MedSurg NCTC Neuro
Question
Two divisions of the nervous systerm
Answer
Central (CNS) Peripheral (PNS)
Sensory Neurons
Transmit impulses to the CNS
Motor Neurons
Transmit impulses from the CNS
Three parts of the Brain
Cerebrum cerebebellum brain stem
Cranial Nerve I
Olfactory nerve: sense of smell
Cranial Nerve II
Optic nerve: sight
Cranial Nerve III
Oculomotor nerve: Contraction of iris and eye
muscles
Cranial Nerve IV
Trochlear nerve: eye movement
Cranial Nerve V
Trigeminal nerve: sensory nerve to face,
chewing
Cranial Nerve VI
Abducens nerve: eye movement
Cranial Nerve VII
Facial nerve: facial expression, taste, secretions
of salivary and lacrimal glands
Cranial Nerve VIII
Vestibulocochlear (or auditory) nerve: hearing,
balance
Cranial Nerve IX
Glossopharyngeal nerve: taste, sensory fibers
of the pharynx and tongue, swallowing,
secretions of parotid gland
Cranial Nerve X
Vagus nerve: Motor fibers to glands producing
digestive enzymes, heart rate, muscles of
speech, gastrointestinal motility, respiration,
swallowing, coughing, vomiting reflex.
Cranial Nerve XI
Accessory (or spinal accessory) nerve: head
and shoulder movement.
Cranial Nerve XII
Hypoglossal nerve: movement of the tongue
Cranial Contents:
84% brain, blood 4% CSF 12%
Decorticate posturing
one or both arms are fully flexed on the chest
Decerebrate posturing
one or both arms are stiffly extended.
Conscious
the client responds immediately, fully, and
appropriately to visual, auditory, and other
stimulation.
Somnolent or lethargic
The client is drowsy or sleepy at inappropriate
times but can be aroused, only to fall asleep
again. Response to questions are delayed or
inappropriate. Speech in incoherent. The client
responds slowly to verbal commands, responds
to painful stimuli
Stuporous
The client is aroused only by vigorous and
continuous stimulation usually by manipulation
or strong auditiory or visual stimuli...one or two
word answers, or motor activity or purposeful
behavior directed toward avoiding further
stimulation.
Semicomatose
The client is unresponsive except to superficial,
relatively mild painful stimuli to which the client
makes some purposeful motor response to
evade stimulation.
Comatose
The client responds only to very painful stimuli
by fragmentary , delayed reflex withdrawl; in
deeper stages, he or she loses all
responsiveness. There is no spontaneous
movement and the respiratory rate is irregular.
Glasgow Coma Scale
a tool for assessing a client's response to
stimuli. A score of 10 or less indicates a need
for emergency attention. A score of 7 is
generally interpreted as coma. 3 categories eye
opening, verbal response, and motor response
gives points from 1-4
C.T Scan - Computer Tomography
uses x-rays and computer analysis to produce
three dimensional views of thin cross sections
of the body * if using contrast requires consent
MRI - Magnetic Resonance Imaging
Is based on the magnetic behavior of protons in
body tissues. it uses radio frequency waves to
produce images of tissues of hight fat and water
content such a soft tissue, veins, arteries and
the brain and spinal cord no radiation.
Positron Emission Tomography
uses radioactive substances to examine
metabolic activity of body structures.
Single Photon Emission Computed
Tomography
Lumbar Pucture
provides information about the brain's function,
cerebral blood flow and status of receptors for
neurotransmitters. Early identification on lesions
Examination of CSF for pressure, pathogenic
microorganisms and blood cells
Contrast Studies -cerebral
angiography -
detects distortion of cerebral angiography
Electroencephalogram
records the electrical impulses generated by the
brain.
Increased Intracranial pressure
Brain 84% Blood 4% CSF 12%
Foramen magnum -
the opening in the lower part of the skull through
which the upper part of the spinal cord connects
with the brain. The only hole in the brain. ...too
much pressure the brain with herniate ....DRT
dead right there.
IICP - signs and symptoms
Decreasing LOC Confusion, restlessness
Headache - especially one that is more severe
in the morning, increases with activities that
elevate ICP such as coughing sneezing or
straining at stool. vomiting with no nausea
Cushings Triad
pulse rises then falls widening pulse pressure
irregular respiratory rate
Cheyne-Stokes respirations -
shallow rapid breathing followed by periods of
apnea.
head injury
compresses the brain - big changes quickly the
pop off valve is the foramen magnum (big hole
at the bottom of the skull) Brain stem - heart
rate, respirations, LOC - no going back
○ Glasgow Coma scale
§ 3-15 § 7 is comatose □ Eye opening □ Speak
□ Move independently □ response to pain
Vomiting
especially without nausea is a neurological
issue
Papilledema
§ optic nerve swollen □ vision change □ pupil
response □ fixed and dilated □ unequal pupils □
check for prosthetic eyes if no pupillary
response
* Tests that determine underlying
cause of IICP:
○ CT scan 10-15 min ○ MRI ○ Lumbar puncture
○ Intracranial pressure monitor ○ Do a good
assessment -can tell how they are doing by a
good neuro assessment
* Meningitis:
○ headache --light sensitive (photophobia) quiet
cool dark area ○ stiff neck - nucle rigidity ○ fever
○ rash on trunk ○ mental alterations - can be
wild Seizures
Meningococcal:
faster onset; diagnosed by spinal tap cloudy
fluid make sure we do a CT before the spinal
tap, antibiotics, anticonvulsants, pain, low
stimulus environment.
Spinal tap
roll into a ball shoulder and hips inline so the
vertebre make more space. Check fluid then
send to the lab numbered tubes first one they
disregard RBS from the tap, usually to a head ct
first before the tap in case of a bleed in the
brain.
Cerebral Vasculitis:
Inflammation of the blood vessels in the brain
can result in irreversible coma, long lasting
neurological problems hearing and vision. Can
be fatal
Encephalitis Patho & Etio
many different causes usually vector borne.
Most common is west nile. find source;
mosquito control.
Gillian Barre Syndrome Patho & Etio
Auto immune - commonly follows a viral
infection usually a respiratory or vaccines
effects the myelin sheet
weakness numbness tingling effects the arms
and legs. Starts at the bottom and works their
Assessment: Gillian Barre Syndrome
way up. Gradual onset with a slow and recovery
will be the reverse. Can take up to a year
depending on the severity of the problem.
Brain Abscess Patho & Etio:
Infections; caused sinus, teeth ear, surgery,
tongue piercing,
Assessment: Brain Abscess
headaches, vomiting, fever, seizures, LOC,
difficulty walking, pt may be compensating for
some time if the abscess is severe.
Medical Mgmt: Brain Abscess
Antibiotics, surgery, may need life support *
Nursing Mgmt: measure I &O, LOC, Monitor for
intracranial pressure,
Multiple Sclerosis Patho & Etio:
Destruction of the myelin sheath chronic and
progressive with exacerbations and remissions
but keep getting worse. Onset 20 to 40 years
affects men and women approximately equally
in more northern climates.
* Capizole - new drug foe MS
○ flushing ○ heart palpitations ○ anxiety ○
dyspnea ○ raised burning welt possible ○ lasts
15 min or less
* Nursing Mgmt: MS
Keep immune system up, supportive care for pt
and family, many different drugs for symptoms,
no cure but meds to help with lessening
exacerbations.
Myasthenia Gravis Patho & Etio:
thymus gland issues - drooping of eyelids,
difficulty chewing and swallowing, different
muscle groups effected. May see improvement
with rest
*Myasthenia Gravis Medical &
Surgical Mgmt:
diagnostic Tensilon will see improvement for 5
min. * Nursing Mgmt: Monitor respiratory, allow
for periods of rest,
Amyotrophic Lateral Sclerosis Lou
Gerick's disease Patho & Etio:
lack of muscle control degeneration of the
myelin sheath, degeneration of muscle neurons
and spinal cord. Potentially fatal, can be very
aware that their mind is here but their body is
failing.
Amyotrophic Lateral Sclerosis Lou
Gerick's disease** Assessment:
progressive wasting of extremities, then
respiratory, swallowing, speech, emotional
inability to appropriately respond, watch for
respiratory issues and failure.
Cranial Nerve Disorders Trigeminal
Neuralgia Patho & Etio:
affects the 5th cranial nerve pain with chewing
might be from compression from the nerve, will
be reoccurring, sudden severe burning pain.
can think of nothing but pain. May not be able to
communicate effectively until their pain is
treated.
Treated with narcotics, watch for respiratory
depression. may take lots of meds to get their
Trigeminal Neuralgia * Medical Mgmt:
pain under control but may not be able to make
it go away completely. Anticonvulsants seem to
help settle down the nerves some.
Trigeminal Neuralgia * Surgical
Mgmt:
Sever the sensory route, may lose control of
that side of their face, really look carefully
before taking this step
Trigeminal Neuralgia * Nursing
Process:
any little thing can set off a reaction, protect this
person's face from cool breezes, fans, washing
their face, eating cold things, cold drinks, any
stimulation may set off this reaction. Sometimes
it may resolve as quickly as it started.
Bell’s Palsy Patho & Etio:
7th nerve * drooping of the face and eyelid,
usually see more of the eye than a stroke ( with
stroke you will see more lip ), Decreased
sensation, usually not a headache, limited to the
face (stroke is the whole body)
Bell’s Palsy * Assessment:
symptoms develop in a few hours to one or two
days. Most cases recover but if still have
symptoms after three months it may be
permanent. eye damage, trouble swallowing,
need ointment on the eye at night and tape
close.
Temporomandibular Disorder Patho
& Etio:
The meniscus of cartilaginous disk between the
condyle and the temporal bone becomes
displaced.
Temporomandibular Disorder *
Assessment:
pain, headache, muscle spasm, clicking, lock
jaw, chewing and talking problems, could be
swallowing problems. Nutrition, cold or hot food
may be irritating.
Patho: affects the dopamine receptors stiffness,
Extrapyramidal Disorders tremors, rigidity, hips and knees slightly flexed,
Huntington's and Parkinson's disease short shuffling steps, stooped posture, arms
most common Parkinson's
flexed at elbows and wrists. Progressive
disorder, watch for falls, pill rolling( early sign)
Parkinson's Medical Management:
prolong their independence for as long as
possible. Rehab: maintain the highest level of
function available train them and their
caregivers for their needs and care.
Huntington's Disease Patho -
hereditary disorder, genetically passed
symptoms usually show up when the pt is in
their 40-50's
hallucinations, emotional disturbances, impaired
judgment, fast changes, speech and swallowing
S/S no early symptoms - Huntington's difficulty, twisting of the body, bowel and
Disease
bladder control depletes, people wither down to
almost nothing, contortions odd body
positioning,
Nursing mgnt: Huntington's Disease
try to prevent complications, support them
nutritionally , try to keep safe, emotional support
try to maintain the highest level of functioning.
Seizures - Partial
won't lose consciousness, may have some
uncontrolled jerking movement of a body part
usually last lest than a minute. May have
sensory manifestations.
Generalized - Grand Mal
Tonic clonic movements, whole body involved,
may have sensation before called an aura.
Sudden excessive jerking, may have a preictal
phase vague emotional stage, after may have
post ictal phase, pt very tired needs to sleep,
Status Epilepticus -
Series of tonic clonic seizures blood to brain,
breathing, must be stopped, valium, may have
to paralyze them and put on a vent, Cerebyx or
dilantin to keep from seizing. Tergitol, Zarontin,
Depakene, often seen if they don't take their
meds
Brain Tumors, -
some more common in children, some more
common in adults, about 50% of all tumors are
malignant what causes? abnormal growth of
cells, viral immunosuppression, infection,
trauma, genetic, radiation,
Brain Tumors Assessment
headache worse in morning, vomiting without
nausea, LOC, speech, paralysis, double vision,
seizures,
Central Nervous System
* consists of the Brain and Spinal Cord
* Peripheral nervous system
* consists of the 12 pairs of cranial nerves & 31
pairs of spinal nerves
* Brain stem
* Controls awareness/alertness through reticular
activating system * made up of medulla, pons &
midbrain: * -*
Medula
anterior to cerebellum * regulates HR, resps,
BP, coughing, sneezing and swallowing
Pons
- anterior to medulla, relays messages to upper
brain centers
Midbrain
* extends from pons to hypothalamus *
regulates movement of eyes, auditory reflexes,
righting reflexes-to keep head upright
* Cerebellum
* posterior to medulla and pons * Coordinates
involuntary aspects of voluntary movement,
maintains balance, posture, spatial orientation
* Cerebrum
* Controls higher functions and activities,
conscious mental processes, sensations,
emotions, and voluntary movements
Forebrain
Includes the frontal, parietal, occipital, &
temporal lobes & central portion of brain
sympathetic division: Fight or flight
* bronchodilator * increased HR and Resp *
decreased gastric motility * run by
neurotransmitters called catecholamines: epi &
nor-epi
parasympathetic division: Rest &
Digest
* opposite of fight or flight-dominant during nonstressful times * Bronchi-constricted or normal *
decreased HR and resp, or normal * increased
gastric motility
* Stroke lateral side of the bottom of foot-if
How do you perform a Babinski
positive-great toe pulls towards nose and other
reflex, also known as a plantar reflex, toes flare * normal response is for toes to curl
and what does it indicate?
when foot stroked * positive response indicates
abnormalities
* What is an EEG and what prep is
necessary?
* A graphic representation of electrical activity of
brain cells * shampoo hair thoroughly so that
electrodes will adhere to scalp * withhold
seizure meds, anticonvulsants, sedatives and
tranquilizers for 24-48 hours prior to EEG *
restrict caffeine
* assess LOC: is pt somnolent, lethargic,
stuperous, semi-comatose, comatose * assess
How would you do Neuro checks on a mental status: ask them to say their name, date
head trauma pt?
and place, include a question with a commonly
known answer- * assess pupil response: *
assess extremity strengt
subarachnoid bleed
* S/S-sudden onset, severe HA, stiff neck,
decreased LOC, photophobia
* What is a coup and contrecoup
injury?
* Coup injury is a closed head injury caused by
hitting an unmoving object-the brain hits on the
inside of the skull * Contrecoup injury is when
an object hits the head and the brain bounces
off the opposite side of the skull.
What is ICP, and how important is
this?
* Intracranial pressure-components that exert
pressure in the cranium-normal 0-15 mm Hg *
anything above 15 mm Hg creates potential life
threatening problems * 3 things control ICP:
brain, blood & CSF
The Monroe Kellie hypothesi
states that in order for ICP to remain normal
one must decrease if one increases.
* Twisting the spinal column in the presence of
Why did you take care not to twist an injury can decrease the blood supply to the
mva pts back during transfer?
spinal column changing the components that
control ICP, this leads to increased ICP
Glasgow Coma Scale what is
normal?
* Measures eye opening, best motor and best
verbal response * each assessment receives a
score * normal score: 15 * ask open ended
questions
What S/S occur with increased ICP?
* LOC-most reliable indicator of mental status -
earliest changes seen * pupillary changes are
second * altered motor function * Posturing *
change in temp * as pressure on hypothalamus
increases body unable to control temp
Biots respiration
2 shallow breaths followed by a period of apnea
* What are some of the effects of
spinal cord injury?
* Damage can be complete or incomplete *
above C4 interrupts respirations-can be fatal *
C5 and below spares diaphragm so able to
maintain respirations but still have respiratory
compromise
spinal shock
reflexes below level of injury temporarily stopsextremities are flaccid-becomes spastic as
shock resolves (pg. 439) loss of sensation
below the level of injury increases the risk of
other injuries
* autonomic dysreflexia
* most dangerous problem, may occur as spinal
shock subsides * exaggerated response to
painful or noxious stimuli, distended bladder,
constipation, renal calculi, ejaculation or uterine
contractions, enemas, position change
* autonomic dysreflexia S/S
* severe vasoconstriction leads to severe
hypertension * vasodilation occurs above injury:
flushing, sweating * vagus nerve stimulated
causing bradycardia * Treat cause to correct
Contact lenses and a head injury
patient
You remove them and place them in a safe
container.
What would you do if the pt did not
have an intact corneal reflex?
Lubricate eyes regularly with saline
* Why would you space out the care
for a spinal cord pt instead of doing
his bath, PROM, oral care and
dressing changes all at one time?
* you want to prevent autonomic dysreflexia
Decadron
a corticosteroid- decreases brain swelling
Dilantin
decreases possibility of sezures
Mannitol IV
used to decrease intracranial pressure
* Patient’s with neurological
impairment often become easily
agitated and combative. What
medication can be given to help with
this problem?
* Haldol
* Can cause extrapyramidal symptoms such as
* What problems are associated with
Tardive dyskinesia and Dystonia * Give
Haldol?
Cogentin to control this problem
Kernig’s sign-
flex leg at hip then extend knee * may cause
pain in hamstring
Brudzinski’s sign
when neck flexed, hip flexion occurs
What medical treatment is used for
bacterial meningitis?
* Antimicrobials for bacterial meningitis *
anticonvulsants for seizure activity
* What medical treatment is used for
Viral meningitis?
requires supportive care
What causes Parkinson’s?
* idiopathic-no known cause
* What are the early s/s of
Parkinson's disease?
* Tremor, rigidity * bradykinesia-extremely slow
movements * loss of dexterity & power in
affected limbs, aching, handwriting changes,
drooling, lack of facial expression, rhythmic
head nodding, pill rolling
* Why would physical therapy be
used for Parkinson's?
* To help control symptoms of disease * PT
includes massage, heat, exercise and gait
retraining
Levodopa
* crosses the blood brain barrier-converted to
dopamine to supplement the levels of dopamine
in the brain to improve motor movement
What medication is used in
* Sinemet- converts dopamine in the brain and
combination with Levodopa and why? is used in combo so that lower dosages can be
used to achieve therapeutic levels
* hemorrhage * blood vessel ruptures causing
bleeding into brain leading to increased
What are the 2 major causes of CVA?
intracranial pressure * ischemia * embolic &
thrombotic strokes-obstructs blood flow to brain
cells and they become ischemic and die
* What part of the brain are often
affected by CVA?
* cerebrum * right hemisphere controls left side
* left hemisphere controls right side * brain stem
* controls vital functions-resp, HR, LOC
What s/s might a person with CVA
experience?
* Depends on type, location, and extent of injury
* Hemorrhagic * Sudden onset * Severe HAdescribed as the “worst HA of my life” *
Photophobia * Stiff neck * Loss of
consciousness * Vomiting * Seizures
* Embolic CVA S/S
* Depends on the area of the brain that
becomes ischemic * Unilateral numbness,
weakness or paralysis * Visual problems *
Confusion or memory loss * HA * Dysphagia *
Memory loss * Thrombotic S/S same, but more
gradual
What is affected by left brain
damage?
* Right sided paralysis * Aphasia * Slow
cautious behavior * Memory deficits *
Reasoning * Logic * Ability to analyze
What is affected by right brain
damage?
* Left sided paralysis * Spatial-perceptual
deficits * Quick impulsive behavior * Memory
deficits * Emotions * Loss of creativity *
Imagination
What is a TIA?
* Transient Ischemic Attack * Temporary
blockage of a cerebral vessel * 85% blockage
causes symptoms of a TIA * TIA’s are warning
signs of an impending stroke
What tests are done to determine if
* CT scan * MRI * Cardiac ultrasound * Cerebral
the CVA is caused by a clot or bleed?
and carotid angiogram * EKG * PET scan
clot busters
* Streptokinase * tPA * Activase
“clot busters” what makes a
candidate
You must start this medication within three
hours of the onset of symptoms. Stroke must be
from a clot, no recent surgeries, no medications
that contraindicate it.
Mannitol
for cerebral edema
Corticosteroids
for increased ICP reduce inflammation,
suppresses immune system, monitor glucose
levels. watch for GI bleeds.
Nimodipine or Nimotop
a CCB used to decrease cerebral spasm (for
hemorrhagic stroke)
Dilantin
decrease the incidence of seizures makes birth
control pills inactive, and causes birth defects.
Heparin
anticoagulation
What drugs are used to prevent TIA
or CVA’s?
* ASA * Ticlid * Warfarin Sodium * Lovenoxmust inject in the “love handles” **using a 25 g,
5/8” needle
What options are available for
patients who are S/P stroke?
* Physical Therapy * Occupational Therapy *
Speech Therapy * Home Health * Rehab
hospitals
Hemianopsia
loss of vision
Agnosia
inability to recognize objects
Aphasia
inability to speak, read, write, use language, or
comprehend words
Dysphagia
difficulty swallowing
Dyspraxia
difficulty initiating voluntary movements
Hemiplegia
half of the body is paralyzed
What can the nurse do to help
communicate to either type of
aphasia?
* speak slowly & clearly * use gestures * listen
attentively when pt tries to speak * use alphabet
board or pictures * use simple questions that
require only yes or no answers
PT is going to assist your patient with
* With the left hand, 6” lateral to the left foot
right sided weakness. How does the
**Opposite the side of weakness!!
patient need to hold the cane?
What is Guillain-Barre’ Syndrome?
* rapid progression (1-3 weeks)-myelin sheath
destroyed along peripheral nervous system * an
autoimmune response to a viral infection
What lab tests might be performed for lumbar puncture shows increased protein in
Guillain-Barre’ Syndrome?
CSF
What is Myasthenia Gravis?
* A chronic, progressive disease with a defect in
the neuromuscular junction (causes electrical
impulses to be impaired to muscle)
What meds might be used for
Myasthenia Gravis?
* Anticholinesterase drugs-Neostigmineincreases availability of acetylcholine at the
neuromuscular junction * Corticosteroids-used
when anticholinesterase drugs don’t work
myasthenic crisis?
* Myesthenic crisis-sudden exacerbation of
myasthenia symptoms-difficulty breathing and
swallowing, resp arrest * precipitated by
infection
* cholinergic crisis-
sudden extreme weakness and resp impairment
precipitated by overdose of anticholinesterase
drugs
What is Amyotrophic Lateral
Sclerosis?
Lou Gehrig’s disease * rapid progression of
degeneration of the anterior horn cells and
corticospinal tracts of the motor neuron causing
spasticity, hyperreflexia , weakness, atrophy,
cramps and muscle twitching, * maintains
intellectual ability
* Describe Post Polio Syndrome.
* Pt’s with this syndrome experience
progressive muscle weakness years after
having Polio * care is supportive-help pt to
adapt to symptoms and maintain maximum
function * Must maintain strict bed rest while
feeling weak
What meds are commonly used with
MS?
prednisone, interferon 1B, baclofen, Tegretol,
Symmetrel
What are the S/S of MS?
* Weakness * Vision changes * Nystagmusinvoluntary eye movements * Tingling in
extremities * Difficulty with coordination *
Bowel/bladder dysfunction * Spasticity *
Depression
What can cause an exacerbation of
MS?
* Illnesses * flu, URI, **UTI
Describe the medical treatment for
MS.
* Treat symptomatically * Supportive care *
Solumedrol for exacerbations * Interferon 1B
and 1A to prevent progression * Baclofen for
spasticity
What meds are used for a pt with a
seizure disorder?
* Dilantin * Cerebrex * Neurontin * Topamax
Seizure discharge teaching
* Must take meds for the rest of their life *
NEVER suddenly stop taking your meds-contact
physician first * When taking Phenytoin, you
must have good oral hygiene
What is the first step you the nurse
must do to dislodge a foreign object
from the ear?
* Gentle flush with sterile NS May need to use
mineral oil or alcohol if an insect is present
* Pain that increases when auricle pulled *
What S/S occurs with external otitis? Dizziness, fever, drainage * Topical ATB, ASA
Treatment?
or codeine for pain * Also known as “swimmer’s
ear”
What is otitis media and how is it
treated?
* Infection of the middle ear * Treated with ATB
* If chronic-tubes, myrongotomy
What is Meniere’s disease?
* Disorder of the labyrinth, possibly caused by
fluid in the inner ear
What S/S does a pt with Meniere’s
disease experience?
* Acute attack-unilateral hearing loss, vertigo *
Attacks usually become more frequent and
closer together as it progresses * Tinnitus is
most common c/o associated w/inner ear
problems
How is Menieres disease treated?
* Meds for an acute attack are-atropine, Valium,
antihistamines and vasodilators * Surgical txdrain fluid from the inner ear or cut the acoustic
nerve that controls balance * Ototoxic ablationinstilling ATB that are toxic to the inner ear
battery acid splashed in his right eye.
* Flush the eye with saline continuously for 30
He is in severe pain. What is your first
minutes or until the burning stops
intervention?
How will the doctor check for damage
* With a Woods Lamp
to the cornea?
What is the difference between
central cataracts and peripheral
cataracts?
* Central-good peripheral vision * Peripheralgood central vision
What medical treatment may be
appropriate for a cataract pt in the
early stages? Late?
* Early-mydriatics * Late-cataract extraction with
intraocular lens implant
* Mydriatics
-dilation
Cycloplegics
paralyze muscles necessary for accomodation
so eye won’t move during surgery
* HOB up 45 * Lie on unaffected side *
What nursing interventions post-op
Antiemetics to prevent or tx N/V * Administer
are necessary to keep intraocular
eye drops as ordered * Instruct pt no lifting >5pressure in the operative eye normal? 10 lbs * Don’t bend forward until released by Dr.
* Report severe pain immed.-usually sign of
increased IOP
What observations do you need to
make if you witness a seizure?
* Respiratory * Airway * S/S of hypoxia * Length
of time seizure is lasting * What body parts are
involved * LOC * Incontinence