THE CLINICAL PRACTICE OF NEUROLOGICAL AND NEUROSURGICAL NURSING This title has been archived.

Author: Joanne Hickey, PhD, RN, ACNP-BC, CNRN, FAAN, FCCM
Affiliation: University of Texas Health Science Center, Houston
Publisher: Lippincott Williams & Wilkins
Publication Date: 2009
ISBN 10: 078179529X
ISBN 13: 9780781795296
Edition: 6th

Description:

The new Sixth 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 peripheral neuropathies. This edition has been thoroughly revised to reflect standards of care based on evidence-based practice. It now includes case studies, community nursing sections throughout, and increased coverage of normal pressure hydrocephalus, inflammatory demyelinating polyneuropathy, and Creutzfeld-Jacob disease.

Table of Contents

Front Matter

  • ABOUT
  • DEDICATION
  • About the Author
  • Contributors
  • Reviewers
  • Preface
  • Acknowledgments

Section 1 Neuroscience Nursing: Contemporary Practice

    The State of the Science of Neuroscience Nursing Practice

    • THE STATE OF HEALTH CARE AND PRACTICE
    • THE INFORMATION SOCIETY AND KNOWLEDGE WORKERS
    • TRENDS SHAPING HEALTH CARE DELIVERY
    • POLITICAL TRENDS AND REGULATIONS
    • ECONOMIC TRENDS
    • DEMOGRAPHICS
    • SOCIOLOGICAL TRENDS
    • TECHNOLOGICAL TRENDS
    • NATIONAL AGENDA FOR HEALTH
    • PROFESSIONAL NURSING AND NEUROSCIENCE SPECIALTY PRACTICE
    • REFERENCES
    • RESOURCES

    Care Settings and Transitions in Care

    • HEALTH CARE FINANCING
    • THE FOCUS OF HEALTH CARE
    • THE CONTINUUM OF HEALTH CARE SERVICES
    • TRANSITIONS IN CARE AND DISCHARGE PLANNING
    • PLANNING FOR TRANSITIONS IN HEALTH CARE SETTINGS
    • DISCHARGE PLANNING FOR NEUROSCIENCE PATIENTS
    • REFERENCES
    • RESOURCES

    Ethical Perspectives and End-of-Life Care

    • AN ETHICAL PERSPECTIVE OF NEUROSCIENCE PRACTICE
    • ETHICS, MORALITY, AND LEGALITY
    • FRAMEWORK FOR ETHICAL DECISION MAKING
    • INDEPENDENT ROLE OF THE NURSE
    • INDEPENDENT ROLE OF THE PHYSICIAN
    • COLLABORATIVE ROLES
    • DECISION-MAKING CAPACITY AND ADVANCE DIRECTIVES AND LIVING WILLS
    • END-OF-LIFE CARE
    • SELECTED END-OF-LIFE ETHICAL ISSUES COMMON IN NEUROSCIENCE NURSING PRACTICE
    • FOSTERING PROFESSIONAL GROWTH IN ETHICAL DECISION MAKING
    • REFERENCES
    • RESOURCES

Section 2 Assessment and Evaluation of Neuroscience Patients

    Overview of Neuroanatomy and Neurophysiology

    • EMBRYONIC DEVELOPMENT OF THE NERVOUS SYSTEM
    • CELLS OF THE NERVOUS SYSTEM
    • COMPONENTS OF THE CELL BODY
    • CELL PROCESSES: AXONS AND DENDRITES
    • PHYSIOLOGY OF NERVE IMPULSES
    • FUNCTIONS AND DIVISIONS OF THE NERVOUS SYSTEM
    • CRANIAL AND SPINAL BONES
    • SUTURES OF THE SKULL
    • SPINE
    • LIGAMENTS OF THE SPINE
    • INTERVERTEBRAL DISCS
    • MENINGES
    • CEREBROSPINAL FLUID
    • FORMATION OF CEREBROSPINAL FLUID
    • CEREBROVASCULAR CIRCULATION
    • CHARACTERISTICS OF THE CEREBRAL CIRCULATION
    • BLOOD–BRAIN BARRIER
    • BRAIN (ENCEPHALON)
    • GENERAL FUNCTIONS OF THE CEREBRAL CORTEX ACCORDING TO LOBES
    • DOMINANCE OF A CEREBRAL HEMISPHERE
    • CORPUS CALLOSUM
    • BASAL GANGLIA
    • DIENCEPHALON
    • INTERNAL CAPSULE
    • HYPOPHYSIS (PITUITARY GLAND)
    • BRAINSTEM (MIDBRAIN, PONS, AND MEDULLA)
    • CEREBELLUM
    • SPECIAL SYSTEMS WITHIN THE BRAIN
    • SPINAL CORD
    • DORSAL (SENSORY) ROOTS
    • VENTRAL (MOTOR) ROOTS
    • CLASSIFICATION OF NERVE FIBERS
    • MOTOR SYSTEM
    • SENSORY SYSTEM
    • AUTONOMIC NERVOUS SYSTEM
    • CRANIAL NERVES
    • RESOURCES

    Diagnostic Procedures and Laboratory Tests for Neuroscience Patients

    • PATIENT AND FAMILY TEACHING
    • OUTPATIENT PROCEDURES
    • HOSPITALIZED PATIENTS AND PROCEDURES
    • INFORMED CONSENT
    • X-RAYS OF THE HEAD AND VERTEBRAL COLUMN
    • SPINAL X-RAYS
    • ANATOMIC IMAGING TECHNIQUES OF THE BRAIN
    • PHYSIOLOGIC IMAGING TECHNIQUES OF THE BRAIN
    • CEREBROSPINAL FLUID AND SPINAL PROCEDURES
    • CEREBROVASCULAR STUDIES
    • BIOPSIES
    • NERVOUS SYSTEM ELECTRICAL ACTIVITY AND CONDUCTION
    • TESTING OF THE SPECIAL SENSES
    • NEUROPSYCHOLOGICAL EXAMINATION
    • COMMON NEUROPSYCHOLOGICAL DEFICITS ASSOCIATED WITH CEREBRAL DYSFUNCTION
    • SUMMARY
    • REFERENCES

    Comprehensive Neurological Examination

    • PURPOSES
    • THE NEUROLOGICAL EXAMINATION
    • CONDUCTING THE NEUROLOGICAL EXAMINATION
    • LEVEL OF CONSCIOUSNESS
    • MENTAL STATUS EXAMINATION
    • CRANIAL NERVE EXAMINATION
    • MOTOR SYSTEM EXAMINATION
    • UPPER EXTREMITIES
    • LOWER EXTREMITIES
    • SENSORY SYSTEM EXAMINATION
    • CEREBELLAR SYSTEM EXAMINATION
    • REFLEXES
    • THE NEUROLOGICAL EXAMINATION OF THE COMATOSE PATIENT
    • SUMMARY
    • REFERENCES
    • RESOURCES

    Neurological Assessment

    • ESTABLISHING A NURSING DATABASE
    • OVERVIEW OF NEUROLOGICAL ASSESSMENT
    • FREQUENCY OF ASSESSMENT AND DOCUMENTATION
    • CONCEPT OF CONSCIOUSNESS
    • IDENTIFYING THE LEVELS OF CONSCIOUSNESS
    • THE GLASGOW COMA SCALE
    • CHANGES IN LEVEL OF CONSCIOUSNESS
    • RECOVERY AND REHABILITATION
    • CRANIAL NERVE ASSESSMENT
    • ASSESSMENT OF VISUAL FIELDS (OPTIC NERVE)
    • ASSESSMENT OF PUPILS (OCULOMOTOR NERVE)
    • ASSESSMENT OF EXTRAOCULAR MOVEMENT (OCULOMOTOR, TROCHLEAR, AND ABDUCENS NERVES)
    • ASSESSMENT OF THE CONSCIOUS, COOPERATIVE PATIENT
    • ASSESSMENT OF THE UNCONSCIOUS PATIENT
    • ASSESSMENT OF MOTOR FUNCTION
    • ASSESSMENT OF MUSCLE STRENGTH
    • INVOLUNTARY MOVEMENT, POSTURE, AND GAIT
    • SENSORY ASSESSMENT
    • FREQUENCY AND DOCUMENTATION OF SENSORY DATA
    • ASSESSMENT OF CEREBELLAR FUNCTION
    • VITAL SIGNS AND CLINICAL IMPLICATIONS
    • SUMMARY
    • REFERENCES
    • RESOURCES

Section 3 General Considerations in Neuroscience Nursing

    Nutritional Support for Neuroscience Patients

    • BASIC NUTRITIONAL REQUIREMENTS
    • METABOLIC CHANGES AND CHARACTERISTICS OF ACUTE STRESS
    • NUTRITIONAL ASSESSMENT
    • ESTIMATING NUTRIENT REQUIREMENTS
    • PROVIDING NUTRIENTS
    • PROBLEMS ASSOCIATED WITH TUBE FEEDINGS
    • THE NURSE’S ROLE: MEETING THE NUTRITIONAL NEEDS OF PATIENTS
    • REFERENCES

    Fluid and Metabolic Disorders in Neuroscience Patients

    • HYPOTHALAMIC-NEUROHYPOPHYSEAL SYSTEM
    • HYPONATREMIA
    • HYPERNATREMIA
    • OTHER COMMON ELECTROLYTE IMBALANCES
    • SYNDROME OF INAPPROPRIATE SECRETION OF ANTIDIURETIC HORMONE
    • DIABETES INSIPIDUS
    • CEREBRAL SALT WASTING
    • HYPEROSMOLAR NONKETOTIC HYPERGLYCEMIA
    • SUMMARY
    • REFERENCES

    Behavioral and Psychological Responses to Neurological Illness

    • STRESS AND THE STRESS RESPONSE
    • HUMAN ADAPTATION AND COPING
    • NEUROLOGICAL CONDITIONS AND THEIR PSYCHOLOGICAL EFFECTS
    • GENERAL PRINCIPLES: EMOTIONAL AND PSYCHOLOGICAL RESPONSES TO NEUROLOGICAL CONDITIONS
    • COMMON EMOTIONAL AND PSYCHOLOGICAL RESPONSES TO THE STRESS ASSOCIATED WITH NEUROLOGICAL CONDITIONS
    • SUMMARY
    • REFERENCES

    Rehabilitation of Neuroscience Patients

    • FRAMEWORK FOR DISABILITY
    • CONCEPTS OF REHABILITATION
    • A PHILOSOPHY OF REHABILITATION
    • ASSESSMENT OF ACTIVITIES OF DAILY LIVING
    • PRINCIPLES OF REHABILITATION NURSING
    • THE BASIS OF MOVEMENT AND TREATMENT OF MOVEMENT DISORDERS
    • MANAGEMENT OF THE SKIN
    • SENSORY-PERCEPTUAL DEFICITS
    • COMMUNICATION DEFICITS
    • SWALLOWING DEFICITS
    • BLADDER DYSFUNCTION AND RETRAINING
    • BOWEL ELIMINATION AND DYSFUNCTION
    • COGNITIVE REHABILITATION
    • THE HOME-BASED VENTILATOR-DEPENDENT PATIENT
    • DISCHARGE PLANNING
    • REHABILITATION LEGISLATION AND ENTITLEMENT PROGRAMS
    • REFERENCES
    • RESOURCES

    Pharmacologic Management of Neuroscience Patients

    • OVERVIEW
    • COMMONLY USED DRUGS ALONG THE CONTINUUM OF CARE
    • ANTIBIOTICS
    • STEROIDS
    • DIURETICS
    • GASTROINTESTINAL AGENTS
    • ANTICOAGULANTS AND ANTIPLATELET AGENTS
    • VOLUME EXPANDERS AND INTRAVENOUS FLUIDS
    • ELECTROLYTE MANAGEMENT
    • PHARMACOLOGIC TREATMENT OF MULTIPLE SCLEROSIS
    • PHARMACOLOGIC TREATMENT OF MYASTHENIA GRAVIS
    • PHARMACOLOGIC TREATMENT OF PARKINSON’S DISEASE
    • SUMMARY
    • REFERENCES
    • RESOURCES

Section 4 Common Management Problems With Neuroscience Patients

    Intracranial Hypertension: Theory and Management of Increased Intracranial Pressure

    • CONCEPT OF INTRACRANIAL PRESSURE
    • PATHOPHYSIOLOGY
    • HERNIATION SYNDROMES OF THE BRAIN
    • SIGNS AND SYMPTOMS OF INCREASED INTRACRANIAL PRESSURE
    • MANAGEMENT OF PATIENTS WITH INTRACRANIAL HYPERTENSION: A COLLABORATIVE PROBLEM
    • MONITORING INTRACRANIAL PRESSURE
    • SPECIAL SYNDROMES: BENIGN INTRACRANIAL HYPERTENSION AND HYDROCEPHALUS
    • SUMMARY
    • REFERENCES

    Management of Patients Undergoing Neurosurgical Procedures

    • THE PREOPERATIVE PHASE
    • THE INTRAOPERATIVE PHASE
    • SITTING POSITION
    • NEUROSURGICAL PROCEDURES AND OTHER RELATED THERAPEUTIC TECHNIQUES
    • POSTOPERATIVE PHASE
    • POSTOPERATIVE MANAGEMENT AND PREVENTION OF COMPLICATIONS
    • NEUROLOGICAL DEFICITS IN THE POSTOPERATIVE PERIOD
    • NURSE’S ROLE IN REHABILITATION AND DISCHARGE PLANNING
    • SELECTED NEUROSURGICAL PROCEDURES
    • FUTURE TRENDS
    • REFERENCES
    • RESOURCES

    Nursing Management of Patients With a Depressed State of Consciousness

    • IMMOBILITY
    • SPECIALTY BEDS AND SUPPORT SURFACES
    • THE CONSEQUENCES OF IMMOBILITY: NURSING MANAGEMENT OF THE PATIENT WITH DEPRESSED CONSCIOUSNESS
    • THE CARE ENVIRONMENT
    • THERAPEUTIC COMMUNICATIONS
    • REGAINING CONSCIOUSNESS
    • SUMMARY
    • REFERENCES

    Neuroscience Critical Care

    • CRITICAL CARE PERSONNEL
    • THE INTENSIVE CARE UNIT PHYSICAL ENVIRONMENT
    • CLINICAL MANAGEMENT ISSUES
    • ANXIETY, AGITATION, AND DELIRIUM
    • TRANSPORT OF THE CRITICAL CARE PATIENT
    • EVIDENCE-BASED PRACTICE AND RESEARCH
    • INSTITUTE FOR HEALTHCARE IMPROVEMENT INITIATIVES
    • INTERACTING WITH THE FAMILIES OF NEUROSCIENCE INTENSIVE CARE UNIT PATIENTS
    • NURSING MANAGEMENT IN ORGAN DONATION
    • ETHICAL AND LEGAL CONCERNS
    • FUTURE TRENDS
    • REFERENCES

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

    Craniocerebral Injuries

    • SCOPE OF THE PROBLEM
    • OVERVIEW OF CRANIOCEREBRAL TRAUMA
    • PATHOPHYSIOLOGY
    • PRIMARY BRAIN INJURY
    • SECONDARY BRAIN INJURY
    • PRIMARY INJURY: DIAGNOSIS AND MANAGEMENT
    • OTHER INJURIES RELATED TO TRAUMATIC BRAIN INJURY
    • MANAGEMENT OF THE TRAUMATIC BRAIN INJURY PATIENT: THE CONTINUUM OF CARE
    • PREHOSPITAL MANAGEMENT
    • EMERGENCY DEPARTMENT OR TRAUMA CENTER MANAGEMENT
    • INTENSIVE CARE UNIT MANAGEMENT OF SEVERE TRAUMATIC BRAIN INJURY
    • MANAGEMENT OF SEVERE TRAUMATIC BRAIN INJURY DURING THE POSTACUTE PHASE
    • REHABILITATION
    • PREDICTING OUTCOME FROM TRAUMATIC BRAIN INJURY
    • PREVENTION OF TRAUMATIC BRAIN INJURY
    • MANAGEMENT OF TRAUMATIC BRAIN INJURY: A DYNAMIC PROCESS THROUGH RESEARCH
    • ASSESSMENT AND CLINICAL REASONING: KEY ROLE OF THE NEUROSCIENCE NURSE IN PATIENT CARE
    • NURSING MANAGEMENT OF TRAUMATIC BRAIN INJURY
    • NURSING MANAGEMENT FOR SPECIAL PROBLEMS
    • SUMMARY AND FUTURE TRENDS
    • REFERENCES
    • RESOURCES

    Vertebral and Spinal Cord Injuries

    • A PERSPECTIVE
    • UNDERSTANDING SPINAL CORD INJURIES
    • SPECIFIC CATEGORIES OF INJURIES
    • ACUTE SPINAL CORD TRAUMA
    • EARLY MANAGEMENT OF PATIENTS WITH SPINAL CORD INJURY
    • SURGICAL MANAGEMENT OF SPINAL CORD INJURY
    • NONSURGICAL MANAGEMENT OF SPINAL CORD INJURIES
    • FOCUS ON COLLABORATIVE MANAGEMENT IN THE ACUTE AND POSTACUTE PHASES
    • MAJOR PATIENT MANAGEMENT RESPONSIBILITIES OF THE NURSE
    • SUMMARY
    • REFERENCES
    • RESOURCES

    Back Pain and Spinal Disorders

    • CONDITIONS RELATED TO BACK OR NECK PAIN
    • HERNIATED INTERVERTEBRAL DISCS
    • ADDITIONAL COMMON DIAGNOSES
    • RECURRENT SYMPTOMS AFTER SURGERY
    • SUMMARY
    • REFERENCES
    • RESOURCES

    Peripheral Nerve Injuries

    • MECHANISMS OF INJURY
    • PATHOPHYSIOLOGY
    • CLASSIFICATION OF PERIPHERAL NERVE INJURIES
    • DIAGNOSIS OF PERIPHERAL NERVE INJURIES
    • PERIPHERAL NERVE INJURIES: TREATMENT
    • COLLABORATIVE AND NURSING MANAGEMENT OF THE PATIENT WITH PERIPHERAL NERVE TRAUMA
    • REFERENCES

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

    Brain Tumors

    • OVERVIEW OF BRAIN TUMORS
    • SIGNS AND SYMPTOMS OF BRAIN TUMOR
    • ASSOCIATED INCREASED INTRACRANIAL PRESSURE SIGNS
    • APPROACH TO THE PATIENT WITH A BRAIN TUMOR
    • NURSING MANAGEMENT OF THE PATIENT WITH A BRAIN TUMOR
    • SUMMARY
    • REFERENCES

    Spinal Cord Tumors

    • EPIDEMIOLOGY
    • CLASSIFICATION
    • DIAGNOSIS
    • PRINCIPLES OF TREATMENT
    • NURSING MANAGEMENT OF THE PATIENT WITH A SPINAL CORD TUMOR
    • REFERENCES
    • RESOURCES

Section 7 Nursing Management of Patients With Cerebrovascular Problems

    Cerebral Aneurysms

    • OVERVIEW
    • FAMILIAL ANEURYSMS
    • ETIOLOGY
    • ANEURYSM HEMODYNAMICS
    • CLASSIFICATION
    • LOCATION
    • RUPTURED ANEURYSM
    • SIGNS AND SYMPTOMS
    • DIAGNOSIS
    • INITIAL APPROACH TO MEDICAL MANAGEMENT
    • SURGICAL/INTERVENTIONAL TREATMENT
    • COMPLICATIONS OF ANEURYSMAL RUPTURE/BLEEDING
    • NURSING MANAGEMENT OF THE PATIENT WITH AN ANEURYSM
    • SUMMARY
    • REFERENCES
    • RESOURCES

    Arteriovenous Malformations and Other Cerebrovascular Anomalies

    • CLASSIFICATIONS OF VASCULAR MALFORMATIONS
    • ARTERIOVENOUS MALFORMATIONS IN THE ADULT: AN OVERVIEW
    • PEDIATRIC ARTERIOVENOUS MALFORMATIONS
    • ARTERIOVENOUS MALFORMATIONS AND PREGNANCY
    • NURSING MANAGEMENT OF ARTERIOVENOUS MALFORMATIONS
    • REFERENCES
    • RESOURCES

    Stroke

    • DISEASE-SPECIFIC CERTIFICATION: PRIMARY STROKE CENTER
    • PUBLIC AND PROFESSIONAL EDUCATION
    • DEFINITION AND CLASSIFICATION OF STROKE
    • ANATOMY, ATHEROGENESIS, AND PATHOPHYSIOLOGY RELATED TO STROKE
    • SIGNS AND SYMPTOMS OF STROKE SYNDROMES ACCORDING TO THE INVOLVED VESSEL
    • MEDICAL MANAGEMENT AND TREATMENT OF ACUTE ISCHEMIC STROKE
    • GENERAL NURSING MANAGEMENT OF THE STROKE PATIENT
    • REFERENCES
    • RESOURCES

    Other Cerebrovascular Disorders

    • CEREBRAL VENOUS THROMBOSIS
    • MOYAMOYA DISEASE
    • SUMMARY
    • REFERENCES

Section 8 Nursing Management of Patients With Pain, Seizures, and CNS Infections

    Chronic Pain

    • DEFINITION OF TERMS
    • PAIN THEORIES
    • ANATOMY AND PHYSIOLOGY OF PAIN
    • ASSESSMENT AND MANAGEMENT OF CHRONIC PAIN
    • NURSING MANAGEMENT OF PATIENTS WITH CHRONIC PAIN
    • PAIN MANAGEMENT AND THE FUTURE
    • REFERENCES

    Headaches

    • PAIN-SENSITIVE CRANIAL STRUCTURES AND PATHOPHYSIOLOGY
    • CLASSIFICATION OF HEADACHES
    • APPROACH TO MANAGEMENT OF HEADACHES
    • NURSING MANAGEMENT OF THE PATIENT WITH HEADACHE
    • REFERENCES
    • RESOURCES

    Seizures and Epilepsy

    • BACKGROUND AND DEFINITIONS
    • SEIZURE CLASSIFICATION AND OBSERVATIONS/IDENTIFICATION
    • DIAGNOSIS
    • TREATMENT
    • MANAGEMENT OF SEIZURES AND STATUS EPILEPTICUS IN AN ACUTE CARE SETTING
    • NURSING MANAGEMENT OF PATIENTS WITH EPILEPSY: COMMUNITY-BASED CARE
    • REFERENCES
    • RESOURCES

    Infections of the Central Nervous System

    • MENINGITIS
    • OTHER VIRAL ORGANISMS THAT ATTACK THE CENTRAL NERVOUS SYSTEM
    • SUMMARY
    • REFERENCES
    • RESOURCES

Section 9 Nursing Management of Patients With Neurodegenerative Diseases

    Dementias and Alzheimer’s Disease

    • DEMENTIA
    • ALZHEIMER’S DISEASE
    • REFERENCES
    • RESOURCE

    Neurodegenerative Diseases

    • MODELS FOR CHRONIC ILLNESS MANAGEMENT
    • PARKINSON’S DISEASE
    • MULTIPLE SCLEROSIS
    • AMYOTROPHIC LATERAL SCLEROSIS
    • MYASTHENIA GRAVIS
    • SUMMARY
    • REFERENCES

Section 10 Nursing Management of Patients With Peripheral Nerve Diseases

    Peripheral Neuropathies

    • PATHOPHYSIOLOGY
    • DISTRIBUTION PATTERNS OF PERIPHERAL NEUROPATHIES
    • DEVELOPMENT AND CAUSES
    • SIGNS, SYMPTOMS, AND CLINICAL PRESENTATIONS
    • ASSESSMENT, INVESTIGATION, AND DIAGNOSIS OF NEUROPATHIES
    • SELECTED PERIPHERAL NEUROPATHIES
    • REFERENCES

    Cranial Nerve Diseases

    • TRIGEMINAL NEURALGIA
    • BELL’S PALSY
    • MÉNIÈRE’S DISEASE
    • GLOSSOPHARYNGEAL NEURALGIA
    • REFERENCES