Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Chapter 47
Neurological Function,
Assessment, and Therapeutic
Measures
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Review of Normal A&P
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Synapse
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Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Cross Section of Spinal Cord
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Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Brain
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Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Cranial Nerves
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Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
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Facial
Vestibulocochlear
Glossopharyngeal
Vagus
Accessory
Hypoglossal
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Autonomic Nervous System
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Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Aging
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Basic Neurological Assessment
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Level of Consciousness
Vital Signs
Pupil Response to Light
Extremity Strength and Movement
Sensation
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
History
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Symptoms
Medication Use
Surgical History
Family History
Life Style
WHAT’S UP?
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Subjective Data
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Mental Status
Intellectual Function
Thought Content
Perception
Language Ability
Memory
Pain
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Physical Assessment
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Level of Consciousness
Mental State Examination
Pupillary Response
Muscle Function
Cranial Nerve Function
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Glasgow Coma Scale
 Eye Opening
 Verbal Response
 Motor Response
 Posturing
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Abnormal Posturing
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Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Pupil Assessment
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Equal
Round
Reactive to Light
Reactive to
Accommodation
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Diagnostic Tests
 Laboratory Tests
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Thyroid
B12
ESR
CBC
Electrolytes
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Hormone Levels
Creatine Kinase
VDRL
Liver Function
Renal Function
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Lumbar Puncture
 Pre-Procedure Nursing Care
 Verify Informed Consent
 Assist with Positioning
 Post-Procedure Care
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Maintain Flat Bedrest 6 to 8 Hours
Encourage Fluids
Monitor Puncture Site
Monitor Movement, Sensation, Headache
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Lumbar Puncture (cont’d)
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
CT Scan
 Pre-Procedure
 Teach
 Administer Contrast if
Ordered
 Check Allergies
 Check BUN, Cr
 Request Order for
Sedation if Indicated
 Contrast May Cause
Feeling of Warmth
 Signs and Symptoms
of Allergic Reaction to
Report
 Post Procedure
 Encourage Fluids if
Dye Used
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
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 © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Angiogram
 Pre-Procedure Nursing Care
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Verify Informed Consent
Give Clear Liquid Diet
Insert IV Needle
Check BUN/Cr
Check PT and PTT
Administer Sedation as Ordered
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Angiogram (cont’d)
 Post-Procedure Care
 Keep Flat in Bed 6 to 8 Hours
 Monitor
 VS
 Catheter Insertion Site
 Pulses
 Encourage Fluids
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
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 © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Electroencephalogram
 Pre-Procedure Nursing Care
 Assure Hair Clean and Dry
 Check Medication Orders
 Post-Procedure Care
 Wash Hair
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Therapeutic Measures
 Moving and
Positioning
 Maintain Functional
Positions
 Avoid Injury
 Prevent Contracture
 Mobilize ASAP
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Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Activities of Daily Living
 Encourage Independence Based on
Functional Level
 Maintain Routine
 Provide Assistance as Needed
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Communication
 Problems
 Interventions
 Dysarthria
 Expressive Aphasia
 Receptive Aphasia
 Use Care with Yes-No
Questions
 Correct Substituted
Words
 Anticipate Needs
 Use Gestures
 Be Patient!
Copyright © 2011. F.A. Davis Company
Understanding Medical Surgical Nursing, 4th Edition
Linda S. Williams / Paula D. Hopper
Nutrition
 Evaluate Swallowing
 Interventions for Impaired Swallowing
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Thicken Liquids
Position Upright for Eating
Monitor Meals
Tube Feedings
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