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LMU NURS 241 - Lesson Plan: Alterations In Neurological Function

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Lincoln Memorial UniversityCaylor School of NursingNURS 2411Lincoln Memorial UniversityCaylor School of NursingNURS 241Spring 2010LESSON PLAN: Nursing Strategies: Alterations in Neurological FunctionDATES: See class syllabusTIMES: See class syllabusOBJECTIVES: Upon completion of this unit, the student will be able to demonstrate, in clinical/ campus laboratory settings, in individual and group conferences, and on written materials, the ability to:1. Describe structure and function of the sensory organs and nervous system.2. Explain basic pathophysiology of increased intracranial pressure 3. Utilize the Roy Adaptation Model (RAM) nursing process to collect appropriate history and physical exam on adults experiencing alterations in neurologic function.4. Identify the clinical significance and related nursing implications of laboratory and diagnostic testsand procedures used for assessment and evaluation of neurological function.5. Describe: risk factors, causes, prevention, pathophysiology, complications, clinical manifestations,and management of adults experiencing common neurological disorders.6. Identify neurological emergencies and appropriate nursing interventions.7. Utilizing the RAM nursing process, identify nursing diagnosis associated with and develop a care plan for adults experiencing neurological dysfunction.8. Describe pharmacologic agents used in care of clients with neurological dysfunction (including safe dosage calculation, side effects/toxic effects, and the nursing implications for their use).9. Identify corrective and rehabilitative measures and community resources for persons with neurological disorders.10. Specify health maintenance--health promotion needs in regard to adults with ineffective responses to neurological function.11. Identify psychosocial effects of neurological dysfunction on adults and their families and describe appropriate nursing interventions.12. Define terminology utilized in caring for adults with neurological disorders (as identified in the vocabulary lists at the beginning of each assigned reading chapter and throughout the chapters).13. Provide teaching/learning to adults to promote adaptation when faced with neurological dysfunction.Rev 12/092CLINICAL OBJECTIVES: 1. Perform neurosensory assessment on assigned patient. 2. Provide appropriate teaching/learning to the adult undergoing neurosensory diagnostic evaluation. 3. Monitor lab values/test results pertinent to neurosensory function of assigned patient. 4. Utilize nursing process to provide care for patient having an alteration in neurosensory function. 5. Participate in discharge planning for adults with neurosensory disorder. 6. Utilize the RAM nursing process to develop comprehensive nursing care plans for the adult experiencing increased intracranial pressure.7. Identify safety needs of assigned adult with neurosensory impairment and implement nursing measure to prevent injury.TOPICAL OUTLINE: I. Assessment of Neurologic Function – student to review anatomy and physiology in chapter 60 A. Neurologic examination (See handout attached to lesson plan. Review physical assessment from NURS 115) 1. Health history 2. Clinical manifestations 3. Physical examination 4. Gerontologic considerations B. Diagnostic evaluation (See handout attached to lesson plan) 1. CT 2. PET 3. SPECT 4. MRI 5. Cerebral angiography 6. Myelography 7. Blood flow studies 8. EEG 9. EMG 10. Nerve conduction studies 11. Lumbar punctureII. Nursing Strategies R/T Neurologic Dysfunction A. Care of patients with altered level of consciousness B. Care of patients with increased intracranial pressure C. Care of patients with intracranial surgery D. Care of patients with headache - Primary (migraine)III. Nursing Strategies R/T Cerebrovascular Disorders A. Care of patients with ischemic (thrombotic) strokeB. Care of patients with hemorrhagic stroke1. Intracranial bleeding2. Subarachnoid bleeding3. Aneurysms Rev 12/093IV. Nursing Strategies R/T Neurologic Trauma A. Care of patients with head injury B. Care of patients with traumatic brain injury 1. Concussion 2. Contusion 3. Diffuse Axonal Injury (DAI) 4. Intracranial hemorrhage a. Epidural hematoma b. Subdural hematoma B. Care of patients with spinal cord injuryIV. Nursing Strategies R/T Neurologic Infections, Autoimmune Disorders and Neuropathies A. Care of patients with infectious neurologic disorders (Brain Abscess)A. Care of patients with Multiple SclerosisB. Care of patients with Myasthenia gravisC. Care of patients with Guillain-Barre’ SyndromeD. Care of patients with Trigeminal neuralgia (Tic Douloureux)E. Care of patients with Bell’s PalsyV. Nursing Strategies R/T Oncologic or Degenerative Neurologic DisordersA. Care of patients with Neurologic Cancers (Brain, Spine, primary and metastasis) B. Care of patients with Parkinson’s diseaseC. Care of patients with Huntington’s diseaseD. Care of patients with amyotrophic lateral sclerosis (ALS)E. Care of patients with disc disorders REQUIRED READINGS:Smeltzer, S. C., Bare, B. G., Hinkle, J.L., & Cheever, K.H. (2008). Brunner and Suddarth’s textbook of medical – surgical nursing. (11th ed.). Philadelphia: Lippincott, Williams & Wilkins. Chapters:- 60- 61 (pp 2160 – 2189; 2198 – 2204) – Seizures and Epilepsy will be covered in NURS 245- 62 (pp 2205 – 2231)- 63 (pp 2232 – 2268)- 64 (pp 2273 – 2274, 2277 – 2298) – Meningitis and Encephalitis will be covered in NURS 245- 65 (pp 2300 – 2331) – Muscular Dystrophy will be covered in NURS 245Kee, J. L., Hayes, E. R., & McCuistion, L. E. (2009). Pharmacology: A nursing process approach.(6th ed.). St. Louis: Saunders, Elsevier, Inc.Chapters:Rev 12/094- 19 (pp 304 – 306)- 20 (pp 309 – 317)- 22 (pp 331 – 343)- 23 (pp 344 – 352)Wissmann, J. (Ed.). Adult Medical-Surgical Nursing: Content mastery series review module (Ed 7.1). Kansas City, MO: Assessment Technologies Institute, LLC. Ch 78-79; 81-90.Medication ListIncreased ICP and Spinal Cord Injury-


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LMU NURS 241 - Lesson Plan: Alterations In Neurological Function

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