Table of Contents
Cover
Table of Contents
Half title page
Title page
Copyright page
Contributor List
Preface
Acknowledgements
Section I: Anatomy and Physiology of the Nervous System
1 Cells of the CNS and How They Communicate
INTRODUCTION
COMPONENTS OF THE NEURONE AND THEIR FUNCTIONS
NEUROGLIA
COMMUNICATION BY NEURONES
NEUROTRANSMISSION
SUMMARY
2 The Structural and Biochemical Defences of the CNS
INTRODUCTION
BONY ENCASEMENT
THE MENINGES AND CEREBROSPINAL FLUID (CSF)
BLOOD SUPPLY TO THE CNS
THE BLOOD–BRAIN BARRIER (BBB)
SUMMARY
3 The Anatomy and Physiology of the Brain
INTRODUCTION
DESCRIBING ANATOMICAL STRUCTURES
FOETAL DEVELOPMENT OF THE BRAIN
THE GROSS ANATOMY OF THE BRAIN
CEREBRUM
FRONTAL LOBE
PARIETAL LOBE
TEMPORAL LOBE
OCCIPITAL LOBE
LIMBIC SYSTEM
AMYGDALA
HIPPOCAMPUS AND MEMORY
MAMILLARY BODIES
SEPTUM PELLUCIDUM
CINGULATE GYRUS, INSULA AND PARAHIPPOCAMPAL GYRUS
CEREBELLUM
BASAL GANGLIA AND THE THALAMUS
THE HYPOTHALAMUS
PITUITARY GLAND (HYPOPHYSIS)
BRAIN STEM
RETICULAR FORMATION AND RETICULAR ACTIVATING SYSTEM
SUMMARY
4 The Spinal Cord
INTRODUCTION
GROSS ANATOMY
PHYSIOLOGY
SUMMARY
5 The Autonomic Nervous System
INTRODUCTION
ANATOMY
NEUROTRANSMITTERS AND RECEPTORS
THE SENSORY COMPONENT
THE ENTERIC NERVOUS SYSTEM
VISCERAL PAIN
THE FUNCTION OF THE AUTONOMIC NERVOUS SYSTEM
THE HYPOTHALAMUS
THE AUTONOMIC NERVOUS SYSTEM, EMOTION AND THE CONSCIOUS BRAIN
SUMMARY
6 Intracranial Physiology
INTRODUCTION
INTRACRANIAL PRESSURE
CEREBRAL BLOOD FLOW (CBF)
OXYGEN AND GLUCOSE REQUIREMENTS
SUMMARY
Section II: Assessment, Interpretation and Management of Specific Problems in the Neurological Patient
7 Assessment and Management of Raised Intracranial Pressure
INTRODUCTION
CAUSES OF RAISED ICP
SIGNS AND SYMPTOMS
INVESTIGATIONS
ASSESSMENT
TREATMENT OF RAISED ICP
GENERAL MEASURES AND NURSING CARE FOR PATIENTS WITH RAISED ICP OR SUSPECTED RAISED ICP
FIRST LINE MEASURES TO REDUCE ICP
SUMMARY
8 Assessment, Interpretation and Management of Altered Consciousness
INTRODUCTION
CONSCIOUSNESS
SLEEP
ASSESSMENT OF CONSCIOUSNESS
INTERPRETATION OF GCS FINDINGS
ALTERED STATES OF CONSCIOUSNESS
BRAIN STEM DEATH
NURSING MANAGEMENT OF A PATIENT WITH ALTERED CONSCIOUSNESS
NURSING MANAGEMENT OF A PATIENT WITH BRAIN STEM DEATH
SUMMARY
9 Assessment, Interpretation and Management of Impaired Cognition
INTRODUCTION
PHYSIOLOGY OF COGNITION
PATHOPHYSIOLOGY AND ALTERED COGNITION
AETIOLOGY AND PRESENTATION OF DELIRIUM
ASSESSING PATIENTS WITH IMPAIRED COGNITION
INTERPRETATION OF ASSESSMENT FINDINGS
NURSING MANAGEMENT OF DELIRIUM
MULTIDISCIPLINARY TEAMWORKING
POST-DELIRIUM COUNSELLING
SUMMARY
10 Assessment and Management of Challenging Behaviour
INTRODUCTION
PATHOPHYSIOLOGY
EPIDEMIOLOGY
ASSESSMENT
MANAGEMENT
ENVIRONMENTAL AND BEHAVIOURAL MANAGEMENT STRATEGIES
STAFF INTERACTIONS AND BEHAVIOURS
PHARMACOLOGICAL MANAGEMENT
PHYSICAL RESTRAINT
SUMMARY
11 Assessment, Interpretation and Management of Altered Perceptual, Motor and Sensory Function
INTRODUCTION
SENSATION
SENSORY ASSESSMENT
SENSORY IMPAIRMENT
PHYSIOLOGY OF MOVEMENT
ASSESSMENT OF MOVEMENT
ABNORMAL MOVEMENTS AND MOVEMENT DISORDERS
SPASTICITY, RIGIDITY AND CONTRACTURE
NURSING CARE OF THE PATIENT WITH MOTOR IMPAIRMENT
SPECIFIC NURSING MANAGEMENT OF SPASTICITY
SPECIFIC NURSING MANAGEMENT OF FLACCIDITY
SUMMARY
12 Assessment, Interpretation and Management of Altered Speech and Swallowing
INTRODUCTION
OVERVIEW OF ALTERED SPEECH
THE ASSESSMENT AND INTERPRETATION OF COMMUNICATION
ASSESSMENT OF COMMUNICATION
NURSING MANAGEMENT OF ALTERED COMMUNICATION
MEDICAL MANAGEMENT RELATED TO ALTERED COMMUNICATION
OVERVIEW OF ALTERED SWALLOWING (DYSPHAGIA)
AETIOLOGY OF NEUROGENIC DYSPHAGIA
ASSESSMENT OF DYSPHAGIA
NURSING MANAGEMENT OF DYSPHAGIA
SUMMARY
13 Assessment, Interpretation and Management of Cranial Nerve Dysfunction
INTRODUCTION
FUNCTIONS OF THE CRANIAL NERVES
TESTING CRANIAL NERVES AND INTERPRETING FINDINGS
CRANIAL NERVE DISORDERS
MEDICAL AND NURSING MANAGEMENT OF COMMON CRANIAL NERVE DISORDERS
SUMMARY
14 Assessment, Interpretation and Management of Altered Cardiovascular Status in the Neurological Patient
INTRODUCTION
HAEMODYNAMICS
AUTONOMIC CONTROL OF HAEMODYNAMICS
HAEMODYNAMIC ASSESSMENT
TEMPERATURE
HAEMODYNAMIC EFFECTS OF NERVOUS SYSTEM DISEASE
BRAIN STEM DEATH
AUTONOMIC EFFECTS OF PERIPHERAL NERVE DISEASE
TEMPERATURE ABNORMALITIES AND NERVOUS SYSTEM DISEASE
SUMMARY
15 Assessment, Interpretation and Management of Impaired Respiratory Function in the Neurological Patient
INTRODUCTION
PHYSIOLOGY
ASSESSMENT OF RESPIRATORY FUNCTION
MONITORING AND INVESTIGATION OF RESPIRATORY FUNCTION
ACID–BASE BALANCE
DISTURBANCES OF ACID–BASE BALANCE
NURSING CARE/MANAGEMENT
RESPIRATORY SUPPORT
NON-INVASIVE RESPIRATORY SUPPORT
SUCTIONING
ASSISTED COUGH
SUMMARY
16 Assessment and Management of Fluid, Electrolytes and Nutrition in the Neurological Patient
INTRODUCTION
PHYSIOLOGY OF FLUID AND ELECTROLYTE BALANCE
FLUID ASSESSMENT IN THE NEUROSCIENCE PATIENT
FLUID MANAGEMENT
MANAGEMENT OF COMMON CAUSES OF HYPONATRAEMIA IN THE NEUROLOGICAL PATIENT
MANAGEMENT OF COMMON CAUSES OF HYPERNATRAEMIA IN THE NEUROLOGICAL PATIENT
NUTRITION IN THE NEUROSCIENCE PATIENT
BIOCHEMICAL AND PHYSICAL ASSESSMENT
MECHANISMS OF NUTRITIONAL SUPPORT
SUMMARY
17 Assessment and Management of Pain
INTRODUCTION
DEFINING PAIN
PHYSIOLOGY OF PAIN
SOMATIC AND VISCERAL PAIN
NEUROPATHIC PAIN
ASSESSMENT OF PAIN
HEADACHE
MEDICAL AND NURSING MANAGEMENT OF PAIN
MANAGEMENT OF HEADACHE
MANAGEMENT OF NEUROPATHIC, SOMATIC AND VISCERAL PAIN
SUMMARY
18 Assessment and Management of Bladder and Bowel Problems
INTRODUCTION
PHYSIOLOGY OF MICTURITION
URINARY SYMPTOMS AND INCONTINENCE
NEUROLOGICAL CONDITIONS AND BLADDER DYSFUNCTION
ASSESSMENT OF BLADDER FUNCTION
MEDICAL AND NURSING MANAGEMENT OF URINARY INCONTINENCE
PHYSIOLOGY OF DEFECATION
NEUROLOGICAL CONDITIONS AND BOWEL DISORDERS
ASSESSING BOWEL FUNCTION
BOWEL MANAGEMENT PROGRAMMES
SUMMARY
Section III: Neurological Investigations and Neurosurgical Procedures
19 Neurological Investigations
INTRODUCTION
STRUCTURAL NEUROIMAGING: CRANIAL STRUCTURES
STRUCTURAL NEUROIMAGING: SPINAL STRUCTURES
FUNCTIONAL NEUROIMAGING
NEUROPHYSIOLOGY
BIOPSIES
LUMBAR PUNCTURE (LP)
SUMMARY
20 Common Neurosurgical Procedures
INTRODUCTION
GENERAL PRE-OPERATIVE NURSING MANAGEMENT
IMMEDIATE PRE-OPERATIVE PREPARATION
OVERVIEW OF SURGICAL PROCEDURES
POST-OPERATIVE NURSING MANAGEMENT FOR ALL NEUROSURGICAL PATIENTS
SPECIFIC POST-OPERATIVE NEUROSURGICAL NURSING CARE
SUMMARY
Section IV: Management of Patients with Intracranial Disorders and Disease
21 Management of Patients with Intracranial Tumours
INTRODUCTION
EPIDEMIOLOGY
PATHOPHYSIOLOGY
AETIOLOGY
OVERVIEW OF TUMOUR TYPES AND CLASSIFICATION
COMMON TYPES OF TUMOUR: GLIOMA, MENINGIOMA AND METASTASES
CLINICAL SIGNS AND SYMPTOMS
DIAGNOSIS
TREATMENT
SPECIFIC TREATMENT FOR EACH TYPE OF TUMOUR
LESS COMMON TYPES OF TUMOUR
PITUITARY TUMOURS
FUNCTIONING PITUITARY TUMOURS
NON-FUNCTIONING PITUITARY TUMOURS
RARE TUMOURS INVOLVING THE PITUITARY GLAND
VESTIBULAR SCHWANNOMA – ACOUSTIC NEUROMA
RARE TUMOURS: INCIDENCE OF LESS THAN 1–2 PER MILLION PER YEAR
SERVICE GUIDANCE FOR THE MANAGEMENT OF PATIENTS WITH BRAIN TUMOURS
NURSING CARE AND MANAGEMENT
CARE OF THE PATIENT UNDERGOING RADIOTHERAPY
CARE OF THE PATIENT UNDERGOING CHEMOTHERAPY
CARE OF THE PATIENT UNDERGOING STEROID THERAPY
SUMMARY
22 Management of Patients with Stroke and Transient Ischaemic Attack
INTRODUCTION
DEFINITIONS
EPIDEMIOLOGY
AETIOLOGY
RISK FACTORS
PATHOPHYSIOLOGY
CLINICAL SIGNS AND SYMPTOMS OF STROKE
DIAGNOSIS
MEDICAL MANAGEMENT OF STROKE AND TIA
SURGICAL MANAGEMENT OF STROKE AND TIA
EVIDENCE-BASED NURSING MANAGEMENT
STROKE REHABILITATION
SUMMARY
23 Management of Patients with Intracranial Aneurysms and Vascular Malformations
INTRODUCTION
ANEURYSMS
INCIDENCE OF ANEURYSMS
AETIOLOGY OF ANEURYSMS
OTHER CAUSES OF SPONTANEOUS SUBARACHNOID HAEMORRHAGE (SAH)
SIGNS AND SYMPTOMS OF ANEURYSMAL SAH
DIAGNOSIS
NURSING AND MEDICAL MANAGEMENT OF THE PATIENT WITH AN ANEURYSMAL SAH
EXTRACRANIAL COMPLICATIONS ASSOCIATED WITH SAH
TREATMENT OF THE ANEURYSM
SPECIFIC NURSING MANAGEMENT TO MONITOR/TREAT FOR POST-COILING COMPLICATIONS
PROGNOSTIC FACTORS
OUTCOMES
ARTERIOVENOUS MALFORMATIONS
INCIDENCE
AETIOLOGY
PRESENTATION SIGNS AND SYMPTOMS
TREATMENT
NURSING MANAGEMENT
OUTCOMES
OTHER VASCULAR MALFORMATIONS
SUMMARY
24 Management of Patients with Central Nervous System Infections
ACUTE BACTERIAL MENINGITIS
AETIOLOGY AND EPIDEMIOLOGY
PATHOPHYSIOLOGY
CLINICAL SIGNS AND SYMPTOMS
DIAGNOSIS
MEDICAL MANAGEMENT AND TREATMENT
NURSING MANAGEMENT
TRANSMISSION
PROGNOSIS
PHYSICAL, COGNITIVE AND PSYCHOSOCIAL IMPAIRMENTS FOLLOWING MENINGITIS
SUPPORT
SUBACUTE MENINGITIS
ENCEPHALITIS
EPIDEMIOLOGY AND AETIOLOGY
PATHOPHYSIOLOGY
CLINICAL SIGNS AND SYMPTOMS
DIAGNOSIS
MEDICAL MANAGEMENT
NURSING MANAGEMENT
PROGNOSIS
PHYSICAL, COGNITIVE AND PSYCHOSOCIAL IMPAIRMENTS FOLLOWING ENCEPHALITIS
FURTHER INFORMATION
CEREBRAL ABSCESS
AETIOLOGY AND EPIDEMIOLOGY
PATHOPHYSIOLOGY
CLINICAL SIGNS AND SYMPTOMS
DIAGNOSIS AND MEDICAL MANAGEMENT
NURSING MANAGEMENT
PROGNOSIS
NEUROLOGICAL COMPLICATIONS OF HUMAN IMMUNODEFICIENCY VIRUS (HIV)
EPIDEMIOLOGY OF HIV
PATHOPHYSIOLOGY
CLINICAL SIGNS AND SYMPTOMS
DIAGNOSIS AND INVESTIGATIONS
MEDICAL MANAGEMENT AND DRUGS
NURSING MANAGEMENT
SUMMARY
25 Management of Patients with Hydrocephalus
INTRODUCTION
EPIDEMIOLOGY
AETIOLOGY AND PATHOPHYSIOLOGY
CLINICAL SIGNS AND SYMPTOMS
INVESTIGATIONS
TREATMENT
MEDICAL MANAGEMENT
NURSING MANAGEMENT
SUMMARY
Section V: Management of Patients with Long-Term Conditions
26 Management of Patients with Common Movement Disorders
PARKINSON’S DISEASE
INTRODUCTION
EPIDEMIOLOGY
AETIOLOGY
PATHOPHYSIOLOGY
CLINICAL SIGNS AND SYMPTOMS
DIAGNOSIS
MEDICAL MANAGEMENT
NURSING MANAGEMENT
PARKINSON PLUS DISORDERS
DYSTONIA
EPIDEMIOLOGY
AETIOLOGY
PATHOPHYSIOLOGY
SIGNS AND SYMPTOMS
DIAGNOSIS
MEDICAL MANAGEMENT
NURSING MANAGEMENT
HUNTINGTON’S DISEASE (HD)
EPIDEMIOLOGY
AETIOLOGY
PATHOPHYSIOLOGY
SIGNS AND SYMPTOMS
CLINICAL VARIANTS
DIAGNOSIS
MEDICAL MANAGEMENT
NURSING MANAGEMENT
SUMMARY
FURTHER INFORMATION
27 Management of Patients with Motor Neurone Disease
INTRODUCTION
EPIDEMIOLOGY
AETIOLOGY
PATHOPHYSIOLOGY
CLINICAL SIGNS AND SYMPTOMS
DIAGNOSIS
MEDICAL MANAGEMENT
EVIDENCE-BASED NURSING MANAGEMENT
PSYCHOSOCIAL ISSUES
PALLIATIVE AND END OF LIFE CARE
EXPERIMENTAL TREATMENTS/ CLINICAL TRIALS
SUMMARY
USEFUL CONTACTS
28 Management of Patients with Multiple Sclerosis
INTRODUCTION
EPIDEMIOLOGY
AETIOLOGY
PATHOPHYSIOLOGY
CLASSIFICATION/TYPES OF MS
CLINICAL SIGNS AND SYMPTOMS
DIAGNOSIS
STAGES OF MS
MEDICAL MANAGEMENT
NURSING MANAGEMENT IN THE DIAGNOSTIC PHASE
NURSING MANAGEMENT IN RELAPSE AND ACUTE EPISODE PHASE
NURSING MANAGEMENT IN PROGRESSIVE PHASE
NURSING MANAGEMENT FOR PEOPLE WITH ADVANCED MS
ROLE OF THE MS SPECIALIST NURSE (MSSN)
SUMMARY
29 Management of Patients with Dementias
INTRODUCTION
EPIDEMIOLOGY
AETIOLOGY
PATHOPHYSIOLOGY
CLINICAL SIGNS AND SYMPTOMS
DIAGNOSIS
MEDICAL MANAGEMENT
NURSING MANAGEMENT
SUMMARY
FURTHER INFORMATION
30 Management of Patients with Epilepsy
INTRODUCTION
INCIDENCE
AETIOLOGY
PATHOPHYSIOLOGY
SEIZURE CLASSIFICATION
CLASSIFICATION OF EPILEPSIES
DIAGNOSIS
MEDICAL MANAGEMENT
NURSING MANAGEMENT OF SEIZURES
SEIZURE MANAGEMENT IN THE HOME
INFORMATION PROVISION
REDUCING SEIZURE OCCURRENCE
SUMMARY
31 Management of Patients with Myasthenia Gravis
INTRODUCTION
EPIDEMIOLOGY
AETIOLOGY
PATHOPHYSIOLOGY
OTHER MYASTHENIC SYNDROMES
CLINICAL FEATURES OF MYASTHENIA GRAVIS
DIAGNOSIS
MEDICAL MANAGEMENT
MYASTHENIC CRISIS
CHOLINERGIC CRISIS
NURSING MANAGEMENT
PSYCHOSOCIAL ISSUES
PROGNOSIS
EMERGING TREATMENTS AND CLINICAL TRIALS
SUMMARY
ACKNOWLEDGEMENTS
Section VI: Management of Patients Following Head and Spinal Trauma
32 Management of Patients with Traumatic Brain Injury
INTRODUCTION
EPIDEMIOLOGY
AETIOLOGY
CLASSIFICATION
OVERVIEW OF PRIMARY AND SECONDARY INJURY
PATHOPHYSIOLOGY
DIAGNOSIS
ASSESSMENT AND MANAGEMENT
NEURO-REHABILITATION: ACUTE PHASE
NEURO-REHABILITATION: ONGOING PHYSICAL PROBLEMS
PROGNOSIS
THE FUTURE
SUMMARY
33 Management of Patients with Spinal Injury
INTRODUCTION
EPIDEMIOLOGY
AETIOLOGY
MECHANISMS OF INJURY
PATHOPHYSIOLOGY
PRIORITISING MEDICAL INTERVENTIONS
NURSING MANAGEMENT OF THE ACUTE SCI PATIENT
NURSING ROLE AND RESPONSIBILITIES WITHIN SCI REHABILITATION PROGRAMMES
FUTURE RESEARCH
SUMMARY
USEFUL WEBSITES
Section VII: Management of Patients with Neuropathies and Spinal Disorders and Disease
34 Management of Patients with Disorders of the Vertebral Column and Spinal Cord
INTRODUCTION
AETIOLOGY AND PATHOPHYSIOLOGY
SIGNS AND SYMPTOMS
DIAGNOSIS
INVESTIGATIONS
MEDICAL MANAGEMENT
NURSING MANAGEMENT
COMPLICATIONS FOLLOWING SPINAL SURGERY
POST-OPERATIVE NURSING MANAGEMENT
GENERAL NURSING MEASURES
REHABILITATION
SPECIAL CONSIDERATIONS IN NURSING PATIENTS WITH MALIGNANT SPINAL CORD COMPRESSION (MSCC)
SUMMARY
35 Management of Patients with Guillain–Barré Syndrome and Other Peripheral Neuropathies
INTRODUCTION
EPIDEMIOLOGY
AETIOLOGY
PATHOPHYSIOLOGY
SUB-TYPES OF GUILLAIN–BARRÉ SYNDROME
SIGNS AND SYMPTOMS
DIAGNOSIS
MEDICAL MANAGEMENT
NURSING MANAGEMENT
NURSING MANAGEMENT IN THE ACUTE PHASE
REHABILITATION
SUMMARY
Section VIII: Fundamental Concepts of Neuroscience Nursing
36 Ethical and Legal Issues
INTRODUCTION
ETHICS
LAW
LAW AND ETHICS IN NURSING
CONSENT AND MENTAL CAPACITY
HUMAN RIGHTS
RESOURCE ALLOCATION
RISK MANAGEMENT
END OF LIFE CARE
SUMMARY
37 The History and Development of Neuroscience Nursing
THE BACKGROUND TO A DEVELOPING SPECIALISM
BIRTH OF A SPECIALISM
EPILEPSY
THE NEED FOR EDUCATION
A CONTINUALLY DEVELOPING SPECIALISM
SUMMARY
Index
