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Neurology Part 2
Neurology Part 2
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Optic nerves and chiasm
Cerebrum
Cerebellum
Spinal cord
MULTIPLE SCLEROSIS
CLINICAL MANIFESTATIONS
1. visual problems such as
3. Fatigue
swings, depression
5. spasticity
MULTIPLE SCLEROSIS
DIAGNOSTIC TESTS
1. MRI- primary diagnostic study
2. CSF Immunoglobulin G
MULTIPLE SCLEROSIS
NURSING INTERVENTIONS
1. Promote physical mobility
Exercise
useful
MULTIPLE SCLEROSIS
NURSING INTERVENTIONS
2. Prevent injuries
Wide stance walking
Wheelchair
MULTIPLE SCLEROSIS
3. Enhance bladder and bowel
control
Set a voiding schedule
Intermittent bladder
catheterization
Use of condom catheter
materials
Offer emotional support
agencies
MULTIPLE SCLEROSIS
7. improve self-care abilities
Modify activities according to
physical strength
Provide assistive devices
MULTIPLE SCLEROSIS
8. promote sexual functioning
Refer to sexual counselor
MULTIPLE SCLEROSIS
MEDICAL MANAGEMENT
Pharmacotherapy
Interferons
Immunomodulators
Corticosteroids
BACLOFEN for muscle spasms
NSAIDS for pain
Guillian-Barre’ Syndrome
An auto-immune attack of the
peripheral nerve myelin
Acute, rapid segmental
demyelination of peripheral
nerves and some cranial
nerves
Guillian-Barre’ Syndrome
CAUSE: post-infectious
polyneuritis of unknown origin
commonly follows viral
infection
Guillian-Barre’ Syndrome
PATHOPHYSIOLOGY
Cell-mediated imune attack to
the myelin sheath of the
peripheral nerves
Infectious agent may elicit
antibody production that can also
destroy the myelin sheath
Guillian-Barre’ Syndrome
CLINICAL MANIFESTATIONS
1. Ascending weakness and
paralysis
2. diminished reflexes of the lower
extremities
3. paresthesia
IVF
Parenteral nutrition
Assess frequently return o gag refelx
Guillian-Barre’ Syndrome
NURSING INTERVENTIONS
4. Improve communication
Provide Referrals
Answer questions
Provide diversional activities
6. Monitor and manage
complications
DVT, Urinary retention, pulmonary
embolism, respiratory failure
Guillian-Barre’ Syndrome
MEDICAL MANAGEMENT
ICU admission
Mechanical Ventilation
PLASMAPHERESIS
IV IMMUNOGLOBULIN
ALZHEIMER’S disease
A progressive neurologic
disorder that affects the brain
resulting in cognitive
impairments
ALZHEIMER’S disease
CAUSES:
Unknown
PET scan
symptoms- antipsychotics
2. anxiolytics
3. Donepezil
4. Tacrine
ALZHEIMER’S disease
Nursing Interventions
1. Support patient’s abilities
and gestures
Maintain a calm and consistent
approach
Attempt to analyze behavior for
meaning
ALZHEIMER’S disease
4. protect the patient from injury
Provide a safe and structured
environment
Requests a family member to
to destruction of pigmented
neuronal cells in the substantia
nigra in the basal ganglia
Clinical symptoms do not appear
movement
4. Dementia, depression, sleep
Levodopa, Carbidopa
2. Anti-cholinergic therapy
4. Dopamine Agonists-
Thymoma
2. TENSILON TEST
3. CT scan
4. Serum anti-AchReceptor
antibodies
Myasthenia gravis
MEDICAL THERAPY
Anticholinesterase drugs-
pyridostigmine and
neostigmine
Corticosteroids
Immunosuppresants
Plasmapheresis
Thymectomy
Myasthenia gravis
NURSING INTERVENTIONS
1. Administer prescribed medication as
scheduled
2. Prevent problems with chewing and
swallowing
3. Promote respiratory function
prevent fatigue
5.maximize functional abilities
Myasthenia gravis
6. Prepare for complications like
myasthenic crisis and cholinergic
crisis
7. prevent problems associated
with impaired vision resulting from
ptosis of eyelids
8. provide client teaching
9. promote client and family
coping
Meningitis
Infection or inflammation of the
meninges covering the brain and
spinal cord.
Caused by bacterial, viral and
fungal agents
Brain Abscess
A free or encapsulated collection of
pus in the brain parenchyma
Causes: usually secondary to
another infection like- sinusitis,
meningitis, dental abscess,
mastoiditis, bacteremia and
trauma
Encephalitis
Intense inflammation of the brain
tisssue with lymphocytic
infiltration, cerebral edema,
degeneration of brain cells and
diffuse nerve cell destruction
CNS infections
ASSESSMENT FINDINGS
Meningitis
1. fever, headache, vomiting
2. positive meningeal sings
Brain abscess
1. headache, N/V, seizures, changes in
LOC
2. Focal neurologic deficits
CNS infections
DIAGNOSTIC TESTS
1. CT scan
2. MRI
3. EEG
MEDICAL TREAMENT
1. Antibiotics
2. Surgical drainage
3. Drugs to reduce increased ICP
CNS infections
NURSING INTERVENTIONS
1. Frequent monitoring of
neurologic status
2. Monitor intake and output
3. Administer antibiotics
4. Administer mild laxative to
prevent constipation
5. maintain quiet environment
Neoplastic diseases
A brain tumor is a localized
intracranial lesion that occupies
space within the skull
Primary brain tumors originate
from cells and structures within the
brain.
Neoplastic disease
The cause of brain tumors is
unknown
The only risk factor accepted is
radiation exposure to ionization
rays
Neoplastic disease
CLINICAL MANIFESTATIONS
1. increased ICP
Vomiting
Headache. Especially early in the
morning
Vomiting
Visual disturbances
Neoplastic disease
2. Localized symptoms
Hemiparesis
Seizures
Mental status changes
Neoplastic disease
DIAGNOSTIC TESTS
1. CT scan
2. MRI
3. PET
4. EEG
Neoplastic disease
MEDICAL MANAGEMENT
Surgery
Chemotherapy
Radiotherapy
Neoplastic disease
NURSING INTERVENTIONS
1. promote self-care independence
2. improve nutrition
3. relieve anxiety
4. enhance family processes
5. provide pre-operative and post-
operative care
6. manage pain