Journal of neurosurgical nursing最新文献

Neurofibromatosis (NF) is a devastating illness which is extremely variable in its symptoms, intensity, and progression. Nursing literature has suffered markedly from lack of information on this important health care problem. This article is the result of an interface of the senior author's own personal experience with neurofibromatosis and an extensive review of international and multidisciplinary publications on the subject. The nurse can exert a profound impact on the care of the patient/family experiencing the crisis of neurofibromatosis.

Monitoring of somatosensory evoked potentials (SSEP) of head-injured patients is a frequent and interesting topic in the neuroscience nursing arena. Often, however, nursing involvement in the recording of somatosensory evoked potentials has been limited to observing the once a week procedure and documenting patient outcome. Active nursing involvement and input in this fast moving area of research has been developed in a large midwestern neuroscience center where nurses in the NICU are responsible for the continuous monitoring (24 hours a day) of somatosensory evoked potentials of the brain-injured patient. These nurses are accountable for an accurate clinical assessment of the patient, placement and upkeep of the monitoring equipment, and evaluation of the waveform for abnormalities. The purpose and physiology of the monitoring process and the aspects of nursing care will be discussed in this article.

Within the last ten years, twenty pregnant women with ruptured intracranial aneurysms were managed at Los Angeles County-University of Southern California Medical Center. Difficulties encountered in the care of these patients will be illustrated with case studies. In two patients, failure to diagnose subarachnoid hemorrhage delayed management. In another patient, cerebral vasospasm complicated the course. Selection of appropriate diagnostic tests, timing of surgery, importance of fetal monitoring, and method of delivery will be discussed.

Multiple sclerosis is one of the most common causes of chronic neurologic disease in adults. Although the exact pathogenesis of multiple sclerosis is unknown, evidence suggests that it is an autoimmune disease. Recent studies have shown a possible significant beneficial effect of cyclophosphamide in the treatment of multiple sclerosis. This article will discuss the rationale of immunosuppressive therapy and identify nursing measures required in such a clinical trial.

Establishment of an early rehabilitation program for patients with neurological/neurosurgical illness or injury is the focus of this article. The Neuroscience Clinical Nurse Specialist (NCNS) is identified as having a major responsibility in initiating early rehabilitation in the acute care setting. Development of the rehabilitation program is discussed through the NCNS's roles as educator, clinician, consultant, and researcher. Implementation of the rehabilitation program emphasizes the use of the nursing process, the role of the staff nurse, active patient and family participation, and use of the interdisciplinary team approach. General concepts rather than specific practices are used in order to present an overview of the role.

The brain is capable of mediating complex regulatory functions in the cardiopulmonary and gastrointestinal systems. Increased intracranial pressure may have detrimental effects not only upon cerebral structure and function but also upon the cardiopulmonary and gastrointestinal systems. Although the manifestations of systemic dysfunction produced by cerebral disease have been defined, the precise role of the interaction and interrelationship of increased intracranial pressure and the nervous system pathways to specific organ systems in delineating the mechanisms of these manifestations continues to be a topic of inquiry.

Multiple sclerosis is a debilitating disease that is the focus of study in many clinical settings. In one center conducting research on multiple sclerosis, an investigational drug being studied is called polyinosinic-polycytidylic acid poly-l-lysine (Poly-ICLC). The role of the primary nurse in this research project is described and discussed. A case presentation is included to illustrate how a patient receives continuity of professional nursing care while participating in a research protocol.

There are many important issues to be addressed in the relationship between families and health professionals. These include supporting each other without impairing each other and reciprocity with regard to learning and respect for each other. The nurse's role is vital. Nurses can build a partnership with the person, and their family because they have a major role in supporting the family, providing them with information, and directing them to the services they need. Nursing schools may need to re-evaluate their curricula to prepare individuals for this responsibility. Nurses may experiment with innovative approaches to care. Such innovations can then be evaluated by both families and professionals. The medical, social, and nursing implications of Alzheimer's disease are staggering. Surveys indicate that this disease probably affects more than a million people in the United States. These people and their families need supervision and care. It is hoped that this review will increase nurses' understanding of the disease process and that recent advances in research may stimulate further investigations in this still largely unexplored illness. The description of nursing care herein provided will enable clinicians to better serve Alzheimer's patients and their families.

A retrospective record audit was done to address the following research question: Are there factors associated with the length of hospital stay of laminectomy patients? According to the information on their records, patients with the following characteristics tended to have longer stays: were of the black race, had other medical diagnoses, had cervical region procedure, had "partial" procedure, had "extensive" pathology, and had greater use of pain medications. Those who were employed prior to admission, who were permitted to be more active, and who had muscle spasms had significantly shorter stays. The implications for nursing practice are discussed.