목차
1. 용어 및 약어
1) 용어 및 약어 ······································································································· 3
2. 주요 학습내용
1) 신경계 병동에서 주로 시행하는 특수 검사 전후 간호 ··············································· 5
1-1) Cerebral angiography(뇌혈관 조영술) ····························································· 5
1-2) MRI(자기공명영상) ··························································································· 5
1-3) DTR (Deep Tendon Reflex, 심부건 반사) ························································ 6
1-4) Lumbar puncture (요추천자) ·········································································· 6
1-5) EEG (electroencephalogram, electroencephalography, 뇌파검사) ···················· 6
1-6) 경두개 초음파 도플러(Transcranial Doppler, TCD) ·········································· 6
1-7) Glasgow coma scale ; GCS ··········································································· 6
2) 무의식 환자 간호 ································································································· 7
3) 두개내압 상승 환자 간호 ······················································································· 9
4) 두개수술 후 간호 ································································································ 11
5) 경련환자 간호 ···································································································· 14
6) 마비환자 간호 ···································································································· 15
3. 주요 질환
1) 감염성 질환 ······································································································· 16
2) 뇌혈관성 질환 ···································································································· 21
3) 신경계 종양 ······································································································· 26
4) 신경계 외상 ······································································································· 29
5) 퇴행성 질환 ······································································································· 32
6) 경련성 질환 ······································································································· 40
7) 말초신경질환 ······································································································ 42
4. 주요 수술
1) 동정맥 기형 절제술 ····························································································· 46
2) 뇌종양 절제술 ···································································································· 46
3) 경동맥 내막절제술 ······························································································ 47
4) 개두술 ··············································································································· 48
5) 추간판 절제술, 척수궁 절제술, 후방 요추간 융합술 ················································ 49
5. 참고문헌
1) 참고문헌 ·········································································································· 50
본문내용
2. 주요 학습내용
1) 신경계 병동에서 주로 시행하는 특수 검사 전·후 간호
1-1) 뇌혈관 조영술(Cerebral angiography) : 뇌혈관 속에 조영제를 주입하고 X선 촬영을 하여 뇌혈관 이상 유무를 진단하는 검사
√ 검사 전 간호
– 검사 동의서를 받음
– 8~12시간 금식하고 요오드와 해조류의 알레르기 확인하고 알레르기 반응을 예방하기 위해 항히스타민제나 스테로이드를 투여
– X-ray 테이블 위에 앙와위로 눕히고 정맥주입로를 확보함
– 검사절차와 조영제 주입 시 홍조감이 있음을 설명
√ 검사 후 간호
– 카테터 삽입 부위 압박 드레싱과 얼음주머니 적용
– 활력징후, 출혈징후, 말초맥박, 신경학적 징후를 사정
– 목의 내부 출혈을 나타낼 수 있는 삼킴곤란 및 호흡곤란을 사정
– 활동은 24시간 동안 제한
1-2) MRI(자가공명영상)
√ 검사 전 간호
– 통증이나 위험이 없음을 설명
– 조영제를 사용할 경우 동의서와 6시간 동안 금식이 필요함
– 검사 2시간 전에 알코올, 카페인, 흡연 및 철분함유 약물을 금함
– 인공보철물, 동맥류클립, 인공심장박동기 착용한 경우 금기
– 검사 전 눈화장과 가발을 제거
– 검사 동안 움직이지 않도록 설명
– 소음이 많은 원통형 기계에서 촬영하여 폐쇄공포감이 올 수 있고 촬영기사와 의사소통이 가능함을 설명
√ 검사 후 간호
– 조영제를 사용하였을 경우 몸에 남아있는 조영제를 배출하기 위해 충분한 수분 섭취를 해야 함
– 조영제를 사용하고 나서 드물게 조영제 과민 반응이 나타날 수 있음을 설명. (과민 반응에는 가벼운 구토증, 두드러기, 얼굴이 붉어짐, 기침, 쉰 목소리, 콧물, 반점, 일시적 호흡곤란 등) 대개는 아무런 조치 없이 증상이 사라짐
1-3) DTR (Deep Tendon Reflex, 심부건반사)
√ 검사 전 간호
– 해머 및 도구에 관해 설명한다.
– 검사 부위가 이완되어야 검사가 원활히 이루어지니 힘을 빼라고 설명한다.
출처 : 해피캠퍼스
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