NURSE-UN 1243 Lecture Notes - Lecture 3: Glasgow Coma Scale, Mean Arterial Pressure, Tracheal Tube
29 Apr 2019
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Week 3: neurological problems (iv) paralytics (never used without sedative: maintain airway, put in a catheter (c) barbituates (refractory to other treatments) (i) usually used in high doses with severe head-injury. Pt may deny their illnesses (b) 2nd stage: homonymous hemianopsia (i) spatial & perceptual deficits. Often omit small words such as "is", "and", and "the, often aware of their difficulties and can become easily frustrated by their speaking problems. (c) global: have severe communication difficulties, may be totally nonverbal. Impaired verbal communication: impaired physical mobility, disturbed sensory perception, impaired urinary elimination- if incontinent determine the cause, constipation: fluids and attention to bowel routine; no straining! Loss of consciousness again: medical management, surgical evacuation of hematoma, neuro icu with icp monitor, nursing management neurological assessment, sudden change in loc, nonreactive and dilated pupil on. Nursing management: seizures, pupil changes, hemiparesis, frequent neurological assessment: monitor loc. Icp is the pressure inside the skull and thus in the brain tissue and csf.
