NUR 2755 Multidimensional Care IV MDC 4 Exam 1 What does the Glasgow Coma Scale measure? - Measures LOC after brain injury Eyes (4-1) Movement (6-1) Voice (5-1) How to care for a patient with homonymous hemianopia after a stroke? - Turn head side to side to expand visual field Scanning technique is useful when eating or ambulating How to Care for a patient with Left side stroke and right sided deficit - Reorient as needed Establish a structured routine Encourage patient to do ADL as independently as possible Give patient simple easy to follow instructions What do Left side stroke patients with right side deficits experience? - Aphasia (Inability to speak) Alexia (Difficulty reading) Agraphia (Difficulty writing) Acalculia (Difficulty with math) What do Right side stroke patients with Left side deficits experience? - Impaired sense of Humor Disorientation of time, place and person Loss of depth perception Impulsiveness Loss of ability t hear tonal variations Left side hemiplegia or hemiparesis Patient education for Parkinson’s - Report dizziness Delirium Maintain quality of life Help alleviate or manage symptoms Take medication at the same time How to manage a patient with proprioception (position sense)? - Teach the patient to touch and use both sides of the body. When dressing, remind the patient to dress the affected side first. Assessment findings for Parkinson’s - Tremors Muscle rigidity Bradykinesia Postural instability Medication for Parkinson’s - Carbidopa/ Levodopa Give at set time do not change assessing gbs - Halmark finding: Ascending paralysis which can cause acute respiratory failure Patient interventions for gbs - Monitor vitals and ECG Help feed patient if needed Maintain hydration passive ROM Q2 turns What is a patient with GBS at risk for? - Respiratory compromise Swallowing disorders Assessment finding for bell’s palsy - Facial drooping unilateral Loss of cornea reflex on one side Loss of taste on one side Excess tearing on one side Excess drooling Can’t sip or chew on one side Patient education for bell’s palsy - Tape eye closed or wear a patch QHS, protective glasses while awake Manually close eyelid often High-calorie snacks, soft diet Warm, moist compresses and massage to the affected area Don't chew on face What is Generalized - Reversible LOC, inhibits neuronal impulses when is generalized anesthesia appropriate? - Major surgeries such as Open heart Brain surgery