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The Clinical Practice of Neurological and Neurosurgical Nursing

by: Hickey, Joanne V.

The Clinical Practice of Neurological and Neurosurgical Nursing

by: Hickey, Joanne V.

ISBN 13:
9780781726603
ISBN 10:
0781726603
Edition: 5th
Format: Hardcover
Copyright: 06/27/2002
Publisher: LWW
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Summary

The new, Fifth Edition of this award-winning classic prepares its users for delivering expert care in this most challenging nursing specialty. It addresses neuroanatomy, assessment, diagnostic evaluation, and management of the complete range of neurological disorders for which nurses provide patient care, including trauma, stroke, tumors, seizures, headache, aneurysms, infections, degenerative disorders, and features new chapters on neurological critical care and peripheral neuropathies. The new edition has been thoroughly revised to reflect standards of care based on evidenced-based practice. It now includes separate pathophysiology sections in each chapter; new resource guides, such as Internet sites and professional and patient information sources; key points summaries; and, nursing research features.

Neuroscience Nursing: A Perspective on Practice	p. 1
Neuroscience Nursing: The Dawn of the 21st Century	p. 3
Neuroscience Nursing Practice: Coming of Age	p. 3
Toward a Global Community	p. 4
Trends Shaping Health Care Delivery	p. 4
Power, Special Interest Groups, and the Balance of Power	p. 4
Impact of Regulations	p. 5
Economic Trends	p. 5
Demographics	p. 6
Sociological Trends	p. 7
Technological Trends	p. 8
National Agenda for Health	p. 8
Prevention Guidelines	p. 9
Health Care Reform and Implications for Neuroscience Patients and Practice	p. 9
Restructuring of Health Care	p. 9
Reengineering of Health Care	p. 10
Redesigning of Health Care	p. 11
Living in the Present While Preparing for the Future	p. 11
The Health Care Continuum and Transitions in Levels of Care	p. 13
Health Care Financing	p. 13
Organization of Health Care	p. 14
The Continuum of Health Care	p. 16
Transitions in Care	p. 19
Planning for Transitions in Health Care Settings	p. 19
Discharge Planning for Neuroscience Patients	p. 20
Providing Care to Patients and Families	p. 22
Models of Nursing Practice	p. 23
Summary	p. 24
Clinical Reasoning and Outcomes	p. 27
Nursing Process	p. 27
Critical Thinking and Nursing Practice	p. 28
Defining Critical Thinking and Related Concepts	p. 28
Evidence-Based Practice, Best Practice, and Outcomes	p. 29
Application to Neuroscience Nursing Practice	p. 29
Ethical Perspectives and End-of-Life Care	p. 31
An Ethical Perspective of Neuroscience Practice	p. 31
Ethics, Morality, and Legality	p. 32
Framework for Ethical Decision Making	p. 32
Independent Role of the Nurse	p. 34
Independent Role of the Physician	p. 34
Collaborative Roles	p. 34
Decision-Making Capacity and Advance Directives and Living Wills	p. 34
End-of-Life Care	p. 35
Selected Ethical Issues Common in Neuroscience Nursing Practice	p. 36
Fostering Professional Growth in Ethical Decision Making	p. 39
Assessment and Evaluation of Neuroscience Patients	p. 43
Overview of Neuroanatomy and Neurophysiology	p. 45
Embryonic Development of the Nervous System	p. 45
Cells of the Nervous System	p. 45
Components of the Cell Body	p. 46
Cell Processes: Axons and Dendrites	p. 47
Physiology of Nerve Impulses	p. 47
Functions and Divisions of the Nervous System	p. 50
Cranial and Spinal Bones	p. 50
Sutures of the Skull	p. 53
Spine	p. 53
Ligaments of the Spine	p. 54
Intervertebral Discs	p. 54
Meninges	p. 55
Cerebrospinal Fluid	p. 55
Formation of Cerebrospinal Fluid	p. 57
Cerebrovascular Circulation	p. 58
Characteristics of the Cerebrovascular Circulation	p. 59
Blood-Brain Barrier	p. 61
Brain (Encephalon)	p. 61
General Functions of the Cerebral Cortex According to Lobes	p. 63
Dominance of a Cerebral Hemisphere	p. 66
Corpus Callosum	p. 67
Basal Ganglia	p. 67
Diencephalon	p. 67
Internal Capsule	p. 68
Hypophysis (Pituitary Gland)	p. 69
Brainstem (Midbrain, Pons, and Medulla)	p. 70
Cerebellum	p. 71
Special Systems Within the Brain	p. 72
Spinal Cord	p. 72
Dorsal (Sensory) Roots	p. 73
Ventral (Motor) Roots	p. 74
Classification of Nerve Fibers	p. 75
Motor System	p. 77
Sensory System	p. 77
Autonomic Nervous System	p. 79
Cranial Nerves	p. 87
Diagnostic Procedures and Laboratory Tests for Neuroscience Patients	p. 93
Patient and Family Teaching	p. 93
Outpatient Procedures	p. 93
Hospitalized Patients and Procedures	p. 94
Informed Consent	p. 94
X-rays of the Head and Vertebral Column	p. 94
Spinal X-rays	p. 95
Anatomic Imaging Techniques of the Brain	p. 95
Physiologic Imaging Techniques of the Brain	p. 100
Cerebrospinal Fluid and Spinal Procedures	p. 102
Cerebrovascular Studies	p. 104
Biopsies	p. 108
Nervous System Electrical Activity and Conduction	p. 108
Testing of the Special Senses	p. 112
Neuropsychological Examination	p. 113
Common Neuropsychological Deficits Associated With Cerebral Dysfunction	p. 114
Emerging Technologies in Neuroimaging	p. 114
Summary	p. 115
The Neurological Physical Examination	p. 117
Purposes	p. 117
The Neurological Examination	p. 117
Mental Status Examination	p. 120
Cranial Nerve Examination	p. 126
Motor System Examination	p. 138
Upper Extremities	p. 138
Lower Extremities	p. 142
Sensory System Examination	p. 142
Cerebellar System Examination	p. 147
Reflexes	p. 150
The Neurological Examination of the Comatose Patient	p. 153
Summary	p. 157
Neurological Assessment	p. 159
Establishing a Nursing Database	p. 159
Overview of Neurological Assessment	p. 160
Frequency of Assessment and Documentation	p. 160
Concept of Consciousness	p. 161
Identifying the Levels of Consciousness	p. 163
The Glasgow Coma Scale	p. 164
Changes in Level of Consciousness	p. 166
Recovery and Rehabilitation	p. 168
Cranial Nerve Assessment	p. 168
Assessment of Visual Fields (Optic Nerve)	p. 169
Assessment of Pupils (Oculomotor Nerve)	p. 170
Assessment of Extraocular Movement (Oculomotor, Trochlear, and Abducens Nerves)	p. 172
Assessment of the Conscious, Cooperative Patient	p. 172
Assessment of the Comatose Patient	p. 174
Assessment of Motor Function	p. 176
Assessment of Muscle Strength	p. 179
Involuntary Movement, Posture, and Gait	p. 179
Sensory Assessment	p. 179
Frequency and Documentation of Sensory Data	p. 180
Assessment of Cerebellar Function	p. 180
Vital Signs and Clinical Implications	p. 180
Summary	p. 184
General Considerations in Neuroscience Nursing	p. 185
Nutritional Support for Neuroscience Patients	p. 187
Basic Nutritional Requirements	p. 187
Metabolic Changes Following Injury and Starvation	p. 189
Nutritional Assessment	p. 189
Estimating Nutrient Requirements	p. 190
Providing Nutrients	p. 192
Problems Associated With Tube Feedings	p. 193
The Nurse's Role: Meeting the Nutritional Needs of Patients	p. 196
Fluid and Electrolyte Management in Neuroscience Patients	p. 201
Fluid and Electrolyte Balance	p. 201
Hypothalamic-Neurohypophyseal System	p. 201
Hypernatremia	p. 205
Other Common Electrolyte Imbalances	p. 206
Special Metabolic and Electrolyte Imbalances	p. 211
Pharmacological Management of Neuroscience Patients	p. 215
Overview	p. 215
Commonly Used Drugs Along the Continuum of Care	p. 215
Antibiotics	p. 224
Steroids	p. 229
Diuretics	p. 230
Gastrointestinal Agents	p. 231
Anticoagulants and Antiplatelet Agents	p. 232
Volume Expanders and IV Fluids	p. 234
Electrolyte Management	p. 235
Respiratory Drugs	p. 236
Behavioral and Psychological Responses to Neurological Illness	p. 239
Stress and the Stress Response	p. 239
Human Adaptation and Coping	p. 240
Neurological Conditions and Their Psychological Effects	p. 240
General Principles for Considering the Patient's Emotional and Psychological Responses to Neurological Conditions	p. 241
Common Emotional and Psychological Responses to the Stress Associated With Neurological Conditions	p. 242
Emotional and Psychological Responses to Specific Aspects of Illness: Nursing Implications	p. 245
Psychological, Emotional, and Behavioral Responses of the Family or Significant Others	p. 249
Emotional and Psychological Responses of the Nurse Caring for Neurological Patients	p. 249
Rehabilitation of Neuroscience Patients	p. 253
Frameworks for Disability	p. 253
Concepts of Rehabilitation	p. 253
A Philosophy of Rehabilitation	p. 254
Assessment of Activities of Daily Living	p. 255
Principles of Rehabilitation Nursing	p. 256
The Basis of Movement and Treatment of Movement Disorders	p. 258
Management of the Skin	p. 267
Sensory-Perceptual Deficits	p. 268
Communication Deficits	p. 268
Swallowing Deficits	p. 270
Bladder Dysfunction and Retraining	p. 272
Bowel Elimination and Dysfunction	p. 277
Cognitive Rehabilitation	p. 279
The Home-Based Ventilator-Dependent Patient	p. 279
Discharge Planning	p. 279
Rehabilitation Legislation and Entitlement Programs	p. 281
Common Management Problems and Approaches to Neuroscience Patients	p. 283
Intracranial Hypertension: Theory and Management of Increased Intracranial Pressure	p. 285
Concept of Intracranial Pressure	p. 285
Pathophysiology	p. 289
Herniation Syndromes of the Brain	p. 291
Signs and Symptoms of Increased Intracranial Pressure	p. 296
Management of Patients With Intracranial Hypertension: A Collaborative Problem	p. 301
Monitoring Intracranial Pressure	p. 309
Special Syndromes: Benign Intracranial Hypertension and Hydrocephalus	p. 315
Summary	p. 316
Management of Patients Undergoing Neurosurgical Procedures	p. 319
The Preoperative Phase	p. 319
The Intraoperative Phase	p. 320
Sitting Position	p. 322
Neurosurgical Procedures and Other Related Therapeutic Techniques	p. 322
Postoperative Nursing Management	p. 326
Postoperative Management and Prevention of Complications	p. 330
Neurological Deficits in the Postoperative Period	p. 334
Nurse's Role in Rehabilitation and Discharge Planning	p. 335
Selected Neurosurgical Procedures	p. 336
Management of the Unconscious Neurological Patient	p. 345
Immobility	p. 345
Support Surfaces and Specialty Beds	p. 345
The Consequences of Immobility: Nursing Management of the Unconscious Patient	p. 349
Regaining Consciousness	p. 357
Neuroscience Critical Care	p. 359
Components of Intensive Care Environments	p. 359
Alterations in Cerebral Oxygen: A Basis for Physiological Instability	p. 361
Implications of Technological Dependence and High Risk of Complications	p. 362
Use of Technology for Monitoring of Neuroscience Patients in Intensive Care Units	p. 362
Vulnerability to Complications	p. 365
Medical Treatment and Management in the Intensive Care Unit	p. 365
Transfer of Critically Ill Patients	p. 366
Future Trends in ICU Care	p. 367
Nursing Management of Patients With Injury to the Neurological System	p. 371
Craniocerebral Trauma	p. 373
Scope of the Problem	p. 373
Overview of Craniocerebral Trauma	p. 373
Primary and Secondary Injuries	p. 373
Mechanisms, Pathophysiology, and Pathology Associated With Traumatic Brain Injury	p. 374
Primary Injury: Blunt Traumatic Brain Injury	p. 378
Diagnosis and Treatment	p. 383
Other Injuries Related to Traumatic Brain Injury	p. 385
Management of the TBI Patient: The Continuum of Care	p. 385
Assessment and Clinical Reasoning: Key Role of the Neuroscience Nurse	p. 394
Nursing Management of Multisystem Complications of Traumatic Brain Injury	p. 396
Nursing Management for Special Problems	p. 400
Predicting Outcome From Traumatic Brain Injury	p. 402
Personality and Behavioral Deficits	p. 403
Family Relationship Deficits	p. 403
Summary	p. 403
Vertebral and Spinal Cord Injuries	p. 407
A Perspective	p. 407
Understanding Spinal Cord Injuries	p. 407
Specific Categories of Injuries	p. 411
Acute Spinal Cord Trauma	p. 422
Overview of Early Management of Patients With Spinal Cord Injury	p. 423
Selection of Treatment Approach: Surgical or Nonsurgical	p. 430
Surgical Management of Spinal Cord Injury	p. 430
Nonsurgical Management of Spinal Cord Injuries	p. 431
Focus on Collaborative Management in the Acute and Postacute Phases	p. 433
Major Patient Management Responsibilities of the Nurse	p. 433
Back Pain and Intervertebral Disc Injury	p. 451
Conditions Related to Back Pain	p. 451
Herniated Intervertebral Discs	p. 453
Summary	p. 469
Peripheral Nerve Injuries	p. 471
Mechanisms of Injury	p. 471
Pathophysiology	p. 471
Classification of Peripheral Nerve Injuries	p. 473
Diagnosis of Peripheral Nerve Injuries	p. 473
Peripheral Nerve Injuries: Treatment	p. 476
Collaborative and Nursing Management of the Patient With Peripheral Nerve Trauma	p. 477
Nursing Management of Patients With Neoplasms of the Neurological System	p. 481
Brain Tumors	p. 483
Overview of Brain Tumors	p. 483
Signs and Symptoms of Brain Tumor	p. 486
Associated Increased ICP Signs	p. 488
Approach to the Patient With a Brain Tumor	p. 494
Nursing Management of the Patient With a Brain Tumor	p. 503
Summary	p. 507
Spinal Cord Tumors	p. 509
Epidemiology	p. 509
Diagnosis	p. 514
Principles of Treatment	p. 515
Nursing Management of the Patient With a Spinal Cord Tumor	p. 516
Nursing Management of Patients With Cerebrovascular Problems	p. 521
Cerebral Aneurysms	p. 523
Overview	p. 523
Familial Aneurysms	p. 523
Etiology	p. 524
Aneurysm Hemodynamics	p. 524
Classification	p. 525
Location	p. 525
Ruptured Aneurysm	p. 525
Signs and Symptoms	p. 526
Diagnosis	p. 528
Initial Approach to Medical Management	p. 530
Surgical/Interventional Treatment	p. 531
Complications of Aneurysmal Rupture/Bleeding	p. 538
Nursing Management of the Patient With an Aneurysm	p. 540
Arteriovenous Malformations and Other Cerebrovascular Anomalies	p. 549
Classifications of Vascular Malformations	p. 549
Arteriovenous Malformations in the Adult: An Overview	p. 550
Stroke and Other Cerebrovascular Diseases	p. 559
Definition and Classification of Stroke	p. 560
Anatomy, Atherogenesis, and Pathophysiology Related to Strokes	p. 564
Signs and Symptoms of Stroke Syndromes According to the Involved Vessel	p. 568
Treatment of Transient Ischemic Attacks and Ischemic Stroke	p. 572
General Nursing Management of the Stroke Patient	p. 577
Nursing Management of Patients With Pain, Seizures, Infections, Degenerative Diseases, and Peripheral Nerve Diseases of the Neurological System	p. 589
Management of Chronic Pain: A Neuroscience Perspective	p. 591
Definition of Terms	p. 591
Pain Theories	p. 592
Mechanisms of Pain	p. 593
Management of Chronic Pain	p. 594
Pain and Pain Management: The Future	p. 601
Headaches	p. 603
Headache: Anatomical Considerations and Pathophysiology	p. 603
Classification of Headaches	p. 605
Approach to Management of Headaches	p. 608
Nursing Management of the Patient With Headache	p. 614
Seizures and Epilepsy	p. 619
Background and Definitions	p. 619
Seizure Classification and Observations/Identification	p. 621
Diagnosis	p. 625
Treatment	p. 626
Management of Seizures and Status Epilepticus in an Acute Care Setting	p. 634
Nursing Management of Patients With Epilepsy: Community-Based Care	p. 636
Selected Infections of the Nervous System	p. 641
Meningitis	p. 641
Encephalitis	p. 646
Other Viral Organisms That Attack the Central Nervous System	p. 651
Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome	p. 654
Neurodegenerative Diseases	p. 661
Models for Chronic Illness Management	p. 661
Dementia	p. 662
Alzheimer's Disease	p. 666
Vascular Dementia	p. 670
Parkinson's Disease	p. 671
Multiple Sclerosis	p. 677
Amyotrophic Lateral Sclerosis	p. 682
Myasthenia Gravis	p. 685
Summary	p. 689
Peripheral Neuropathies	p. 693
Pathological Processes	p. 693
Distribution Patterns of Peripheral Neuropathies	p. 693
Development and Causes	p. 694
General Clinical Presentations	p. 694
Selected Peripheral Nerve Conditions	p. 695
Cranial Nerve Diseases	p. 703
Trigeminal Neuralgia	p. 703
Facial Paralysis or Bell's Palsy	p. 705
Meniere's Disease	p. 706
Glossopharyngeal Neuralgia	p. 706
Index	p. 709
Table of Contents provided by Rittenhouse. All Rights Reserved.

Amazon no longer offers textbook rentals. We do!

The Clinical Practice of Neurological and Neurosurgical Nursing

The Clinical Practice of Neurological and Neurosurgical Nursing

9780781726603

0781726603

Summary

Table of Contents

Supplemental Materials

Write a Review

Amazon no longer offers textbook rentals. We do!

The Clinical Practice of Neurological and Neurosurgical Nursing

The Clinical Practice of Neurological and Neurosurgical Nursing

9780781726603

0781726603

Summary

Table of Contents

Supplemental Materials

Write a Review

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