Procedures - neuro

8/7/2019 Procedures - neuro

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PROCEDURES RELATED TO

NEUROMUSKULOSKELETALSYSTEMS


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ARTHROSCOPICEXAMINATION


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y Direct visualization of a joint with a fiber-optic scopeinserted through a small skin incision

y PURPOSES: Evaluate joint changes

Removal of torn cartilage and repair of torn ligaments

Reduces period required for rehabilitation


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C T S C A N

COMPUTERIZEDTOMOGRAPHY


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y Cross section visualization of the brain determinedby computer analysis of relative tissue density as anX-ray beam passes through

y Provides valuable information regarding infarcts,tumors, atrophy and vascular lesions


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NURSING CARE

y Explain procedure

y Evaluate allergy to iodine (if + dye)

y Withhold foods 4 hours prior to testing

y Remove wigs, clips, and pins prior to the test

y Assess claustrophobia


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CEREBRAL ANGIOGRAPHY


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y Visualization of cerebral vasculature with contrastdye and x-ray projection

y NURSING CARE: Informed consent

Allow time for verbalization of fears

NPO 6-8 hours before procedure

Allergies: iodine Administer sedatives as orders


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y After procedure:

Monitor V/S

Assess puncture site for bleeding, sand bags or ice packs are

used if the femoral artery is used Assess involved extremity for ischemia

Maintain bed rest for a prescribed number of hours


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ELECTROENCEPHALOGRAPHY


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y Measurement of the electrical activity of the brain inthe form of waves

y Provides information regarding tumors, infections,

and chemical toxicityy Client may be asked to hyperventilate or flashing

lights may be used to trigger abnormal wave pattern


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NURSING CARE

y Explain procedure to the client

y Provide client a normal meal to avoid hypoglycemia

y Withhold stimulants

y Shampoo hair after the procedure to removeconducting jelly


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ELECTROMYOGRAPHY


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y Measurement and recording of the electrical activityof specific muscles into which needle electrodes havebeen inserted

y NURSING CARE:

Explain procedure to the client


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MAGNETIC RESONANCEIMAGING


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y Utilizes magnetism and radio waves to produceimages of cross sections of the body

y Can produce accurate images of blood vessels, bone

marrow, gray and white matter, the spinal cord, theglobe of the eye, the heart


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NURSING CARE

y Assess for claustrophobia

y Instruct client to toilet before procedure

y Advise client to remove jewelry, clothing with metal

fasteners, dentures, hearing aids, glasses prior toentering the scanner

y Assess for:

Metal prostheses, orthopedic screws

Pacemaker

Dysrhythmias

Unstable medical conditions


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POSITRON EMISSIONTOMOGRAPHY


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y Registers glucose metabolism in a cross section ofthe brain, glucose metabolism increases in areas ofthe brain that are active

y Utilized to diagnose Alzheimers disease, depression,dementia, brain tumors


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NURSING CARE

y Instruct client to abstain from alcohol, tobacco, andcaffeine prior to the test

y Allow client to eat a meal 3 hours before the

procedurey Provide a safe and quiet environment


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y Instruct client what to expect:

2 IVlines will be utilized

Blindfold and cotton plugs may be utilized

Mental activities are done prior to the procedure Scan will take 60 to 90 minutes and patient must remain still

y Following test, encourage client to void to clearradioactive isotope from the body


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LUMBAR PUNCTURE


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MOBILITY


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MOBILITY

y BRACES/SPLINTS

y CANE

y CRUTCHES

y TRANSFER

y WALKER


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NEUROLOGIC ASSESSMENT


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y CRANIAL NERVES

y MOTORFUNCTION Balance: gait, Rombergs test

Coordination Muscle strength

y SENSORYFUNCTION

y MENTAL STATUS


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y MENTAL STATUS

LOC (alert-comatose)

Orientation

Judgment Appropriateness of mood and behavior

y REFLEXES

Deep tendon reflexes Plantar (babinski)


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GLASSGOW COMA SCALE


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y EYE Score:

Spontaneous opening: 4

Opens to voice 3

Opens to pain 2 None 1


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y VERBAL RESPONSE

Oriented 5

Confused 4

Incomprehensible 3 Incoherent 2

None 1


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y MOTOR RESPONSE:

Obeys command 6

Localizes pain 5

Withraws the pain 4 Flexion 3

Extension 2

None 1


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NURSING CARE

y 7 and below is considered comatose

y 3 is the less responsive, 15 is the most responsive

y Assess other indicators like VS, pupillary reaction,

movement of extremities, strengthy Document findings


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S H E E T O F P A P E R

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Procedures - neuro

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