Journal of neurosurgical nursing最新文献

Physical assessment for nursing purposes is necessarily different from that of medicine because the focus of nursing is to diagnose and treat human responses to disease rather than the disease itself. Nursing assessment pathophysiology, implications for daily living, and nursing interventions for selected functional aspects of mentation, namely language, remembering, and performing learned movements, are presented in this article.

Physical assessment for nursing purposes is necessarily different from that of medicine because the focus of nursing is to diagnose and treat human responses to disease rather than the disease itself. This article will consider nursing assessment, pathophysiology, implications for daily living, and nursing implications for selected functional aspects of movement, namely seeing, eating, expressing (facially), speaking, moving, and walking.

Wounds, such as pressure ulcers, are frequent complications of neurologic disorders. Recently, many new products have been developed to assist nursing service personnel in the prevention and management of problems of impaired skin integrity. This article reviews the physiology of wound healing, nursing assessment of risk factors, and pressure ulcer status. In addition, specific nursing interventions will be discussed as they relate to pressure ulcer management in the neurologically impaired patient.

Adrenoleukodystrophy is an X-linked disorder characterized by adrenal insufficiency and progressive demyelination of the cerebral white matter. Young boys usually become symptomatic during pre- or primary school years and follow a time-variable, downhill, terminal course. Diagnostic and carrier testing and prenatal diagnosis are available. Several treatments have been used but presently treatment is symptomatic. Nursing in adrenoleukodystrophy involves management of issues including but not limited to diagnosis, genetics, counseling, physical care, emotional care, family care and research.

Arteriovenous malformations occur in approximately 4 percent of the population and are frequently seen in young adulthood. Controversy exists in the neurosurgical community as to the management of arteriovenous malformations; the four most common methods are medical management, radiation, embolization, and surgical intervention. Complications occur frequently regardless of the treatment selected. These complications are discussed using a selected patient population and case studies. Nursing diagnosis is used and a plan of care formulated for each problem. A one-year follow-up status will also be given for the selected patient population.

Symptomatic cerebral vasospasm following subarachnoid hemorrhage from ruptured saccular aneurysms is a major factor in the neurologic deterioration of these patients. Many therapeutic interventions have been proposed to treat this cerebral vasospasm; however, the most effective means to counteract this development still eludes the health care team. Faced with this dilemma, recent investigators have examined subarachnoid blood as visualized on CT scan. These studies have enabled them to identify those patients most at risk for developing symptomatic cerebral vasospasm. Predicting the occurrence as well as the severity and location of symptomatic cerebral vasospasm will facilitate early implementation of preventative measures. This knowledge may help to minimize the frequent unfavorable outcomes following subarachnoid hemorrhage and the subsequent development of vasospasm. The neuroscience nurse can apply this information to the clinical setting by being able to identify those patients at high risk for developing symptomatic cerebral vasospasm, to improve assessment skills, and to plan and anticipate the patient's future needs. A case study is offered to illustrate how this is accomplished.

Urination dysfunction is a problem commonly associated with stroke. However, the types of urination abnormalities have yet to be adequately classified. An exploratory, descriptive study was conducted to determine the definition and classification of urination dysfunctions amenable to nursing diagnosis and therapy. A model was constructed for this study that enumerated psychological, social and biological factors and their relationships to urination dysfunction. An abstracting form was developed for obtaining relevant data from discharged patients' records. The sample consisted of thirteen stroke patients discharged from a rehabilitation service. Tabular presentations and comparisons suggested patient characteristics that are pertinent to the diagnosis and treatment of urination dysfunction. This study was an initial step in formulating a theory about urination dysfunction.

While techniques and practice of stereotaxic surgery have been available for decades, recent technical and theoretical advances have allowed for a rebirth of this neurosurgical subspecialty. One of the newer applications of this technique is the stereotaxic treatment of malignant brain tumors. This method depends on the CT-guided placement of a tiny coaxial catheter system precisely on target within the tumor area. Radioactive sources in the catheter deliver a precise amount of radiation over a specific time course. The system is then removed. Follow-up of the patients who undergo this procedure continues throughout their lives.

Hydrocephalus is a chronic disease process and one of the most prevalent conditions in pediatric neurosurgery. At Oklahoma Children's Memorial Hospital, the neurosurgery department treats approximately 200 cases of hydrocephalus annually. This volume of patients has caused us to revise our diagnostic and operative protocols in order to more effectively meet the needs of our patients. At the current time, a shunting procedure is the most effective way to treat chronic long-term hydrocephalus. However, shunts are not without associated problems and it is these difficulties that have served as encouragement to continue our research into new and more improved methods of treatment.