Table
of Contents
|
|
|
|
|
SECTION
1 |
NEUROSCIENCE
NURSING: CONTEMPORARY PRACTICE |
1 |
|
Chapter 1 |
The State
of the Science of Neuroscience Nursing Practice Joanne V. Hickey |
2 |
|
|
The State of |
2 |
|
|
The Information
Society and Knowledge Workers |
2 |
|
|
Trends Shaping
Health Care Delivery |
3 |
|
|
Political Trends and
Regulations |
3 |
|
|
Economic Trends |
4 |
|
|
Demographics |
4 |
|
|
Sociological Trends |
5 |
|
|
Technological Trends |
6 |
|
|
National Agenda for
Health |
6 |
|
|
Professional Nursing
and Neuroscience Specialty Practice |
6 |
|
Chapter 2 |
Care
Settings and Transitions in Care Joanne V. Hickey |
11 |
|
|
Health Care Financing |
11 |
|
|
The Focus of Health
Care |
12 |
|
|
The Continuum of
Health Care Services |
14 |
|
|
Transitions in Care
and Discharge Planning |
17 |
|
|
Planning for
Transitions in Health Care Settings |
17 |
|
|
Discharge Planning
for Neuroscience Patients |
18 |
|
Chapter 3 |
Ethical Perspectives
and End-of-Life Care Joanne V. Hickey and Kathryn Montgomery |
21 |
|
|
An Ethical
Perspective of Neuroscience Practice |
21 |
|
|
Ethics, Morality,
and Legality |
21 |
|
|
Framework for
Ethical Decision Making |
22 |
|
|
Independent Role of
the Nurse |
24 |
|
|
Independent Role of
the Physician |
24 |
|
|
Collaborative Roles |
24 |
|
|
Decision-Making
Capacity and Advance Directives and Living Wills |
26 |
|
|
End-of-Life Care |
28 |
|
|
Selected End-of-Life
Ethical Issues Common in Neuroscience Nursing Practice |
28 |
|
|
Fostering
Professional Growth in Ethical Decision Making |
33 |
|
SECTION 2 |
ASSESSMENT AND
EVALUATION OF NEUROSCIENCE PATIENTS |
39 |
|
Chapter 4 |
Overview of
Neuroanatomy
and Neurophysiology Joanne V. Hickey and Joseph T. Kanusky |
40 |
|
|
Embryonic
Development of the Nervous System |
40 |
|
|
Cells of the Nervous
System |
40 |
|
|
Components of the
Cell Body |
41 |
|
|
Cell Processes:
Axons and Dendrites |
42 |
|
|
Physiology of Nerve
Impulses |
43 |
|
|
Functions and
Divisions of the Nervous System |
45 |
|
|
Cranial and Spinal
Bones |
45 |
|
|
Sutures of the Skull |
48 |
|
|
Spine |
48 |
|
|
Ligaments of the
Spine |
49 |
|
|
Intervertebral Discs |
50 |
|
|
Meninges |
50 |
|
|
Cerebrospinal Fluid |
52 |
|
|
Formation of
Cerebrospinal Fluid |
52 |
|
|
Cerebrovascular Circulation |
53 |
|
|
Characteristics of
the Cerebral Circulation |
54 |
|
|
Blood-Brain Barrier |
59 |
|
|
Brain (Encephalon) |
59 |
|
|
General Functions of
the Cerebral Cortex According to Lobes |
60 |
|
|
Dominance of a
Cerebral Hemisphere |
63 |
|
|
Corpus Callosum |
63 |
|
|
Basal Ganglia |
63 |
|
|
Diencephalon |
63 |
|
|
Internal Capsule |
64 |
|
|
Hypophysis (Pituitary Gland) |
64 |
|
|
Brainstem (Midbrain,
Pons, and
Medulla) |
65 |
|
|
Cerebellum |
67 |
|
|
Special Systems
within the Brain |
67 |
|
|
Spinal Cord |
68 |
|
|
Dorsal (Sensory)
Roots |
70 |
|
|
Ventral (Motor) Roots |
70 |
|
|
Classification of
Nerve Fibers |
71 |
|
|
Motor System |
72 |
|
|
Sensory System |
73 |
|
|
Autonomic Nervous
System |
76 |
|
|
Cranial Nerves |
82 |
|
Chapter 5 |
Diagnostic
Procedures and Laboratory Tests for Neuroscience Patients Joanne V. Hickey |
89 |
|
|
Patient and Family
Teaching |
89 |
|
|
Outpatient Procedures |
89 |
|
|
Hospitalized
Patients and Procedures |
90 |
|
|
Informed Consent |
90 |
|
|
X-rays of the Head
and Vertebral Column |
90 |
|
|
Spinal X-rays |
91 |
|
|
Anatomic Imaging
Techniques of the Brain |
91 |
|
|
Physiologic Imaging
Techniques of the Brain |
96 |
|
|
Cerebrospinal Fluid
and Spinal Procedures |
97 |
|
|
Cerebrovascular Studies |
100 |
|
|
Biopsies |
104 |
|
|
Nervous System
Electrical Activity and Conduction |
104 |
|
|
Testing of the
Special Senses |
108 |
|
|
Neuropsychological
Examination |
109 |
|
|
Common
Neuropsychological Deficits Associated with Cerebral Dysfunction |
110 |
|
|
Summary |
110 |
|
Chapter 6 |
Comprehensive
Neurological Examination Joanne V. Hickey |
111 |
|
|
Purposes |
111 |
|
|
The Neurological
Examination |
111 |
|
|
Conducting the
Neurological Examination |
113 |
|
|
Level of
Consciousness |
113 |
|
|
Mental Status
Examination |
113 |
|
|
Cranial Nerve
Examination |
120 |
|
|
Motor System
Examination |
132 |
|
|
Upper Extremities |
133 |
|
|
Lower Extremities |
133 |
|
|
Sensory System
Examination |
134 |
|
|
Cerebellar System Examination |
138 |
|
|
Reflexes |
138 |
|
|
The Neurological
Examination of the Comatose Patient |
144 |
|
|
Summary |
152 |
|
Chapter 7 |
Neurological
Assessment Joanne V. Hickey |
154 |
|
|
Establishing a
Nursing Database |
154 |
|
|
Overview of
Neurological Assessment |
154 |
|
|
Frequency of Assessment
and Documentation |
155 |
|
|
Concept of
Consciousness |
155 |
|
|
Identifying the
Levels of Consciousness |
158 |
|
|
The Glasgow Coma
Scale |
159 |
|
|
Changes in Level of
Consciousness |
159 |
|
|
Recovery and
Rehabilitation |
163 |
|
|
Cranial Nerve
Assessment |
163 |
|
|
Assessment of Visual
Fields (Optic Nerve) |
163 |
|
|
Assessment of Pupils
(Oculomotor
Nerve) |
163 |
|
|
Assessment of Extraocular
Movement (Oculomotor,
Trochlear,
an Abducens
Nerves) |
168 |
|
|
Assessment of the
Conscious, Cooperative Patient |
169 |
|
|
Assessment of the
Unconscious Patient |
170 |
|
|
Assessment of Motor
Function |
170 |
|
|
Assessment of Muscle
Strength |
172 |
|
|
Involuntary Movement
Posture, and Gait |
173 |
|
|
Sensory Assessment |
173 |
|
|
Frequency and
Documentation of Sensory Data |
173 |
|
|
Assessment of Cerebellar
Function |
173 |
|
|
Vital Signs and
Clinical Implications |
174 |
|
|
Summary |
179 |
|
SECTION 3 |
GENERAL
CONSIDERATIONS IN NEUROSCIENCE NURSING |
181 |
|
Chapter 8 |
Nutritional
Support for Neuroscience Patients Joanne V. Hickey and
Theresa Dildy |
|
|
|
Basic Nutritional
Requirements |
182 |
|
|
Metabolic Changes
and Characteristics of Acute Stress |
184 |
|
|
Nutritional
Assessment |
184 |
|
|
Estimating Nutrient
Requirements |
186 |
|
|
Providing Nutrients |
186 |
|
|
Problems Associated
with Tube Feedings |
188 |
|
|
The Nurse’s Role:
Meeting the Nutritional Needs of Patients |
190 |
|
Chapter 9 |
Fluid and Metabolic
Disorders in Neuroscience Patients Joanne V. Hickey |
|
|
|
Hypothalamic-Neurohypophyseal
System |
195 |
|
|
Hyponatremia |
196 |
|
|
Hypernatremia |
198 |
|
|
Other Common
Electrolyte Imbalances |
199 |
|
|
Syndrome of Inappropriate
Secretion of Antidiuretic
Hormone |
201 |
|
|
Diabetes Insipidus |
201 |
|
|
Cerebral Salt Wasting |
203 |
|
|
Hyperosmolar Nonketotic Hyperglycemia |
204 |
|
|
Summary |
204 |
|
|
Behavioral
and Psychological Responses to Neurological Illness Joanne V. Hickey |
206 |
|
|
Stress and the
Stress Response |
206 |
|
|
Human Adaptation and
Coping |
207 |
|
|
Neurological
Conditions and their Psychological Effects |
207 |
|
|
General Principles:
Emotional and Psychological Responses to Neurological Conditions |
207 |
|
|
Common Emotional and
Psychological Responses to the Stress Associated with Neurological Conditions |
208 |
|
|
Summary |
212 |
|
Chapter 11 |
Rehabilitation
of Neuroscience Patients Joanne V. Hickey |
213 |
|
|
Framework for
Disability |
213 |
|
|
Concepts of
Rehabilitation |
213 |
|
|
A Philosophy of
Rehabilitation |
214 |
|
|
Assessment of
Activities of Daily Living |
216 |
|
|
Principles of
Rehabilitation Nursing |
216 |
|
|
The Basis of
Movement and Treatment of Movement Disorders |
218 |
|
|
Management of the
Skin |
225 |
|
|
Sensory-Perceptual
Deficits |
225 |
|
|
Communication
Deficits |
226 |
|
|
Swallowing Deficits |
229 |
|
|
Bladder Dysfunction
and Retraining |
230 |
|
|
Bowel Elimination
and Dysfunction |
236 |
|
|
Cognitive Rehabilitation |
237 |
|
|
The Home-Based
Ventilator-Dependent Patient |
238 |
|
|
Discharge Planning |
238 |
|
|
Rehabilitation
Legislation and Entitlement Programs |
238 |
|
Chapter 12 |
Pharmacologic
Management of Neuroscience Patients Timothy F. Lassiter
and Amy I. Henkel |
239 |
|
|
Overview |
239 |
|
|
Commonly Used Drugs
Along the Continuum of Care |
239 |
|
|
Antibiotics |
248 |
|
|
Steroids |
253 |
|
|
Diuretics |
254 |
|
|
Gastrointestinal
Agents |
254 |
|
|
Anticoagulants and Antiplatelet
Agents |
256 |
|
|
Volume Expanders and
Intravenous Fluids |
258 |
|
|
Electrolyte
Management |
259 |
|
|
Pharmacologic
Treatment of Multiple Sclerosis |
260 |
|
|
Pharmacologic
Treatment of Myasthenia Gravis |
262 |
|
|
Pharmacologic Treatment
of Parkinson’s Disease |
264 |
|
|
Summary |
266 |
|
SECTION 4 |
COMMON MANAGEMENT
PROBLEMS WITH NEUROSCIENCE PATIENTS |
269 |
|
Chapter 13 |
Intracranial
Hypertension: Theory and Management of Increased Intracranial
Pressure Joanne V. Hickey and DaiWai M. Olson |
270 |
|
|
Concept of
Intracranial Pressure |
270 |
|
|
Pathophysiology |
275 |
|
|
Herniation Syndromes of the
Brain |
279 |
|
|
Signs and Symptoms
of Increased Intracranial Pressure |
284 |
|
|
Management of
Patients with Intracranial Hypertension: A Collaborative Problem |
287 |
|
|
Monitoring
Intracranial Pressure |
296 |
|
|
Special Syndromes:
Benign Intracranial Hypertension and Hydrocephalus |
303 |
|
|
Summary |
304 |
|
Chapter 14 |
Management of
Patients Undergoing Neurosurgical Procedures Joanne V. Hickey and
Jamie L. Zoellner |
308 |
|
|
The Preoperative
Phase |
308 |
|
|
The Intraoperative
Phase |
309 |
|
|
Sitting Position |
311 |
|
|
Neurosurgical Procedures
and Other Related Therapeutic Techniques 3U Postoperative Phase |
315 |
|
|
Postoperative
Management and Prevention of Complications |
321 |
|
|
Neurological
Deficits in the Postoperative Period |
324 |
|
|
Nurse’s Role in
Rehabilitation and Discharge Planning |
326 |
|
|
Selected
Neurosurgical Procedures |
327 |
|
|
Future Trends |
334 |
|
Chapter 15 |
Nursing
Management of Patients with a Depressed State of
Consciousness Joanne V. Hickey and Mary Bray Powers |
336 |
|
|
Immobility |
336 |
|
|
Specialty Beds and
Support Surfaces |
340 |
|
|
The Consequences of
Immobility: Nursing Management of the Patient with Depressed Consciousness |
341 |
|
|
The Care Environment |
350 |
|
|
Therapeutic
Communications |
350 |
|
|
Regaining
Consciousness |
350 |
|
|
Summary |
350 |
|
Chapter 16 |
Neuroscience
Critical Care Susan Chioffi |
352 |
|
|
Critical Care
Personnel |
352 |
|
|
The Intensive Care
Unit Physical Environment |
355 |
|
|
Clinical Management
Issues |
356 |
|
|
Anxiety, Agitation,
and Delirium |
360 |
|
|
Transport of the
Critical Care Patient |
361 |
|
|
Evidence-Based
Practice and Research |
362 |
|
|
Institute for
Healthcare Improvement Initiatives |
363 |
|
|
Interacting with the
Families of Neuroscience Intensive Care Unit Patients |
364 |
|
|
Nursing Management
in Organ Donation |
364 |
|
|
Ethical and Legal
Concerns |
365 |
|
|
Future Trends |
365 |
|
SECTION 5 |
NURSING MANAGEMENT
OF PATIENTS WITH INJURY TO THE NEUROLOGICAL SYSTEM |
369 |
|
Chapter 17 |
Craniocerebral Injuries Joanne V. Hickey and
Bettina C. Prator |
370 |
|
|
Scope of the Problem |
370 |
|
|
Overview of Craniocerebral
Trauma |
370 |
|
|
Pathophysiology |
370 |
|
|
Primary Brain Injury |
371 |
|
|
Secondary Brain
Injury |
373 |
|
|
Primary Injury.
Diagnosis and Management |
374 |
|
|
Other Injuries
Related to Traumatic Brain Injury |
382 |
|
|
Management of the
Traumatic Brain Injury Patient: The Continuum of Care |
382 |
|
|
Prehospital Management |
385 |
|
|
Emergency Department
or Trauma Center Management |
387 |
|
|
Intensive Care Unit
Management of Severe Traumatic Brain Injury |
389 |
|
|
Management of Severe
Traumatic Brain Injury During the Postacute Phase |
400 |
|
|
Rehabilitation |
400 |
|
|
Predicting Outcome
From Traumatic Brain Injury |
401 |
|
|
Prevention of
Traumatic Brain Injury |
401 |
|
|
Management of
Traumatic Brain Injury: A Dynamic Process Through Research |
401 |
|
|
Assessment and
Clinical Reasoning: Key Role of the Neuroscience Nurse in Patient Care |
402 |
|
|
Nursing Management
of Traumatic Brain Injury |
404 |
|
|
Nursing Management
for Special Problems |
405 |
|
|
Summary and Future
Trends |
406 |
|
Chapter 18 |
Vertebral
and Spinal Cord Injuries Joanne V. Hickey |
410 |
|
|
A Perspective |
410 |
|
|
Understanding Spinal
Cord Injuries |
410 |
|
|
Specific Categories
of Injuries |
414 |
|
|
Acute Spinal Cord
Trauma |
426 |
|
|
Early Management of
Patients with Spinal Cord Injury |
427 |
|
|
Surgical Management
of Spinal Cord Injury |
432 |
|
|
Nonsurgical Management of
Spinal Cord Injuries |
433 |
|
|
Focus on
Collaborative Management in the Acute and Postacute Phases |
434 |
|
|
Major Patient
Management Responsibilities of the Nurse |
438 |
|
|
Summary |
451 |
|
Chapter 19 |
Back Pain
and Spinal Disorders Joanne V. Hickey and Andrea L. Strayer |
|
|
|
Conditions Related
to Back or Neck Pain |
454 |
|
|
Herniated Intervertebral
Discs |
460 |
|
|
Additional Common
Diagnoses |
474 |
|
|
Recurrent Symptoms
After Surgery |
483 |
|
|
Summary |
484 |
|
Chapter 20 |
Peripheral
Nerve Injuries Joanne V. Hickey |
|
|
|
Mechanisms of Injury |
486 |
|
|
Pathophysiology |
486 |
|
|
Classification of
Peripheral Nerve Injuries |
487 |
|
|
Diagnosis of
Peripheral Nerve Injuries |
488 |
|
|
Peripheral Nerve
Injuries: Treatment |
491 |
|
|
Collaborative and
Nursing Management of the Patient with Peripheral Nerve Trauma |
493 |
|
SECTION 6 |
NURSING MANAGEMENT
OF PATIENTS WITH NEOPLASMS OF THE NEUROLOGICAL SYSTEM |
495 |
|
Chapter 21 |
Brain
Tumors Joanne V. Hickey and Terri S. Armstrong |
|
|
|
Overview of Brain
Tumors |
496 |
|
|
Signs and Symptoms
of Brain Tumor |
498 |
|
|
Associated Increased
Intracranial Pressure |
|
|
|
Signs |
501 |
|
|
Approach to the
Patient with a Brain Tumor |
501 |
|
|
Nursing Management
of the Patient with a Brain Tumor |
515 |
|
|
Summary |
519 |
|
Chapter 22 |
Spinal Cord
Tumors Joanne V. Hickey and Terri S. Armstrong |
|
|
|
Epidemiology |
521 |
|
|
Classification |
521 |
|
|
Diagnosis |
527 |
|
|
Principles of
Treatment |
528 |
|
|
Nursing Management
of the Patient with a Spinal Cord Tumor |
529 |
|
SECTION 7 |
NURSING MANAGEMENT
OF PATIENTS WITH CEREBROVASCULAR PROBLEMS |
535 |
|
Chapter 23 |
Cerebral
Aneurysms Deidre A. Buckley and Joanne V. Hickey |
536 |
|
|
Overview |
536 |
|
|
Familial Aneurysms |
537 |
|
|
Etiology |
538 |
|
|
Aneurysm Hemodynamics |
539 |
|
|
Classification |
540 |
|
|
Location |
540 |
|
|
Ruptured Aneurysm |
540 |
|
|
Signs and Symptoms |
541 |
|
|
Diagnosis |
544 |
|
|
Initial Approach to
Medical Management |
546 |
|
|
Surgical/lnterventional
Treatment |
549 |
|
|
Complications of Aneurysmal
Rupture/Bleeding |
558 |
|
|
Nursing Management
of the Patient with an Aneurysm |
562 |
|
|
Summary |
567 |
|
Chapter 24 |
Arteriovenous Malformations and Other Cerebrovascular
Anomalies DeidreA. Buckley and Joanne
V. Hickey |
570 |
|
|
Classifications of
Vascular Malformations |
570 |
|
|
Arteriovenous Malformations in
the Adult: An Overview |
572 |
|
|
Pediatric Arteriovenous
Malformations |
578 |
|
|
Arteriovenous Malformations and
Pregnancy |
584 |
|
|
Nursing Management
of Arteriovenous
Malformations |
585 |
|
Chapter 25 |
Stroke Joanne V. Hickey and
Ann Quinn Todd |
588 |
|
|
Disease-Specific Certification:
Primary Stroke Center |
589 |
|
|
Public and
Professional Education |
589 |
|
|
Definition and
Classification of Stroke |
589 |
|
|
Anatomy, Atherogenesis,
and Pathophysiology
Related to Stroke |
593 |
|
|
Signs and Symptoms
of Stroke Syndromes According to the Involved vessel |
598 |
|
|
Medical Management
and Treatment of Acute Ischemic Stroke |
603 |
|
|
General Nursing
Management of the Stroke Patient |
610 |
|
Chapter 26 |
Other Cerebrovascular
Disorders Joanne V. Hickey |
620 |
|
|
Cerebral Venous
Thrombosis |
620 |
|
|
Moyamoya Disease |
621 |
|
|
Summary |
621 |
|
SECTION 8 |
NURSING MANAGEMENT
OF PATIENTS WITH PAIN, SEIZURES, AND CNS INFECTIONS |
625 |
|
Chapter 27 |
Chronic
Pain Joanne V. Hickey |
624 |
|
|
Definition of Terms |
624 |
|
|
Pain Theories |
625 |
|
|
Anatomy and
Physiology of Pain |
626 |
|
|
Assessment and
Management of Chronic Pain |
627 |
|
|
Nursing Management
of Patients with Chronic Pain |
631 |
|
|
Pain Management and
the Future |
632 |
|
Chapter 28 |
Headaches Joanne V. Hickey |
633 |
|
|
Pain-Sensitive
Cranial Structures and Pathophysiology |
633 |
|
|
Classification of
Headaches |
634 |
|
|
Approach to
Management of Headaches |
635 |
|
|
Nursing Management,
of the Patient with Headache |
643 |
|
Chapter 29 |
Seizures
and Epilepsy Joanne V. Hickey |
646 |
|
|
Background and
Definitions |
646 |
|
|
Seizure
Classification and Observations/Identification |
647 |
|
|
Diagnosis |
651 |
|
|
Treatment |
653 |
|
|
Management of
Seizures and Status Epilepticus
in an Acute Care Setting |
658 |
|
|
Nursing Management
of Patients with Epilepsy: Community-Based Care |
660 |
|
Chapter 30 |
Infections
of the Central Nervous System Joanne V. Hickey |
665 |
|
|
Meningitis |
665 |
|
|
Encephalitis |
670 |
|
|
Other Viral
Organisms that Attack the Central Nervous System |
675 |
|
|
Summary |
678 |
|
SECTION 9 |
NURSING MANAGEMENT
OF PATIENTS WITH NEURODECENERATIVE DISEASES |
679 |
|
Chapter 31 |
Dementias
and Alzheimer’s Disease Joanne V. Hickey |
680 |
|
|
Dementia |
680 |
|
|
Alzheimer’s Disease |
684 |
|
|
|
|