Linda S. Williams / Paula D. Hopper Copyright © F.A. Davis Company Understanding Medical Surgical Nursing, 4th Edition Chapter 47 Neurological Function, Assessment, and Therapeutic Measures

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Review of Normal A&P

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Synapse

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Cross Section of Spinal Cord

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Brain

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Cranial Nerves  Olfactory  Optic  Oculomotor  Trochlear  Trigeminal  Abducens  Facial  Vestibulocochlear  Glossopharyngeal  Vagus  Accessory  Hypoglossal

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Autonomic Nervous System

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Aging

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Basic Neurological Assessment  Level of Consciousness  Vital Signs  Pupil Response to Light  Extremity Strength and Movement  Sensation

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition History  Symptoms  Medication Use  Surgical History  Family History  Life Style  WHAT’S UP?

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Subjective Data  Mental Status  Intellectual Function  Thought Content  Perception  Language Ability  Memory  Pain

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Physical Assessment  Level of Consciousness  Mental State Examination  Pupillary Response  Muscle Function  Cranial Nerve Function

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Glasgow Coma Scale  Eye Opening  Verbal Response  Motor Response  Posturing

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Abnormal Posturing

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Pupil Assessment  Equal  Round  Reactive to Light  Reactive to Accommodation

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnostic Tests  Laboratory Tests  Thyroid  B12  ESR  CBC  Electrolytes  Hormone Levels  Creatine Kinase  VDRL  Liver Function  Renal Function

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Lumbar Puncture  Pre-Procedure Nursing Care  Verify Informed Consent  Assist with Positioning  Post-Procedure Care  Maintain Flat Bedrest 6 to 8 Hours  Encourage Fluids  Monitor Puncture Site  Monitor Movement, Sensation, Headache

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Lumbar Puncture (cont’d)

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition CT Scan  Pre-Procedure  Administer Contrast if Ordered  Check Allergies  Check BUN, Cr  Request Order for Sedation if Indicated  Teach  Contrast May Cause Feeling of Warmth  Signs and Symptoms of Allergic Reaction to Report  Post Procedure  Encourage Fluids if Dye Used

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition MRI  Pre-Procedure Nursing Care  Assure No Pacemaker or Metal on Patient  Administer Analgesic or Sedative as Ordered  Teach Relaxation  Post-Procedure Care  No Special Care

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Angiogram  Pre-Procedure Nursing Care  Verify Informed Consent  Give Clear Liquid Diet  Insert IV Needle  Check BUN/Cr  Check PT and PTT  Administer Sedation as Ordered

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Angiogram (cont’d)  Post-Procedure Care  Keep Flat in Bed 6 to 8 Hours  Monitor  VS  Catheter Insertion Site  Pulses  Encourage Fluids

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Myelogram  Pre-Procedure Nursing Care  Check Allergies to Contrast  Assess History of Seizures  Verify Informed Consent  Post-Procedure Care  Similar to LP  Encourage Fluids  HOB Elevated 30 Degrees

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Electroencephalogram  Pre-Procedure Nursing Care  Assure Hair Clean and Dry  Check Medication Orders  Post-Procedure Care  Wash Hair

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Measures  Moving and Positioning  Maintain Functional Positions  Avoid Injury  Prevent Contracture  Mobilize ASAP

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Activities of Daily Living  Encourage Independence Based on Functional Level  Maintain Routine  Provide Assistance as Needed

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Communication  Problems  Dysarthria  Expressive Aphasia  Receptive Aphasia  Interventions  Use Care with Yes-No Questions  Correct Substituted Words  Anticipate Needs  Use Gestures  Be Patient!

Copyright © F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nutrition  Evaluate Swallowing  Interventions for Impaired Swallowing  Thicken Liquids  Position Upright for Eating  Monitor Meals  Tube Feedings