NR 330 -Neurologic Problems Assignment

NR 330 -Neurologic Problems Assignment

NR 330 -Neurologic Problems Assignment

Chapter 45: Neurologic Problems

 

Transient Ischemic Attack

 

  • TIAà temporary neurologic dysfunction resulting from a brief interruption in cerebral blood flow
    • WARNING SIGN for a stroke
  • Symptoms typically resolve in 30 to 60 minutes
  • NO BRAIN DAMAGE OCCURS WITH TIA
  • Neurologic assessment, labs, EKG, and HCT done
    • Possible admission to look at risk factors for stroke
  • Treatment focused on PREVENTING TIA or stroke
    • Reducing BP
      • Most common RF!
    • Aspirin or antiplatelet drugs
    • Controlling DM and keeping BGL 100-180 mg/dL
    • Lifestyle changes
      • Smoking cessation
      • Healthy diet
      • Physical activity

Stroke (Brain Attack)

  • Strokeà any interruption of PERFUSION to the brain
    • “Brain Attack”
  • MEDICAL EMERGENCY!!
    • Treated promptly to reduce disability
  • Pathophysiologic Changes in the Brain
    • Brain needs glucose and oxygen!!
      • Through cerebral blood flow
        • Also removes waste
      • Without blood flow à infarction (tissue death)
      • Brain metabolism and blood flow are affected around the infarction site and the contralateral hemisphere
      • Brain edema à ­ ICP and secondary brain damage
    • Types of Stroke

      • Ischemicà occlusive
        • MORE COMMON!
        • Caused by the blockage of a cerebral artery by a thrombus or embolus
          • Thrombotic stroke
            • Associated with atherosclerosis in the cranial arteries
              • Carotid arteries and vertebral arteries with the basilar artery are the most common sites
            • The rupture of plaques promotes clot formation
            • Slow onset
              • Minutes to hours
            • Embolic stroke
              • Caused by a thrombus or group of thrombi that break off from one area of the body and travel to the cerebral arteries
                • Source is usually the heart
                  • A-fib, MI, prosthetic heart valves
                • Middle cerebral artery is the most common site
                • Sudden development with rapid neurologic deficits
                  • May resolve over several hours or a few days
                • Can progress to hemorrhagic strokeà brain bleed
              • Hemorrhagic Stroke
                • Vessel integrity is interrupted, and bleeding occurs into the brain tissue or into the subarachnoid space
                • Intracerebral Hemorrhageà bleeding into the brain tissue
                  • Results from severe HTN
                  • Brain damage occurs from bleeding, causing edema, distortion, and displacement
                • Subarachnoid Hemorrhageà bleeding into the subarachnoid space
                  • Usually caused by ruptured aneurysm or arteriovenous malformation
                    • Aneurysmà abnormal ballooning or blister of artery
                    • AVMà tangled, weak vessels without capillary network
                      • Subject to rupture and bleeding
                    • Vasospasmà constriction of a cerebral artery that allows bleeding from another source
                  • Etiology
                    • Major RF include family history, HTN, atherosclerotic disease, and aneurysm

NR 330 -Neurologic Problems Assignment

Traumatic Brain Injury

 

  • Pathophysiology
    • TBIà damage to the brain from an external force
    • Can lead to temporary or permanent impairment of cognitive, physical, or psychosocial functions
    • Types:
      • Direct injuryà blow to the head
      • Indirect injuryà force to another part of body that rebounds to the brain
        • Movement within the skull
        • Shearing injuries
        • Contusions
        • Lacerations
      • Brain injury occurs from forces on the head and brain and a result of secondary derangements of physiologic stability
      • Types of Force and Mechanisms:
        • Acceleration Injury
          • Caused by external force
          • Contacts the head
          • Places the head in motion
        • Deceleration Injury
          • When the moving head is suddenly stopped
          • Results in shearing, straining, and distortion of brain tissue

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