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MEDICAL SURGICAL NURSING REVIEW NOTES

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  • MEDICAL-SURGICAL NURSING
    NERVOUS SYSTEM
    Overview of structures and functions:
    Central Nervous System
    Brain
    Spinal Cord
    Peripheral Nervous System
    Cranial Nerves
    Spinal Nerves
    Autonomic Nervous System
    Sympathetic nervous system
    Parasympathetic nervous system
    AUTONOMIC NERVOUS SYSTEM
    Sympathetic Nervous System
    (ADRENERGIC)
    Parasympathetic Nervous
    System
    (CHOLINERGIC, VAGAL,
    SYMPATHOLYTIC)
    - Involved in fight or aggression
    response.
    - Release of Norepinephrine
    (cathecolamines)
    from adrenal glands and causes
    vasoconstriction.
    - Increase all bodily activity except GIT
    EFFECTS OF SNS
    - Dilation of pupils(mydriasis) in order
    to be aware.
    - Dry mouth (thickened saliva).
    - Increase BP and Heart Rate.
    - Bronchodilation, Increase RR
    - Constipation.
    - Urinary Retention.
    - Increase blood supply to brain, heart
    and skeletal
    muscles.
    - SNS
    I. Adrenergic Agents
    - Give Epinephrine.
    Signs and Symptoms:
    - SNS
    Contraindication:
    - Contraindicated to patients suffering
    from COPD (Broncholitis,
    Bronchoectasis, Emphysema, Asthma).
    - Involved in fight or withdrawal
    response.
    - Release of Acetylcholine.
    - Decreases all bodily activities
    except GIT.
    EFFECTS OF PNS
    - Constriction of pupils (meiosis).
    - Increase salivation.
    - Decrease BP and Heart Rate.
    - Bronchoconstriction, Decrease
    RR.
    - Diarrhea
    - Urinary frequency.
    I. Cholinergic Agents
    - Mestinon, Neostigmine.
    Side Effects
    - PNS
    II. Anti-cholinergic Agents
    - To counter cholinergic agents.
  • II. Beta-adrenergic Blocking Agents
    - Also called Beta-blockers.
    - All ending with “lol
    - Propranolol, Atenelol, Metoprolol.
    Effects of Beta-blockers
    B – roncho spasm
    E – licits a decrease in myocardial
    contraction.
    T – reats hypertension.
    A – V conduction slows down.
    Should be given to patients with
    Angina Pectoris, Myocardial
    Infarction, Hypertension.
    ANTI- HYPERTENSIVE AGENTS
    1. Beta-blockers – “lol”
    2. Ace Inhibitors – Angiotensin, “pril”
    (Captopril, Enalapril)
    3. Calcium Antagonist – Nifedipine
    (Calcibloc)
    In chronic cases of arrhythmia give
    Lidocaine(Xylocaine)
    - Atropine Sulfate
    Side Effects
    - SNS
    CENTRAL NERVOUS SYSTEM
    Brain and Spinal Cord.
    I. CELLS
    A. NEURONS
    Basic cells for nerve impulse and conduction.
    PROPERTIES
    Excitability ability of neuron to be affected by changes in external
    environment.
    Conductivity ability of neuron to transmit a wave of excitation from one cell
    to another.
    Permanent Cell – once destroyed not capable of regeneration.
    TYPES OF CELLS BASED ON REGENERATIVE CAPACITY
    1. Labile
    Capable of regeneration.
    Epidermal cells, GIT cells, GUT cells, cells of lungs.
  • 2. Stable
    Capable of regeneration with limited time, survival period.
    Kidney cells, Liver cells, Salivary cells, pancreas.
    3. Permanent
    Not capable of regeneration.
    Myocardial cells, Neurons, Bone cells, Osteocytes, Retinal Cells.
    B. NEUROGLIA
    Support and protection of neurons.
    TYPES
    1. Astrocytes – maintains blood brain barrier semi-permeable.
    Majority of brain tumors (90%) arises from called astrocytoma.
    2. Oligodendria
    3. Microglia
    4. Epindymal
    SUBSTANCES THAT CAN PASS THE BLOOD-BRAIN BARRIER
    1. Ammonia
    Cerebral toxin
    Hepatic Encephalopathy (Liver Cirrhosis)
    Ascites
    Esophageal Varices
    Early Signs of Hepatic Encephalopathy
    asterixis (flapping hand tremors).
    Late Signs of Hepatic Encephalopathy
    Headache
    Dizziness
    Confusion
    Fetor hepaticus (ammonia like breath)
    Decrease LOC

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MEDICAL SURGICAL NURSING REVIEW NOTES

MEDICAL-SURGICAL NURSINGNERVOUS SYSTEMOverview of structures and functions:Central Nervous System Brain Spinal CordPeripheral Nervous System Cranial Nerves Spinal NervesAutonomic Nervous System Sympathetic nervous system Parasympathetic nervous systemAUTONOMIC NERVOUS SYSTEMSympathetic Nervous System(ADRENERGIC)Parasympathetic NervousSystem(CHOLINERGIC, VAGAL,SYMPATHOLYTIC)- Involved in fight or aggression response.- Release of Norepinephrine (cathecolamines) from adrenal glands and causes vasoconstriction.- Increase all bodily activity except GITEFFECTS OF SNS- Dilation of pupils(mydriasis) in order to be aware.- Dry mouth (thickened saliva).- Increase BP and Heart Rate.- Bronchodilation, Increase RR - Constipation.- Urinary Retention.- Increase blood supply to brain, heart and skeletal muscles.- SNSI. Adrenergic Agents- Give Epinephrine.Signs and Symptoms:- SNSContraindication: - Contraindicated to patients suffering from COPD (Broncholitis, Bronchoectasis, Emphysema, Asthma).- Involved in fight or withdrawal response.- Release of Acetylcholine.- Decreases all bodily activities except GIT.EFFECTS OF PNS- Constriction of pupils (meiosis).- Increase salivation.- Decrease BP and Heart Rate.- Bronchoconstriction, Decrease RR.- Diarrhea- Urinary frequency.I. Cholinergic Agents- Mestinon, Neostigmine.Side Effects- PNSII. Anti-cholinergic Agents- To counter cholinergic agents.

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