• In the PNS, the motor nerve fibers and the myelin sheath degenerate with advancing age. • Reflexes may be diminished or absent. • Pupils decrease in size. • Older patients may need more time to process questions, solve problems, or learn new information. • Using the brain and keeping it active promote continued intellectual function in healthy older adults.
NEUROLOGIC DISORDERS • Genetic and acquired developmental disorders. Infections and inflammation, benign and malignant tumors, vascular or neuromuscular degeneration, metabolic and endocrine disorders, and chemical or physical trauma (Box 21.1) Causative factors • Nurses can help prevent neurologic problems in many ways. The goals for Healthy People 2020 encourage health protection through education about safety and responsible self-care. Preventio n Evaluatio n • Cranial nerves, Coordination and balance Neuromuscular function testing, Reflexes
NEUROLOGIC DISORDERS CONT. Health promotion Protecting the Nervous System • Encourage people to wear helmets when biking, in-line skating, skateboarding, or riding motorcycles, and when involved in other sports activities that may lead to head injury. • Remind people that wearing safety hats or helmets when in a workplace where head injury is a danger reduces the number of injuries. • Review safety precautions when diving and swimming. To help prevent spinal cord injury, never dive into water of unknown depth. • Encourage people to fasten their seat belts before putting the car into gear. • Be certain that children are fastened into appropriate restraints. • Wear mask, gloves, long pants, and long-sleeved shirt when spraying with insecticide; wash up immediately afterward and change clothes. • Refrain from using recreational drugs, because they can affect the cardiovascular system and can cause a stroke.
REFLEXES • A reflex is an action or movement that is built into the nervous system and does not need the intervention of conscious thought to take place. (Automatic Response) • Clonus is a continued rhythmic contraction of the muscle while there is continuous application of the stimulus • Grading Reflexes Scale Gr ad e Descriptions 0/ 5 Absent 1/ 5 Weak response 2/ 5 Normal 3/ 5 Exaggerated response 4/ 5 Hyperreflexia and clonus Knee jerk or patellar reflex (and others) Babinski reflex Oculocephalic (“doll’s eye”) and oculovestibular reflexes
NORMAL AND BABINSKI REFLEXES 15 Normal Adult – Toes flare out; Child – Toes flare in
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- Fall '18