NCLEX Review & Nursing School

Here are some Neurological diseases of the Adults:

Spinal Cord Injury

– Trauma to the Spinal Cord

– Spinal Shock (Neurogenic Shock occurs within the first hour of injury)

• Spinal Shock could cause hypotension
• Bradycardia, Assess bowel Sounds.
• Flaccid Paralysis, loss of reflex  activity.

–  Watch out for Autonomic Dysreflexia ( Occurs after the period of Spinal Shock)

• Severe Headache
• Severe Hypertension
• Nasal Stiffness

♣   Cerebral Aneurysm

– a dilation in the weakened wall of a cerebral artery.

Assessment:

• Headache
• Nuchal Rigidity
• Irritability
• Diplopia

Interventions:

– Administer O2 as prescribed

– Maintain Ct. on bedrest in Semi Fowler’s or sidelying.

Seizures

– Abnormal electrical excessive discharge within the brain.

Epilepsy– Chronic seizure activity.

Types of Seizures:

• Generalized Seizures

– Tonic- Clonic (begins w/ aura), Absent

• Partial Seizures

– Simple Partial and Complex Partial.

Myasthenia Gravis

– A Neuromuscular disease characterized by considerable weakness and fatigued muscles.

Parkinsons Disease

– A degenerative disease caused by the depletion of dopamine.

Trigeminal Neuralgia (5th Cranial Nerve)

– A sensory disorder of the fifth cranial nerve.

Bells Palsy (Facial Paralysis)

– Affects the (7th) seventh cranial nerve

– Results in a paralysis in one side of the face.

Guillain- Barre’ Syndrome

– acute infectious neuronitis of the cranial and peripheral nerves.

– the immune system destroys its own myelin sheath.

Neurological Diseases in Pediatrics

Pediatric Neuro Diseases

Cerebral Palsy

– Impaired motor and postural movements of a child due to abnormality within the Nervous System.

Assessment:

• Crying and Irritability
• Abnormalities with Motor skills
• Muscle stifness and rigid upper  & lower extremities
• Moro Tonic Reflex (after 6 months)

Interventions

– Prepare the child for the use of mobilizing devices.

– Provide Safety for Child Dvelopmental Level

– Administration of Prescribed Medications:

• Antispasmic
• Anti Seizure

ADHD (Attention Deficit Disorder)

– High degree of inattentiveness and great impulse activity in the child.

– Child will show a lower intellectual development and difficulty w/ social skills.

Assessment

– Behavioral Therapy.

Hydrocephalus

– An imbalance of the CSF production & absorption causing hemorrhage, tumor and malformations.

Assessment w/ an Infant

• An increase in head circumference
• Macewan’s Sign (separated bones in cranium)
• Bulging Anterior Fontanels

Assessment w/ a Child

• Irritability and Lethargy
• Headaches
• Ataxia
• Nausea and Vomiting

Late Signs for both: High pitch cries and seizures

Interventions

Surgical: A ventriculoperitoneal shunt (which CNS into peritoneal cavity)

Ventriculoatrial Shunt:  The CSF is drained into the right atrium of the heart.

Reyes Syndrome

– A toxic encephalopathy that is characterized by cerebral edema & fatty liver.

– There is an association with the use of Aspirin. (Usually occurs after infection)

Diagnosis: is liver biopsy.

♣  Encephalitis

– Inflammatory process of the CNS.

Assessment: Malaise, fever, headache, nausea and vomiting.

Treatment: Adequate hydration, monitor signs of Increased ICP.

Bacterial Meningitis

– An inflammation of the meninges and the cerebrospinal fluid.

Meningococcal Meningitis- Droplet Precaution.