Chapter 29 Neurologic Conditions

1. Chapter 29Neurologic Conditions

2. Risk Factors for Neurologic Disorders • Cigarette smoking • Obesity • Ineffective stress management • Elevated cholesterol • Unsafe actions • Infections of the ear or sinus • Sexually transmitted diseases

3. Subtle Indicators of Neurological Disease • New headaches • Change in vision • Sudden deafness; ringing in ears • Mood, personality changes • Altered level of consciousness

4. Subtle Indicators of Neurological Disease (cont.) • Clumsiness; unsteady gait • Numbness and tingling of extremities • Unusual sensation of pain over nerve

5. Possible Factors Involved in the Development of Parkinson’s Disease • A history of metallic poisoning • Encephalitis • Cerebrovascular disease, especially arteriosclerosis • Presence of the Lewy body

6. Symptoms of Parkinson’s Disease • A faint tremor in the hands or feet that progresses • Muscle rigidity and weakness • Masklike appearance of face • Increased appetite • Shuffling gait

7. Treatment of Parkinson’s Disease • Anticholinergics • Avoidance of foods that are high in vitamin B6 • Use of the herb passion flower • Use of pulse generators • Use of drug infusion systems • Gene therapy • Performing active and passive range-of-motion exercises

8. Causes of Transient Ischemic Attacks • Situations that reduce cerebral circulation • Hyperextension and flexion of the head • Reduced blood pressure resulting from anemia and certain drugs • Cigarette smoking • Sudden standing from a prone position

9. Manifestations of a TIA • Hemiparesis • Hemianesthesia • Aphasia • Unilateral loss of vision • Diplopia • Vertigo • Nausea; vomiting • Dysphagia

10. Risk Factors for Cerebrovascular Accident • Hypertension • Diabetes • Hypothyroidism • MI • TIA • Dehydration • Cigarette smoking

11. Warning Signs of a CVA • Light-headedness • Dizziness • Headache • Drop attack • Memory and behavioral changes

12. Nursing Interventions to Reduce Effect of Limitations of CVA • Talking in normal voice • Offering short explanations • Using familiar objects • Providing sensory stimulation • Offering positive feedback • Showing patience

13. Nursing Interventions in the Acute Phase of CVA • Maintain a patent airway. • Provide adequate nutrition and hydration. • Monitor neurologic and vital signs. • Prevent complications associated with immobility.

14. Nursing Interventions Following the Acute Phase of CVA • Talk to the patient during routine activities. • Briefly explain what occurred and what to expect. • Speak distinctly but do not shout. • Devise an easy means of communication. • Minimize environmental confusion, noise, traffic, and clutter. • Aim for consistency of those providing care and of care activities.

15. Nursing Interventions Following the Acute Phase of CVA (cont.) • Use objects familiar to patients. • Keep a calendar or sign in the room. • Supply sensory stimulation. • Provide frequent positive feedback. • Expect and accept errors and failures.

16. Nursing Interventions to Promote Independence • Self-help devices • Periodic home visits by a nurse • Regular contact with a family member or friend • Daily call from a local telephone reassurance program • Continuing patience, reassurance, and encouragement

17. Preventing Injury to Patients Following CVA • Scrutinize the environment for unsafe conditions • Loose carpeting • Poorly lit stairwells • Clutter • Ill-functioning appliances • Lack of fire warning systems and fire escapes • Lack of tub rails and nonslip tub surfaces, and other safeguards

18. Source • Eliopoulos, C. (2005).  Gerontological Nursing, (6th ed.).  Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).