Neurological

You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.

NUR_418 Post #1

 Diana Figueroa

St. Thomas University

Health Assessment & Promotion

Instructor Rafael Rojas

Due Date: 9/22/22

 

 

 Nursing: Neurological

Q1. List the risk factors for cerebrovascular accidents and why? 

Neurological Disorders are diseases and conditions that affect the nervous system, which includes the brain, spinal cord, nerves, and muscles. Risk factors for cerebrovascular accidents may include genetic disorders, smoking, hypertension, alcohol use, diabetes, and hyperlipidemia. Treatments to prevent cerebrovascular accidents include physical activity, medications, and dietary changes. Hypertension can cause degradation of the blood vessels. High pressures weaken and stiffen the blood vessel wall, causing the vessel to leak (Minhas et al., 2016). If a blood vessel leaks, the pressure in the blood vessel is lower. Blood starts leaking out of the leaky area if the pressure is low. When this happens, a person may experience dizziness and vertigo, which can be deadly if not treated quickly. Smoking exposes one to carbon monoxide, which can lead to hypoxia (low oxygen levels) and further damage blood vessels. Alcohol consumption decreases platelet adhesiveness, increasing the risk of bleeding. Diabetes and high levels of triglyceride in the blood increase risk for cerebrovascular accidents such as stroke and heart attack by damaging arteries.

Q2. What cultures are at higher risk for cerebrovascular accidents and why? 

Certain cultures have a higher risk of cerebrovascular accidents. For example, the Japanese have a high rate of vascular diseases such as stroke, heart attack, and cerebral accident. Japan's risk factors include low education levels, low income, and high blood pressure (Artiga et al., 2020). The gap between rich and poor is widening in Japan, increasing the risk for cerebrovascular accidents. There is also an increase in obesity among children in Japan because of the availability of cheap food from fast food restaurants that are rampant in Japan. The increased brain size among Japanese compared to other cultures could be due to the larger size at birth, which leads to greater cerebral growth and faster neurological development compared to other cultures.

Q3. Describe the 0 to 4+ scale for scoring deep tendon reflexes. 

Deep tendon reflexes can be assessed using a 0 to 4+ scale, with the normal range being rated 4+. 0 is no reflex, 1 is equal to patellar or Achilles tendon reflex, 2 is equal to triceps and ankle jerks, 3 is equal to knee jerks, and 4+ is equal to biceps and quadriceps jerk (Rodriguez-Beato & De Jesus, 2020). The Achilles tendon reflex involves tapping below the distal tendon of the Achilles tendon, and the patellar reflex involves tapping the patellar surface. The triceps jerk is assessed by tapping below the elbow, while the quadriceps jerk is tapped below the knee. The biceps jerk is assessed by tapping above and below where the biceps attaches to the forearm.

Q4. What would you expect to find in a patient with diabetic peripheral neuropathy? Share any experience you have encountered and elaborate. 

Neuropathy is the damage of neurons that occurs due to diabetes. The nerves are damaged due to glucose buildup, which causes painful sensations and, in some cases, decreased sensation and paralysis. Lack of sensation may cause the person to suffer a foot injury without feeling it until it becomes serious. Neuropathy can also cause alterations in motor function (Minhas et al., 2016). Peripheral neuropathy is rare compared to other types of diabetes, but it is the most common type of neuropathy that includes sensory and motor deficits. Patients with peripheral neuropathy show loss of sensation in their feet, changes in muscle strength, decreased pain sensations, and reduced warmth sensitivity.

During my training, I had a patient diagnosed with diabetes in his 50s. He suffered from neuropathy and other medical conditions such as congestive heart failure and hypertension. After several years of neglecting his health, he developed severe foot ulcerations that caused him to be a non-weight bearing on the affected foot. He used crutches to get around, but he had the potential risk of falling, which could lead to further complications. It was my job to clean and bandage the wound while preventing infection until it healed up on its own because there were no other options given due to the lack of adequate treatment facilities in the area.

 

Reference

Artiga, S., Garfield, R., & Orgera, K., (2020, April 8). Communities of color at higher risk for health and economic challenges due to COVID-19. KFF.  https://www.kff.org/coronavirus-covid-19/issue-brief/communities-of-color-at-higher-risk-for-health-and-economic-challenges-due-to-covid-19/  (Links to an external site.)

Minhas, S. V., Goyal, P., & Patel, A. A. (2016, March). What are the Risk Factors for Cerebrovascular Accidents After Elective Orthopaedic Surgery? Clinical Orthopaedics &Amp; Related Research, 474(3), 611–618. https://doi.org/10.1007/s11999-015-4496-2

Rodriguez-Beato, F. Y., & De Jesus, O. (2020). Physiology, Deep Tendon Reflexes.

NUR_418 Post #2

Neurological

Kerline Eugene

St. Thomas University

NUR-418-AP2

Professor Rafeal 

September 22, 2022

The risk factors for cerebrovascular accidents and why?

They are numerous risks which has been associated with the cerebral accidents and some of them includes hypertension, alcohol, high amount of cholesterol intake as well as obesity. High blood pressure which is also referred as hypertension causes the blood vessels in the body to be damaged and this acts as one of the major risk which exposes an individual to high chances of getting cerebrovascular accidents. In addition, the strength which is possessed by the vessel walls is damaged by the blood pressure. On the other hand, obesity is known to contribute into hypertension as well as diabetes which exposes an individual into cerebrovascular accidents. When the body has high accumulation of the cholesterol, the blood vessels tend to be blocked which hinders the blood flow and this even affects some organs in the body due to insufficient supply of oxygen in the body.

Besides, some habits such as smoking and drinking alcohol has been also associated with the damage to the blood vessels. Research which has been carried out shows that the blood vessels of people who do not smoke are stronger compared to ones of the people who smoke and drink alcohol. (Chen, R., Ovbiagele, & Feng, 2016) Cognitive heart failure and valvar heart disease raises the risks of one being affected by cerebrovascular accidents and these disorders are influenced by the habit of an individual. Additionally, those women who are experiencing hypertension can also increase the risk of cerebrovascular accidents if they take the birth control pills.

What culture are at higher risk and why?

Studies carried out shows that the African Americans have high chances of being affected by cerebrovascular accidents when compared to the white people. This is because you find that, they have been reported to have incidences of substance abuse, hypertension as well as diabetes which has been outlined as the risk factors which contributes into cerebral accidents. Individual who are above 65 years as bee outlined to be at high risk of being affected by cerebrovascular accident and in most cases the men. This is because men have been outlined to be exposed to the risk's factors of CVA such as cigarette smoking and taking alcohol. 

Describe the 0 to 4+ scale for scoring deep tendon reflexes.

A convention on a scale of 0 up to 4 as been very important when it comes to grading deep tendon reflexes. In this case, 0 has been used to show cases where there is no response or when abnormal results are obtained. In addition, 1+ is bused to show instances when the tendon reflex is either normal or abnormal and if there is slight response while 2+ is used to show swift response or tendon reflex which is normal. On the other hand, 3+ has been used to show either abnormal or normal deep tendon reflex. Additionally, the 4+ indicates when a reflecting process is repeated or in instances of normal deep tendon reflexes. However, the reflexes in these cases are deemed to be normal in instances where there are no differences between the legs and the arms. 

What would you expect to find in a patient with diabetic peripheral neuropathy?

In the case of individuals who are affected by diabetic peripheral neuropathy, numbness has been reported as one of the common symptoms among them. In addition, other symptoms which has been associated with this disorder include cramps, sharp pain, burning sensation as well as prickling. In addition, when walking, gait issues has been reported to be experienced by individuals affected by this disorder. (Zghoul, et al. 2017) Therefore, you find that those individual face challenges when it comes to walking and standing. For example, I managed to come across a woman who was affected by diabetic neuropathy and was complaining of pain on the legs upon standing from her bed. In addition, this woman complained of stabbing pain which she said that she experienced it in the middle of the toes. The pain on the legs and toes was experienced when she gets out of the bed and to curb this the woman had to undergo pain management by the help of health professionals.

Reference:

Zghoul, N., Ross, E. L., Edwards, R. R., Ahmed, A., & Jamison, R. N. (2017). Prevalence of chronic pain with neuropathic characteristics: a randomized telephone survey among medical center patients in Kuwait.  Journal of pain research, 10, 679.

Chen, R., Ovbiagele, B., & Feng, W. (2016). Diabetes and stroke: epidemiology, pathophysiology, pharmaceuticals and outcomes.  The American journal of the medical sciences, 351(4), 380-386.