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Chapter 29 Neurologic Conditions. Risk Factors for Neurologic Disorders. Cigarette smoking Obesity Ineffective stress management Elevated cholesterol Unsafe actions Infections of the ear or sinus Sexually transmitted diseases. Subtle Indicators of Neurological Disease. New headaches
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Risk Factors for Neurologic Disorders • Cigarette smoking • Obesity • Ineffective stress management • Elevated cholesterol • Unsafe actions • Infections of the ear or sinus • Sexually transmitted diseases
Subtle Indicators of Neurological Disease • New headaches • Change in vision • Sudden deafness; ringing in ears • Mood, personality changes • Altered level of consciousness
Subtle Indicators of Neurological Disease (cont.) • Clumsiness; unsteady gait • Numbness and tingling of extremities • Unusual sensation of pain over nerve
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
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
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
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
Manifestations of a TIA • Hemiparesis • Hemianesthesia • Aphasia • Unilateral loss of vision • Diplopia • Vertigo • Nausea; vomiting • Dysphagia
Risk Factors for Cerebrovascular Accident • Hypertension • Diabetes • Hypothyroidism • MI • TIA • Dehydration • Cigarette smoking
Warning Signs of a CVA • Light-headedness • Dizziness • Headache • Drop attack • Memory and behavioral changes
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
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.
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.
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.
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
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
Source • Eliopoulos, C. (2005). Gerontological Nursing, (6th ed.). Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).