Скачать или смотреть Neurological examination; Week two Medical Surgical, Sec 05 - summary note from Abdulkareem

This presentation woth Dr. Abdulkareem ‪@AbdulkareemIblasi‬ provides a comprehensive guide to performing a neurological assessment on a patient, with a focus on nursing procedures and diagnostic tests. It begins by outlining key course outcomes related to nursing care for clients with various disorders, including neurological conditions.

The assessment process starts with a thorough

health history, where the nurse asks relevant questions about the patient's symptoms such as pain, seizures, dizziness, visual disturbances, and weakness. The nurse also inquires about the patient's past medical and family history of neurological disorders.

The physical neurological examination is divided into several key sections. The first is

assessing cerebral function, which includes evaluating the patient's level of consciousness using the Glasgow Coma Scale. A score of 8 or less indicates a severe neurological deficit. The nurse also assesses

speech and language by checking for fluency, comprehension, repetition, naming, reading, and writing.

Memory is tested for immediate recall, recent events, and remote memories.

Intellectual function is assessed through attention, calculation, general knowledge, insight, and reasoning questions. The nurse then evaluates

gait, movement, and balance using tests like the Romberg test, finger-to-nose test, and heel-to-shin test, noting any loss of balance or uncoordinated movements.



The presentation provides detailed instructions on

assessing the twelve cranial nerves. For example, the





olfactory nerve (I) is tested by identifying familiar odors, while the facial nerve (VII) is assessed by observing symmetrical facial movements when smiling or frowning. The


trigeminal nerve (V) is tested by asking the patient to clamp their jaws and by stroking the face with various objects.

Next, the document covers

assessing reflexes, including the biceps, triceps, knee, and ankle reflexes. It also describes the




plantar response and the significance of a positive Babinski sign, where the great toe extends upward. A grading scale from 0 (absent) to 4 (markedly hyperactive) is provided for reflexes.



The

motor system assessment focuses on muscle strength. The nurse tests the strength of various muscles and grades the patient's ability to resist gravity or applied force, with a score of 5 indicating full power and 0 indicating complete paralysis.



The

sensory function is evaluated by testing the extremities for sensitivity to temperature, touch, pain, and vibration.

The presentation also details how to assess for

meningeal signs using the Kernig and Brudzinski tests, which identify neck pain and resistance, indicating possible meningeal irritation.


Finally, the document lists several

diagnostic tests for neurological disorders, such as CT, MRI, and EEG. These tests aid in diagnosing conditions like tumors, hemorrhages, epilepsy, and nerve damage