Neurological alterations are mainly characterized by the numerous difficulties resulting from acute illnesses such as brain and spinal cord injury. The changes have made it hard to provide effective care to people with other underlying health disorders worldwide (Bohmwald et al., 2018). Therefore, this paper will discuss medical management, teaching, cultural considerations, and nursing interventions for increased intracranial pressure, skull fractures, spinal cord injury, cerebrovascular disease, and Status epilepticus.
Increased Intracranial Pressure
Medical management of increased intracranial pressure includes sedation, osmotherapy, and Cerebrospinal fluid (CSF) drainage using hypertonic saline. CSF help reduce the intracranial volume in the short term and allows the edema fluid to drain into the ventricular system (Changa et al., 2019). Sedation involves the use of sedatives to reduce cerebral blood volume. Osmotherapy involves the usage of a hyperosmolar agent to reduce intracranial pressure through volume redistribution.
Patients and their families need to be informed about reducing the risk of underlying conditions that may result in increased intracranial pressure. First, a patient may be advised to avoid smoking, manage their blood sugar levels, and many more. Second, a patient and family should be informed that high blood pressure is a risk factor for increased intracranial pressure (Changa et al., 2019). This information is integral to the effective management of the condition.
When caring for patients with this condition, cultural aspects of the patient should be taken into consideration. One of the cultural concepts to consider is language barriers. It is important to understand any barrier that may hinder communication. The other cultural consideration is a belief in alternative medication for the condition (Changa et al., 2019). Some of the communities have ways to reduce the increased intracranial pressure conventionally.
Nursing Interventions and Rationale
The three nursing interventions for increased intracranial pressure are maintaining the position of the patient’s neck, elevating the head to an angle of 30 degrees, and maintaining an average body temperature (Changa et al., 2019). The interventions are quick techniques for preventing further increased pressure in the skull. The interventions mentioned should be employed to manage the condition and reduce pressure. The measures help manage the patient’s condition and stabilize them before being taken to radiology for brain imaging.
The purpose of medical management of skull fractures is to control pain, enhance healing and prevent complications. Most skull fractures are usually managed through surgery to rectify the problem. One of the most common surgery performed to treat severe head injuries is a craniotomy (Vincent et al., 2019). During a craniotomy, a hole in the skull is created to provide the surgeon access to the brain.
Teaching plays an integral role when caring for patients with skull fractures. There is a need for patients and families to understand that skull fractures happen when an individual’s head is subjected to a strong force to break the skull bone (Vincent et al., 2019). As a result, patients and families should be informed about preventive measures, such as wearing protective headgear while riding a bicycle, which may help avoid a skull fracture.
Culture determines a patient’s expectations and interactions with physicians during care. The first cultural consideration is a language barrier through body language and actual variations in a language spoken. The second cultural consideration is family involvement during care. There are some cultures where involving extended family can play a significant role. Health providers should consider engaging a patient’s family when providing care in such cultures.
The three nursing interventions assess cranial nerve function, assess swallowing prior to giving anything through the mouth, and administer prescribed medication. For example, when performing a comprehensive examination for a skull fracture, a nurse may assess the functioning of the cranial nerves (Vincent et al., 2019). In addition, a nurse should determine whether the patient is capable of swallowing before using the mouth as a medium.
The identified nursing interventions help in the recovery of the patient. Assessing the cranial nerve help provide early and detailed information about brain injury. Skull fractures carry a high risk of cranial nerve damage (Vincent et al., 2019). Due to muscle weakness, a patient may have a problem with swallowing. Conducting speech therapy to assess swallowing is an important intervention to avoid aspiration. Administering prescribed drugs is crucial for eliminating severe symptoms such as pain.
Spinal Cord Injury
There is a need for emergency surgery for a spinal cord injury, especially if there is trauma to another part of the body. Laminotomy is a common type of surgery conducted for spinal cord injury (Donovan & Kirshblum, 2018). It involves the surgical elimination of bone to decompress the spinal cord nerves. The surgery can address spinal cord damage from broken bones, damaged tissues, and blood clots.
Teaching is important for the effective management of spinal cord injuries. Families and close friends of patients with spinal cord injuries should recognize that they play an important role depending on the degree of the injury (Donovan & Kirshblum, 2018). As part of their physical therapy program, they should assist them with changing postures and managing pain. Thus, psychosocial support can help people make more informed decisions and cope better with the condition.
Cultural sensitivity is vital for efficient healthcare provision. Healthcare providers should understand the culture of the patients on family involvement. If the culture promotes family involvement, the provider should make sure that families offer psychosocial support to the patient (Donovan & Kirshblum, 2018). In addition, physical therapy should align with a patient’s culture to promote healing. Thus, integrating culture with treatment helps in the effective provision of healthcare services.
There are various nursing interventions used during the management of spinal cord injuries. The first intervention is the maximization of respiratory function for the patient. For example, a nurse should ensure that patients breathe effectively (Donovan & Kirshblum, 2018). The second nursing intervention is promoting patient mobility during care. The third intervention performed by nurses provides support for patients’ psychological improvement. These interventions are crucial for the effective management of the condition.
Nurses use these interventions to enhance recovery and avoid further spinal cord damage in the patient. They provide additional assistance to these individuals to promote independence while minimizing problems. For example, they promote patients’ mobility to enable them to move without any assistance (Donovan & Kirshblum, 2018). In addition, the nurses offer psychosocial support to patients to promote healing and recovery. Thus, the interventions help in the attainment of quality care for patients.
Medical management of cerebrovascular disease includes lifestyle changes, medication use, and surgery. A healthcare provider may suggest a healthy diet, exercise, and smoking cessation (Khaku & Tadi, 2020). Medications such as anticoagulants may aid lower the risk of severe complications from cerebrovascular disease. Surgery may also be used in situations of leakages in the brain. Therefore, these procedures are crucial in the effective management of the disease.
The patients and families should be informed about cerebrovascular disease and what can be done to reduce the severity. They should be informed that the condition occurs when damage happens to a blood vessel in the brain (Khaku & Tadi, 2020). In addition, they should be told that smoking, obesity, blood pressure, lack of exercise, and poor diet are some of the risk factors for cerebrovascular disease.
There are various cultural aspects that should be considered during disease management. The first cultural considerations are language barriers because they can hinder effective care. A health provider should know their patient’s preferred method of communication and organize a solution if a problem is determined. The second consideration should be food culture because many cultures have specialized dietary considerations. A health provider should consider these cultural aspects for effective care provision.
Nursing interventions have a significant impact on patient recovery. One of the nursing interventions used for cerebrovascular diseases is positioning. Nurses should make sure that patients are placed in the right position (Khaku & Tadi, 2020). The other intervention is encouraging movement to make sure that the patient recovers fast. Another intervention is enhancing self-care, which is the ability of an individual to prevent and cope with illness without the help of a healthcare provider.
Nurses use interventions for the effective delivery of healthcare services to patients. They use positioning to prevent contractures and compressive neuropathies and relieve pressure on patients (Khaku & Tadi, 2020). Physical activity is also used to assist patients in maintaining joint mobility. Self-care is used to build resilience as well as eliminate anxiety and depression. Therefore, the interventions are used to help with the effective management of the disease.
Status epilepticus is a neurologic emergency that needs prompt management. The use of medication such as benzodiazepines helps in treating this condition. Benzodiazepines are a type of medicine that acts on the central nervous system, generates sedation and muscle relaxation, and reduces levels of anxiety (Crawshaw & Cock, 2020). In addition, surgery to get rid of a part of the brain causing seizures is used to manage the condition.
Teaching is an important practice for the effective management of status epilepticus. Patients and families should be informed that adherence to medical direction is integral during treatment (Crawshaw & Cock, 2020). For instance, they should understand that taking the medication as prescribed is mandatory. In addition, they should be advised on how to avoid severe injuries during seizure episodes. The patient requires close supervision and adequate attention to promote effective recovery.
Cultural aspects can affect the provision of healthcare to patients. There is a need to determine language barriers that may hinder proper communication. A healthcare provider should make sure that communication barriers are eliminated. The other aspect to consider is the misconception about status epilepticus. Some cultures perceive status epilepticus as evil. Therefore, there is a need to factor in these aspects during treatment.
Nursing Interventions and Rationale
The first intervention is keeping the bed in a low position while fencing up the edges. If the patient suffers a seizure, the nurses normally stay with him and monitor him. Nurses are aware of their role in managing status epilepticus and, as a result, implement primary interventions to prevent injury when the patient has seizures (Crawshaw & Cock, 2020). They also consider cushioning the patient to help them remain relaxed.
Neurological alterations have become a hindrance in providing effective care to people with other underlying illnesses. The changes are primarily defined by the numerous difficulties resulting from acute diseases such as brain and spinal cord injury and stroke. The problems are caused by a neurological malfunction in the body. Therefore, all neurological changes described here are considered medical emergencies, and the general public should be made aware of them.
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