Assessing : The Neurological System
Week 3: Assessment of the Neurological System
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Randy Adams is a 38-year-old male patient of Dr. Joseph Reynolds who was admitted yesterday morning for 24-hour observation for mild concussion following a motor vehicle accident. Randy lost consciousness during the accident and was very confused when he arrived in the ER after EMS transport. He is an Iraq war veteran and he seemed to think after the accident that this all happened in Iraq. Dr. Reynolds is concerned that Randy has some residual problems from a couple of explosive incidents that occurred while he was in Iraq. The physician is unsure whether Randy’s current symptoms are from the car accident or from prior injuries so he has referred him for consultations to both a neurologist and to a behavioral health specialist.
Based on the above please discuss the following.
Pathophysiology of concussive injuries and treatment
Neurological assessment tools used in your current practice setting (if not presently working, please describe one used during prior employment or schooling)
Current best practices associated with post-traumatic stress disorder (PTSD)
Nursing interventions you would include in this patient’s plan of care
Week 2: General Survey/Skin/Nutrition
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Your home health agency has received an order from a local hospital to evaluate and treat an elderly woman being discharged from its medical surgical unit.
Millie Gardner, an 83-year-old female patient, is being discharged home today to the care of her husband Fred (87 years old) following a 9-day hospitalization for pneumonia, dehydration, and failure to thrive. She has a history of hypertension (HTN), Type II Diabetes, and cerebral vascular accident (CVA) with left-sided weakness. Patient is alert and oriented but does have periods of forgetfulness during the overnight hours. Patient has intermittent incontinence of bowel and bladder and requires assistance with all activities of daily living (ADLs).
Novolin R per sliding scale *NEW*
Upon arrival you are greeted by Champ, the couple’s rambunctious miniature Doberman pinscher dog. Millie is in her wheelchair staring blankly out the window, and Fred is busy in the kitchen preparing the couple’s lunch.
Based on the scenario above, please use the general survey process to describe the areas that you would be observing immediately upon entry to the home.
What, if any, concerns related to Millie’s skin and nutritional status do you have?
What nursing interventions will you include in the plan of care to address these concerns?
What teaching strategies will you use to educate Millie and Fred on the new medications?
Assessing : The Neurological Systemt.
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