NLE Neurosensory Nursing — Seizure, Infectious, and Degenerative Neurologic DisordersConcept Map

Related concepts

Concept connections

• Seizures and Epilepsy→Status EpilepticusStatus epilepticus is a severe, life-threatening extension of recurrent seizures lasting 5+ minutes without consciousness recovery; requires emergency benzodiazepine therapy and airway management
• Seizures and Epilepsy→Antiseizure MedicationsAntiseizure drugs are the primary pharmacologic treatment for preventing seizures and maintaining therapeutic levels; phenytoin requires careful IV administration, monitoring of therapeutic levels (10-20 mcg/mL), and management of gingival hyperplasia
• CNS Infections→Bacterial MeningitisBacterial meningitis is the most critical CNS infection; presents with fever, nuchal rigidity, and positive Kernig's and Brudzinski's signs; requires immediate empiric IV antibiotics, dexamethasone, and droplet precautions
• CNS Infections→EncephalitisEncephalitis is viral brain inflammation often caused by herpes simplex or arboviruses; treated with IV acyclovir; common in tropical regions like the Philippines with Japanese encephalitis risk
• Parkinson's Disease→Levodopa-CarbidopaLevodopa-carbidopa is the cornerstone treatment for Parkinson's disease; carbidopa protects levodopa from peripheral breakdown, allowing more drug to cross the blood-brain barrier and be converted to dopamine in the CNS
• Multiple Sclerosis→Trigger AvoidancePatients with MS must avoid heat, stress, and infection, which can precipitate relapses; heat exposure particularly worsens symptoms temporarily due to impaired nerve conduction in demyelinated areas
• Amyotrophic Lateral Sclerosis→Respiratory FailureALS is progressive motor neuron degeneration that inevitably leads to respiratory muscle weakness and respiratory failure, the primary cause of death; requires advance planning for mechanical ventilation and end-of-life care
• Myasthenia Gravis→Myasthenic vs. Cholinergic CrisisMG patients face two opposing critical crises: myasthenic crisis (too little anticholinesterase, inadequate treatment) and cholinergic crisis (too much drug causing toxicity); the Tensilon test differentiates them; airway protection is the priority for both
• Myasthenia Gravis→PyridostigminePyridostigmine is an anticholinesterase that increases available acetylcholine at the neuromuscular junction; must be given on time (especially before meals for swallowing), and never abruptly stopped; management timing is critical for preventing crisis
• Guillain-Barré Syndrome→Respiratory MonitoringGBS causes ascending paralysis from legs upward to respiratory muscles; serial vital capacity measurement is the critical monitoring priority; mechanical ventilation must be available and ready for use as weakness advances
• Alzheimer's Disease→Dementia vs. DeliriumAlzheimer's is the most common cause of dementia (irreversible, gradual, progressive); distinguished from delirium (acute, fluctuating, reversible with identifiable cause); nursing care emphasizes safety, routine, and caregiver support
• Nursing Process and Priorities→Maslow's Hierarchy of NeedsNeurologic disorder nursing prioritization follows Maslow's hierarchy: physiologic (airway, breathing, circulation) → safety (seizure precautions, fall prevention) → social (family support, communication) → higher needs (meaning, control); addresses NANDA diagnoses at each level
• Nursing Process and Priorities→RA 9173 StandardsAll nursing interventions must comply with RA 9173 (Philippine Nursing Practice Law); nurses operate at NCM competency levels I-IV depending on patient acuity; independent, interdependent, and dependent functions are clearly delineated
• Patient Safety→Seizure PrecautionsDuring seizure risk: padded side rails, emergency suction and oxygen at bedside, emergency medications (benzodiazepines) ready, continuous or frequent monitoring; if seizure occurs: turn to lateral position, protect from injury, do not restrain or force objects in mouth
• Medication Adherence→Never Stop Antiseizure Drugs AbruptlyCritical patient teaching: abrupt withdrawal of antiseizure medications can trigger status epilepticus and death; requires consistent dosing, steady blood levels, regular follow-up, and medic alert identification; applies to phenytoin, carbamazepine, valproic acid, levetiracetam, lamotrigine
• Aspiration Risk→Swallowing DysfunctionAcross neurologic disorders (ALS, Parkinson's, GBS, myasthenia gravis, Alzheimer's), dysphagia and weak swallowing increase aspiration risk; require assessment of gag reflex, positioning semi-Fowler's, and careful monitoring during feeding; some patients need thickened liquids or feeding tubes
• Degenerative Disorders→Progressive Functional DeclineAll degenerative neurologic conditions show progressive, irreversible functional decline; nursing care must adapt to changing abilities, maintain safety and dignity, plan for advance care decisions, and provide robust caregiver education and support
• Phenytoin Administration→Normal Saline OnlyCritical IV phenytoin safety rule: must be diluted and infused in normal saline only (NS), never in dextrose solutions (D5W, D5NS), as phenytoin precipitates in dextrose; infuse slowly at no faster than 50 mg/min to prevent hypotension and dysrhythmias
• Lumbar Puncture CSF Analysis→Bacterial vs. Viral Meningitis DifferentiationCSF analysis is diagnostic: bacterial meningitis shows cloudy CSF with high protein, LOW glucose, high neutrophils (PMN), and high pressure; viral meningitis shows CLEAR CSF with normal glucose, lymphocytes, and normal pressure; distinguishes need for immediate antibiotics vs. supportive care
• Droplet Precautions→Meningococcal and H. influenzae MeningitisDroplet precautions are required for meningococcal and Haemophilus meningitis until 24 hours of effective IV antibiotics have been given; prevents respiratory transmission to healthcare workers and other patients; standard precautions remain for viral meningitis
• Disease-Modifying Therapy→Multiple Sclerosis Relapse PreventionInterferon beta, glatiramer, and other disease-modifying agents reduce the frequency and severity of MS relapses; must be continued consistently even when asymptomatic; combined with trigger avoidance (heat, stress, infection) and corticosteroids for acute relapses
• Vital Capacity Monitoring→Guillain-Barré Syndrome Emergency PreparednessSerial vital capacity measurements in GBS detect early respiratory muscle weakness before respiratory failure occurs; declining vital capacity is an indicator for mechanical ventilation; allows time for preparation rather than emergency intubation
• Anticholinesterase Medication Timing→Myasthenia Gravis Symptom ManagementPyridostigmine must be given on precise schedule, especially before meals to optimize swallowing and chewing ability; patients learn to self-time doses; timing errors increase risk of myasthenic crisis from underdosing or cholinergic crisis from overdosing
• Cholinergic Crisis Antidote→Atropine AvailabilityAtropine is kept at bedside for any patient on anticholinesterases; used to reverse cholinergic crisis symptoms (SLUDGE, miosis, fasciculations, bradycardia); nursing staff must know location and be ready to administer if crisis identified
• Gingival Hyperplasia→Phenytoin Long-Term UsePhenytoin chronic therapy causes gingival hyperplasia (gum overgrowth); requires meticulous oral hygiene including frequent brushing, flossing, and dental visits; patient education on this side effect is essential; other antiseizure drugs do not have this effect

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