lOMoAR cPSD| 63316909
1
Peripheral Neuropathy
• Polyneuropathy: from diabetes, bilateral legs, Guillain-Barre, start with bottom move up
• Mononeuropathy: tennis elbow, typing, unilateral, specific to a certain nerve.
• Guillain-Barre:
o Usually starts at feet, moves upward, problem with walking initially, end up with
wheelchair, respiratory difficulties, start improve, symptoms reverse, gradually
get better
o Problems with walking, leg weakness (initially) may end up in wheelchair,
respiratory distress
o Improvement of symptoms: improve from head to toe
o Usually have had respiratory or GI infection for 1-4 wks. Prior to onset of
symptoms
o Stocking/ glove pattern (feel like they are wearing socks or gloves)
• Risk factors: Depend on type of neuropathy (mono vs poly) o Play tennis tennis
elbow (mono); DM (poly)
• Clinical manifestations: also depend on type o Poly: burning, aching, shooting pain,
impaired pain/temp/sensation
• Treatment
o Gabapentin = seizure medication used to treat neuropathy (esp. in DM)
• Nursing interventions: o SAFETY
Dec. sensation inc. risk of fall, injury, burns, etc. encourage pt maintain
safety.
o DM: foot care, pt. edu. Wear fitting shoes, not bare foot,
Colon Cancer
• Risk factors:
o Age > 50
o Any history of IBD (UC, Crohn’s)
• Diet
o Diet high in animal proteins = risk
Which food is best to dec. risk of cancer? (high fiber, low
fat, etc.)
Poached eggs, steamed/ broiled foods = healthy
preparation
• Radiation o Done before surgery to shrink tumor
• Symptoms
o Often advanced cancer before signs develop o Important to have colon
screenings
, lOMoAR cPSD| 63316909
2
o Often first symptom = changes in bowel habits: diarrhea follow by constipation
May have tumor blocking passage of stool
Bloody stool anemia (blood in stool) weakness
Nursing care
o Assess abdomen/ bowel sounds
• NANDAs
o Most appropriate nursing diagnosis?
• General staging o T) primary tumor o N) nodal involvement o M) metastasis
Presence of symptoms usually indicates metastasis
• Diagnostic tests o Guaiac stool test (stool smear to assess for blood). Blue color change
of the film o Colonoscopy o Upper endoscopy o CBC anemia?
• Surgery o Colostomy o Post-op assessment:
Fever indicates assessment: infection
Stoma: nice and pink, moist. Grey/ dusky color indicates poor
perfusion!
Return of bowel sounds/ BM after 24 h post-op (probably 2-3
days, gradual have bowel sound and stool) o Interventions:
TCDB, incentive spirometry, coughing and deep breathing
DVT prophylaxis
Early ambulation
Seizures
• Nursing interventions during seizure: SAFETY + AIRWAY o
Seizure precautions!!!
Pad side rails o Do not
restrain patient o Lower patient
to ground if OOB o Turn patient
on side
o Don’t put anything in patient’s mouth o Can suction airway
if needed
• Assessment
o Pregnancy planning (seizure meds may have risk for fetus) o
Pregnancy follow up w/ neurologist, OB
May need higher doses of meds as fetus grows o Triggers:
Females: hormonal imbalances (menstrual cycle, ovulation)
Decrease sleep
Dehydration (virus, vomiting, diarrhea, dec. input) o Postictal
phase: period during after seizure
1
Peripheral Neuropathy
• Polyneuropathy: from diabetes, bilateral legs, Guillain-Barre, start with bottom move up
• Mononeuropathy: tennis elbow, typing, unilateral, specific to a certain nerve.
• Guillain-Barre:
o Usually starts at feet, moves upward, problem with walking initially, end up with
wheelchair, respiratory difficulties, start improve, symptoms reverse, gradually
get better
o Problems with walking, leg weakness (initially) may end up in wheelchair,
respiratory distress
o Improvement of symptoms: improve from head to toe
o Usually have had respiratory or GI infection for 1-4 wks. Prior to onset of
symptoms
o Stocking/ glove pattern (feel like they are wearing socks or gloves)
• Risk factors: Depend on type of neuropathy (mono vs poly) o Play tennis tennis
elbow (mono); DM (poly)
• Clinical manifestations: also depend on type o Poly: burning, aching, shooting pain,
impaired pain/temp/sensation
• Treatment
o Gabapentin = seizure medication used to treat neuropathy (esp. in DM)
• Nursing interventions: o SAFETY
Dec. sensation inc. risk of fall, injury, burns, etc. encourage pt maintain
safety.
o DM: foot care, pt. edu. Wear fitting shoes, not bare foot,
Colon Cancer
• Risk factors:
o Age > 50
o Any history of IBD (UC, Crohn’s)
• Diet
o Diet high in animal proteins = risk
Which food is best to dec. risk of cancer? (high fiber, low
fat, etc.)
Poached eggs, steamed/ broiled foods = healthy
preparation
• Radiation o Done before surgery to shrink tumor
• Symptoms
o Often advanced cancer before signs develop o Important to have colon
screenings
, lOMoAR cPSD| 63316909
2
o Often first symptom = changes in bowel habits: diarrhea follow by constipation
May have tumor blocking passage of stool
Bloody stool anemia (blood in stool) weakness
Nursing care
o Assess abdomen/ bowel sounds
• NANDAs
o Most appropriate nursing diagnosis?
• General staging o T) primary tumor o N) nodal involvement o M) metastasis
Presence of symptoms usually indicates metastasis
• Diagnostic tests o Guaiac stool test (stool smear to assess for blood). Blue color change
of the film o Colonoscopy o Upper endoscopy o CBC anemia?
• Surgery o Colostomy o Post-op assessment:
Fever indicates assessment: infection
Stoma: nice and pink, moist. Grey/ dusky color indicates poor
perfusion!
Return of bowel sounds/ BM after 24 h post-op (probably 2-3
days, gradual have bowel sound and stool) o Interventions:
TCDB, incentive spirometry, coughing and deep breathing
DVT prophylaxis
Early ambulation
Seizures
• Nursing interventions during seizure: SAFETY + AIRWAY o
Seizure precautions!!!
Pad side rails o Do not
restrain patient o Lower patient
to ground if OOB o Turn patient
on side
o Don’t put anything in patient’s mouth o Can suction airway
if needed
• Assessment
o Pregnancy planning (seizure meds may have risk for fetus) o
Pregnancy follow up w/ neurologist, OB
May need higher doses of meds as fetus grows o Triggers:
Females: hormonal imbalances (menstrual cycle, ovulation)
Decrease sleep
Dehydration (virus, vomiting, diarrhea, dec. input) o Postictal
phase: period during after seizure
