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NEUROLOGICAL DISORDERS ((SIGNS AND SYMPTOMS (Rigid muscles, Speech changes…
NEUROLOGICAL DISORDERS
Parkinson's disease- a progressive neurological disorder that affect the movement especially in older people.
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CAUSES
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The cause of Parkinson's disease is unknown bur several factors appear to play a role including: Genes, Environmental factors such as exposure to certain toxins
RISK FACTORS
Heredity - Having a close relative with Parkinson's diseases increases chances to develop the disease.
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Age - It commonly affects older people, rare in young ones.
Exposure to toxins- Prolonged exposure to herbicides and pesticides may slightly increases risk of Parkinson's disease
PATHOPHYSIOLOGY
The cause of Parkinson's diseases is unknown, it likely involves the interaction of the host susceptibility and environmental factors.
- Physiologically, the symptoms associated with Parkinson's disease are the result of loss of number of neurotransmitters, mostly notable dopamine
- Symptoms worsen over time as more and more of cells affected by the diseases are lost
- The cause of the disease is highly variable with some patients exhibiting very few symptoms as they age and others whose symptoms progress rapidly
- Parkinson's is increasingly seen as a complex neurodegenerative disease with a sequence of progression.
- There is a strong evidence that it first affect the dorsal motor nucleus of the vagus nerve and the olfactory bulb and nucleus, then the locus coeruleus, and eventually the substantia nigra.
- Cortical areas of the brain are affected at a large stage.
NURSING CARE PLAN
- Nursing intervention for each of the symptoms of Parkinson's disease, muscle rigidity, bradykinesia, tremor and postural reflex abnormalities, are designed to increase the patient's quality of life by minimizing symptoms
- Nurses are responsible for planning patient's medication schedules to maximize drug effectiveness.
- Dietary implication include a low-protein regimen for the patient during the day, eliminating foods high in vitamin B6, high calories food and soft-solid food offered at frequent feeding.
- Constipation is addressed by increasing the patient's fiber and fluid intake and by increasing the patient's mobility.
- Patient's mobility is increased when the patient is taught purposeful activities and to concentrate on the way he/she walks.
- Communication is facilitated if the patient is takes deep breaths before speaking and uses diaphragmatic speech.
NURSING MANAGEMENT
- Administer Dopaminergic medication such as Levodopa which the most effective medication for managing symptoms of Parkinson's disease
- Administer Dopamine antagonists they work directly by stimulating dopamine receptors in the brain.
- Manage side effects of the medication
- Encourage intake of fluids by the patient to prevent dehydration
- Involve family in the management so they understand about the condition and able to manage it at home
- Encourage patient for physical exercise
STROKE
- Is a neurological disorder where by blood supply to pert of the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrient. .
SIGNS AND SYMPTOMS
Paralysis or numbness on the face, arm or leg
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CAUSES
- Stroke may cause by the blocked arteries(ischemic stroke) or the leaking or busting of the blood vessel( Hemorrhagic stroke).
ISCHEMIC STROKE
Thrombotic stroke- occurs when the blood clot forms in one of the arteries that supply to the brain.
- A clot may be caused by fatty deposits that build up in the arteries and cause reduced blood flow or any other artery disorders.
Embolic stroke- occurs when the blood clots or other debris forms away from the brain, commonly in the heart and it swept through bloodstream to lodge in narrow brain arteries.
- The type of blood clot is called embolus
HEMORRHAGIC STROKE
- It occurs when the blood vessel in the brain leaks or ruptures.
- Brain hemorrhages can result from many conditions that may affect the blood vessels,
-These includes: - Hypertension, overtreatment with anticoagulants and aneurysm.
- Intracerebral hemorrhage: a blood vessel in the brain bursts and spill into surrounding brain tissue, damaging brain cells
- Subarachnoid hemorrhage: an artery on or near the surface of the brain bursts and spill s into the space between the surface of the brain and the skull.
- This bleeding is often signaled by a sudden, severe headache
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PATHOPHYSIOLOGY
- The primary pathophysiology of stroke is an underlying heart or blood vessels disease.
- The secondary manifestation in the brain are the result of one or more of the underlying disease.
- The primary pathologies includes hypertension, atherosclerosis leading to coronary artery diseases, dyslipidemia, heart disease and hyperlipidemia
NURSING INTERVENTION
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Monitor vital signs- compare blood pressure with the other arm
-Assess heart rate and rhythm for murmurs
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Administer medication as per doctor's orders: Thrombolytic agents are useful in dissolving clot when started within 3 hours of initial symptoms
- Warfarin may be used to improve cerebral blood flow and prevent further blood clotting when embolism and thrombosis is the problem
-Antihypertensive
NURSING CARE PLAN
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Provide hygiene to elderly patience such as bed bath, mouth wash and nappy changing
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