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.

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