1. Linda S. Williams / Paula D. Hopper Copyright © 2011. F.A. Davis Company Understanding Medical Surgical Nursing, 4th Edition Chapter 48 Nursing Care of Patients with Central Nervous System Disorders

2. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Meningitis  Pathophysiology  Infection/Inflammation of Brain and Spinal Cord  Purulent Exudate  Increased Intracranial Pressure  Possible Cranial Nerve Involvement

3. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Etiology  Bacterial  Neisseria meningitidis  Streptococcus pneumoniae  Haemophilus influenzae type b (Hib)  Viral

4. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Severe Headache  Fever  Photophobia  Petechial Rash  Nuchal Rigidity  Positive Kernig’s and Brudzinski’s Signs  Nausea and Vomiting  Encephalopathy

5. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Kernig’s and Brudzinski’s Signs

6. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Complications  Seizures  Cranial Nerve Damage  Occasional Permanent Neurological Deficits

7. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  Lumbar Puncture  Culture and Sensitivity  CT, MRI

8. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Antibiotics  Antipyretics  Cooling Blanket PRN  Dark, Quiet Environment  Analgesics  Codeine Products  Corticosteroids  Antiemetics  Isolation if Contagious

9. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Encephalitis  Pathophysiology  Inflammation of Brain Tissue  Nerve Damage, Edema, Necrosis  IICP

10. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Etiology  Viruses  Parasites  Bacteria  Vaccines  Fungi

11. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Headache  Fever  Nausea and Vomiting  Nuchal Rigidity  Confusion  Decreased LOC  Seizures  Photophobia  Ataxia  Hemiparesis  Tremors  Coma  Death

12. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Complications  Cognitive Disabilities  Personality Changes  Ongoing Seizures  Motor Deficits  Blindness

13. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  CT  MRI  EEG  LP with CSF Analysis

14. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Analgesics  Anticonvulsants  Antipyretics  Corticosteroids  Antivirals  Sedatives  Neurological Assessment  Symptomatic Care

15. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Increased Intracranial Pressure  Pathophysiology  Increase in  Brain  Blood  CSF

16. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Etiology  Brain Trauma  Brain Tumor  Intracranial Hemorrhage

17. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Restlessness  Irritability  Decrease in LOC  Hyperventilation  Pupil Changes  Cushing’s Response

18. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition ICP Monitoring  External Ventricular Drain  Subarachnoid Bolt  Intraparenchymal Monitor

19. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition ICP Monitoring (cont’d)

20. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses: CNS Infections  Acute Pain  Hyperthermia  Acute Confusion  Self-Care Deficit  Disturbed Sensory Perception  Impaired Physical Mobility  Risk for Injury: Seizures

21. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Headaches  Tension  Migraine  Cluster

22. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Care for Headaches  Assessment  Where is the pain?  How does it feel?  What Aggravates or Alleviates it?  What Times does it occur?  How bad is it on a 0–10 Scale?  Useful other data?  What is the Patient’s Perception?

23. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Headaches (cont’d)  Patient Education  Keep Diary  Record Triggers, Timing, Symptoms  Teach Relaxation and Stress Reduction  Teach re: Medications

24. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Seizures A seizure is defined as “abnormal electrical discharge in the brain. Seizures can be related to injury, high fever, substance abuse, metabolic disorders, and other health conditions such as diabetes, and are not always a sign of epilepsy.” (Epilepsy Foundation, 2009)

25. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Classification  Partial  Begin on One Side of Cerbral Cortex  Generalized  Both Hemispheres Involved

26. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Etiology  Idiopathic  No Cause Identified  Acquired  Underlying Neurological Disorder  Brain Injury

27. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Aura  Visual Distortion  Odor  Sound

28. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms (cont’d)  Partial Seizures  Automatisms  Maintain Consciousness  Usually < 1 Minute  Paresthesias  Visual Disturbances  Complex Partial  Lose Consciousness, 2–15 Minutes

29. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms (cont’d)  Generalized Seizures  Absence (Petit Mal)  Staring  Tonic Clonic  May Have Aura  Usually Lose Consciousness  Rigidity Followed by Muscle Contraction and Relaxation  Incontinence  Postictal Period

30. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  EEG  Look for Underlying Cause

31. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Correct Cause  Anticonvulsant Medication  Surgical Resection

32. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Emergency Care: Seizure  Pad Side Rails  Prevent Injury  Monitor Airway  Do Not Restrain  Turn on Side to Prevent Aspiration  Suction PRN  Observe and Document

33. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Status Epilepticus  30 Minutes of Seizure Activity  Therapeutic Interventions  Ensure Airway and Oxygenation  Administer IV Diazepam or Lorazepam

34. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses  Risk for Injury  Risk for Ineffective Self Health Management

35. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Traumatic Brain Injury (TBI)  Trauma  Hemorrhage  Contusion  Laceration  Can Cause  Cerebral Edema  Hyperemia  Hydrocephalus  Brain Herniation  Death

36. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Etiology  MVA Most Common  Falls  Assaults  Sports-related Injuries

37. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Mechanisms of Injury  Acceleration  Deceleration  Acceleration-Deceleration  Rotational

38. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Types of Injury  Concussion  Contusion  Hematoma  Subdural  Epidural

39. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  CT  MRI  Neuropsychological Testing

40. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Surgical Removal of Hematoma  Control IICP  ICP Monitoring  Osmotic Diuretic  Mechanical Ventilation  Therapeutic Coma

41. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Complications of TBI  Brain Herniation  Diabetes Insipidus  Acute Hydrocephalus  Labile Vital Signs  Posttraumatic Syndrome  Cognitive and Personality Changes

42. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Brain Herniation

43. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses  Ineffective Cerebral Tissue Perfusion  Ineffective Airway Clearance  Ineffective Breathing Pattern

44. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Additional Nursing Diagnoses  Acute Confusion  Self-Care Deficit  Acute/Chronic Pain  Disturbed Sensory Perception  Impaired Physical Mobility  Risk for Injury

45. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Brain Tumor  Pathophysiology  Neoplastic Growth of the Brain or Meninges  Primary or Metastatic  Compress or Infiltrate Brain Tissue  Cause IICP

46. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Seizures  Motor and Sensory Deficits  Headaches  Speech and Vision Disturbances  Personality Changes  Hormone Disturbances

47. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  MRI  Angiogram, MRA  Hormone Levels

48. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Surgical Removal  Radiation Therapy  Chemotherapy  Symptom Control  Anticonvulsants  Dexamethasone

49. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Complications  Seizures  Headaches  Memory Impairment  Cognitive Changes  Ataxia  Hemiparesis  Aphasia  Lethargy  Coma  Death

50. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses  Acute or Chronic Confusion  Self-Care Deficit  Pain  Sensory-Perceptual Disturbance  Impaired Physical Mobility  Risk for Injury

51. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Intracranial Surgery  Indications  Hematoma  Tumor  AV Malformation  Trauma  Seizures

52. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Types of Intracranial Surgery  Craniotomy  Craniectomy  Cranioplasty

53. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Preoperative Care  Patient Education  Anxiety Control  ICU Visit

54. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Postoperative Care  Nursing Diagnoses  Risk for Ineffective Cerebral Tissue Perfusion  Risk for Infection  Disturbed Body Image  Deficient Knowledge

55. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Herniated Disk  Pathophysiology  Herniation of Nucleus Pulposis  Compression of Nerve Root(s)  Cervical, Lumbar Most Common

56. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Etiology  Injury  May be Unknown

57. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Pain  Muscle Spasm  Numbness or Tingling of Extremity  Weakness  Atrophy

58. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  MRI  Myelogram

59. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Rest  Physical Therapy  Traction  Muscle Relaxants  NSAIDs, Analgesics  Epidural Anesthetic/Steroid  Surgery

60. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Surgery  Laminectomy  Diskectomy  Spinal Fusion  NEW Artificial Disk

61. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Complications of Surgery  Hemorrhage  Nerve Root Damage  Reherniation  Herniation of Another Disk

62. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Preoperative Care  Routine Teaching  Teach Log-rolling Technique

63. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Postoperative Care  Nursing Diagnoses  Acute Pain  Risk for Impaired Urinary Elimination  Risk for Impaired Physical Mobility

64. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Spinal Stenosis

65. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Spinal Cord Injury  Pathophysiology  Damage to Nerve Fibers  Interference with Communication Between Brain and Body

66. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Causes  MVA  Falls  Sports Injuries  Assault

67. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Cervical Injury  Paralysis  Paresthesias  Impaired Respiration  Loss of Bladder and Bowel Control  Quadriplegia/paresis  C3 or Above Fatal

68. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms (cont’d)  Thoracic/Lumbar Injury  Paraplegia/paresis  Altered Bowel and Bladder Control

69. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Spinal Shock  SNS Disruption  Vasodilation  Hypotension  Bradycardia  Hypothermia  Urine and Feces Retention

70. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Complications of Spinal Cord Injury  Infection  DVT  Orthostatic Hypotension  Skin Breakdown  Renal Complications  Depression and Substance Abuse  Autonomic Dysreflexia

71. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Spinal Cord Injury

72. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  X-Ray  CT Scan  MRI

73. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Emergency Management  Respiratory  Gastrointestinal  Genitourinary  Immobilization

74. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Surgical Management  Stabilize Spine  Halo Brace  Rods  Corset  Brace  Body Cast

75. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Skeletal Traction

76. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses  Impaired Gas Exchange  Ineffective Airway Clearance  Risk for Autonomic Dysreflexia  Reflex Urinary Incontinence  Constipation  Impaired Physical Mobility

77. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses (cont’d)  Self-Care Deficit  Risk for Impaired Skin Integrity  Risk for Ineffective Role Performance  Risk for Sexual Dysfunction  Anxiety

78. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Dementia  Significantly Impaired Intellectual Functioning  Impaired Normal Activities and Relationships  Impaired Problem Solving and Emotional Control  Personality Changes  Behavioral Problems

79. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Etiology  Huntington’s Disease  Parkinson’s Disease  Alzheimer’s Disease  Vascular Dementia  Chronic Alcoholism  Medications

80. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Lower Risk  Higher Education  Higher Socioeconomic Status  Engagement in Simulating Intellectual and Leisure Activities

81. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Recent Memory Affected First  Remote Memory Affected Later  Forget How to Perform Simple Tasks  Wandering  Aphasia  Behavioral Problems  Total Dependence

82. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  Neuropsychological Testing  Depression Testing  Medication Review  MRI, CT, PET Scan for Underlying Cause

83. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Medications Delay Progression  Cholinesterase Inhibitors  NMDA Agonist  End of Life Decision Making

84. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses: Dementia  Risk for Injury  Imbalanced Nutrition  Chronic Confusion  Caregiver Role Strain

85. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Delirium  Temporary Mental Disturbance  Medical Emergency  Underlying Cause Must be Corrected  Pain  Hypoxia  Medications  Illness

86. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Parkinson’s Disease  Destruction of Substantia Nigra  Decreased Dopamine Production  Relative Excess of Acetylcholine  Impairment of Semiautomatic Movements

87. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Etiology  Unknown  Genetic  Certain Drugs  Encephalitis

88. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Muscular Rigidity  Bradykinesia  Changes in Posture  Pill-Rolling Tremor  Difficulty Initiating Movement  Shuffling and Freezing Gait

89. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms (cont’d)

90. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Symptoms of ANS Dysfunction  Diaphoresis  Constipation  Orthostatic Hypotension  Drooling  Dysphagia  Seborrhea  Frequent Urination

91. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  History  Physical Examination  MRI

92. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Anticholinergic Agents  Dopamine Agonists  Monoamine Oxidase B Inhibitors  COMT Inhibitors  Pallidotomy  Deep Brain Stimulation

93. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses  Impaired Physical Mobility  Self-Care Deficit  Risk for Injury  Diagnoses for Dementia

94. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Huntington’s Disease  Pathophysiology/Etiology  Genetic  Autosomal Dominant  Degeneration of Parts of Brain

95. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Dementia  Personality Changes  Inappropriate Behavior  Paranoia  Violence  Choreiform Movements  Dysphagia  Depression  Death

96. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms (cont’d)

97. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  Family History  MRI  CT  Genetic Testing/Counseling

98. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Antipsychotics  Antidepressants  Antichorea Agents  Stem Cell Transplants

99. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Alzheimer’s Disease  Pathophysiology  Progressive Degenerative DIsease  Neurofibrillary Tangles  Neuritic Plaques

100. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Etiology  Unknown  May be Genetic  Down’s Syndrome

101. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms  Stage 1  Increasing Forgetfulness  Stage 2  Progressive Memory Loss  Irritability  Depression  Aphasia  Sleep Disruption  Hallucinations  Seizures

102. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Signs and Symptoms (cont’d)  Stage 3  Complete Dependency  Bowel and Bladder Control Lost  Emotional Control Lost  Inability to Recognize Significant Others  Death

103. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Diagnosis  History  Physical Examination  MRI  PET, SPECT  Autopsy

104. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Therapeutic Interventions  Cholinesterase Inhibitors  NMDA Antagonists  Antidepressants  Antipsychotics  Antianxiety Agents

105. Copyright © 2011. F.A. Davis Company Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition Nursing Diagnoses: Dementia  Risk for Injury  Imbalanced Nutrition  Chronic Confusion  Caregiver Role Strain