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Transcript
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems
Part C – Neurological Problems
1.
Behavioral Objectives
Apply the terms listed in the content
column appropriate to the patient
situations involving the
neurological system.
I.
Content Outline
Application of terms
A. Aphasia
B. Dysphagia (hemiplegia/hemiparesis)
C. Increased intracranial pressure
D. Sensorium
E. Syncope
F. Thrombolytic
G. Vertigo
2.
Compare and contrast the normal
anatomy and physiology to the
pathophysiology of selected
neurological disease processes in
the content column.
II. Anatomy & Physiology of Neurological system
A. Developmental considerations
1. Infant
2. Child
3. Adolescent
4. Adult
5. Older adult
B. Pathophysiology of neurological system
1. Altered cerebral tissue perfusion
3.
Analyze factors included in the
assessment of the patient
experiencing commonly occurring
neurological problems, including
the developmental and cultural
considerations.
III. Selected commonly occurring neurological
problems
A. Interview
1. Chief complaint
2. Precipitating event
3. Medical history
4. Family/ Social/Occupational history
5. Medication history
1. Prescription
2. Nonprescription
6. Knowledge of health maintenance
7. Risk factors
B. Physical exam – neurological
1. Level of consciousness
2. Motor function
1. Strength
2. Symmetry
3. Tone
68
Clinical Objectives
Learning Opportunities
Readings:
Adams
Lewis
McKinney
Estes
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems
Part C – Neurological Problems
Behavioral Objectives
Content Outline
Posture
Reflex
(1) Gag
(2) Swallow
(3) Babinski
3. Sensory
4. Vital signs (breathing pattern)
5. Glasgow coma scale
6. Pupillary response
C. Diagnostic tests
1. Radiology
1. Computed axial tomography (CT)
2. Magnetic Resonance Imaging (MRI)
3. Magnetic Resonance (MRA)
4. Cerebral arteriogram
2. Laboratory studies
1. PT/PTT
2. INR
3. Other
1. Carotid Doppler studies
2. Lumbar puncture
D. Risks
1. Cultural influences
2. Hereditary
3. Environmental
4. Health beliefs/practices
5. Developmental
(1) Age specific assessment data
(2) Vital signs
(3) Fluid /electrolytes
(4) Nutritional
(5) Behavioral/emotional response
to health care providers
4.
5.
3.
Differentiate between the etiology,
pathophysiology, and clinical
manifestations of selected
IV. Common Occurring Neurological Problems
A. Neurological / Cerebral Vascular Disease
1. Cerebral Vascular Accident (CVA)
69
Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems
Part C – Neurological Problems
4.
Behavioral Objectives
commonly occurring neurological
disease processes.
Content Outline
1. Ischemic
2. Hemorrhagic
2. Transient Ischemic Attack (TIA)
Discuss analysis, planning,
implementation, and evaluation for
the nursing management of patients
with commonly occurring
neurological disease processes.
V. Selected Nursing Diagnoses/Implementation/
Evaluation
A. Altered Cerebral Tissue Perfusion
1. Independent Interventions
1. Monitor neurological status
(Glasgow Coma Scale)
2. Positioning
(1) Prevention of aspiration
(2) Prevention of contractures
(3) Decrease intracranial pressure
3. Range of Motion (ROM)
4. Safety Issues: prevention of injuries
5. Monitor VS
2. Collaborative interventions
1. Oxygen support
2. Administer medications and monitor
for desired/adverse/side effects
(1) Antihypertensives
(2) Steroids
(3) Anticonvulsants
(4) Anticoagulants
(a) Low Molecular Weight
Heparin
(b) Low Dose Heparin
(5) Antiplatelets
3. Nutritional support
(1) Prevention of aspiration:
Thickening agents
(2) Enteral feedings
4. Collaborate with other health care
professionals
(1) Physical therapy
(2) Occupational therapy
70
Clinical Objectives
Learning Opportunities
RNSG 1327 – Transition to Professional Nursing
Unit V– Care of the Patient Experiencing Commonly Occurring Health Problems
Part C – Neurological Problems
Behavioral Objectives
3.
4.
Content Outline
(3) Speech therapy
Recognition of complications
1. Aphasia
2. Contractures
3. Aspiration pneumonia
4. Death
Evaluation of Outcomes: The patient
will have improved cerebral tissue
perfusion as evidenced by:
1. Level of consciousness
2. Motor function
3. Sensory function
4. Glasgow coma scale
5. Vital signs
6. Breathing pattern
N:\ADN/Transition/RNSG 1327/Unit V – C/ Neurological
Clinical Objectives
Learning Opportunities
Reviewed 03/12
Reviewed 03/13
71