Nervous System CNA 2 OSBN Curriculum Nervous System

Nervous System CNA 2 OSBN Curriculum

Nervous System Central Nervous System http: //www. medcomrn. com/dev/flash/flvplayer/movie. php? movi e=http: //ss 1. medcomrn. com/flv/78718 r_sec 03_300 k. flv&title= &detectflash=false Peripheral Nervous System http: //www. medcomrn. com/dev/flash/flvplayer/movie. php? movie= http: //ss 1. medcomrn. com/flv/78718 r_sec 04_300 k. flv&title=&det ectflash=false&detectflash=false

Anatomy & Physiology Central Nervous System CNS Peripheral Nervous System PNS

Nerves �Sensory: to CNS �Motor: From CNS �Spinal: Sensory & Motor �Somatic: Voluntary �Autonomic: Involuntary

Level of Consciousness: LOC �A person’s awareness of surroundings � 3 Levels ◦ Consciousness �Alert & Oriented ◦ Decreased Consciousness �Lethargic �obtunded �Stuporous ◦ Unconsciousness �Report All Changes In LOC

Cerebral Palsy �“Umbrella” Term for Motor Impairment Syndromes �Anomalies at birth ◦ Before ◦ During ◦ Shortly after �Hypoxic-Ischemic Insult at Delivery

Observation & Reporting �Increased Weakness �Worsening Condition �Skin Breakdown �Difficulty w/ADLs �Treatment Compliance

CNA 2 Actions �Assistive �ADL’s �Be Devices as Ordered Patient

Epilepsy �Brain disorder ◦ Repeated Seizures over time �Seizure ◦ Episodes of disturbed brain activity ◦ Changes in Attention & Behavior �Causes ◦ ◦ Congenital Brain Trauma Strokes Tumors

Types Seizures �Grand Mal ◦ May loose consciousness ◦ Twitching/shaking body �Petit Mal ◦ Slight change in behavior ◦ Staring �Stimulus Sensitive ◦ Provoked seizure �Causes ◦ Multiple Sclerosis ◦ Parkinson’s Disease

Observation & Reporting General Seizure � Shaking/Twitching � Loss of Consciousness � Incontinence Partial Seizure � Brief Blackout � Staring � Daydreaming After the Seizure � Altered Consciousness

CNA 2 Actions: Seizure �Call for Help STAT �Time & Description �Protect from Injury �Clear the Way �Seizure Precautions ◦ As Directed by Nurse �DON’T ◦ Restrain the person ◦ Put anything in their mouth ◦ Move the person

CNA 2 Actions: After Recovery Position � �Remain CALM �Emotional Support �Seizure Precautions �NPO until fully awake DON’T �“Bring them Around”

Alzheimer’s Disease � Degenerative Cognitive Disorder � Multiple Causes � Distinct Stages ◦ Stage I �Mild Memory Loss ◦ Stage II �Intellectual Deterioration ◦ Stage III �ADL Dependency �Treatment ◦ Environmental Structuring ◦ Drug Therapy

Observation & Reporting �Wandering �Sundowers �Hallucinations �Delusions �Agitation/Restlessness �Combativeness �Catastrophic Rxns �Abnormal Sexual Behaviors

CNA 2 Actions �Feed Patients PRN �Monitor for Aspiration ◦ HOB. 30 degrees �Stay Calm �Provide Reassurance �Re-Direct Activities �Remove Distracting Stimuli �Do NOT Argue

Parkinson’s Disease �Common, �CNS Chronic Disease �Produces: ◦ Movement Disorders ◦ Changes in Cognition/Mood �Cause Unknown

PD: S&S

CNA 2 Actions Report any changes to Nurse ASAP �Increased Difficulty ◦ Swallowing ◦ With Mobility �Change in Bowel/Bladder Continence �More Severe ◦ Trembling ◦ Rigidity �Severe Mood Swings

CNA 2 Actions con’t �Assist w/ADLs prn �Safe Environment �Fall Risk Safety as Directed �Be PATIENT ◦ Cares ◦ Communications �Change Position Q 2 and prn �Report Changes in Condition

Multiple Sclerosis �Chronic �CNS �Myelin Disease Sheaths �Relapses/Remissions �Ave. onset: 18 -35 �Can Deteriorate Many Organs

Observation & Reporting paraesthesia

CNA 2 Actions �Avoid: ◦ Fatigue ◦ Over-Exertion ◦ Stress ◦ Exposure to Extremes �Assist w/ADL’s �Report Abnormals to Nurse

Brain Pressures

Head Injury �Concussion ◦ Mild to Severe �Contusion ◦ Brain Bruise �Intracranial Hemorrhage ◦ Within the Skull �Subdural Hematoma ◦ Between the Layers

Observation & Reporting �Dazed/Confused �Loss �N/V of Consciousness �Stiff Neck �Muscle Weakness �Bloody/Watery Drainage from Nose/Ears �Seizures

CNA 2 Actions �Report ANY observations to nurse STAT �Changes in LOC? �Patent Airway �Elevate HOB �VS �Safety Measures �Assist w/ADLS prn

Spinal Cord Injuries

Spinal Cord Injuries �Acute & Traumatic �S&S Depends on injury level �Damage to Nerves ◦ As a result of the Injury ◦ As a result of the Swelling � C 5 and above = Quad

Treatment Phases �Acute Phase ◦ Immobilization ◦ ◦ �C-Spine Precautions High Corticosteroids Airway Maintenance Foley Cath Regulation of Body Temp �When Stabilized ◦ Frequent Neruo Checks �Ongoing Assessment ◦ Paralysis ◦ Loss of Sensation/Reflexes ◦ Immobilization Complications

Observation & Reporting �Discoloration of the Skin �Further Paralysis �Body Image �Loss of Control �Anger �Depression

CNA 2 Actions �Report Changes to Nurse STAT �Assist w/ADLs prn �Clear Communication �Emotional Support �Safety Measures

TIA Transient Ischemic Attack � Temporary ◦ Numbness/Paralysis ◦ Impaired Speech 5 -50 minutes ◦ Loss a portion of blood supply � Sudden Onset � Risk of Impending CVA CNA 2 Actions � Treat Symptoms as a Stroke ◦ We don’t know what it is

Cerebrovascular Accident �AKA: CVA, Stroke, Brain Attack �Loss of Function �Impaired Circulation ◦ Intracranial Hemorrhage ◦ Cerebral Emboli � 3 rd US Deaths

Presentation �R-brain CVA �L-brain CVA ◦ L-sided paralysis ◦ L facial droop ◦ Rarely aphasia ◦ R-sided paralysis ◦ Aphasia �Expressive �Receptive

Treatment Acute Phase � 1 st 90 -180 TPA: Clot Buster ◦ Triples Risk of Hemorrhage � Decrease ◦ ◦ Cerebral Venous BP As directed by nurse Elevate HOB Avoid Straining Monitor VS and Neuro’s �Carefully �Frequently �Accurately

Treatment Rehabilitative Phase � Rehab when stable � Retraining � Adaptive & Supportive Devices � Communication Board

Observation & Reporting SUDDEN � Weakness or Numbness of Arm, Leg, or Face � Severe HA � Falling � Dizziness � Dimming of Vision � Loss of Vision � Difficulty Speaking � Gait Disturbances

CNA 2 Actions Acute Phase � Stay w/Patient � Call for Help � Patent Airway Later: Rehabilitation Phase � ADLs: Encourage Self-Care � VS: Report Abnormals � HOB 30 -45 � Aspiration Precautions