May be a first obvious sign of brain lesion Ĭlinical Manifestations DIZZINESS AND VERTIGO Dizziness is an abnormal sensation of imbalance or movement. Ĭlinical Manifestations SEIZURES Are the result of abnormal paroxysmal discharges in the cerebral cortex, which manifests as alteration in sensation, perception, movement or consciousness May be long or short The type of seizure activity is a direct result of the brain affected. Symptoms may be: Varied or intense Fluctuating or permanent Inconvenient or devastating PAIN SEIZURES DIZZINESS a nd VERTIGO VISUAL DISTURBANCES WEAKNESS ABNORMALSENSATION Ĭlinical Manifestations PAIN unpleasant sensory perception & emotional experience associated with actual or potential tissue damage - Subjective - Acute > lasts shorter & remits as pathology resolves > trigeminal neuralgia, spinal disk disease - Chronic or persistent > Lasts longer than 6 months > degenerative and chronic neurologic cond. Evaluate ability to move eye Note nystagmus Ability of eyes to move together Resting position of iris should be at mid-position of the eye socket PERRLA Ĭlinical Manifestation The clinical manifestation of neurologic disease are as varied as the disease processes themselves. PHYSICAL ASSESSMENT Assess Pupillary Status and Eye movement Size of pupils should be equal Reaction of pupils Accommodation : pupillary constriction to accommodate near vision Direct light reflex : constriction of pupil when light is shone directly into the eye Consensual reflex : constriction of the pupil in the opposite eye when the direct light reflex is tested. Mood Thought content & intellectual capacity
PHYSICAL ASSESSMENT Mental Status General appearance and behavior Level of consciousness Oriented to person, place and time Appropriate response to verbal and tactile stimuli Memory, problem solving abilities. PHYSICAL ASSESSMENT General Observation of the client: Posture, gait, coordination: perform Romberg test Personal hygiene and grooming Evaluate speech and ability to communicate Place of speech: rapid, slow, halting Clarity: slurred or distinct Tone: high-pitched, rough Vocabulary: appropriate choice of words *** Facial features may suggest specific syndromes in children Questions about the use of alcohol, medications and illicit drugs are also relevant. The nurse should be aware of history of trauma or falls that may have involved the head or spinal injury. HEALTH HISTORY Review of medical history including the system-by-system evaluation is part of the nursing history.
Complaints Precipitating, aggravating and relieving factors Progression, remission and exacerbation Presence or absence of similar signs and symptoms among family members History of genetic disease
HEALTH HISTORY INCLUDES: Onset, character, severity, location duration and frequency of signs and symptoms. HEALTH HISTORY Depending on the patients condition, the nurse may rely on: YES or NO answer Review of Medical Records Input from Family HEALTH HISTORY History of Present Illness Important aspect of neurologic assessment Initial Interview Provides an excellent opportunity to systematically explore the patient’s current condition and related events while observing the: Overall appearance Mental status Posture Movement Affect NEUROLOGIC EXAMINATION Presented by: Reyna Paredes
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