Neuro rotation

[w120hmb]

Hello, I am on NEURO, ICU, and ER this quarter. I was wondering if anyone had any input on what they see diagnosed the most between these floors, and I understand that there is a variety of Dx that a part of each of the listed units. During this rotation I have to chose a patient that I am caring for and write out a C-map. This includes what to assess/observe, meds that contribute to the condition and any labs/tests. The first day, the patient was on NEURO r/t a stroke. I didnt have much time to firgure anything out. But I am trying now to prepare ahead of time and see what types of meds, labs, test contribute to stroke, so that I have a basis to go from the next time I am in clinical. I know that a lot of this is just learned material, but I am having a hard time putting two and two together. So, what Im asking is if anyone has some input in how conditions deteriorate or what things to keep in mind when looking at critical conditions... I just want to see some brainstorming on how others think that are actually out in the field.

Thanks!

Any helpful stories would be of interest!

[Mike A. Fungin RN]

If you could be a little more specific as to what you're asking, that would help. For example, you didn't say whether you were curious about ischemic stroke, or hemorrhagic stroke.

At this stage in the game, as a student, for preclinical I would recommend you go in the night before to get the basic information and try to connect the dots. Diagnosis, comorbidities, course of treatment to this point, labs, diagnostics, medications, and lastly... you're own physical assessment of the patient.

[w120hmb]

The only thing is we dont get to know anything out our patient until that morning of clinical. we are not allowed to go the night before or anything like that. I was just curious for the people who have already worked in critical care, what types of problems they have encountered, or how they handeled it. CVA is the stroke I was talking about.

Thanks tho.

[ukstudent]

A CVA is not a type of stroke. It is an umbrella name for many diagnosis. You need to get out your patho/phys book and look up the structures in the brain. The different layers surrounding the bain, the different lobes and what each does. You also need to look up the crainial nerves and how to do a neuro exam.

When you get your patient you need to find out just what type of brain injury does the pt have. Embolic or a bleed such as anyerusim, AVM, sub-dural, epi-dural. It could also be a truama from a blunt object or gun-shot etc.

When doing a care-map always look at YOUR pt. What does she/he look like, act like, need. Pt's are never text book.