RNSG 2432-Mod_10 NotesAltered Cerebral Function and Increased

RNSG 2432-Mod_10 NotesAltered Cerebral Function and Increased

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NOTES Module 10: Neursensory Disorders: Altered Cerebral Function and Increased Intracranial Pressure (IICP) Marnie Quick, RN, MSN, CNRN Altered Cerebral Function Etiology/Pathophysiology 1. Normal brain physiology as it relates to altered cerebral function. a. Consciousness is a dynamic state that can fluctuate between awareness of self  and environment to unawareness. b. Etiology of altered cerebral function:  1) Lesions/injury to the RAS or cerebral cortex   2) Metabolic disorders 3) Examples: brain lesions, cardiac (as an MI), respiratory, kidney,  diabetes, fluid and electrolyte imbalance, drugs that suppress the  CNS, and seizures.  c. Arousal/Cognition (Level of Consciousness) patho/assessment 1) Reticular formation (specifically the reticular activating system- RAS)  is a meshwork of gray cell bodies within the brainstem up to the  thalamus that controls wakefulness, arousal and alertness. Injury to  the RAS with an intact cerebral cortex results in difficulty with arousal  which in turn makes assessment of the cognitive function difficult. 2) Cerebral cortex is the outer layer of gray cell bodies of the brain  controls cognition; your thought processes. Widespread injury to the  cerebral cortex with an intact RAS, the individual has sleep-wake  cycles and may respond to stimuli, but not with understanding. 3) Begin assessment of altered cerebral function by observing the  individual’s behavior. Call their name, if no response then shake  individual- may be asleep. 4) Next assess verbal response: Note response to person, place, time,  and event questions a) Normal- appropriately responds to each area b) Abnormal- confusion in any one of the aspects, difficulty  with memory,(immediate recall, recent, or long term  memory) document accurately 5) If unable to assess verbal, then assess response to commands: Note  ability to follow simple (one-part) or complicated commands a) Normal- able to follow commands in absence of paralysis b) Abnormal- hard to arouse, slow, falls asleep easily, unable  to perform task 6) Lastly, if individual is unable to perform commands, then apply central  pain stimuli (sternal rub). RNSG 2432 203
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a) Normal response to central pain- purposeful movements,  tries to move stimulus away b) Abnormal- non-purposeful movements such as random  movements, decorticate or decerebrate posturing (p. 1304  ‘Motor Response’ section below) d. Patterns of breathing 1) The changes in respiratory pattern occur as the brainstem is being  compressed. e.
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This note was uploaded on 09/13/2011 for the course RNSG 2431 taught by Professor Marniequick during the Spring '10 term at Austin Community College.

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RNSG 2432-Mod_10 NotesAltered Cerebral Function and Increased

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