Neurologic Function Assessment and Stimuli You are

Neurologic Function Assessment and Stimuli You are a nurse in the emergency department of the local hospital. A daughter age 24 brings her mother, age 56, to the emergency room and says to you “Something is very wrong with Mom. She has just been getting sicker all day and now she hardly knows what day it is and hardly answers me.” The daughter begins to cry, “I am scared. What are you going to do?” What areas of neurologic function do you need more information about? Why? What are common symptoms/clinical manifestations of an alteration in consciousness? What are some of the possible causes for the alterations in the mother’s state of arousal? One hour later you are not able to awaken the woman and she starts having an ataxic breathing pattern. What does this mean? Parkinson’s Disease F. P. is a 66-year old man hospitalized surgical management of an enlarged prostate. His chart indicates he has had Parkinson disease for 5 years which has been managed by a dopamine precursor (levodopa/carbidopa). He also indicates he had a seizure many years ago. 1. What type of motor difficulties would F. P. be expected to exhibit related to this Parkinson Disease? 2. What is the rationale for managing Parkinson’s disease with the dopamine precursor? 3. What does the nurse need to assess related to the seizure history?4. What is happening in the brain during a seizure? 5. What are the risks when a person has a seizure? 6. What are the differences and similarities between Parkinson’s disease and Alzheimer’s disease? Ima Scared is a 21 year old college junior who was in a motor vehicle accident in which her car rolled 2 times. She was transported to the hospital by ambulance. She was alert and disoriented when she first arrived at the hospital. She was crying and saying that she could not feel her legs and that her head hurt really bad. She then lost consciousness and has been in a coma since that time. 1. Why do you think that she lost consciousness? 2. Why might she have increased intracranial pressure? 3. What are the risks if her intracranial pressure continues to rise? 4. What are potential long term complications she may have from this increased pressure? 5. What level do you think her spinal cord injury is at if she can not feel her legs? 6. What is the difference between a partial and a complete spinal cord injury? 7. What are the differences between spinal shock and autonomic hyperreflexia? When do you anticipate that they will happen? Why do they happen? Cerebrovascular Accident Case Study J. S. is a 72-year-old woman with a long history of atherosclerosis. One afternoon, her grandson Tim found her sitting in a chair staring blankly into space. She was tilting toward the right, drooling, and had been incontinent of urine. She was able to focus her eyes on him when he spoke to her, but she was unable to verbalize a response. She was transported to the local hospital and diagnosed with cerebrovascular accident. 1. What are the possible types of strokes J.S. has experienced? How are they similar and different? What questions could be asked of J. S.’s family to help determine the cause of her stroke? What questions to assess risk factors for each type of stroke? 2. Based on the scenario described above, which brain hemisphere (left or right) suffered the ischemic damage? What other symptoms of this stroke location would be most likely assessed? 3. What are the warning signs of a stroke and why do they happen? 4. What is the difference between a CVA and a transient ischemic attack5. Tim asks you what function his grandmother will get back. How do you respond to him?

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