Week 2 - Nervous System PDF

HCAP 1210 Physical Changes  The nervous system:  Nerve cells are lost.  Nerve conduction and reflexes slow.  Blood flow to the brain is reduced.  Changes occur in brain cells.  Sleep patterns change.  Touch and sensitivity to pain and pre...

HCAP 1210 Physical Changes  The nervous system:  Nerve cells are lost.  Nerve conduction and reflexes slow.  Blood flow to the brain is reduced.  Changes occur in brain cells.  Sleep patterns change.  Touch and sensitivity to pain and pressure are reduced.  Sensing heat and cold are reduced.  Taste and smell dull. Nervous System Disorders NERVOUS SYSTEM DISORDERS CAN AFFECT PHYSICAL FUNCTIONS INCLUDE TASKS SUCH COGNITIVE FUNCTIONS INCLUDE TASKS COGNITIVE AND PHYSICAL FUNCTIONS AS MOVING, TOUCHING, SEEING, HEARING, CONTROLLED BY THE MIND, SUCH AS AND CONTROLLING THE BOWEL AND BLADDER THINKING, REASONING, UNDERSTANDING, REMEMBERING, LEARNING, READING, AND PROBLEM SOLVING Epilepsy  Epilepsy is recurrent episodes of convulsive seizures, sensory disturbances, abnormal behaviours, and loss of consciousness  A seizure involves violent and sudden contractions or tremors of muscle groups and causes uncontrolled movements and loss of consciousness  A single seizure does not mean a person has epilepsy, but it can develop any time  Watch the next video; MANDATORY. It shows you what to do when someone is having a seizure. Critical Thinking!  You are working on a day shift as a HCA at Delta Mountainview Manor. You have checked on all the residents and determine everyone is safe and all their needs are met. As you are walking back to the nursing station you hear a loud noise, turn around and see resident Mrs. Rogers is having a seizure.  What is your immediate response as a HCA?  After the seizure has passed, you notice Mrs. Rogers has voided and has now soiled herself.  What are your responsibilities to ensure Mrs. Rogers are now being met?  What are some of the causes of epilepsy?  Stroke  Stroke (cerebrovascular accident [CVA]) is a disease that affects the arteries that supply blood to the brain.  Stroke occurs when the following happens:  A blood vessel in the brain is blocked or bursts, resulting in the blood supply to a part of the brain being obstructed  A Transient Ischemic Attack (TIA) is known as a “mini-stroke”.  Difference between a TIA & CVA comes down to timing.  Sometimes people can have a TIA and you would not even recognize the symptoms, they occur that quickly. The only way to know if someone has a TIA is through a CT scan or an observable deterioration in their health & ADLS. Stroke (Cont.)  Stroke is the fourth leading cause of death in Canada  It is a leading cause of disability in adults  The person needs emergency care.  Sometimes a warning sign lasts a few minutes  Remember the acronym FAST Stroke (Cont.)  Stroke can occur suddenly  The person may have warning signs:  Sudden weakness, numbness, or tingling of the face, arm, or leg, especially on one side of the body  Sudden loss of speech or trouble understanding speech  Sudden vision problems, especially in one eye  Sudden severe headache with no known cause  Sudden dizziness and loss of balance  REMEMBER TO ACT FAST   Some risk factors can be controlled; others cannot  Age, greater than 65 years at increased risk  Gender: men are at a slightly higher risk than women Stroke (Cont.)  Hypertension  Smoking  Diabetes  High blood cholesterol  Lack of exercise  High alcohol intake Stroke (Cont.)  After a stroke, some brain damage is likely  Functions lost depend on the area of brain damage  Rehabilitation starts at once, you can slowly recover from the effects of a stroke  The health team helps the person regain the highest possible level of function Critical Thinking!  Explain how a CVA occurs and the risk factors that contribute to it?  Explain the difference between a CVA & TIA?  You are working as a home care HCA. Mrs. Betty and you are sitting together in the living room. Together the both of you are laughing and enjoying completing a puzzle. All of a sudden you notice she is struggling to pick up a piece of the puzzle and continues to miss to grab it, all of a sudden her right arm drops and droops. Her smile is now drooping on her right side of her face. And she voices to you “I dmhtgh feelsss shoo ghuud”  What are the warning signs of a stroke? How do you act FAST? What is your immediate response as a HCA? Critical Thinking!  Resident Mr. Dwight is a 79-year-old male with a hx of HTN, smoking one pack per day for twenty years, drinking an average of three beers a day, and living a sedentary lifestyle. He has never been married and lives alone in a one-bedroom apartment on the first floor. He experiences a left-sided stroke resulting in right hemiplegia, dysphagia, dimmed vision, and expressive aphasia.  What risk factors for stroke does Mr. Dwight have?  Mr. Dwight likely has brain injury, how is this evident?  What type of meal and drinks can Mr. Dwight have?  You are partially assisting Mr. Dwight with his meal, as he just needs requirement with setup. You allow him to finish his meal and come back later. On return you notice that he has only completed his meal on the right side of the plate. What could be the cause of this?  Who is responsible for the rehabilitation of Mr. Dwight?  Due to Mr. Dwights right hemiplegia he is immobile and requires total assistance in transfer. He is teary eyed when transferring to the commode.  How would you communicate with Mr. Dwight to alleviate his sadness? What skin care concerns do we need to be mindful of? Parkinson’s Disease  A slow, progressive disorder with no cure  The area of the brain that controls muscle movement is affected  Persons over the age of 50 are at risk  Signs and symptoms include:  Tremors  Rigid, stiff muscles in the arms, legs, neck, and trunk Slow movement  Stooped posture and impaired balance  Mask-like expression  Other signs and symptoms develop over time  Drugs to treat and control the disease Exercise and physiotherapy to improve strength, posture, balance, and mobility Parkinson’s The client may need help with activities of daily Disease living (ADLs) Treatment Normal elimination is a goal Safety measures are needed to prevent falls and injury Critical Thinking!  Explain the difference between Parkinson's Dementia & Lewy Bodies Dementia.  Inherited neurological disorder that destroys brain cells—causes uncontrolled movements, emotional disturbances, and cognitive losses Huntington's Symptoms begin between ages 20 and Begins with twitching, fidgeting, clumsiness Difficulty with eating, Disease 60 swallowing, ADLs No cure or treatment Multiple Sclerosis  Multiple sclerosis (MS) is a persistent, slowly progressive disease  Myelin, which covers nerve fibers in the brain and spinal cord, is destroyed  Nerve impulses are not sent to and from the brain in a normal manner  There is no cure  Symptoms usually start between the ages of 15 and 40 years  More women are affected than men  Onset is gradual and symptoms vary greatly among clients Signs and Symptoms of Multiple Sclerosis  Signs and symptoms depend on the damaged area and may include  Vision problems  Muscle weakness in the arms and legs  Balance problems that affect standing and walking  Tingling, prickling, or numb sensations  Difficulty speaking and swallowing  Bladder and bowel issues; diminished sexual arousal  Pain, extreme fatigue, sensitivity to heat  Short-term memory loss; impaired judgement Multiple Sclerosis Support needs There is no cure depend on client’s needs and condition Prevent injury ˜ Eventually the client Promote bowel and may require long- bladder function term care Critical Thinking!  You are caring for Mrs. Margaret at your care facility. Her diagnosis is MS. Her ADL read as follows:  SAFETY: Falls risk, bed alarm, non-slip socks, falls mat, low bed, top railing up  Risk of choking, minced food  Communication: English, slow easy to understand, simple sentences.  Transfer: 2PA with universal lift to W/C  Reposition: Q2 HRS with 2PA and sliding sheet. Contracture in right hand, use mitt.  Continence: Incontinent B&B, Orange Tab. Total assistance, change as per voiced concerns  Dress: Total assistance require. Will pick own clothes, give options.  Skin Care: Risk of pressure ulcer on Coccyx.  Oral: Natural teeth, total assistance  Dinning: Minced meals, total assistance required.  Explain how you would provide care for Mrs. Margaret and what treatments you ca do as an HCA? Amyotrophic Lateral Sclerosis  Amyotrophic lateral sclerosis (ALS) attacks the nerve cells that control voluntary muscles  Commonly called Lou Gehrig’s disease, it is rapidly progressive and fatal  It usually strikes between 40 and 70 years of age  Motor nerve cells in the brain, brain stem, and spinal cord are affected  First sign is difficulty using fingers and hands, progressing to difficulty walking  You may know of heard of Stephen Hawking, incredible and famous scientist diagnosed with ALS  The client will struggle, and eventually all muscle control is lost, with the client being unable to speak, swallow, move or breathe and will pass away.  Remember!!! Clients can think clearly and are alert. They understand everything you say to them. Critical Thinking!  Explain the difference between Parkinson’s Disease, Multiple Sclerosis, & Amyotrophic Lateral Sclerosis.  Spinal Cord Injuries  The spinal cord allows for communication between the brain and the rest of the body.  When damage occurs to the spinal cord, this means that the nerves cannot relay messages between the different parts of the body and brain and vice versa. Partial or total paralysis can occur.  Spinal cord injuries are permanent, mostly resulting from MVA.  Which parts of your body are paralyzed depends where the spinal cord was injured  If higher on the spinal cord (neck/shoulder area) was injured = paralysis from neck down, all limbs affected  If mid region of your spine (chest area) = paralysis from waist down, lower limbs affected  Spinal cord injuries require rehabilitation!