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Nervous System
CNA2 OSBN Curriculum
Central Nervous Systemhttp://www.medcomrn.com/dev/flash/flvplayer/movie.php?movie=http://ss1.medcomrn.com/flv/78718r_sec03_300k.flv&title=&detectflash=false&detectflash=false
Peripheral Nervous Systemhttp://www.medcomrn.com/dev/flash/flvplayer/movie.php?movie=http://ss1.medcomrn.com/flv/78718r_sec04_300k.flv&title=&detectflash=false&detectflash=false
Nervous System
Anatomy & Physiology
Central Nervous SystemCNS
Peripheral Nervous System
PNS
NervesSensory: to CNSMotor: From CNSSpinal: Sensory & MotorSomatic: VoluntaryAutonomic: Involuntary
Level of Consciousness: LOC A person’s awareness of surroundings
3 Levels◦Consciousness
Alert & Oriented
◦Decreased Consciousness Lethargic obtunded Stuporous
◦UnconsciousnessReport All Changes In LOC
“Umbrella” Term for Motor Impairment SyndromesAnomalies at birth
◦Before◦During◦Shortly after
Hypoxic-Ischemic Insult at Delivery
Cerebral Palsy
Increased WeaknessWorsening ConditionSkin BreakdownDifficulty w/ADLsTreatment Compliance
Observation & Reporting
Assistive Devices as OrderedADL’sBe Patient
CNA 2 Actions
Brain disorder ◦ Repeated Seizures over time
Seizure◦ Episodes of disturbed brain activity◦ Changes in Attention & Behavior
Causes◦ Congenital◦ Brain Trauma ◦ Strokes◦ Tumors
Epilepsy
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
Types Seizures
General Seizure Shaking/Twitching Loss of Consciousness Incontinence
Partial Seizure Brief Blackout Staring Daydreaming
After the Seizure Altered Consciousness
Observation & Reporting
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: Seizure
Recovery Position Remain CALM Emotional Support Seizure Precautions NPO until fully awakeDON’T “Bring them Around”
CNA 2 Actions: After
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
Alzheimer’s Disease
WanderingSundowersHallucinationsDelusionsAgitation/RestlessnessCombativenessCatastrophic RxnsAbnormal Sexual Behaviors
Observation & Reporting
Feed Patients PRNMonitor for Aspiration
◦HOB.30 degreesStay CalmProvide ReassuranceRe-Direct ActivitiesRemove Distracting StimuliDo NOT Argue
CNA 2 Actions
Common, Chronic Disease CNS Produces:
◦ Movement Disorders◦ Changes in Cognition/Mood
Cause Unknown
Parkinson’s Disease
PD: S&S
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
Assist w/ADLs prn Safe Environment Fall Risk Safety as Directed Be PATIENT
◦ Cares◦ Communications
Change Position Q2 and prn Report Changes in Condition
CNA 2 Actions con’t
Chronic Disease CNS Myelin Sheaths Relapses/Remissions Ave. onset: 18-35 Can Deteriorate
Many Organs
Multiple Sclerosis
Observation &
Reportingparaesthesia
Avoid:◦Fatigue◦Over-Exertion◦Stress◦Exposure to Extremes
Assist w/ADL’sReport Abnormals to Nurse
CNA 2 Actions
Brain Pressures
Concussion◦Mild to Severe
Contusion◦Brain Bruise
Intracranial Hemorrhage◦Within the Skull
Subdural Hematoma◦Between the Layers
Head Injury
Dazed/Confused Loss of Consciousness N/V Stiff Neck Muscle Weakness Bloody/Watery Drainage from Nose/Ears Seizures
Observation & Reporting
Report ANY observations to nurse STAT
Changes in LOC? Patent Airway Elevate HOB VS Safety Measures Assist w/ADLS prn
CNA 2 Actions
Spinal Cord Injuries
Acute & TraumaticS&S Depends on injury levelDamage to Nerves
◦As a result of the Injury◦As a result of the Swelling
C5 and above = Quad
Spinal Cord Injuries
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
Treatment Phases
Discoloration of the SkinFurther ParalysisBody Image Loss of ControlAngerDepression
Observation & Reporting
Report Changes to Nurse STATAssist w/ADLs prnClear CommunicationEmotional SupportSafety Measures
CNA 2 Actions
Transient Ischemic Attack Temporary
◦ Numbness/Paralysis◦ Impaired Speech 5-50 minutes◦ Loss a portion of blood supply
Sudden Onset Risk of Impending CVACNA 2 Actions Treat Symptoms as a Stroke
◦ We don’t know what it is
TIA
AKA: CVA, Stroke, Brain AttackLoss of Function Impaired Circulation
◦Intracranial Hemorrhage◦Cerebral Emboli
3rd US Deaths
Cerebrovascular Accident
R-brain CVA ◦L-sided paralysis◦L facial droop◦Rarely aphasia
L-brain CVA◦R-sided paralysis◦Aphasia
Expressive Receptive
Presentation
Acute Phase 1st 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
Treatment
SUDDEN Weakness or Numbness of Arm, Leg, or
Face Severe HA Falling Dizziness Dimming of Vision Loss of Vision Difficulty Speaking Gait Disturbances
Observation & Reporting
Acute Phase Stay w/Patient Call for Help Patent AirwayLater: Rehabilitation Phase ADLs: Encourage Self-Care VS: Report Abnormals HOB 30-45 Aspiration Precautions
CNA 2 Actions
This project was funded $3,000,000 (100% of its total cost) from a grant awarded under the Trade Adjustment Assistance Community College and Career Training Grants, as implemented by the U.S. Department of Labor’s Employment and Training Administration. Rogue Community College is an equal opportunity employer/program. Auxiliary aids and services, alternate form and language services are available to individuals with disabilities and limited English proficiency free of cost upon request.
This work is licensed under a Creative Commons Attribution 4.0 International License.