The clinical practice of neurological and neurosurgical nursing / [edited by] Joanne V. Hickey.

Format:

Book

Contributor:

Hickey, Joanne V.

Language:

English

Subjects (All):

Neurological nursing.

Nervous System Diseases--nursing.

Neurosurgery--nursing.

Medical Subjects:

Nervous System Diseases--nursing.

Neurosurgery--nursing.

Physical Description:

xxii, 756 pages : illustrations ; 29 cm

Edition:

Fifth edition.

Other Title:

Neurological and neurosurgical nursing

Place of Publication:

Philadelphia ; London : Lippincott Williams & Wilkins, [2003]

Contents:

Section 1 Neuroscience Nursing: A Perspective on Practice 1

Chapter 1 Neuroscience Nursing: The Dawn of the 21st Century / Joanne V. Hickey 3

Neuroscience Nursing Practice: Coming of Age 3

Toward a Global Community 4

Trends Shaping Health Care Delivery 4

Power, Special Interest Groups, and the Balance of Power 4

Impact of Regulations 5

Economic Trends 5

Demographics 6

Sociological Trends 7

Technological Trends 8

National Agenda for Health 8

Prevention Guidelines 9

Health Care Reform and Implications for Neuroscience Patients and Practice 9

Restructuring of Health Care 9

Reengineering of Health Care 10

Redesigning of Health Care 11

Living in the Present While Preparing for the Future 11

Chapter 2 The Health Care Continuum and Transitions in Levels of Care / Joanne V. Hickey 13

Health Care Financing 13

Organization of Health Care 14

The Continuum of Health Care 16

Transitions in Care 19

Planning for Transitions in Health Care Settings 19

Discharge Planning for Neuroscience Patients 20

Providing Care to Patients and Families 22

Models of Nursing Practice 23

Chapter 3 Clinical Reasoning and Outcomes / Joanne V. Hickey 27

Nursing Process 27

Critical Thinking and Nursing Practice 28

Defining Critical Thinking and Related Concepts 28

Evidence-Based Practice, Best Practice, and Outcomes 29

Application to Neuroscience Nursing Practice 29

Chapter 4 Ethical Perspectives and End-of-Life Care / Joanne V. Hickey 31

An Ethical Perspective of Neuroscience Practice 31

Ethics, Morality, and Legality 32

Framework for Ethical Decision Making 32

Independent Role of the Nurse 34

Independent Role of the Physician 34

Collaborative Roles 34

Decision-Making Capacity and Advance Directives and Living Wills 34

End-of-Life Care 35

Selected Ethical Issues Common in Neuroscience Nursing Practice 36

Fostering Professional Growth in Ethical Decision Making 39

Section 2 Assessment and Evaluation of Neuroscience Patients 43

Chapter 5 Overview of Neuroanatomy and Neurophysiology / Joanne V. Hickey 45

Embryonic Development of the Nervous System 45

Cells of the Nervous System 45

Components of the Cell Body 46

Cell Processes: Axons and Dendrites 47

Physiology of Nerve Impulses 47

Functions and Divisions of the Nervous System 50

Cranial and Spinal Bones 50

Sutures of the Skull 53

Spine 53

Ligaments of the Spine 54

Intervertebral Discs 54

Meninges 55

Cerebrospinal Fluid 55

Formation of Cerebrospinal Fluid 57

Cerebrovascular Circulation 58

Characteristics of the Cerebrovascular Circulation 59

Blood-Brain Barrier 61

Brain (Encephalon) 61

General Functions of the Cerebral Cortex According to Lobes 63

Dominance of a Cerebral Hemisphere 66

Corpus Callosum 67

Basal Ganglia 67

Diencephalon 67

Internal Capsule 68

Hypophysis (Pituitary Gland) 69

Brainstem (Midbrain, Pons, and Medulla) 70

Cerebellum 71

Special Systems Within the Brain 72

Spinal Cord 72

Dorsal (Sensory) Roots 73

Ventral (Motor) Roots 74

Classification of Nerve Fibers 75

Motor System 77

Sensory System 77

Autonomic Nervous System 79

Cranial Nerves 87

Chapter 6 Diagnostic Procedures and Laboratory Tests for Neuroscience Patients / Joanne V. Hickey 93

Patient and Family Teaching 93

Outpatient Procedures 93

Hospitalized Patients and Procedures 94

Informed Consent 94

X-rays of the Head and Vertebral Column 94

Spinal X-rays 95

Anatomic Imaging Techniques of the Brain 95

Physiologic Imaging Techniques of the Brain 100

Cerebrospinal Fluid and Spinal Procedures 102

Cerebrovascular Studies 104

Biopsies 108

Nervous System Electrical Activity and Conduction 108

Testing of the Special Senses 112

Neuropsychological Examination 113

Common Neuropsychological Deficits Associated With Cerebral Dysfunction 114

Emerging Technologies in Neuroimaging 114

Chapter 7 The Neurological Physical Examination / Joanne V. Hickey 117

Purposes 117

The Neurological Examination 117

Mental Status Examination 120

Cranial Nerve Examination 126

Motor System Examination 138

Upper Extremities 138

Lower Extremities 142

Sensory System Examination 142

Cerebellar System Examination 147

Reflexes 150

The Neurological Examination of the Comatose Patient 153

Chapter 8 Neurological Assessment / Joanne V. Hickey 159

Establishing a Nursing Database 159

Overview of Neurological Assessment 160

Frequency of Assessment and Documentation 160

Concept of Consciousness 161

Identifying the Levels of Consciousness 163

The Glasgow Coma Scale 164

Changes in Level of Consciousness 166

Recovery and Rehabilitation 168

Cranial Nerve Assessment 168

Assessment of Visual Fields (Optic Nerve) 169

Assessment of Pupils (Oculomotor Nerve) 170

Assessment of Extraocular Movement (Oculomotor, Trochlear, and Abducens Nerves) 172

Assessment of the Conscious, Cooperative Patient 172

Assessment of the Comatose Patient 174

Assessment of Motor Function 176

Assessment of Muscle Strength 179

Involuntary Movement, Posture, and Gait 179

Sensory Assessment 179

Frequency and Documentation of Sensory Data 180

Assessment of Cerebellar Function 180

Vital Signs and Clinical Implications 180

Section 3 General Considerations in Neuroscience Nursing 185

Chapter 9 Nutritional Support for Neuroscience Patients / Joanne V. Hickey 187

Basic Nutritional Requirements 187

Metabolic Changes Following Injury and Starvation 189

Nutritional Assessment 189

Estimating Nutrient Requirements 190

Providing Nutrients 192

Problems Associated With Tube Feedings 193

The Nurse's Role: Meeting the Nutritional Needs of Patients 196

Chapter 10 Fluid and Electrolyte Management in Neuroscience Patients / Joanne V. Hickey 201

Fluid and Electrolyte Balance 201

Hypothalamic-Neurohypophyseal System 201

Hypernatremia 205

Other Common Electrolyte Imbalances 206

Special Metabolic and Electrolyte Imbalances 211

Chapter 11 Pharmacological Management of Neuroscience Patients / Stephen W. Janning, Timothy F. Lassiter 215

Commonly Used Drugs Along the Continuum of Care 215

Antibiotics 224

Steroids 229

Diuretics 230

Gastrointestinal Agents 231

Anticoagulants and Antiplatelet Agents 232

Volume Expanders and IV Fluids 234

Electrolyte Management 235

Respiratory Drugs 236

Chapter 12 Behavioral and Psychological Responses to Neurological Illness / Joanne V. Hickey 239

Stress and the Stress Response 239

Human Adaptation and Coping 240

Neurological Conditions and Their Psychological Effects 240

General Principles for Considering the Patient's Emotional and Psychological Responses to Neurological Conditions 241

Common Emotional and Psychological Responses to the Stress Associated With Neurological Conditions 242

Emotional and Psychological Responses to Specific Aspects of Illness: Nursing Implications 245

Psychological, Emotional, and Behavioral Responses of the Family or Significant Others 249

Emotional and Psychological Responses of the Nurse Caring for Neurological Patients 249

Chapter 13 Rehabilitation of Neuroscience Patients / Joanne V.

Hickey 253

Frameworks for Disability 253

Concepts of Rehabilitation 253

A Philosophy of Rehabilitation 254

Assessment of Activities of Daily Living 255

Principles of Rehabilitation Nursing 256

The Basis of Movement and Treatment of Movement Disorders 258

Management of the Skin 267

Sensory-Perceptual Deficits 268

Communication Deficits 268

Swallowing Deficits 270

Bladder Dysfunction and Retraining 272

Bowel Elimination and Dysfunction 277

Cognitive Rehabilitation 279

The Home-Based Ventilator-Dependent Patient 279

Discharge Planning 279

Rehabilitation Legislation and Entitlement Programs 281

Section 4 Common Management Problems and Approaches to Neuroscience Patients 283

Chapter 14 Intracranial Hypertension: Theory and Management of Increased Intracranial Pressure / Joanne V. Hickey 285

Concept of Intracranial Pressure 285

Pathophysiology 289

Herniation Syndromes of the Brain 291

Signs and Symptoms of Increased Intracranial Pressure 296

Management of Patients With Intracranial Hypertension: A Collaborative Problem 301

Monitoring Intracranial Pressure 309

Special Syndromes: Benign Intracranial Hypertension and Hydrocephalus 315

Chapter 15 Management of Patients Undergoing Neurosurgical Procedures / Joanne V. Hickey 319

The Preoperative Phase 319

The Intraoperative Phase 320

Sitting Position 322

Neurosurgical Procedures and Other Related Therapeutic Techniques 322

Postoperative Nursing Management 326

Postoperative Management and Prevention of Complications 330

Neurological Deficits in the Postoperative Period 334

Nurse's Role in Rehabilitation and Discharge Planning 335

Selected Neurosurgical Procedures 336

Chapter 16 Management of the Unconscious Neurological Patient / Joanne V. Hickey 345

Immobility 345

Support Surfaces and Specialty Beds 345

The Consequences of Immobility: Nursing Management of the Unconscious Patient 349

Regaining Consciousness 357

Chapter 17 Neuroscience Critical Care / Melanie S. Minton, Joanne V. Hickey 359

Components of Intensive Care Environments 359

Alterations in Cerebral Oxygen: A Basis for Physiological Instability 361

Implications of Technological Dependence and High Risk of Complications 362

Use of Technology for Monitoring of Neuroscience Patients in Intensive Care Units 362

Vulnerability to Complications 365

Medical Treatment and Management in the Intensive Care Unit 365

Transfer of Critically Ill Patients 366

Future Trends in ICU Care 367

Section 5 Nursing Management of Patients With Injury to the Neurological System 371

Chapter 18 Craniocerebral Trauma / Joanne V. Hickey 373

Scope of the Problem 373

Primary and Secondary Injuries 373

Mechanisms, Pathophysiology, and Pathology Associated With Traumatic Brain Injury 374

Primary Injury: Blunt Traumatic Brain Injury 378

Diagnosis and Treatment 383

Other Injuries Related to Traumatic Brain Injury 385

Management of the TBI Patient: The Continuum of Care 385

Assessment and Clinical Reasoning: Key Role of the Neuroscience Nurse 394

Nursing Management of Multisystem Complications of Traumatic Brain Injury 396

Nursing Management for Special Problems 400

Predicting Outcome From Traumatic Brain Injury 402

Personality and Behavioral Deficits 403

Family Relationship Deficits 403

Chapter 19 Vertebral and Spinal Cord Injuries / Joanne V. Hickey 407

A Perspective 407

Understanding Spinal Cord Injuries 407

Specific Categories of Injuries 411

Acute Spinal Cord Trauma 422

Overview of Early Management of Patients With Spinal Cord Injury 423

Selection of Treatment Approach: Surgical or Nonsurgical 430

Surgical Management of Spinal Cord Injury 430

Nonsurgical Management of Spinal Cord Injuries 431

Focus on Collaborative Management in the Acute and Postacute Phases 433

Major Patient Management Responsibilities of the Nurse 433

Chapter 20 Back Pain and Intervertebral Disc Injury / Joanne V. Hickey 451

Conditions Related to Back Pain 451

Herniated Intervertebral Discs 453

Chapter 21 Peripheral Nerve Injuries / Joanne V. Hickey 471

Mechanisms of Injury 471

Pathophysiology 471

Classification of Peripheral Nerve Injuries 473

Diagnosis of Peripheral Nerve Injuries 473

Peripheral Nerve Injuries: Treatment 476

Collaborative and Nursing Management of the Patient With Peripheral Nerve Trauma 477

Section 6 Nursing Management of Patients With Neoplasms of the Neurological System 481

Chapter 22 Brain Tumors / Joanne V. Hickey 483

Overview of Brain Tumors 483

Signs and Symptoms of Brain Tumor 486

Associated Increased ICP Signs 488

Approach to the Patient With a Brain Tumor 494

Nursing Management of the Patient With a Brain Tumor 503

Chapter 23 Spinal Cord Tumors / Joanne V. Hickey 509

Epidemiology 509

Diagnosis 514

Principles of Treatment 515

Nursing Management of the Patient With a Spinal Cord Tumor 516

Section 7 Nursing Management of Patients With Cerebrovascular Problems 521

Chapter 24 Cerebral Aneurysms / Joanne V. Hickey, Deidre M. Buckley 523

Familial Aneurysms 523

Etiology 524

Aneurysm Hemodynamics 524

Classification 525

Location 525

Ruptured Aneurysm 525

Signs and Symptoms 526

Diagnosis 528

Initial Approach to Medical Management 530

Surgical/Interventional Treatment 531

Complications of Aneurysmal Rupture/Bleeding 538

Nursing Management of the Patient With an Aneurysm 540

Chapter 25 Arteriovenous Malformations and Other Cerebrovascular Anomalies / Joanne V. Hickey, Deidre M. Buckley 549

Classifications of Vascular Malformations 549

Arteriovenous Malformations in the Adult: An Overview 550

Chapter 26 Stroke and Other Cerebrovascular Diseases / Joanne V. Hickey, Nanette H. Hock 559

Definition and Classification of Stroke 560

Anatomy, Atherogenesis, and Pathophysiology Related to Strokes 564

Signs and Symptoms of Stroke Syndromes According to the Involved Vessel 568

Treatment of Transient Ischemic Attacks and Ischemic Stroke 572

General Nursing Management of the Stroke Patient 577

Section 8 Nursing Management of Patients With Pain, Seizures, Infections, Degenerative Diseases, and Peripheral Nerve Diseases of the Neurological System 589

Chapter 27 Management of Chronic Pain: A Neuroscience Perspective / Joanne V. Hickey, Rosemary P. Brown 591

Pain Theories 592

Mechanisms of Pain 593

Management of Chronic Pain 594

Pain and Pain Management: The Future 601

Chapter 28 Headaches / Joanne V. Hickey 603

Headache: Anatomical Considerations and Pathophysiology 603

Classification of Headaches 605

Approach to Management of Headaches 608

Nursing Management of the Patient With Headache 614

Chapter 29 Seizures and Epilepsy / Joanne V. Hickey 619

Background and Definitions 619

Seizure Classification and Observations/Identification 621

Diagnosis 625

Treatment 626

Management of Seizures and Status Epilepticus in an Acute Care Setting 634

Nursing Management of Patients With Epilepsy: Community-Based Care 636

Chapter 30 Selected Infections of the Nervous System / Joanne V. Hickey 641

Meningitis 641

Encephalitis 646

Other Viral Organisms That Attack the Central Nervous System 651

Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome 654

Chapter 31 Neurodegenerative Diseases / Joanne V. Hickey 661

Models for Chronic Illness Management 661

Dementia 662

Alzheimer's Disease 666

Vascular Dementia 670

Parkinson's Disease 671

Multiple Sclerosis 677

Amyotrophic Lateral Sclerosis 682

Myasthenia Gravis 685

Chapter 32 Peripheral Neuropathies / Joanne V. Hickey 693

Pathological Processes 693

Distribution Patterns of Peripheral Neuropathies 693

Development and Causes 694

General Clinical Presentations 694

Selected Peripheral Nerve Conditions 695

Chapter 33 Cranial Nerve Diseases / Joanne V. Hickey 703

Trigeminal Neuralgia 703

Facial Paralysis or Bell's Palsy 705

Meniere's Disease 706

Glossopharyngeal Neuralgia 706.

Notes:

Includes bibliographical references and index.

ISBN:

0781726603

OCLC:

48711186