Nursing
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| Causes of ICP | Brain tumors
Infectious and inflammatory disorders
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| Pathophysiology of ICP | Dilation or constriction of cerebral blood vessels in response to changes in blood pressure leafs to ICP
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| Assessment findings for ICP | Decreasing LOC, lethargic, stuperous, semi comatose, confusion, restlessness, periodic distortion.
Headache that's worse in the morning
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| 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.
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| Other signs of ICP | Vomiting without nausea
Decorticate or decerbrate posturing
Cheyne stokes breathing
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| Goals for tx of ICP | Maintain Bp,prevent hypoxia, and ensure cerebral perfusion
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| Avoid IV Solutions containing | Glucose
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| Medical Mgmt For ICP bed should be: | Midline HOB elevated to 30 degrees
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| Drug given for ICP | Mannitol
Which is an osmotic diuretic
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| 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
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| Meningitis | Caused by infectious bacteria, viruses, fungi,or parasites
Damages CN responsible for seeing and hearing
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| Assessment findings for meningitis | Headache, fever, nuchal rigidity, N/V,photophobia, restlessness, irritability, seizures, purpura on face and hands
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| Meningitis diagnostics | Cloudy LP
CT scan shows inflammation
CBC shows an increase in WBC'S
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| Encephalitis | Inflammation of white and gray matter
48 to 72 hours after being infected from vector
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| Assessment findings for encephalitis | Sudden fever, headache, stiff neck, vomiting, drowsiness, tremors, seizures, spastic or flaccid paralysis, irritability, lethargy, delirium, coma, incontinence, visual disturbances
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| Medical Mgmt For encephalitis | Antipyretic, anticonvulsant, anti inflammatory, and analgesic
Monitor VS and LOC frequently
I/O
Bowels (eenema or stool softener)
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| Guillain Barre synd | Antibodies attack the Schwann cells that make up the mylin sheath surrounding the axon nerves
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| 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
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| 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
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| Brain abscess | infection in nearby structure
Bacterial endocarditis
Pulmonary or abdominal Infection
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| Assessment findings for brain abscess | Increased ICP
Fever
Headache
Paralysis, seizures, muscle weakness
Lethargy
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| Diagnostic findings for brain abscess | Neuro changes depending on location
Increase in WBC'S
Mri or xray to determine the location
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| Ms | Causes permanent destruction of the myelin sheath
Made worse by infection, stress, and emotional upset
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| 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
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| Nursing management for ms | Assess emotional status
Identify vision problems
Adaptive services needed
Ambulatory devices
Skin care
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| Ms can cause difficulty breathing what are some interventions | Fowler position support the arms
Encourage client to deep breathe
Provide rest between activities
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| Pathophysiology of myasthenia gravis | Antibodies bind to and degrade the acetylcholine receptor on the surface of skeletal muscles
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| 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
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| 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
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| Nursing Mgmt for myasthenia gravis | Must administer meds at the exact time to maintain a therapeutic level in the blood
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| Pathophysiology of ALS | Degeneration of the motor neurons of the spinal cord or brain stem
Results in muscle weakness and wasting
Cause is unknown
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| 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
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| 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
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| Tic douloureux | Involves the trigeminal nerve
Cause is unknown
causes sudden severe burning pain
Pain begins and ends quickly multiple times a day
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| 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
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| Surgical management of tic douloureux | Severe the root of the trigeminal nerve it can cause a lot of complications
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| 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
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| Bells palsy carries a risk of | Eye infection Lubricant may be necessary
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| Question to ask someone with bells palsy | Any recent viral infections?
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| Parkinsons disease | Onset begins after age 50
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| Symptoms of parkinsons | Stiffness
Tremors
Bradykinesia
Mask like expression
stooped posture
Low volume of speech
Shuffling gait
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| Parkinsons triad | Pill rolling
Cogwell rigidity
Bradykinesia
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| Management for parkinsons | Lots of patient and family education on safety rom exercises
Assistance with adls
Thickened liquids
Small Frequent Meals
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| Huntington disease | Inherited
High risk of suicide
develops between 30 and 50
Difficulty chewing and swallowing
Uncontrolled twisting mmovements
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| Seizures and brain tumors | Still need flashcards can't make any more without dying
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