Spinal cord function
what is autonomic dysreflexia and how is it treated?
a dangerous, sudden spike in blood pressure in people with spinal cord injuries (usually T6 or above) caused by a painful stimulus below the injury; typically caused by bowel or bladder fullness; treated by first elevating head of the bed, finding the cause, and removing the stimulus
what differentiates dementia from delirium?
delirium is acute onset and typically reversible, dementia is a gradual progressive decline in cognition function
what scale do we use to quickly assess a patient's level of consciousness in head injuries and other neurological conditions?
Glasgow coma scale- assesses for eye opening response, verbal response, and motor response; normal score is 15- lowest score is 3
what neurotransmitter is most responsible for the changes seen in Parkinson's disease?
dopamine- caused by a deficit of dopamine
what are the main side effects of phenytoin?
drowsiness, rash, gingival hyperplasia; blood serum levels must be monitored frequently due to narrow therapeutic range
what type of multiple sclerosis is characterized by gradual worsening of neurological function over time?
primary progressive multiple sclerosis
what are major risk factors for development of delirium in the hospital?
admission to ICU, older age, more comorbid conditions, administration of more medications
what patient population is at highest risk of head injuries?
older adults- due to fall risk, frailty, and often being on blood thinners which increases risk of complications with falls
what are the most common symptoms associated with parkinson's disease?
shuffling gait, resting tremor, balance difficulties, muscle rigidity, stooped posture
what are major side effects with carbidopa-levodopa?
nausea, vomiting, orthostatic hypotension
what type of multiple sclerosis is characterized by periods of worsening symptoms followed by periods of recovery and stability?
why do we try to use nonpharmacologic measures first when taking care of a patient with dementia or delirium?
many medications may worsen confusion and increase the risk of falls
what is cerebral edema?
swelling of the brain that results in increased intracranial pressure- can be from trauma, tumor, electrolyte imbalance
why are patient's with parkinson's disease at an increased risk of falls?
due to shuffling gait, balance problems, possible orthostatic hypotension from medication side effect
what are main side effects of carbamazepine?
headaches, ataxia, blurry vision, fluid retention, bone marrow suppression- which means increased risk of infection
what is cauda equina syndrome caused by and what are the symptoms?
cauda equina syndrome is caused by compression of the nerves in the lumbar area of the spine; this is an emergency- symptoms include severe low back pain, numbness and weakness of the legs, and bowel and bladder dysfunction with sudden onset
what are common symptoms of dementia?
what are the most common symptoms of an unruptured cerebral aneurysm?
none- they are usually asymptomatic until they become large or rupture
what safety precautions should be taken when caring for a patient with parkinson's disease?
fall precautions, aspiration precautions, assess for wandering risk
what are main side effects of valproic acid?
GI upset, liver toxicity- liver function tests must be monitored routinely with this medication
what are the most common symptoms of degenerative disc disease?
pain, numbness, tingling, weakness to lower extremities
what causes Alzheimer's disease?
a buildup of protein that cause damage to the brain; some genetic predisposition- associated with increased age
what safety considerations should a nurse take when caring for a patient with cerebral edema or a cerebral aneurysm?
close monitoring of blood pressure to keep within parameters to reduce intracranial pressure, maintain head of bed at 30-45 degrees to reduce pressure, reduce stimuli, frequent neuro checks for any acute changes
why is it important for patients to take levodopa-carbidopa at the same times every day?
due to on-off phenomenon, this medication wears off quickly and the patient can start to have significant symptoms of Parkinson's disease if they are not taken at specific times
why do antiseizure medications need to be taken at the same time every day?
to ensure that blood levels stay consistent to reduce risk of breakthrough seizures