Neurologic Function Case Study Essay

Neurologic Function Case Study Essay

 

Pain and Neurologic Syndromes

 

Pain and neurologic syndromes entail disorders that affect neurological function. Various pain and neurological disorders differ in risk factors, pathophysiology, and clinical manifestations. Nurses should be aware of these conditions and their identifiable characteristics, thus being able to provide the appropriate diagnosis and treatment plans. This assessment presents a comparison between three neurological syndromes, a hypothetical patient case for one selected condition, and a reflection on the hypothetical case.

Neurological Function

 

Part 1:

Compare and contrast the three conditions in the charts below:

 

NEUROLOGIC SYNDROME
	Dementia	Depression	Anxiety
Risk Factors	Old age Genetics/family history of dementia Diabetes Mild cognitive impairment Smoking and alcohol use	Chronic stress History of trauma Medication and substance use Unresolved grief/loss Chronic health problems Major life changes	Stress build-up Trauma Other mental health conditions Genetics-family history of anxiety
Pathophysiology	Most types of dementia, apart from vascular dementia, result from the accumulation of native proteins in the brain, including Lewy bodies (Emmady, Schoo &Tadi, 2022). These proteins are insoluble in the brain, thus causing pathological changes in the brain.	According to Zakaria et al. (2022), depression is caused by the imbalance f neurotransmitters, resulting from the dysregulation of the monoamine system. Different monoamines are responsible for regulating pleasure, emotions, rewards, attentiveness, cognition, and social interactions. Thus, their dysregulation causes the manifestation of depression symptoms.	Chand and Marwaha (2022) note that norepinephrine, serotonin, dopamine, and gamma-aminobutyric acid (GABA) mediate anxiety symptoms in the central nervous system. Pathologic anxiety impairs functions of the response to threat, leading to cognitive and somatic symptoms.
Clinical Manifestations	Poor judgment Memory loss Confusion Difficulties with planning and organizing Difficulty in reasoning and problem-solving	Mood changes Loss of interest and pleasure in daily activities Feeling empty and hopeless Angry outbursts and irritability over minor issues.	Having a sense of impending danger, doom, or panic Trouble concentrating or thinking about anything Feeling nervous and restless Increased heart rate and hyperventilation

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Part 2:

Choose a pain or neurologic syndrome to explore.

Dementia: Hypothetical Case

Vital Information and Pathophysiology/Clinical Manifestation

Mrs. T. L., a 75-year-old widow, is accompanied by her 45-year-old daughter to the clinic. The daughter is concerned by her recent cognitive decline and says she can no longer communicate effectively with her mother because she is hardly interested in conversations. She adds that the mother is restless and irritable, making it difficult to interact with her. She is often disorganized, and the house is messy, and she knows her mother as organized and tidy. She also complains that she has forgotten food on the stove and was alerted by the smoke detector after it burnt. Her daughter is concerned about her mother’s safety due to her recent changes. Her mother is often disoriented and confused; these symptoms have worsened over the last six months. The mother is agitated and denies these allegations.

Diagnostic tests

There are various diagnostic tests used to make a clinical decision on dementia. Since there are different dementia types, the definitive diagnosis is made using an autopsy. The diagnostic test I recommend r this patient include an autopsy, MRI scan, and laboratory evaluation. According to Emmady et al. (2022), brain imaging and laboratory evaluation are used to diagnose dementia. A brain MRI scan differentiates pathologies by highlighting dopamine transporter proteins. Laboratory evaluation, on the other hand, includes complete blood count, urinalysis, thyroid function tests, and serological tests.

Comparison with Other Differentials

The three conditions considered a differential diagnosis for dementia are mild cognitive impairment, depression, and delirium. The conditions are considered differentials of dementia since they all affect the individual’s mental state and present with almost similar clinical manifestations. Delirium is ruled out as the primary diagnosis since the onset of the symptoms is usually sudden, while the patient, in this case, has had the symptoms for up to six months. Depression is ruled out since the patient presents with memory loss, whereas in depression, the patient can recall something when prompted. Mild cognitive impairment is ruled out since, despite the patient, in this case, having memory and thinking problems, it affects their daily life, whereas, in mild cognitive impairment, the effects do not affect daily living.

Condition Management/Patient Safety Issues

The clinical management guideline by the European Academy of Neurology (Frederiksen et al., 2020) states that dementia in elderly patients should not be managed using antipsychotics and opioids. The guideline also stresses the importance of follow-up for these patients. Similarly, the best way to manage the condition for the patient, in this case, is to avoid antiepileptic drugs since they might worsen cognitive functions. Cholinesterase inhibitors such as Donepezil can be used instead, and encourage the daughter to avail the patient for follow-ups. Lifestyle modification t improve cognitive function is also necessary (Emmady et al., 2022)

The patient safety issues for the condition include increased risk for patient falls, self-harm, malnutrition, and unsafe living conditions due to the current cognitive state. Therefore, it is essential not to allow dementia patients to live alone. 

Part 3: Reflection

 Among the information that a master’s prepared nurse would gather from a patient with this condition include the history of the condition obtained from family members/caregivers, characterization of the cognitive changes, and safety concerns. The information can be used to develop patient education, focusing on addressing patient safety concerns and ways to improve the condition. For instance, the patient education content would include suggestions for support groups for the caregivers and family members since taking care of a dementia patient can be overwhelming. The most challenging information presented in this case is that the condition, for this patient, affects social interaction and the constant disoriented state. Therefore, engaging the patient’s daughter in all management steps is crucial, and encouraging her to offer the mother the required support.         

Conclusion

Neurological and pain conditions affect neurological functions, and their pathophysiology can be traced back to the brain. The hypothetical case presented above involves a dementia patient. It is essential to consider patient safety issues related to neurological conditions and encourage family and caregivers to support these patients. Masters-prepared nurses should collect the relevant information from the patient and use it to offer patient education.   

    

References

Chand, S.P. & Marwaha, R. (2022). Anxiety. In: StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK470361/

Emmady, P.D., Schoo, C. & Tadi, P. (2022). Major Neurocognitive Disorder (Dementia). In: StatPearls [Internet] https://www.ncbi.nlm.nih.gov/books/NBK557444/

Frederiksen, K. S., Cooper, C., Frisoni, G. B., Frölich, L., Georges, J., Kramberger, M. G., C. Nilsson, P. Passmore, L. Mantoan Ritter, D. Religa, R. Schmidt, E. Stefanova, A. Verdelho, M. Vandenbulcke, B. Winblad , B. & Waldemar, G. (2020). A European Academy of Neurology guideline on medical management issues in dementia. European Journal of Neurology, 27(10), 1805-1820. https://doi.org/10.1111/ene.14412

Zakaria, F. H., Samhani, I., Mustafa, M. Z., & Shafin, N. (2022). Pathophysiology of Depression: Stingless Bee Honey Promising as an Antidepressant. Molecules, 27(16), 5091. https://doi.org/10.3390/molecules27165091

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The purpose of the case study is for you to expand on the pathophysiological disease process by searching for evidence-based practice treatment and advanced practice nursing role implications related to the disease. Click here Download hereto download the attachment for this assignment.

Part 1:

Compare and contrast the 3 conditions in one of the charts below:

PAIN SYNDROME

Migraine Headaches

Tension Headaches

Meningitis

Risk Factors

Pathophysiology

Clinical Manifestations

OR

NEUROLOGIC SYNDROME

Dementia

Depression

Anxiety

Risk Factors

Pathophysiology

Clinical Manifestations

Part 2:

Choose a pain or neurologic syndrome to explore. You can also choose a diagnosis not listed (that coincides with your advanced practice specialty) as long as it relates to the neurological function.

Present a hypothetical case that includes the following:

Vital information about a person who might be predisposed to this condition (I.e., a person who may have risk factors for this condition).

The pathophysiology of the disease, including clinical manifestations.

Which diagnostic tests you’d recommend and a rationale for the one(s) you choose.

How this condition compares to other differentials.

The evidence-based recommendations from the AHRQ GuidelinesLinks to an external site. or guidelines recommended from a professional organization. Based on these recommendations, discuss how  to manage the condition best.

A patient safety issue that could be associated with the condition presented in this case.

 

 

Part 3:

 

 

Answer these reflection questions:

What information would a master’s prepared nurse gather from a patient with this condition?

How could the master’s prepared nurse use this information to design a patient education session for someone with this condition?

What was the most confusing or challenging information presented in this case?

Expectations:

Your paper should be 3–4 pages (excluding cover and reference pages).

Use medical terminology and appropriate graduate level writing.

Your resources must include research articles and reference to non-research evidence-based

AHRQ Guidelines.Links to an external site.

Use APA format to style your paper and to cite your sources. Your source(s) should be integrated into the paragraphs. Use internal citations pointing to evidence in the literature and supporting your ideas. You will need to include a reference page listing those sources. Cite a minimum of three resources.