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Neurological System PDF
Neurological System PDF
Decreased HR and BP
Decresead RR
Diarrhea
Urinary Frequency
Seizures
II. SNS
a. Adrenergic Agents
1. Epinephrine (Adrenaline)
2. Note: Side Effects (SE) – normal drug expectancies
b. Beta-Adrenergic Agents (Beta-Blockers)
MEDICAL-SURGICAL NURSING 1. Propanolol, metoprolol, atenolol
2. Bronchospasm, Elicits decreased cardiac contractions,
Treats HPN, AV conduction slows down (BETA)
Neurologic Nursing 3. Anti-HPN Management
Beta-blockers – ―-olol‖
Lecturer: Mark Fredderick Abejo RN, MAN ACE inhibitors – ―-pril‖
________________________________________________________ Ca-Antagonist – nifedipine
Transient headache and dizziness
OVERVIEW OF THE STRUCTURE AND FUNCTION OF THE Orthostatic hypotension
NERVOUS SYSTEM Assist in ambulation
Pt. to rise slowly from sitting position
I. Divisions 4. BP = CO x PR
a. CNS – brain and spinal cord 5. CO = HR x SV
b. PNS – 12 pairs of cranial nerves and 31 pairs of spinal 6. (N) HR = 60-100 bpm
nerves 7. (N) SV = 60-70 ml of H2O
1. Spinal nerves:
TOXIC SUBSTANCES THAT CAN PASS THE BLOOD-BRAIN
Cervical – 8
BARIER: (BLACK)
Thoracic – 12
Bilirubin – yellow pigment
Lumbar – 5
Lead – Antidote: Ca+ EDTA
Sacral – 5
Ammonia – cerebral toxin; present in hepatic encephalopathy
Coccygeal - 1
(liver cirrhosis)
c. ANS – sympathetic and parasympathetic systems
Carbon Monoxide – in Parkinson’s and Epilepsy
Ketones – cerebral depressant
III. CNS
a. Cells
1. Neurons
Excitability
Conductivity
Permanence
2. Neuroglia – majority of tumors arise from here; about
40% from astrocytes
Astrocytes – maintains integrity of BBB
Oligodendrocytes – production of myelin
Myelin sheath – insulates axons; for rapid
impulse transmission
Microglia – STATIONARY cells which carry on
phagocytosis (cell eating)
Sympathetic – flight or aggression response release of Ependymal cells – produces chemoattractants
norepinephrine increase in all bodily activity except GI which concentrates bacteria
(constipation); adrenergic; parasympatholytic response. b. Composition
1. 80% brain mass
REMEMBER: GIT is the least important area during stress CEREBRUM – divided into two hemispheres, the
decreased blood flow in the area; Increased blood flow in the brain, left and right and is bridged by the corpus
heart and skeletal muscles callosum
Mydriasis (―dilat‖-ation) Motor, sensory, integrative function
Dry mouth Lobes:
Increase in HR and BP Frontal – controls higher cortical thinking,
Tachypnea personality development, motor activity,
Constipation contains BROCA’s are or the motor-speech
Urinary retention center. (Expressive Aphasia)
Parasympathetic – flight or withdrawal response release of Occipital – vision
Acetylcholine decrease in all bodily activity except GI (diarrhea); Parietal – appreciation and discrimination
chonlinergic/ vagal/ sympatholytic response
of sensory impulses (pain, touch, pressure,
Meiosis heat and cold)
Increased salivation
MS 1 Abejo
Lecture Notes on Neurologic Nursing
Prepared By: Mark Fredderick R Abejo R.N, MAN
Clinical Instructor
NEUROLOGIC ASSESSMENT
F. Sensory Assessment
1. PAIN - Gingerbread test
100% very painful
75% tolerable pain
25% moderate pain
0% no pain
2. 10 % CSF 2. TOUCH – Stereognosis
3. 10% Blood Identifying familiar object placed on clients hands
Astereognosis – if patient cannot identify object;
MONROE KELLY HYPOTHESIS – the skull is a closed damage in parietal lobe
vault, any increase in one component will bring about increases 3. PRESSURE AND TOUCH – Graphesthesia
in ICP Identify numbers or letters written on client’s
NORMAL ICP IS 0-15 MMHG; NORMAL CSF: 120-250CC/DAY palm
NORMAL CSF OPENING PRESSURE: 60-150 MMHG Agraphesthesia if (-), damage to parietal lobe
NORMAL CSF CONTENTS: GLUCOSE, PROTEINS, WBCS
FORAMEN MAGNUM - The large opening in the basal part of
the occipital bone through which the spinal cord becomes
continuous with the medulla oblongata. G. Cerebellar Test
MS 2 Abejo
Lecture Notes on Neurologic Nursing
Prepared By: Mark Fredderick R Abejo R.N, MAN
Clinical Instructor
IgM – acute infections (mabilis) Brought about by increase in the three intracranial components
IgE – allergic reactions
IgD – Chronic infections (dalas) A. PREDISPOSING FACTORS
a. Head injury
b. Tumor
c. Localized abscesses
d. Cerebral edema
e. Hydrocephalus
f. Hemorrhage
g. Inflammatory conditions
1. Meningitis
2. Encephalitis
MS 5 Abejo
Lecture Notes on Neurologic Nursing
Prepared By: Mark Fredderick R Abejo R.N, MAN
Clinical Instructor
7. Assist in
THYMECTOMY – removal of thymus which is
believed to produce autoimmunity
Plasmaparesis – filtering of blood; removal of
autoimmune antibodies in the blood
8. Prevent complications respiratory arrest
9. Prepare trache set in pts with MG
MS 8 Abejo
Lecture Notes on Neurologic Nursing
Prepared By: Mark Fredderick R Abejo R.N, MAN
Clinical Instructor
MS 9 Abejo
Lecture Notes on Neurologic Nursing
Prepared By: Mark Fredderick R Abejo R.N, MAN
Clinical Instructor
C. DIAGNOSTICS
1. CT-SCAN – brain lesion d/t head trauma
2. EEG – hyperactivity of brain waves (all elevated)
Alpha, beta, delta, theta waves
D. NURSING MANAGEMENT
1. Maintain patent airway and promote safety before
seizure activity
Clear the site of sharps, harmful objects
Loosen clothing of the patient
Avoid use of restraints fractures
Maintain side rails
Turn head to side to prevent aspiration
Tongue guard is between mouth and teeth to
prevent biting of the tongue
2. Avoid precipitating stimulus
Bright/glaring lights
Noise
3. Administer medications as ordered
Phenytoin (Dilantin)
Gingival Hyperplasia
Use soft-bristled toothbrush
Ataxia
Nystagmus
Hirsutism
MS 10 Abejo