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Download Disease & Drug Consult: Neurologic Disorders by Lippincott PDF

By Lippincott

Disease & Drug Consult is a distinct new sequence of handbooks that mix ailment monographs plus monographs on medicinal drugs used to regard ailments. each one Disease & Drug Consult e-book makes a speciality of a particular physique method and has sections. half 1 provides illnesses alphabetically, with an outline, reasons & occurrence, symptoms & indicators, issues, analysis, therapy together with medications used to regard the ailment and the cause of utilizing every one drug, and distinct concerns. half 2, additionally geared up alphabetically, bargains entire drug monographs for every drug pointed out within the disorder part. within the Neurologic Disorders quantity, for instance, the nurse can learn an entire description of advanced nearby discomfort syndrome, then flip to the drug monographs for a whole dialogue of every of the medicine used to regard that disease.

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For other astrocytomas, treatment consists of repeated surgery, radiation therapy, and shunting of fluid from ob structed CSF pathways. Radiation therapy works best in radiosensitive astrocytomas; some astrocytomas are radioresistent. qxd 1/7/09 8:58 AM Page 43 Brain tumor, malignant 43 Assessment findings General Ⅲ Increased ICP Localizing Ⅲ Brain and cerebrum: papilledema, nystagmus, hearing loss, perception of flashing lights, dizziness, ataxia, paresthesia of face, cranial nerve palsies (V, VI, VII, IX, X, primarily sensory), hemiparesis, suboccipital tenderness; compression of supratentorial area produces other general and focal symptoms General Ⅲ Headache Ⅲ Seizures (in two-thirds of patients) Ⅲ Vomiting Ⅲ Changes in mental activity Ⅲ Other assessment findings similar to those of schwannomas Localizing Ⅲ Skull changes (bony bulge) over tumor Ⅲ Sphenoidal ridge, indenting optic nerve: unilateral Ⅲ Vision changes and papilledema Ⅲ Prefrontal parasagittal: personality and behavioral changes Ⅲ Motor cortex: contralateral motor changes Ⅲ Anterior fossa compressing both optic nerves and frontal lobes: headaches and bilateral vision loss Ⅲ Pressure on cranial nerves, causing varying symptoms General Ⅲ Unilateral hearing loss with or without tinnitus Ⅲ Stiff neck and suboccipital discomfort Ⅲ Secondary hydrocephalus Ⅲ Ataxia and uncoordinated movements of one or both arms due to pressure on brain stem and cerebellum Localizing Ⅲ V: early signs including facial hypoesthesia and paresthesia on the side of hearing loss; unilateral loss of corneal reflex Ⅲ VI: diplopia Ⅲ VII: paresis progressing to paralysis (Bell’s palsy) Ⅲ X: weakness of palate, tongue, and nerve muscles on same side as tumor resection and radiation therapy.

Muscle transfer procedures may be needed to improve function of the wrist or other joints. Children with milder forms of CP should attend a regular school; severely afflicted children m y need special education. A gastrostomy tube may be needed to provide adequate nutrition if oromotor dysfunction exists. Pharmacotherapy helps reduce symptoms, prevent complications, and improve quality of life. qxd 1/7/09 8:59 AM Page 57 Cerebral palsy ● Levodopa/carbidopa (Sinemet) in advanced CP to help control muscle spasticity ● Trihexyphenidyl (Artane) to help control muscle tremors ● Botulinum toxin type A (Botox) to control excessive, abnormal muscle contractions ● Baclofen (Lioresal) to relax muscles SPECIAL CONSIDERATIONS ● Provide care in a unhurried man- ner to avoid increasing muscle spasticity.

During meals, maintain a quiet, unhurried atmosphere with as few distractions as possible. The child should be encouraged to feed himself and may need special utensils and a chair with a solid footrest. Teach him to place food far back in his mouth to facilitate swallowing. Stroking the throat may also aid swallowing. Observe for aspiration. ● Encourage the child to chew food thoroughly, drink through a straw, and suck on lollipops to develop the muscle control needed to minimize drooling. ● Allow the child to wash and dress independently, assisting only as 57 needed.

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