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Disorders of the external ear and middle ear, Congenital abnormalities of…
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Cerebrovascular disease
Pathophysiologyg
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Ischemic occlusions contribute to
around 85% of casualties in stroke
patients, with the remainder due to
intracerebral bleeding
Symptoms
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Dizziness, nausea, or vomiting.
Nursing care plan
Nursing diagnosis
Impaired physical mobility related to hemiparesis, loss of balance and coordination, spasticity, and brain injury
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Nursing interventions
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Speak in normal tones and avoid talking too
fast. Give patient ample time to respond,
Assist patient with head control, and position
based on specific dysfunction. Good
positioning can facilitate intake and reduce
risk of aspiration
Assist patient with head control, and position
based on specific dysfunction. Good
positioning can facilitate intake and reduce
risk of aspiration
Risk factors
Age- in adults, the risk for stroke
increases with age
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Viral infections or conditions that cause
inflammation, such as lupus or
rheumatoid arthritis
Clinical manifestations
Paralysis or numbness of the face,
arm or leg
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Trouble walking, dizziness, or loss of
balance or coordination
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Convulsive conditions
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Nursing care plan
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Nursing interventions
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Note client’s age, gender, developmental age, decision-making ability, level of cognition or competence.
Determine factors related to the individual situation, as listed in Risk Factors, and extent of risk.
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Clinical manifestations
High fever, which can be associated with an infection such as meningitis
Lack of sleep
Flashing lights, moving patterns or other visual stimulants
Low blood sodium hyponatremia
which can happen with diuretic therapy
Medications, such as certain pain relievers, antidepressants or smoking cessation therapies, that lower the seizure threshold
Pathophysiology
In epilepsy a spontaneous electrical discharge occurs from a group of neurones referred to as a seizures focus seizures activity may involve the entire brain.
Congenital conditions
Symptoms
blue-tinted skin, shortness of breath, failure to feed
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Nursing care plan
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Nursing interventions
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Check for peripheral pulses, including capillary refill
Note skin colour, temperature, and moisture.
Pathophysiologyg
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In hydrocephalus the cerebrospinal fluid accumulates within the cranial cavity ventricles of the brain causing an increase in pressure in the cranial cavity
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Neurological assessment
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Motor response
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Indications
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Management of symptoms in particular muscle weakeness, excess secretions breathing and nutrition problems
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Assessing metal status
Aims
Diagnose mental health conditions such as anxiety depression schizophrenia post-natal depression eating disorders and psychotic illnesses
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Ineffective conditions
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Pathophysiology
Inflammatory exudate increases intracranial pressure and the infection causes an increase in the cerebrospinal fluid production and pressure that is measurable on lumbar pant
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Clinical manifestations
Bacteria. These one-cell organisms are responsible for illnesses such as strep throat, urinary tract infections and tuberculosis
Fungi. Many skin diseases, such as ringworm and athlete's foot, are caused by fungi.
Other types of fungi can infect your lungs or nervous system.
Nursing care plan
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Nursing interventions
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Supportive measurements to maintain circulation respiration nutrition and hydration should be implemented
Measurement to reduce dangerously high temperature should be implemented such as tepid sponging and giving paracetamol regularly at 6 hour intervals
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Disorders of the nose
Deviated septum
Pathophysiology
The septum is the cartilage in the nose that separates the nostrils
Severe unevenness is known as a deviated septum
It can cause health complications such as a blocked nostril or difficult brething
Clinical manifestations
Difficult breathing especially through the nose having one side of the nose that easy to break through
Nose bleeding
Snoring or loud breathing during sleep
Nasal congestion or pressure
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Nursing care plan
Nursing diagnosis
Ineffective breathing related to nasal obstruction
Impaired swallowing related to pain in the pharynx
Pain related to infection or injury to the nose
Nursing interventions
Increase fluid intake
don't blow your nose elevate your head when you're sleeping avoid strenuous exercises including cardio
wear clothes that fasten in the front instead of pulling over your head
Sinusitis
Pathophysiology
Mucous produced but their sinuses is removed through small openings in the nose called ostia
Inflammation there is edema and increased production of mucus these serve to block the ostia and impair ciliary action
The mucus then accumulates in the sinus causing congestion and with time the mucus becomes infected
Clinical manifestations
Fever and chills along with headaches and facial pains
Which are made worse by bending pain or numbness in the upper teeth and a purulent of discoloured nasal discharge may be present
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Nursing care plan
Nursing diagnosis
Acute pain head and throat sinus related to inflammation of the nose
Anxiety related to lack of client knowledge about disease and medication procedures
Nursing interventions
Apply steam inhalations three to four times a day are recommended to loosen secretions
Local heat can be applied on the nose area to reduce oedema
Prescribed antibiotics can be administered to managed infection
Rhinitis
Pathophysiology
All forms of rhinitis cause sneezing ,nasal discharge with nasal congestion and headache
Acute rhinitis usually last 5 to 7 days with or without treatment
Secondary invasion by bacteria May complicates the cold causing pneumonia bronchitis sinusitis
nasal discharge is usually water at the first and only becomes mucoid later
Clinical manifestations
Headache may be pronounced and persisted
in chronic rhinitis acute symptoms are absent
The chief complained is nasal congestion accompanied by a feeling of stuffiness and pressure in the nose
The breath may be foul smelling
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Nursing care plan
Nursing diagnosis
Ineffective airway clearance related to obstruction or present of thickness secretions
Disturbed sleep pattern related to obstruction of the nose
Nursing interventions
The patient is usually seen in a primary health care centre in community or outpatient department in the hospital's
nursing care is directed toward patient teaching and home care
Treatment is symptomatic
Degenerative conditions
Multiple sclerosis
Pathophysiologyg
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Immune cells invade central nervous system and cause inflammation coma neurodegeneration and tissue damage
Symptoms
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Muscle: cramping, difficulty walking
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Nursing care plan
Nursing diagnosis
Self care deficit related to memory loss evidence by patient will perform self-care activities within the level of own ability
Fatty cue related to decreased energy production evidence by verbalization of overwhelming lack of energy
Nursing interventions
Determine the current activity level and physical condition assess degree of functional impairment using 0-4 scale
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Alzheimer's disease
Pathophysiologyg
Alzheimer disease causes progressive cognitive deterioration and is characterized by beta-amyloid deposits and neurofibrillary tangles in the cerebral cortex and subcortical gray matter.
The beta-amyloid deposition and neurofibrillary tangles lead to loss of synapses and neurons, which results in gross atrophy of the affected areas of the brain, typically starting at the mesial temporal lobe
Symptoms
Agression, agitation, difficulty with self care
mental decline, difficulty thinking and understanding, confusion in the evening hours
depression, hallucination, or paranoia
Also common: inability to combine muscle
Nursing care plan
Nursing diagnosis
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Impaired memory loss related to process
Changes in cognitive abilities evidenced by disorientation to time, place, person,
Nursing interventions
Frequently orient client to reality and surroundings. Allow client to have familiar objects around him or her; use other items, such as a clock, a calendar
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Hamorrhage
Intracerebral hemorrhage
Pathophysiology
, compressing the brain stem and often causing secondary hemorrhages in the midbrain and pons.
If the hemorrhage ruptures into the ventricular system (intraventricular hemorrhage), blood may cause acute hydrocephalus.
Symptoms
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bleeding, decreased level of consciousness, altered level of consciousness
Clinical manifestations
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Visual disturbances. Visual loss, diplopia, and ptosis occur if the aneurysm is adjacent the oculomotor nerve.
Nursing care plan
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Nursing interventions
Check blood pressure, pulse, level of consciousness, pupillary responses, and motor function hourly
monitor respiratory status and report changes immediately.
Subarachnoid hemorrhage
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Clinical manifestations
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Sudden change in the level of consciousness. As the aneurysm presses on nerves and tissues, there is a sudden early change in the level of consciousness.
Symptoms
severe headache, abnormal heart rhythm, altered level of consciousness
Nursing care plan
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Nursing interventions
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Calcium channel blockers that is nimodipine which is specially indicated for use in subarachnoid hemorrhage can be used to prevent vasospasm