify vision problems Adaptive services needed Ambulatory devices Skin care
Ms can cause difficulty breathing what are some interventions Fowler position support the arms Encourage client to deep breathe Provide rest between activities
Pathophysiology of myasthenia gravis Antibodies bind to and degrade the acetylcholine receptor on the surface of skeletal muscles
Assessment findings for myasthenia gravis Ptosis of the eyelids Difficulty chewing or swallowing Diplopia Voice weakness mask like facial expressions weakness of the extremities and respiratory system
Diagnostic findings for myasthenia gravis Acetylcholine receptor antibody titer Chest xray may show an enlargement of the thymus IV tensilon may make better for a few minutes but only lasts a few minutes
Nursing Mgmt for myasthenia gravis Must administer meds at the exact time to maintain a therapeutic level in the blood
Pathophysiology of ALS Degeneration of the motor neurons of the spinal cord or brain stem Results in muscle weakness and wasting Cause is unknown
ALS Wasting of arms legs and trunk development Difficulty speaking and swallowing Episodes of muscle twitching periods of inappropriate laughter and crying respiratory failure and total paralysis
ALS treatment Relutex protects nerves from glutamate thought to be the cause of the disease this drug is metabolizes in the liver and kidneys so frequent function tests are necessary
Tic douloureux Involves the trigeminal nerve Cause is unknown causes sudden severe burning pain Pain begins and ends quickly multiple times a day
Tic douloureux patients Eating can trigger the pain so they may not eat as much. Small frequent meals Figure out how often the pain is and how frequent also what activities are associated with the pain
Surgical management of tic douloureux Severe the root of the trigeminal nerve it can cause a lot of complications
Bells palsy Inflammation occurs around one of the paired facial nerves Cause is unknown but viral link is suspected Improvement may begin in a few weeks but if hasn't begun to heal in 3 months may be permanent
Bells palsy carries a risk of Eye infection Lubricant may be necessary
Question to ask someone with bells palsy Any recent viral infections?
Parkinsons disease Onset begins after age 50
Symptoms of parkinsons Stiffness Tremors Bradykinesia Mask like expression stooped posture Low volume of speech Shuffling gait
Parkinsons triad Pill rolling Cogwell rigidity Bradykinesia
Management for parkinsons Lots of patient and family education on safety rom exercises Assistance with adls Thickened liquids Small Frequent Meals
Huntington disease Inherited High risk of suicide develops between 30 and 50 Difficulty chewing and swallowing Uncontrolled twisting mmovements
Seizures and brain tumors Still need flashcards can't make any more without dying
Created by: 100000839384613