Tips for neurology patients

1. I want to prepare a small lecture on neurology nursing, but I don’t know what to talk about

Observation of cerebrovascular disease nursing conditions: 1. Closely observe changes in the condition, such as worsening of consciousness disorder, If you have a severe headache, unequal pupils, elevated blood pressure, or slow breathing and pulse, there is a possibility of bleeding or brain damage again. You should notify the doctor in time to do rescue work such as lowering intracranial pressure and stopping bleeding; if you suddenly become aphasic or the degree of limb paralysis worsens, , deepening of consciousness disorder, etc., new embolism may be formed, and the doctor should be notified in time for treatment.

2. For patients with cerebral infarction who are treated with heparin anticoagulation or streptokinase, urokinase or rt-PA thrombolytic treatment, KBTT should be measured once a day and closely observed for bleeding tendencies, such as oral mucosa, gums and Subcutaneous bleeding, hematuria, melena, etc.; prepare protamine zinc, 6-aminocaproic acid and other drugs for countermeasures. Symptomatic care: 1. Patients with subarachnoid hemorrhage who have severe headaches and vomiting should be actively treated to reduce intracranial pressure.

2. Patients with high fever, convulsions, paralysis, and aphasia should follow corresponding nursing routines. General care: 1. Patients with cerebral infarction who are absolutely bedridden in the acute stage should be placed in a supine position; patients with cerebral hemorrhage should have the head of the bed elevated by 15° to 30°; patients with subarachnoid hemorrhage should remain in bed for 4 to 6 weeks, and those with recurrence should be extended to 8 weeks.

Try to avoid moving the head and unnecessary operations, and turn over every 2 to 4 hours. 2. Patients in critical condition should fast within 24-48 hours and be given liquid nasal feeding for 48 hours; those who are clear and have no dysphagia should be given a liquid or semi-liquid diet.

Patients with high blood pressure and heart disease are given a low-fat or low-salt diet. 3. Avoid emotional excitement and keep bowel movements smooth.

Health guidance: Patients with subarachnoid hemorrhage should not engage in heavy physical labor and strenuous physical activities after recovery. They should live a regular life, avoid emotional excitement, and have regular examinations. Female patients should avoid it within 1 to 2 years. Pregnant.

2. What are the common diseases in neurology?

Problem analysis: It is caused by damage to the facial nerve nucleus or facial nerve. All facial muscles on the ipsilateral side of the lesion will be paralyzed from top to bottom. Inability to frown, frown, close eyes, disappearance of corneal reflexes, shallow nasolabial folds, inability to show teeth, puff out cheeks, or whistle, and drooping of the corners of the mouth (or the corners of the mouth are tilted to the opposite side of the lesion, that is, the opposite side of the paralyzed facial muscles).

Peripheral facial nerve paralysis is more common due to cold, ear or meningeal infection, and neurofibroma. In addition, dysgeusia in the front 2/3 of the tongue may also occur.

Suggestions: Greater occipital neuralgia is often seen by a neurology department. It's a neurological disease.

Guidance: This situation can often be treated with non-steroidal anti-inflammatory drugs and neurotrophic drugs. It can also be combined with traditional Chinese medicine treatment.

Keep yourself in a good mood. Don't catch a cold from exertion.

3. Common diseases and common drugs in neurology

Peripheral neuropathy~ (common) Spinal cord disease and cerebrovascular disease (common) Central nervous system infectious diseases (common) Central nervous system degeneration Myelin diseases, movement disorders, epilepsy, headaches (common), degenerative diseases of the nervous system, hereditary diseases of the nervous system, neuromuscular junction and muscle diseases, autonomic nervous diseases, mental disorders associated with neurological diseases (common), commonly used clinical drugs in neurology ~ lowering intracranial pressure and Dehydration and diuretics n Mannitol (Mannitolum, D-mannitol) Pharmacological effects: Hypertonic diuresis, lowering intracranial pressure by producing tissue dehydration.

It takes effect about 20-30 minutes after intravenous injection, reaches its peak in 2-3H, and lasts 6-8H. In ischemic cerebrovascular disease, it can scavenge free radicals, reduce blood viscosity, and improve blood circulation.

Usage: 1. Used for the treatment of cerebral edema and glaucoma; 2. Used for edema caused by large-area burns and scalds; Usage: Intravenous infusion of 250-500ml of 20% solution at a rate of 10ml per minute, every Repeat as needed every 4-6 hours. Precautions: 1. Injecting too quickly may cause transient headache, dizziness, and pain at the injection site; 2. Use with caution in patients with heart and kidney dysfunction; 3. Allergic reaction; 4. Crystals are likely to precipitate when the temperature is low.

Anti-cranial pressure, dehydration, and diuretic drugs n Glycerofructose (10% Glycerosteril) Pharmacological effects: 1. Hypertonic dehydration; 2. Utilize the energy generated by glycerol metabolism to improve metabolism and reduce electrolytes in the body No adverse effects on balance. Purpose: dehydration and reducing intracranial pressure. Usage: intravenous infusion, 200-500ml each time for adults, 1-2 times a day. It takes 2.5-3 hours to finish 200ml.

Notes: Too fast intravenous infusion may cause hemolysis and hemoglobinuria. Reduce intracranial pressure and dehydration. Acetazolamide, a diuretic, is also known as Acetazolamide, Acetazolamide, and Diamox. Pharmacological effects: Carbonic anhydrase inhibitors. It is well absorbed orally and takes effect 30 minutes after taking the medicine. It reaches the peak in 2 hours and lasts for 12 hours. Usage: cardiogenic edema, cerebral edema, major and minor epilepsy. Instructions: Treat cerebral edema 0.25g/time, bid-tid. Precautions for best results when taken after breakfast: 1. The following adverse reactions may occur: granulocytopenia, drowsiness, numbness of the face and limbs, and hypokalemia.

2. Avoid the simultaneous use of calcium, iodine and broad-spectrum antibiotics, and should not be combined with anticholinergics and procaine. 3. Patients with high calcium need to follow a low calcium diet.

Plasma volume expansion drug n dextran Dextran 40/20 Pharmacological effects: 1. Increase plasma colloid osmotic pressure and maintain blood pressure; 2. Anti-platelet and red blood cell aggregation, reduce blood viscosity, thereby improving microcirculation and preventing Thrombosis. 3. D20 has a stronger effect on improving microcirculation than D40.

Uses: 1. Anti-shock; 2. Prevention and treatment of cerebral thrombosis and thromboangiitis obliterans. Usage: intravenously infuse 250-500ml, 20-40ml/min, and finish the infusion within 15-30 minutes (for anti-shock).

For patients with CVD, the drug should be infused slowly, once a day, with a course of treatment lasting 7-14 days. Precautions: Allergic rashes or asthma attacks may be seen, and occasionally febrile reactions may be seen.

Contraindicated in patients with congestive heart failure and bleeding disorders. Anti-platelet aggregation drugs nAsprin n dipyridamole nticlopidine (Ticlid, Tianxinlibo), Ticlopidine These drugs are all oral drugs. Common adverse reactions are gastrointestinal symptoms and rash. Taking them after meals can reduce their occurrence.

Anticoagulant and thrombolytic drugs nLow molecular weight heparin calcium (quickly avoids coagulation) Pharmacological effects: It is a subcutaneous injection of heparin. It has anticoagulant and antithrombotic effects.

Uses: For the prevention and treatment of thromboembolic disease or thrombosis. Usage and dosage: deep subcutaneous injection, 5000-10000 u/time.

Notes: 1. Subcutaneous injection should go deep into the subcutaneous fat layer. Injection sites should be changed continuously.

Do not move the needle during injection, and do not rub it during injection. 2. After injection, a small local hematoma may be caused at the injection site, which will disappear on its own after a few days.

3. It is incompatible with drugs containing phosphate buffer. Anticoagulant and thrombolytic drugs nTissue-type plasminogen activator t-PA (Human Tissue-Type Plasminogen Activator) Pharmacological effects: It is a glycoprotein.

Binds to fibrin through its lysine residue and activates the conversion of fibrin-bound plasminogen into plasmin. After intravenous injection of t-PA, it is rapidly cleared from the blood.

Usage: acute myocardial infarction, acute pulmonary embolism, acute cerebral embolism, cerebral thrombosis, intracranial venous sinus thrombosis. Usage and dosage: 50mg/tube.

Dissolve 100 mg in 500 ml of physiological saline, and drip it in as follows within 3 hours: inject 10 mg in the first 2 minutes, drip 50 mg in the next 60 minutes, and drip the remaining 40 mg in the last 120 minutes. Or give 10% of 50 mg intravenously, and dissolve the remaining medicine in 100 ml of saline and finish it within 1 hour.

Note: It cannot be combined with other drugs for intravenous infusion, nor can it be used for intravenous infusion with other drugs. Cerebral vasodilator drugs nCalcium ion antagonists: Nimodipine, Nimoton Pharmacological effects: They are second-generation dihydropyridine calcium antagonists.

For the prevention of cerebral vasospasm. Recent studies have shown that it has the effect of protecting neurons.

Usage: Used to prevent and treat cerebral vasospasm, migraine, ischemic cerebrovascular disease, Alzheimer's disease, etc. caused by SAH. Usage and dosage: 1. For cerebral vasospasm and ischemic cerebrovascular disease, intravenous infusion of 10 mg daily, protected from light.

2. For migraine, take 40mg/time orally, Tid. Note: During intravenous injection, side effects such as slight decrease in blood pressure, accelerated heart rate, facial flushing, phlebitis, and increase in transaminases may occur. Nerve cell activator and nutritional drugs n Nerve cell activator: 1. Piracetam (Naofukang) Pharmacological effects: Directly acts on the cerebral cortex, and has the function of activating, protecting and repairing nerve cells.

Usage: Used for memory impairment caused by aging, cerebrovascular accidents, carbon monoxide toxic encephalopathy, dementia, etc. 2. Other drugs such as: Aniracetam (Sanlexi), Citicoline, Ducox, Xidezhen and other oral drugs.

3. Cholinesterase inhibitors: Aricept is used to treat mild and moderate Alzheimer’s dementia 4. Neurotrophic drugs: cerebrolysin, Aiweizi anti-epileptic drug n-Kama Xepine n sodium valproate, depakin (tablets, injection) n phenytoin antipsychotic n haloperidol: Use: schizophrenia, used for involuntary use of levodopa in extrapyramidal diseases sports. Usage: 1. To control acute excitement symptoms, intramuscular injection of 5-10 mg/day, 3-4 times a day, the elderly and children should reduce the dosage.

2. Treatment is not.